By Rob Verkerk PhD, founder, executive & scientific director, ANH-Intl

It’s the third consecutive year that a news machine – POLITICO EU – with an indefatigable interest in health has convened, alongside the Swiss newspaper Le Temps, a health care summit in Geneva. The aim of the summit is to illuminate thorny issues by using POLITICO journalists and an engaged audience that interact with leading influencers in the health care sector. This of course implies a major turnout for pharma, but also regulators, such as the European Medicines Agency and European Commission.

Pharma was very much present in this week’s third summit, in the form of contributors, sponsors and exhibitors. Leading players were Ferring Pharmaceuticals, Roche and the pharma’s big daddy, the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA). The latter made available a report entitled ‘50 Years of Global Health Progress’, as well as a series of posters, that celebrated the association’s 50-year anniversary.


Campus Biotech, Chemin des Mines 9, 1202 Geneva, Switzerland: the venue for the #POLITICOHealth/Let Temps summit

Geneva, Switzerland was chosen because it’s the home of the World Health Organization (WHO), the global body tasked 70 years ago with guiding the human race’s approach to managing public health. The proximity of the event to the WHO HQ also makes it easy to ensure attendance by WHO staff.

This year’s summit was one we couldn’t miss. The theme? Sustainability and upstream health care. The title of the event: “Going upstream: Assessing the promises of preventive medicine in health care reform.

 

Sarah Wheaton interviews Dr Soumya Swaminathan, Deputy DG of Programmes, UN

That’s exactly where ANH-Intl has been over the last few years in developing a sustainable model for health care, something we’re very close to unleashing.

Rather than giving you a blow by blow run down of the event, you can go direct to the streaming page for the event and view the three opening interviews by POLITICO’s Senior Health Reporter Sarah Wheaton from yesterday:

  • Interview with Professor Guido Rasi, Executive Director of the European Medicines Agency, on the subject of ‘Restoring trust to drive prevention’
  • Interview with Dr. Soumya Swaminathan, Deputy Director-General for Programmes at the WHO on ‘Going upstream in health care: what’s at stake?’
  • Interviews with Ambassador Carlos Foradori of Argentina to the UN, Ambassador Elisabeth Tichy-Fisslberger of Austria to the UN, and Ambassador Adrian Vierița of Romania to the UN on the subject of ‘Leadership and vision – prevention in all policies’.

 


Partners and sponsors of the event

 

View livestream recordings here.

Following this was two series of roundtable discussions, with each delegate being able to participate in one from each group, as follows:

Roundtable discussions 1:

  • Vaccines
  • Data
  • Chronic diseases

Roundtable discussions 2:

  • Antimicrobial resistance (AMR)
  • Value
  • Healthy Living

No surprises, I selected: chronic diseases from the first and healthy living from the second, as much as I wanted to be at least a fly on the wall in all the others!

A dozen take-homes from the summit

Of the 100 or so in attendance, different attendees would have likely had vastly different perceptions on what points were most noteworthy. Dr Aseem Malhotra and I were, as far as I was aware, the only two in attendance who came from a non-drug, non-vaccine perspective. Aseem was also a speaker in the Healthy Living roundtable alongside Alana Officer, senior health advisor on ageing and life-course to the WHO.

Sarah Wheatlon, senior health reporter for POLITICO; event host
and lead interviewer

Here are 12 overriding impressions I got from the mainstream representatives in attendance, these largely representing the views of pharma, the UN and regulatory authorities:

  1. The burden of chronic, preventable diseases will create monumental (if not fatal) problems for existing health care systems, so reform is urgently needed
  2. There is recognition that upstream health care is required, meaning that intervention by the individual, by doctors or other health care professionals, needs to occur much earlier in the disease cycle, preferably before disease has even manifested
  3. There is no solid view on what business model pharma will use to engage in such systems, but it’s clear that vaccination is viewed by pharma as a major pillar of disease prevention
  4. There is recognition that social and commercial determinants of disease are now the biggest drivers of the global disease burden and governments must take major responsibility for dealing with these (as they did with water sanitation, hygiene and the regulation of antibiotic drugs in times gone by). The UN’s sustainability development goals (SDGs) provide a framework for this
  5. Sustainability must be the central platform moving forwards, but this concept has vastly different meanings to different people and sectors
  6. Sustainability solutions will need to be multi-sectoral and involve public-private and NGO partnerships as well as sustained advocacy
  7. Don’t expect immediate results: If society starts to invest in prevention and wellness creation today, the benefits might be expected in 20 years or more from now. But that doesn’t mean delaying!
  8. Current evidence suggests that the quality of diets and the air we breathe, along with how much we move, are the three most important social and commercial determinants of health
  9. Many people on the planet don’t have access to or can’t afford high quality food. They also may not have access to green spaces and exercise facilities, both being important for physical health and mental wellbeing
  10. Electronic devices, artificial intelligence (AI), self-care, remotely guided care (including telemedicine) are likely to play an ever-bigger role in health care in the future, but there will be no substitute for empathy and compassion offered in face-to-face consultations with suitably trained and qualified doctors and other health care professionals
  11. There is a growing emphasis on individual responsibility, but governments and corporations cannot dump all responsibility on citizens
  12. There is a need to adapt health care systems for individual needs, as well as to regions, cultures, ethnicities, socio-economic groups and other factors. Yet there is no consistent view on what needs to be done to create sustainable health care systems at the community level.

One of the panel discussions (L-R): Prof Klaus Dugi (Ferring Pharmaceuticals), Jayaree Iyer (Access to medicine Foundation), Amanda Hosken (Swiss Re), Anne Hasslberger (Swiss Mission the the UN) and Laura Greenhalgh (POLITICO Assistant Policy Editor/interviewer)  

Some noteworthy remarks

I was busy on my notepad through the event, that opened on the Monday evening and finished in Geneva yesterday afternoon. Here are some quotes from various people I scribbled down on my POLITICO notepad. I apologise if they not, in all cases, verbatim, but they are certainly close and represent accurately the intended meaning:

Prof Guido Rasi, Executive Director, European Medicines Agency (EMA)

On quinolone and fluoroquinolone antibiotics: “The EMA has stopped their use following pharmacovigilance showing up serious side effects…..we could have perhaps done this 5 years ago.

On vaccine distrust: “I wish I knew where it was coming from but we have to build more transparency.

On Brexit: “We can expect some [drug] shortages will happen.

On HPV: “HPV [vaccine] induces a specific reaction….there has been a lot of emotion…there has been intervention of doctors who make casual associations [between HPV vaccination and the development of specific disease symptoms]….The EMA must stay [focused] on benefit/risk…and clinical effects.

Dr Soumya Swaminathan, Deputy Director-General, WHO Programmes

On responsibility: “It’s a collective, social responsibility. That includes a balanced diet, exercise everyday, no smoking, open spaces…not only good for your physical health but also for your mental health.

On taxation: “Governments should tax sugar, tobacco and unhealthy foods.

On policy: “Air pollution is among the biggest threats to health.

On how to achieve greater sustainability: “It needs a multi-sectoral approach and partnerships….requires sustained advocacy.

On champions: “We need champions. In Thailand, there have been amazing champions in the area of exercise and tobacco.

Dr Tedros Ghebreyesus, WHO Director-General, WHO 

Who needs to be involved: “Finance, trade, agriculture, food….

Which party needs to play the stewardship role: “The Ministry of Health [in each country].”

On human capital: “If you don’t have a healthy nation, you don’t have a healthy economy.

On time-frames: “Invest today, and you’ll start reaping the benefits in 20 years.”

Regarding the last (third) high level meeting on non-communicable diseases (NCDs): “Many are a bit skeptical because we haven’t seen much action.”

On UN sustainable development goals (SDGs): “The third billion is about healthy lives…housing, safe roads, healthy foods, controlling air quality…the social determinants of health.”

Thomas Cueni, Director General, International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)

On disease prevention in Switzerland (remember the Swiss rejected a full ban on smoking in public spaces): “We had a referendum on prevention a few years ago – but it failed as the Swiss hate a nanny state.

Prevention and the precautionary principle: “Be healthy, be mobile” in reference to the WHO/ITU initiative.

On personal preferences: “I stopped eating chickens as I don’t trust the chicken farmers in this country”. Clearly Mr Cueni trusts chickens less than the drugs his association members make, despite them being the third leading cause of death after heart disease and cancer.

On other concerns: “Now they’re injecting antibiotics [to reverse greening disease] into citrus trees. Should we now stop eating lemons?.

Elisabeth Tichy-Fisslberger, Austrian Permanent Ambassador to the UN [Austria presently holds the EU presidency]

On vaccination: “[It’s difficult] trying to find alignment on vaccination among EU member states.

On the role of tech: “There’s a huge revolution going on in the health sector including in artificial intelligence and there’s huge money in it…but also huge research that needs to be explored.”

Dr Rangarajan Sampath, Chief Scientific Officer at the Foundation for Innovative New Diagnostics (FIND)

On responsibility: “There’s a growing emphasis on individual responsibility.

On tech: “To convert data into something meaningful, you need some kind of artificial intelligence or algorithms….you need to find a way of empowering the individual and allowing them to be the recipient of meaningful information.”

Michelle Rohrer, Senior Vice-President and Global Head of Product Development Regulatory and Policy at Roche

On ways forward: “We have a knowledge of biology like we’ve never had before, plus digital…how do we take all of this information and harness to do good.

On big data: “We need to curate the data so it becomes meaningful data at scale…we need advanced analytics to really uncover the truth that lies within all these data.

Rachel Dunscombe, CEO of the NHS Digital Academy

On what data should be collected: “It’s possible to collect too much data. …you shouldn’t collect data which will not be used for healthcare or wellness….citizens’ own data is most interesting.

On whether digital healthcare should be universal: “You need to segment. Some patients need a more individualised approach, others are very happy to have a more digital relationship with us [the NHS].

On responsibility for data entry: “The onus is on us to make sure people contribute their data for their benefit…better to do it on a regional basis as the public already has a regional political conversation.

Prof Klaus Dugi, Executive Vice President and Chief Medical Officer, Ferring Pharmaceuticals

On public-private partnerships: “People say the [pharma] industry hasn’t done well with these partnerships. But the Innovative Medicines Initiative [IMI] is the biggest in the world, with a budget of €3.3 billion [2014-2020] with half paid by the EU through [represented by the European Commission] and the other half by the industry [represented by EFPIA, the European Federation of Pharmaceutical Industries and Associations].”

Jayasree Iyer, Executive Director, Access to Medicine Foundation

On the business model: “Money’s starting to run out and we need to find new ways of raising money.

On AMR (antimicrobial resistance): “Many companies have left the space as it’s not profitable but a few have stayed on and are investing.

Ann Hasslberger, Swiss Mission to the UN

In response to an Eli Lily manager who said, “the majority of our employees don’t even know a single SDG [sustainable development goal]…they don’t really matter”, she responded: “SDGs really do matter, it’s becoming a movement.

On affordability: “We need to address the triple bottom line: financial, social and environmental.”

Amanda Hosken, Head of Life and Health Hub for EMEA at Swiss Re

On affordability of new drugs and treatments: “It needs to be cost effective, if not profitable.

Nina Renshaw, Director of Policy and Advocacy, NCD Alliance

At the roundtable on chronic diseases, talking about the recent 3rd UN High-level Meeting on NCDs: “…a tsunami of preventable disease….SDG 2.4   aims to reduce deaths by one-third by 2030 plus SDG 3 is pushing for action on mental health…there were 23 heads of state in government and ministers there…there’s a shift from the 4 x 4 approach [4 major risk factors and 4 major diseases] to increasing focus on mental health and junk foods…there’s also recognition that we need to think about not only social determinants of disease, but also commercial determinants.”

Cristina González, Minister Counsellor, Mission of Uruguay to the UN in Geneva

On responsibility: “It’s about building an enabling environment for the citizen to make appropriate decisions – as individuals, as consumers…being an actor in taking responsibility for their health, but with our removing the responsibility of the government.”

On prevention: “Prevention needs to go beyond the health sector. You don’t need much money, but you need to make a case for how other sectors need to work with health.”

Prof Mukesh Kapila,  Professor of Global Health and Humanitarian Affairs at the University of Manchester

On how to tackle chronic diseases: “The last thing you want is a global solution, like it was with AIDS. You need a long-term, sustainable programme. NCDs are not amenable to quick fixes….the biggest problem you have is with scale-up. You just design by intent a fully-scale system….that involves capacity building, community-based scale-up…and you need to demedicalise, democratise and decentralise.”

On tech solutions: “You can’t reduce it to a technical solution. In medicine you also need compassion.”

Alana Officer, Senior Health Adviser, Ageing and life-course, WHO

On challenges to healthy living: “One of the biggest factors is the border environment of the individual and communities – the policies, systems and services needed to help people make the right decisions.

On key factors driving (un)healthy choices: “Social connection and the environment around the individual.”

Dr Aseem Malhotra, Consultant Cardiologist, author, influencer

On key factors driving (un)healthy choices: “Ultra-processed foods.

On best fixes: “If we could just go back to cooking at home with fresh foods we would solve over half of the obesity problem even before taking into account more complex issues like saturated fat.”

On the evidence base: “The real problem is with eminence-based medicine [not evidence-based medicine].”

 

 

Comments

  1. Thank you so much for this information. I can put this to much needed use/proof.

    After many years of experience of what a number of us have been through – re our former health being “attacked” for years and in a medical wilderness, much research, self-diagnosis & self-treatment being forced upon us, while so ill – & with spectacular results, and Drs in awe of those results.

    And ANH helps to clarify what is going on and is such a positive force in all of this.

    Sincere appreciation!

    All of use doing our bit can change this sick system. No men

    1. Thank you for your kind comments an ongoing support Deirdre. It’s great to hear how useful the work ANH-Intl does is to you.

      Warm Regards

      Melissa

    1. Hi Shirley
      Many thanks for a great idea, but we’re still pushing uphill on food supplements given the mainstream remains – despite lack of evidence – solid in its stance that people can get everything the need from the diet. Exasperating in the extreme for those of us that know better, but sadly it’s a fact. Not a reason to give up though!
      Best wishes
      Meleni

  2. Orwell showed how doublespeak works.
    But the lingua franca works the framing of the mind that adopts it.

    In Soviet Russia it is said that people learned to decode their news or government-speak so as to discern something of what was going on.

    I could dissect it – but I felt sick to read it. I would rather align in joy.
    Sickness management – aka health care – is a vector of (global) power over humanity – and is no more concerned with serving or aligning in health or wholeness than a token show of masked agenda. Sickness operates in very complex ways – not least in the search for health and the war on disease – including of course the pre-emptive ‘treatment’ of ‘risk factors’.
    Health freedom is heal-thy self. Medical tyranny defines in terms of fear, lack and unworthiness or incapacity to make choices (and learn from them) – and so defines human being as a sickness to be ‘treated’.
    The ‘sustainability’ meme is not concerned with the abundance of true resource sharing where what we appreciate, appreciates, but with shifting forms of masking over destructive and resource exploitation. The term resource here extends from our creative potentials and abilities down through to our inherited environment.

    I say we need to re-Source or re-cognize our health, wholeness and sanity and grow it by living it. Those who ‘have not’ shall lose even the little that they have – because living FROM a sense of lack grows lack, or living FROM sickness grows sickness.

    “Everything is BACKWARDS; everything is upside down! Doctors destroy health, Lawyers destroy justice, Universities destroy knowledge, Governments destroy freedom, Major media destroys information, And religions destroy spirituality”. Michael Ellner

    Transparency for vaccines – ? Do you believe for a minute that this is anything but a facade? Nothing is so destructive as ‘saving humanity’ or ‘saving the world’.

    Who set up WHO and what exactly is WHO?

  3. EMA Director:
    On vaccine distrust: “I wish I knew where it was coming from but we have to build more transparency.”

    Are they really that ignorant? No idea where it is coming from?
    Any Mr. Nobody like me can do a google search and find countless scientific studies about vaccine damage and links between aluminum and the neurological diseases that have become epidemic, countless reports about people who saw their children regress after vaccination (or worse), billions paid out because of vaccine damage……
    And then I am not even mentioning the hundreds of thousands of people who have experienced vaccine damage themselves. In my case myself, my partner, my nephew and my daughter’s best friend….

    But “I have no idea where it is coming from?”
    I think he means, we are there for the pharmaceutical industry, and even entertaining the thought that vaccines can cause damage is not in the benefit of our sponsors…..

    1. Yes, it is perhaps asserting ‘plausible deniability’, but operates a cognitive dissonance of some sense of being compromised.

      I expect there are those hostage to a ‘too big to fail’ argument – up to a point…
      In the ranks are many ‘faithful believers’ in trust that they are being truly served.
      But the stretching of credibility goes past anything BUT blind belief in the actual account.

      The acceptance of collateral damage, side effects, corruption and fraud that effectively works an anti-life agenda under a Trojan horse of ‘healthcare’ is such a sick and sickening picture of humanity as to be unthinkable. Perhaps that is also part of why it persists, because it is so grievous to accept and so often triggers impotent rage or polarised reactions that immediately break the possibility of communication from an ‘unthinkable’ to a surface world that not only does NOT want to be violated by thinking it – but is heavily invested in the vaccination and pharma medical model as a sense of protection From the unthinkable – not just of feared diseases, but of any threat to their sense of self and world.

      Health education for all levels and as an integration of all levels of being human may depend on recognizing the true need and aligning in its Call and Answer. I put it this way because we humanly mask over and hide our deeper conflicts by seeking to resolve then ‘externally’ or generate external diversion so as NOT to know what is too painful, threatening or fearful to accept.

      Those fixated into a narratively defined surface ‘reality’ don’t know where ANYTHING is coming from, and are invested in mapping, predicting and control as a substitute for knowing.
      The need to believe in the ‘model’ therefore far outlives the ‘honeymoon effect’ of its seeming powers or freedoms. A desperate clinging to a hollow grasp as what still seems like saving the little that is left from total loss.

      I am reminded of a saying of Jesus that is often interpreted materially regardless Jesus offered new eyes to see what we take to be a physical world.

      “To those who have, more shall be added, but to those who have not. more shall be taken away – even the little that they have”.

      having and being are one in truth – but to know this is to give it and not to ‘get it’ just for yourself alone. A sense of self split off from Life is a sense of lack driven to seek wholeness outside itself – be that power, love or health. Of course language and the mind operate a framing that can misinterpret, but the core message is to appreciate and grow what you have instead of growing in the ‘negative appreciation’ and growth in a sense of lack, deprivation or a denial.

      A fearful, lacking and negatively defined sense of self and world seeks out and finds self-reinforcement, in all manner of substitutions for Life, health and happiness – aggressively defended and clung to against any change or communication associated with threat of exposure to a lack of true substance or foundation. It isn’t that the lie was intended to work evil so much as hide from it, or keep it hidden from those who demanded protection.

      The belief we are become evil by our act, choices and thought and are trapped in an evil fate thereby is the mind that must adapts by redefining its world as evil and framing its own acts or inactions in ways that are either ‘forced by circumstance’ or justified by a greater good in the future to which sacrifice has to be made to bring about, or the acting out of fantasies of power without any reference point from which to recognize they are delusional.

      This is also true of sickness. Whatever has passed can be released to the willingness for the true of wholeness – which is the willingness for new perspective in place of struggling within the old. A shift of perspective is often a synchronicity of new information, insight or actions that grow what we HAVE – and so is embracing and inclusive of all approaches to reintegrating and aligning within a balancing with wholeness of being. Including those that may be particular to our current state as a fresh expression of resources we did not know we had.

      Perhaps of our dilemma is that we have desire to know and be known – for this is the nature of love. But we also have a fear of being exposed to invalidation, rejection, unworthiness and inadequacy – and so are invested and identified in all kinds of strategies of masking by which to try to balance irreconcilable and mutually exclusive functions. This is why I feel that a practical spirituality of a true self-acceptance goes hand in hand with healing ‘modalities’ or choices – because we can only accept what we are ready and willing to give or extend and be equal to the measure of. When Life wakes to recognize a true Call, it is not sickness that hears it or rises to join, but health. I write this as a willingness and not a person claiming anything over anyone else.
      Opening in joy (health) also opens the capacity to see the denials or machinations of joylessness, of fear, hatred, and sense of guilt and lack. And of course the incapacity to communicate to anyone who is not already opening in their own recognition – excepting that health in terms of functional being communicated Itself into the whole in ways that we cannot and don’t need to understand – excepting in that we have belonging in wholeness by virtue of our being that is not contingent on our doing. The desire to understand is the willingness to listen FOR it rather than to struggle in an isolation of thinking we think alone. Being is always a ‘movement’ that a stilling of the restless mind in receptivity to being moved CAN notice itself moving. The noticing of the Living is always a ‘communication’ of wholeness that is also recognisably you. I associate it with awakened responsibility from which we take action with ‘both feet’ – which of course includes the decision to rest – but as a consciousness of a gift shared.

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