The COVID-19 pandemic placed health care at the top of everyone’s agendas and brought in a period of innovative thinking. In Europe, synergies emerged between governments, health professionals, industry and academia to develop coordinated solutions. Friends of Europe’s Health Innovation Summit – ‘reimagining health systems: green, agile and citizen-centred’ gathered citizens, policymakers and experts on 29 November 2022 to explore how the spirit of social, policy and practical innovation seen during the pandemic can be maintained to address future challenges and changes. The summit looked at three key shifts: the changing role of citizens in health; health and the green transition; and an ageing Europe.
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Friends of Europe’s Health Innovation Summit – reimagining health systems: green, agile and citizen-centred gathered citizens, policymakers and experts on 29 November 2022 to explore how the spirit of social, policy and practical innovation, seen during the pandemic, can be maintained to address future challenges and changes. The summit looked at three key shifts: the changing role of citizens in health; health and the green transition; and an ageing Europe.
Kicking off the meeting, Paulette Lenert, Luxembourgish Deputy Prime Minister, Minister of Health and Minister Delegate of Social Security, and Minister of Consumer Protection, evoked the potential of innovation to meet today’s health sector challenges and opportunities. Solutions around personalised medicine, reduced carbon emissions and healthier ageing can reframe Europe’s role in the world as a leader in green, patient-centred healthcare.
Despite immense challenges, Europe has a winning combination of strong political will, talented experts, engaged citizens, as well as innovative artificial intelligence (AI), digital, data and green solutions. “There is great potential and reason for optimism,” remarked Andrzej Ryś, Principal Scientific Adviser at the European Commission Directorate General for Health and Food Safety (DG SANTE).
More engaged citizens
Rare diseases offer a model for patient engagement along the healthcare pathway. “We pushed for patient participation in scientific committees of the medicines regulatory agency, and this positive experience has allowed patients to participate in other scientific committees, increasing patient engagement,” commented Yann Le Cam, Chief Executive Officer of the European Organisation for Rare Diseases (EURORDIS). Maciej Gajewski, Executive Director and Head of International Government Affairs and Policy at Alexion Pharmaceuticals, concurred that rare disease patients have driven innovation by providing perspective, insights and data.
As citizens take greater control over their health, the innovative European Health Data Space (EHDS) has the capacity to further empower citizens. “To fully optimise the promise of the EHDS, health and digital literacy must be built among citizens, as well as health workers,” remarked Elina Drakvik, Specialist on the Health Data 2030 project at The Finnish Innovation Fund Sitra.
Stelios Kympouropoulos, Member of the European Parliament Committee on Employment and Social Affairs (EMPL) and Coordinator of the Special Committee on the COVID-19 pandemic (COVI), stressed the need for a social floor to improve population health. “This is a pivotal time for establishing EU support for health systems,” he said, highlighting the increased support and efforts on health at the EU level since the pandemic, plus the benefits it can bring.
Loubna Bouarfa, Founder and CEO of OKRA technologies and 2022 European Young Leader (EYL40), discussed the future of AI for health, which could help define treatments and predict outcomes for individuals, while complementing but not replacing human roles.
Greener health systems
Health systems must reduce their carbon footprints. TheLancet reports that health systems contribute 5.2% to total global greenhouse gas emissions. Sonia Roschnik, Executive Director of the Geneva Sustainability Centre, explained that immediate “no regrets” measures can already be implemented. Shifting system focus to health and wellbeing rather than sickness will help, noting that “hospital admissions equals emissions”. We can also do better by bringing health care closer to patients and prescribing better.
Sir Ciarán Devane, Chair of the Irish Health Service Executive and Trustee of Friends of Europe, described Ireland’s six-pronged initiative to reduce health emissions, which covers buildings and infrastructure, transport and mobility, procurement, water and waste, models of care, as well as adaption and resilience.
Marina Romanello, Executive Director of the Lancet Countdown, warned that the health impacts of climate change are coming fast. Reducing emissions can be achieved through focusing on primary prevention. Secondary prevention and treatment can be done more efficiently in terms of cost, patient outcomes and climate impact. “Decarbonising efforts will have a cascading effect on other countries’ systems,” she noted.
Shifting to a wellbeing focus, which prioritises health promotion and disease prevention, and integrating healthcare in communities are crucial steps. Within the health sector, efficiencies can easily be made, as large employers and purchasers could trigger wider impacts.
Ageing well in Europe
Health systems must address the needs of ageing Europeans. Life expectancy is increasing, but we need to invest in making sure those extra years are lived in good health by ‘compressing morbidity’. Jane Barratt, Secretary General of the International Federation on Ageing, stressed the need for links between health promoting approaches, lifelong learning and social risk pooling.
With 90% of deaths and 80% of disability-adjusted life years linked to non-communicable diseases (NCDs), there is clearly work to do on this area. Sean Lybrand, Executive Director of Access to Healthcare at Amgen Inc, pointed out that early identification and management of NCDs is cost-effective with efficient NCD treatments at secondary prevention level.
Andrea Rappagliosi, Senior Vice President of Public Affairs for EMEA, Canada and LATAM at Edwards Lifesciences, highlighted that we have new technologies and innovations, but we also need innovations in systems that can support their integration into practice.
With an ageing population comes an increased need for long-term care. Joost Korte, European Commission Director-General for Employment, Social Affairs and Inclusion (DG EMPL), noted that 80% of long-term care is presently performed by families, with the burden falling mostly on women. The new EU Care Strategy takes a two-pronged approach to long-term Care: increasing access and affordability; and improving skills and working conditions. Currently, 70% of personal carers have no formal training. “Work conditions must be made more attractive with opportunities for upskilling and reskilling,” he noted.
Stecy Yghemonos, Director of Eurocarers, agreed that an EU initiative is needed, with links to population transfer and common reliance on informal care and supply issues. He commented: “We expect a redistribution of responsibilities between the individual and the collective, to reduce the reliance on informal carers […] who tend to face [issues with] social exclusion and negative health outcomes.”
Natasha Azzopardi-Muscat, Director of Health Policies and Systems at the World Health Organization, stressed the necessity to reduce the need for care, whilst improving long-term and palliative care, noting that mental health and the impacts of an ageing care workforce should be considered too.
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Healthcare is evolving rapidly. New technologies enable people to manage their own healthcare needs, while the data they create could drive new solutions to shared health challenges. As we recover from the pandemic, we need to find new solutions to manage healthcare outside of traditional healthcare facilities while delivering personalised care. Citizens can now be actors and innovators in managing their own health. Is the future of healthcare individual and community-based?
Immersed in epidemiology and new health information during the pandemic, people were asked to make difficult personal choices based on this new knowledge. We are living through an information revolution; more people have more access to more information and disinformation than ever before, while health and wellbeing technologies encourage individuals to increasingly share information about their health status and needs. Now, progress on the European Health Data Space could change the way individual health data is handled, while clinical trials are likely to transform in the future. Changes in the way data is given, collected, and handled could unlock innovation— what are the risks and rewards to patients?
Rare diseases offer an intriguing case study. Population-led campaigns have helped raise awareness and advocate for progress on rare diseases, while data shared and collected by people with rare diseases—and the systems which enable data processing and use—have the potential to unlock new understanding and treatments.
Specialist on the Health Data 2030 project at The Finnish Innovation Fund Sitra
Executive Director, Head of International Government Affairs and Policy at Alexion Pharmaceuticals
Member of the European Parliament Committee on Employment and Social Affairs (EMPL) and coordinator in the special committee on the COVID-19
Yann Le Cam
Chief Executive Officer of the European Organisation for Rare Diseases (EURORDIS)
Principal Scientific Adviser at the European Commission Directorate General for Health and Food Safety (DG SANTE)
Inspiring, multidisciplinary talk focused on the power of ideas to change the world. The speaker leads a solo, eye-opening intervention meant to stimulate further thinking.
Founder and CEO of OKRA Technologies, a leading artificial intelligence analytics company in the life sciences sector and 2022 European Young Leader (EYL40)
The health sector will be heavily impacted by climate change. It is also a major source of pollution and greenhouse emissions itself. Given the huge resource requirements of modern health systems, can they be decarbonised? What can the health sector gain from—and contribute to – green innovation?
Climate change is a major threat to our health and wellbeing. Whether through extreme weather events, heat stress, flooding or evolution of infectious diseases, most of the world will face the direct and indirect health impacts of climate change. Health systems are already preparing mitigation measures.
At the same time, our health systems are also contributors to climate change. The waste created by discarded PPE during the pandemic is easy to visualise, but only accounts for a part of our consumption connected to health. Pharmaceuticals’ impacts on the environment – either from manufacturing or excreted in wastewater – are a key challenge. Clean labs and sterilised equipment have heavy energy and water demands. Beyond that, health systems need administrative supplies, such as energy to heat buildings and power digital health systems, and food to support patients and staff. Healthcare facilities also account for a significant amount of Europe’s building stock and are closely connected to transport systems. This consumption contains within it an opportunity: as large employers, purchasers and manufacturers, health systems can make a significant contribution to Europe’s green transition.
Rapid changes lie ahead; to meet climate goals, Europe needs to innovate. The health sector could align and benefit from those innovations, while in contributing knowledge and experience. At the intersection of these two rapidly changing fields is an opportunity to reflect on the nature of innovation in Europe, and what it means for industry, the public sector, and citizens.
- Both health technologies and green technologies are developing rapidly – can they be brought together? What technologies will help health systems transition into low-carbon and sustainable systems?
- How can we harness the power of health systems as major employers and purchasers to trigger transitions in other sectors and meet climate goals?
- What can we learn from health systems about harnessing behaviour change, and how can we apply that within and outside health systems?
Sir Ciarán Devane
Chair of Irish Health Service Executive, Director of Centre for Trust Peace and Social Relations, Coventry University and trustee of Friends of Europe
Marina Romanello (joining online)
Executive Director of the Lancet Countdown
Executive Director of the Geneva Sustainability Centre
Europe is ageing. By 2030 we will be the oldest continent in the world. By 2050, 7mn more people will need long-term care. Unlike healthcare, where there is a consensus that the risks and costs of ill health should be shared, we leave the burden of care largely on the shoulders of families – particularly women. Remedying this disparity will require a fundamental system and culture shift. Europe needs an innovative approach to ageing well, rebalancing the responsibility of governments and the role of individuals.
Health and long-term care are closely connected issues, yet health and care systems are often run in parallel, not in tandem. Weaknesses in either system heavily impact the other. For example, insufficient care can lead to increased primary care needs, while lack of appropriate care in the community can lead to longer than necessary hospital stays, which in turn generate more need for care.
Europeans have an enshrined right to affordable long-term care services of good quality, but this right is not widely enjoyed. There are notable gender divides; many more women aged 65+ require long-term care compared to men but are less able to pay for it. This is closely connected to the burden of care falling heaviest on women, and how we socially and financially reward labour dedicated to caring. Today 90% of the care workforce is female, while women make up the vast majority of Europe’s estimated 100mn informal carers. This has knock-on effects on carers’ health and wellbeing, as well as individuals’ ability to contribute to society both socially and financially.
The way we grow and age determines how much care we need, as well as our ability to be economically active. Ageing is an intergenerational issue. People who will retire in the 2050s are in their 30s now. Healthcare interventions among both working age and young people will affect future health and care needs.
Social Innovations and health innovations are needed to help Europe’s population grow and age well, and to live well in later years.
- Europe’s health systems were forged in times of crisis and major social and economic change. The pandemic demonstrated changing needs for social protection. Was it enough to trigger a revolution in the way we refine the responsibilities between governments and citizens?
- Affordability is key for individuals, with one-third of households who require homecare unable to access it for financial reasons, and for governments, with expenditure on long-term care one of the fastest growing social expenditures. Women carry most of the care burden and live longer, but also suffer from the EU’s 29% gender pension gap. How will we pay for care and ageing in the future?
- What are the technologies that will help us age well? What will it be like to age in a digital world? What healthcare interventions for working age and young people will support healthy and active ageing?
Secretary General of the International Federation on Ageing (IFA)
European Commission Director-General, for Employment, Social Affairs and Inclusion (DG EMPL)
Executive Director of Access to Healthcare at Amgen Inc
Natasha Azzopardi-Muscat (joining online)
Director of the Division of Country Health Policies and Systems at the World Health Organization (WHO)
Senior Vice-President of Public Affairs for EMEA, Canada and LATAM at Edwards Lifesciences
Executive Director of Eurocarers
Natasha Azzopardi-Muscat is a medical doctor, who specialises in public health. Before joining the WHO, she served as the president of the European Public Health Association (EUPHA), in which role she was actively involved in health advocacy at the European level. Azzopardi-Muscat has previously held various senior positions at the Ministry of Health in Malta and worked in various areas in the country’s health sector, including primary care. She is also a resident academic at the University of Malta and has authored several publications on public health and European health policy.
Jane Barratt is the Secretary General of the International Federation on Ageing (IFA). Population ageing and disability across the life course have been Jane’s passion and interest across an adventurous career that traverses public and private sectors and many disciplines.
During the 1980s and 90s Barratt honed her technical and orating skills through an academic career in population ageing and disability at the Universities in the United Kingdom and Australia with attention to improved understanding of population-based planning models and service provision.
Representing over 75 million older people through the membership of the IFA, Barratt has direct responsibility for the corporation’s operational performance, quality and strategic implementation, and business development. This includes leadership at the United Nations Economic and Social Council in New York, Geneva and Vienna and the WHO.
Barratt is a Winston Churchill Fellow and recipient of the Queen Elizabeth II Diamond Jubilee Medal in Canada in recognition of her commitment and passion to enhance the understanding of issues relating to ageing and engaging in dialogue with governments and the private sector to improve the quality of life of older people.
Among her many current positions Barratt is a Member of Vision Academy, Director, Baycrest Health Sciences and Chair of the Education Advisory Committee, Associate Scientist, Sinai Health System, Member, Global Committee for the DR Barometer Program, and Member of the International Council for Adult Immunisation. Formerly she is a member of the World Economic Forum’s Global Agenda Council on Ageing and until recently Chair, Standing Selection Committee Chair for the Networks of Centres of Excellence of Canada.
A Dutch machine learning scientist turned entrepreneur, Loubna is the Founder and CEO of OKRA Technologies, a leading artificial intelligence analytics company in the life sciences sector. The start-up aims to revolutionise traditional healthcare systems by abandoning the one-size-fits-all model and building a future of personalised medicine. OKRA uses explainable AI to empower healthcare professionals to make decisions that will support the delivery of the right drug to the right patient at speed. In recognition of Loubna’s leadership, OKRA received the StartUp Europe Award for Best Female-Led Startup. The same year, Loubna also accepted the CEO of the Year Award at the Cambridge Independent Science and Technology Awards. As a former member of the European Union High-Level Expert Group on Artificial Intelligence, she supported the implementation of the Union’s strategy on AI within the digital single market.
Sir Ciarán Devane is the Director of the Centre for Trust, Peace, and Social Relations at Coventry University. He is also Chair of the Irish health service and a trustee of Friends of Europe and of the British-Irish Association. A chemical engineer by training, Devane had a twenty year career in industry and management consulting before becoming chief executive of Macmillan Cancer Support and subsequently chief executive of the British Council. He has served on the Board of NHS England, and of Social Finance Limited and was knighted for services to cancer patients.
Elina Drakvik works on Sitra’s Health Data 2030 project and is part of the coordination team of Towards European Health Data Space Joint Action (TEHDAS). Her job involves promoting the secondary use of health data in Finland and Europe, and collaborating with international health ecosystems and organisations. Drakvik has over ten years of experience in European collaborations in the field of health research. She has worked as a project manager and work package leader in various EU-funded research projects in Finland and Sweden, and she has experience in research funding and international co-operation. Drakvik’s professional interests include societal impact, participation and agency, and systemic change towards sustainable development, where health and well-being are understood in a broad sense. In addition to her position at Sitra, Elina is affiliated with the Faculty of Medicine at the University of Helsinki.
Maciej Gajewski leads the government affairs and policy function for the international region at Alexion-AstraZeneca Rare Disease. He is a senior leader with more than 20 years of experience in corporate affairs, stakeholder advocacy and pharmaceutical policy. Throughout his professional career, Gajewski has worked across diverse organisations at the local, regional and global level to support their strategic business and reputational objectives. He is passionate about patient centricity as a core value that should inspire all stakeholders across healthcare systems. Gajewski has helped build several successful multi-stakeholders partnerships, most recently in the area of rare diseases, including the European Expert Group on Orphan Drug Incentives, Rare Conversations and Together4RareDiseases.
Joost Korte is the Director-General for Employment, Social Affairs and Inclusion at the European Commission. Previously, Korte served as Deputy Director-General in the European Commission’s Trade Department, in the Agriculture and Rural Development Department as well as in the Enlargement Department. Furthermore, Mr. Korte spent several years in the Commission’s Secretariat General as Director responsible for the relations with the Council of Ministers and gained extensive experience in the Private offices of Sir Leon Brittan, Chris Patten and Danuta Hübner. These professional experiences within the European institutions allowed him to develop a profound understanding of EU decision-making. A lawyer by training, Joost Korte joined the Commission in 1991, following eight years of academic work on European law at the Universities of Utrecht and Edinburgh.
Stelios Kympouropoulos is a Member of the European People’s Party Group and serves as the Vice-Chair of the European Parliament’s Disability Intergroup, in addition to his role as a Member of the Committee on Employment and Social Affairs. He also sits on the European Parliament Special Committee on the COVID-19 pandemic: lessons learned and recommendations for the future. A psychiatrist by training, Kympouropoulos previously worked as head of the Sexual Functions Clinic at the University General Hospital Attikon in Greece. Additionally, Kympouropoulos is a social activist and the Co-Founder I-living, the first organisation that promotes independent living in Greece.
A Founder of EURORDIS-Rare Diseases Europe, Yann Le Cam has served as the organisation’s CEO for over two decades. He also initiated the global alliance of persons living with a rare disease, Rare Diseases International (RDI), where he sits on the RDI Council and chairs the RDI Advocacy Committee. Notably, Le Cam is a Founding Member and Vice-Chair of the NGO Committee for Rare Diseases. He also serves as the Co-Chair of the Global Commission to End the Diagnostic Odyssey for Children with a Rare Disease and as a Member of the World Economic Forum’s Health Stewards Board and Global Precision Medicine Council.
Sean Lybrand leads Amgen’s Access to Healthcare unit, which focuses on access in low- and middle-income countries. A health policy leader, he has over 20 years of experience in health, having started his research and health outcomes-focused career in academia. Lybrand has considerable experience in developing multistakeholder collaborations and has established a range of important partnerships in health, most notably the development and initiation of the first public-private partnership for HPV vaccination in the developing world. He is also an Adjunct Fellow at the Centre for the Health Economy at Macquarie University and a Health Executive in Residence at University College London’s Global Business School for Health.
A member of the regional executive leadership team at Edwards Lifesciences, Andrea Rappagliosi leads the company’s government affairs, market access, communication and patients advocacy engagement. He recently worked at Sanofi as the vice-president of European public affairs, prior to which he held positions in the public affairs and market access policy area at Baxter Healthcare, Serono International and GSK. A founding member of the Global Policy Forum at HTAi, the scientific and professional society for those who produce or use health technology assessment (HTA), Rappagliosi currently chairs the MedTech Europe HTA Committee and serves on the Board of the European Patient Safety Foundation (EUPSF).
Marina Romanello is the Executive Director of the Lancet Countdown, and climate change and health researcher at UCL. She trained as a clinical biochemist in the Universidad de Buenos Aires, Argentina, and holds a PhD in biomedical sciences from the University of Cambridge, UK. Romanello’s research background spans from toxicology through to environmental health and climate change, and she has previously carried out her research in the Instituto Tecnologico de Buenos Aires, the University of Cambridge, and the Francis Crick Institute. Working as a consultant for the NHS, Romanello led a team of researchers in developing its Net Zero commitments, and is a member of the working group on health co-benefits in climate change mitigation policies of Italy’s Superior Health Council.
Sonia Roschnik manages the Geneva Sustainability Centre, which supports hospital and healthcare leadership contribute towards a healthy and sustainable future for all. A trained clinician and occupational therapist, Roschnik maintains over 30 years of experience in health and social care, specifically senior hospital management and sustainability. As the former international climate policy director at Health Care Without Harm, Roschnik notably worked on the ‘Global Roadmap for Healthcare Decarbonisation’, ‘Race to Zero’ and the ‘COP26 Health Programme’ initiatives. During her tenure as the director of the Sustainable Development Unit (SDU) at the National Health Service (NHS) in England, she launched the ‘Greener NHS’ programme, which positioned the NHS as the first national health system in the world to commit to reaching net-zero climate emissions.
Andrzej Rys has held several key positions in local and national health institutions, notably serving as the Director of the Health Department of the City of Kraków, President of the Polish Public Health Foundation and Polish Deputy Minister for Health, a role which put him on the negotiation team for Poland’s accession to the EU. He later founded and led the School of Public Health and the Centre for Innovation Technology Transfer at Jagiellonian University. In 2006, Rys joined the European Commission as the Director for Public Health and Risk Assessment and was later appointed Director for Health Systems, Medical Products and Innovation at the Directorate-General for Health and Food Safety, where he works on improving EU healthcare systems for citizens.
Stecy Yghemonos is the Executive Director of Eurocarers, the European network working with and for informal, family or unpaid carers. Bringing together 75 organisations from 25 countries, the Eurocarers network aims to ensure that the growing care needs of the European population are addressed in a universal, equitable way and that the vital contribution of carers is valued, recognised and supported. A journalist by trade, Yghemonos is an EU policy and communication specialist. Throughout his career, he has actively contributed to the implementation and reinforcement of EU policies in the areas of human rights, health and social equity, and access to good-quality care.
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