Now is the time to spark a new prevention revolution in healthcare
While the principle of prevention is universally accepted, shifting the dial more strongly towards it and away from reactive, emergency approaches has been an elusive challenge for governments around the world. Yet in the wake of the COVID-19 pandemic, we have an opportunity to use innovation in novel ways to drive a new revolution in prevention. Rhulani Nhlaniki, Pfizer’s UK Vaccines Lead discusses the challenge.
This content has been developed and paid for by Pfizer UK
It is estimated that around 40% of premature mortality in the UK results from preventable diseases including cardiovascular disease (CVD), type II diabetes, chronic obstructive pulmonary disease (COPD) and some cancers. Each of these deaths is an individual tragedy and, collectively, preventable illness places a significant burden on the healthcare system. Research suggests 40% of the burden placed on health services in England is the result of preventable conditionsi.
So, what could be achieved by shifting our focus as a society and a healthcare system, towards a focus on preventing illness and the benefits that brings to both individuals and society as a whole?
The idea of focusing on prevention is nothing new; the phrase ‘prevention is better than cure’ is often attributed to Dutch philosopher Erasmus as early as the 16th century.
We have made major steps forward in public health and prevention, for example childhood vaccination has done much to prevent, and ultimately eradicate, diseases that were once widespread. However, on other fronts, particularly around lifestyle related conditions, we are still very much focused on management.
In fact, prior to the pandemic, the UK Government was spending £97 billion of public money on treating disease and only £8 billion preventing it across the UKii. But now, with the help of improved understanding of the importance of prevention and the innovation to support it, we have a golden opportunity to deliver a new revolution in preventative care.
The reasons for this disparity are complicated and don’t lend themselves to easy solutions. The burden of ill health isn’t shared evenly across society and health inequality is something that will need to be confronted if we are to unlock a prevention revolution. Bringing ‘left behind’ neighbourhoods up to national standards of health and well-being for example, could be a real step forward. Not only would this be the right thing to do for the communities and individuals, but, as the figures suggest, it would also be a significant boon for the UK economy.
An independently authored report by Future Health, commissioned and funded by Pfizer UK, found that by improving the uptake of adult vaccination rates within deprived communities, which often have lower rates of adult vaccine uptake, greater economic and social benefits can in turn be realisediii. Recent analysis estimates that improving health outcomes in local authorities that contain ‘left behind’ neighbourhoods, and bringing them up to England’s average, could add an extra £29.8bn to the country’s economy each year. In 2018, the gap in productivity between local authorities containing these ‘left behind’ neighbourhoods and the rest of the country was estimated at £124.1bniv.
Many private sector employees have understood this and so invest proactively in preventative measures, such as offering flu jabs in office, providing ergonomic seating or incentivising active travel schemes, such as cycle to work. While this is an upfront cost, the downstream savings make it a sound investment for business.
At the national level however, a mindset persists which sees healthcare spending as a net expense, without considering the potential long-term returns. What if we viewed good health as an ‘asset’, both personal and collective, which is required to enjoy a good and productive quality of life?
Government often looks primarily to economic indicators like GDP to take the national pulse, but in future a focus on a wider range of metrics, including health and well-being, will be essential. The piloting of a Health Index by the Office of National Statistics (ONS)v is a welcome step in this direction. The cost of not addressing health factors ultimately has a significant financial and productivity impact.
Alongside government, industry also has a role to play. By leveraging pharmaceutical innovation, such as advanced diagnostic tools or genomics, to prevent illness, it is possible to unlock the productivity lost in the UK to preventable illness. As demonstrated during the pandemic, vaccines are vital when it comes to reducing the spread of infectious disease. Often however, the barriers to preventing illness are more than just technical or scientific but rooted in complicated questions of public awareness and attitudes.
The UK losing its measles‑free status in 2019vi is a stark reminder of how quickly hard-fought health gains can be lost and just how important it is to understand and get to the root of potential barriers. Important not just for the health and well-being of individuals and communities, but also for the wider economy.
And again, effective vaccination programmes with national access and uptake need to be seen as an investment, rather than simply a cost. Work undertaken by the Office for Health Economics (OHE) calculated that, across three UK vaccination programmes, the Government would on average see a £2.18 return on investment for every £1 spentvii.
Seeing the fight against preventable illness as a sound investment then, rather than a cost, will be vital to unlocking better decision and policy making. Long-term thinking is key to this, as is a shift in mindset away from judging the success or failure of a nation on GDP alone.
To learn more about Pfizer’s 10-point plan for how life sciences can drive the UK’s health, wealth and resilience beyond the pandemic read here: https://www.pfizer.co.uk/news-and-featured-stories/breakthrough-nation
Date of preparation: November 2022
[i] House of Lords. The Long-term Sustainability of the NHS and Adult Social Care - Select Committee on the Long-term Sustainability of the NHS. Available at: https://publications.parliament.uk/pa/ld201617/ldselect/ldnhssus/151/15109.htm [Last accessed October 2022]
[ii] Department of Health and Social Care. Prevention is better than cure. Our vision to help you live well for longer. 2018. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/753688/Prevention_is_better_than_cure_5-11.pdf [Last accessed October 2022]
[iii] Future Health/Pfizer | March 2022 | VacciNation and health inequalities: Tackling variations in adult vaccination uptake in England. Available at: https://www.pfizer.co.uk/news-and-featured-stories/vaccination_tackling_health_inequalities_across_england [Last accessed October 2022]
[iv] All-Party Parliamentary Group. Overcoming health inequalities in ‘left behind’ neighbourhoods. 2022. Available at: https://www.thenhsa.co.uk/app/uploads/2022/01/Overcoming-Health-Inequalities-Final.pdf [Last accessed October 2022].
[v] Office for National Statistics. Health Index: England. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandwellbeing/datasets/healthindexengland [Last accessed October 2022]
[vi] Measles in England. UK Health Security Agency. Available at: https://ukhsa.blog.gov.uk/2019/08/19/measles-in-england/ [Last accessed October 2022]
[vii] Office of Health Economics. The Broader Value of Vaccines: The Return on Investment From a Governmental Perspective. August 2020. Available at: https://www.ohe.org/publications/broader-value-vaccines-returninvestment-governmental-perspective [Last accessed October 2022]
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