Health@Davos: Building Global Health Resilience

Welcome to the unDavos Summit - A community-organized series of interactive panels, talks, and networking taking place in Davos, Switzerland - and online - in parallel to the World Economic Forum’s Annual Meeting 20-24 Jan 2025. Our mission is threefold:  
• Democratizing Davos: We open the doors to diverse voices and ideas, breaking down traditional barriers to participation.  
• Humanizing Davos: We foster genuine, relationship-driven connections that go beyond transactional networking.  
• Bringing Action to Davos: We turn meaningful discussions into tangible, real-world solutions.

Join us for **Health@Davos 2025: Advancing Global Health Policy & Innovation**, an essential forum dedicated to shaping the future of global health systems. Set against the backdrop of pressing public health challenges, this event will explore the vital themes of resilience and technological innovation, with an emphasis on equitable health practices for all. Attendees will benefit from insights shared by industry leaders and experienced professionals, ensuring actionable outcomes and innovative solutions.

**Speakers include:**  
- Laura Herman, Partner at Dalberg  
- His Excellency Dr. Mohamed Irfaan Ali, President of Guyana  
- Dr. Joneigh S. Khaldun, President & CEO of Public Health Accreditation Board  
- Dr. Craig Spencer, Emergency Medicine Physician at Brown University School of Public Health  
- Robert Metzke, Global Head of Sustainability at Philips  
- Dr. John Q. Young, Senior VP for Behavioral Health at Northwell Health  
- Tisha Boatman, Global Lead for Healthcare Access at Siemens Healthineers  
- And numerous other experts dedicated to transforming global health.

**Event Details:**  
📍 Mountain Plaza Hotel, Oberwiesstrasse 3, 7270 Davos, Switzerland  
🗓 Date: January 22, 2025  
⏰ Time: 2:00 PM – 6:00 PM CET  

Explore the future of healthcare with dynamic sessions including keynote addresses, panel discussions, and networking opportunities.  

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Transcript

(00:08) little winds guys the small winds um well so just building on what we heard from Laura right there is um you know significant Trends in Health Equity and when we think about our first panel we're focusing on resilience and um we're going to start off by thinking about what's happening in the world so right now the risk of another pandemic over the next few decades is three times higher so when we think about Co that is certainly not our last pandemic uh we know we've heard a lot about climate and health um the when you think about
(00:37) climate change 1.2 billion people will be displaced by 2050 and then the cost of that will be2 to4 billion do and with all the recent conflicts we know conflicts are on the rise as well and so this has had profound implications on our health care System our healthcare workers our infrastructure um and please do do check out the QR codes for everyone's bios um but my first question um is for you Craig um so Craig has you've been working on the front lines of Crisis settings in Guinea Liberia Sierra Leone and can you talk a little bit about your
(01:13) work and how um resilience has been showing up absolutely so my background if you don't click on me I'm an Emergency Physician I still practice I work in public health and I'm on the board of Doctors Without Borders in the US and so work in a lot of context of humanitarian crisis disease outbreaks when I think of resiliency I think not of those places where I work only but Colombia Presbyterian one of the best hospitals in the world where I was in March 2020 and saw more people dying a day of covid than I did in West Africa
(01:45) in 2014 working in an ebola treatment center and so resiliency is not just a thing in developing or low middle-income countries it's an issue at home as well I want to go and tie in what you were saying about Health Equity and defining that when I think about Health Equity whether it's in New yor York or anywhere I'm working I think of three things I think of affordability I think of access I think of quality and there are three big issues that we need to fix with each of these so with quality 25 to 40% of the medications that are available in
(02:14) markets around the world particularly in subsaharan Africa are counterfeit or are not created to the standards that are necessary this is a problem for antimicrobial resistance it's a problem for tackling malaria which will become an increasing issue with climate over the coming years and the issue of affordability look what we just went through over the past 5 years I'm sure everyone in here probably had access to a covid vaccine relatively quickly it took a year sometimes two years for vaccines to get into places
(02:44) that needed them we in the United States bought three to four vaccines per person we're not using them we're holding we're hoarding them well other people Healthcare Providers are 15,000 Healthcare Providers died around the world of Co waiting for their own vaccine and it's because countries were not able to afford them many places that had less means had to pay sometimes double the price for the exact same vaccine and then the last issue I want to talk about is access in 2014 I was working in Guinea taking care of Abola patients at some
(03:16) point in this process um I was infected myself came back to New York City where I fell ill I had access to the best clinical care in the world for that I am here today I had about 30 providers on call at minute to take care of me I was probably taking care of 30 people at any point when I was in Guinea in those Abola treatment tents when I got sick I had access to basically any medicine that I could think of the FDA offered to fly in a dose of a medicine that was apparently gone from the global stockpile but they
(03:48) had a dose and they were going to fly it from Canada to me I spoke with my provider I said I don't think we need it I'm going to survive so let it go to somebody else two months before Dr sh Maran who was a noted physician in sier Leon got sick got Eola as he was lying in a bed in his hospital that medicine was across the hospital he did not know it was there he was not offered this medicine he was not told about its existence so the difference is not just quality affordability it's access this person didn't even have access to the ability
(04:27) to take part in his own care the agency so when we're thinking we're thinking about resilience we're thinking about global Health we need to think about how we improve all of these things if we're going before we think about AI before we think about the other things we'll talk about we need to think about these issues first yeah so well said um speaking of another conflict uh Natasha you've been working on the front lines of uh events in Ukraine um especially with the Frontline healthcare workers can you talk about your work and um what
(04:54) you've been focusing on in terms of mental health sure thanks thanks Lily um hello everyone it's a great pleasure to be here I was here precisely in this room a year ago and we talked on Mental Health Global mental health where are we from then uh lots of problems are still here however lots of Partnerships have been built and lots of issues that I personally was working on actually got a clear answer and I'm very happy about this to the question of uh Global health and resilience uh do we think that Global health and resilience always go together
(05:45) many people do that's not the case you form resilience you build it you cultivate it you often fight for that how do you actually do that that was the question that our Ukrainian health care providers we're asking myself and our wonderful northwell team of psychiatrists and the team of global Health last week when we were doing a stress first aid in ke for 47 Health Care Professionals how do you build re uh resilience how do you make sure you do not fall apart and Global health and health system actually is glued together
(06:26) because the resilience is the glue this is something that keeps us together and helps us to move on the answer that actually John gave how you build resilience is with confidence and hope and kindness I would add from myself that you also add courage and sacrifice because all of us are talking about resilience but often should we ask ourselves what are we actually ready to do to promote that resilience and build it and help countries in war countries in hunger it's it's all people people are behind those countries what are we
(07:04) willing to do for them are we willing to step out of the zoom call and actually do something practical and I know we are one person can change a lot of things our healthc care providers in Ukraine have been uh fighting the third year of the fullscale invasion the biggest war not even a conflict the war in Europe for the past 80 years the largest humanitarian countries Europe and the us the whole world has been dealing with the country that has been holding the fort for the whole civilized world this is who needs resilience very very much
(07:44) right now in global health and right now the Ukrainian healthc care providers have demonstrated amazing excellent examples of resilience today Ukraine has the best blood transfusion system in the world because of the war and how Ukraine learned thanks to Partnerships and to the world best uh cases uh today we have the best which was just launched the best mental health program for healthc care providers on stress first aid in a couple of months we're about to launch a program for war chaplain upon the request of the Ukraine uh Armed Forces
(08:23) on how to actually stay resilient and how to move on so that's why I just want to say that this is super important it's everything is about resilience and resilience is about people I think that's so poignant and it's about the infrastructure it's about our own human spirit it's about our Frontline workers um and the mental health of everyone uh and so you know we spent a little bit time about talking about crisis but resilience does not always at the time of Crisis it is also running our Public Health Systems and
(08:55) how resilient they are um as our communities change evolve um so my next question is for you Jon um we know how important resilience is in public health um given your background in public health can you talk about some of the interventions that you've been putting forward absolutely um I'm Dr Jon calun I'm also practicing emergency medicine physici high high five ER doctors um I worked in corporate healthc care and I'm currently the president and CEO of the public health accreditation board which accredits all of the uh governmental
(09:25) health departments in the United States and so I struggle with this word resilience and I actually looked up the definition like let me just what is bothering me about this word and so when I looked it up don't quote me on this because I'm doing this for memory but it's essentially uh the ability to be able to withstand and recover from from hardships essentially and when I think about that this kind of recover as if the current state is good or something we should actually be aspiring to and so I struggle with this word resilience
(09:52) because and I'll speak from a a domestic United States perspective which is where I've done the majority of my work I would argue that you know the United States we spend about 18% of our GDP on health care and Health Care delivery and of course you know many people know these statistics we have some of the worst uh Health Care outcomes in the world uh we spend the most money of any country um in the world on healthare delivery yet we have the worst outcomes and I would argue that going back to Public Health it's because we actually
(10:22) spend too much time thinking about the healthc care system I'm an ER doctor the reason why I primarily do public health is because very early in my career I realized that I couldn't really you know when someone comes into me and they've got a heart attack orever and I need to crack a chest whatever it is way too late way too late I need to get out in the community to be able to understand what's going on and be able to fix those systems so let me give an example of Co I just so happened to be the State Health officer in the state of Michigan
(10:48) during the covid response um and let that response and so in the state of Michigan African Americans account for about 14% of the general population yet in the very beginning of Co 19 we actually saw about 30 40% of of the cases and deaths were African-Americans and let me be very clear in case anyone doesn't know that has nothing to do with genetics there's no Gene for the amount of melanin in your skin that says you should have a lower quality of life or that you should die earlier just what sometimes people don't understand this I
(11:16) just got to say that and so when you think about that if you think about the recommendations that the CDC was coming out with early in covid-19 make sure you should use a you should not share bathrooms you should stay home you should make sure you you know use your private car if you want to stay safe so me as a physician yeah I could except for when I was in the ERC patients I could stay home and do my administrative job I could be safe I could still make money keep my health insurance and be at home and be protected but that's just
(11:45) out of touch our systems before the Health Care System even comes into play are not set up when you talk about the incidence of chronic diseases and how black and brown people in United States are more likely to have chronic diseases not again not genetic it's because of lack of Access to Health Care to healthy food to clean air to affordable housing to strong education so you can actually get that good job so you can get that good health insurance which I would argue good health insurance still does not mean in the
(12:14) United States that you'll actually have access to Good Health Care I'm a doctor it takes me six months to get into my primary care physici so I would argue that the things that and I won't get too much into you know I feel like I'm taking up too much air time here I can go on all day but I would argue that and this is what we did in Michigan the things that help improve health outcomes are the things that are happening in the community well before the next emergency pandemic whatever hits let's focus on chronic diseases and access to health
(12:41) care and making sure you know we we have actually a primary care system so you don't have to wait six months with good insurance to see your primary care physician let's think about Upstream before the emergency hits and I should have also mentioned this is our third event with northwell and I tell you when we put our events together what we say is you know we could spend a lot of time looking at the problem and admiring the problem but we really want to talk about is action and what's been working um and so I I I
(13:09) frame that up as I position my next question to you Robert um sustainability and we talked about climate climate change that requires um a lot of shifts that are going to happen people on the Move um and the cost of uh incidences related to climate and health and so given your role in sustainability um can you talk about how the private sector is contributing to building resilient Health Systems beyond the scope of their products thanks so much super interesting question um and easy to build on what has been said here right I mean Phillips
(13:41) is one of the leading technology providers in the world but I think we have come to see that Health Care Systems is not a standard on system in the world it is a system within systems which you very eloquently described also really how we distribute Wells and so forth even in in Amsterdam and Holland where I live you see the uh the life expectance in equality life years really decline with the different codes if you just follow follow the Metro my wife is a midwife working in Amsterdam seeing all parts of the population but also
(14:06) telling me about the stress the burn out and so for so access and Equity is not a problem of subsaharan Africa so to say it's everywhere it's globally and at the same time it's very different also if you think about it there are still more than four billion people in the world that don't have access to any type of Hare system and if we make the link to climate then we must state that the other 4 billion are emitting more CO2 with the Healthcare System than all Airlines in world together nobody ever talks about it right and we see the
(14:32) impact of climate change on health carees when my father was sick in his last years a diabetes patient and I I could see that in Berlin these heat waves hitting there um what that does to elderly people and all of us have them in their families and when they have to be hospitalized how that that's adds additional strain and stress to people that have already been working double shifts and so forth and so forth so I think we see that these systems are interlined um and H is not just only suffering from climate change but also a
(14:58) major contributor to and I think with the responsibility that healthare providers feel for the patient um I'm really um blessed and glad to see that a lot of healthcare providers around the world also step up and say we cannot treat people and at the same time kill the planet these things need to go in hand in hand we need to deliver care if you want to really think about making healthare accessible to everyone we also need to make sure that we can deliver it within the planetary boundary conditions now to your question what is then a
(15:24) company like Philips doing well one of the things of course is thinking about enabling hospitals deliver uh making care more accessible we have Target on that by 2030 we want to empower or enable healthare uh for 400 million people in underserved communities which is really a major driver also for thinking differently are Hees delivered what role digitalization can play but also you don't solve that with technology alone it's really about reimbursement uh systems it's about building capabilities and capacity and
(15:53) so forth not going into that uh on the climate side of course uh it's really aligning your entire innovation road maps with science based targets for scope 1 2 and three we have been operating carbon neutral since many years now but the ma majority of the emissions are of course in our supply chain and downstream so really going into the hospital is trying to understand together with the Physicians where actually the emissions are we published about it a lot we did quite a lot of studies also in different uh
(16:17) continents and States working with leading care providers around it but then looking for practical Solutions let me just wrap up with three I think practical steps um to to illustrate what I mean of course there's a lot of energy going into hospitals they are very energy incentive intensive houses so you can have a discussion around energy efficient equipment but I think that's the bare minimum I think U it is more interesting to also think about and engage on top of them about um how for instance Diagnostics is provided as a
(16:45) service through circular means so that you can address embedded carbon all the amount of energy that's required to provide the materials for the hospitals how you address waste and so forth and I think the third level and that's really interesting is where you touch and work very closely together with doctors and care providers is thinking about how you optimize care Pathways for instance if you provide better Diagnostics or allow better Diagnostics you can avoid double scin you have the impact per skin if you
(17:09) can uh find out how the um U condition of a patient is potentially deteriorating you can detect these early signals with AI we mentioned that earlier um then you can intervene before he or she has to come back to the hospital um so there's a lot of things that you can do to really optimize how care is delivered in the existing systems also to get the footprint down so I think these things are very interconnected can I just quickly react to the things that you both just said you know Jana the your point about let
(17:39) us not get back to what our Baseline is and I don't think that's unique to the United States we have Healthcare challenges everywhere but it is very common for us to think about that unidirectional flow of knowledge and solutions we have the money we have the ideas who here has been to Rwanda yeah a lot of folks Rwanda is an amazing place and nearly everyone in here today was alive when 30 years ago Rwanda was torn apart by genocide in three decades Rwanda has built a Health Care system by rwandans with public with private support that
(18:12) was able to successfully manage a mberg outbreak all on its own external support came in CDC came in who came in there was work Equitable access to investigational countermeasures vaccines and treatments through the Sabin Institute ivia who I know is speaking in yesterday this is unbelievable I very very rarely as someone that looks at the history of health and medicine I very rarely say the word unprecedented but I've used it here and this is where resilience is where in 30 years you can turn around from being one of the most
(18:45) dramatically and saddest and hardest where there is no healthcare system at all to be able to manage a threat that has styed many other countries including places like the United States is unbelievable and I think there 's a whole host of lessons there your talk about Community what did Rwanda do they built from the community up in the rebuilding process of the genocide they built in health systems and Health Solutions that were informed by community members they thought about access they thought about using support
(19:16) from the global fund other things created here in Davos over the last quarter Century to say we need to make these Investments and make sure that 33 cents might be too expensive for someone to go to the physician even if they have I think 9 95% of the country has Healthcare okay fine let's find a way to cover those costs for 1.
(19:35) 5 million people so that you have Community Access you have a a focus on Rural populations you're thinking about even amongst that population the most marginalized the most disadvantaged that is why that that system works that is why it was able to do something in the span of just a couple weeks that in many other places would not have worked um Jan a question for you um you know when we think about Health Equity and the role of data data's very powering because it can highlight what the inequities are and I'm just curious um how you've been using data driven
(20:09) solutions to also guide um some of your work absolutely you know data's incredibly important when it comes to whatever the intervention may be you need to have data but there's a couple points I want to make there one we often see in the healthc care space especially in the Health Equity space that people say oh I don't have enough data I don't have all the robust data on Race ethnicity sexual orientation gender identity therefore I can't do anything well data is just meant to be a signal we are never I've worked in public
(20:39) health for a while we are never going to have robust complete data on every single thing in real time I shouldn't say never maybe I should be more optimistic but we're not going to have it anytime soon I don't believe and so for us it's about how can we leverage the data we have how can we democratize the data right how can we actually make sure that you know everyone in this room you're in Doos therefore you you're probably a leader in organization you may have access to a lot of data but how about we to your point give that data to
(21:07) the community show the data to the community ask them to ask the right questions of the data and let them interpret the data and then be able to design the solution so I'll give one example when I was the director of the Detroit uh Health Department in Detroit Michigan one of the worst INF mortality rates um in in the United States and so the mayor you know God bless him wanted he said Jon I want you to fix INF Mort that's what you're going to work on I want to see like weekly infam mortality rates I like may it doesn't work like
(21:33) that you can't get them weekly but but I I hear you I'll work on it right um and one of my colleagues in in the room here uh Dr Renee Kennedy also was part of this this work and so we said okay so we're at the governmental health department we don't have much of a budget but we have a lot of data we have a lot of local data we have a lot of State data so what do we do we said okay there's a lot of folks in Detroit organizations public private sector who are working on INF mortality have been doing it for a long time unfortunately
(21:58) still seeing the same poor outcomes so we said okay let's bring folks together bring the public and private sector sectors together let's stop competing this is something I had to learn early in my career let's stop tripping over each other we may oftentimes organizations are working in the same communities don't know who each other is is impacting we're not looking at data we're looking at oh I served 50 people in my program high five they did well but wait a minute who else is serving that population who's looking at the
(22:25) data what organ what populations are we actually missing and so back to to Detroit so we brought folks together we looked by ZIP code and I you know annoyed my state colleagues who had all the data I wanted zip code level data so in some communities in Detroit it was pre-term birth others it was you know right before they turned one it was sudden infant death syndrome it was a safe sleep related issue so we actually looked by ZIP code and then based on community input we actually designed interventions at the ZIP code level in
(22:55) some places it was the pastor so we actually designed things in certain ways brought together the Healthcare systems that had their own kind of things on the side my health department we decid we determined that there was a lack of access to health care so we designed a free program for people who did not have insurance we brought in a uh ride share service because in Detroit you may not know it Detroit does not have a robust transportation system it's almost like a rural place even though it's a major city and so when we have focused groups
(23:20) and talk to folks we don't have transportation okay you get a free ride so we did all of this we put together this system and lo and behold even though it was quite fragile Detroit in 2019 had the lowest infam mortality rate every recorded in the history of recording INF mortality in the city of Detroit and it was fragile it was not about me it was not about one particular organization and then Co came and again it was very fragile but what happened in that instance is that we shared data we got very granular we understood what was
(23:50) needed in each community and we stopped competing with each other we were actually referring one organization referring to another organization and that's what we need to do stop competing with each other share data make sure we democratize the data and then be very intentional and it helps to have a mayor who wants to have weekly uh INF morality rates um and if you haven't seen the Robert Wood Johnson Foundation if you live in the United States you can put your ZIP code in and it can tell you your life expectancy and so there's
(24:17) something very real when you look even within um not too far of a vicinity on what life expectancy looks like um so it's very neighborhood dependent um I'm going to have one more question for Robert and then we'll go to all of you for a couple of questions Robert you talked about opening up um uh other markets roughly 400 million people um and so can you talk about that experience lessons learned from around the world and where you're seeing similarities and also differences yeah thanks a lot um so that's fascinating
(24:47) also complex right I mean we have been uh around 440 years or something and uh got big with selling big machines um to very well equipped hospitals that pre prefer to do academic research so now you are confronted with a totally different problem how do you address that how can you leverage let's say a trend of digitalization in healthare but um how to how to um Drive Innovation beyond the product Innovation and really say it's about how care is delivered there's a lot of things that need to happen in an organization before you can
(25:15) do that actually um and we we did that actually in and we are still doing that in three different Horizons the first one is we have a lot of equipment that's out there that's not very uh that's not always utilized I mean there are hospitals that have fantastic equipment but only using a 20% of the time which is a shame so that's also about um asset utilization referrals um working with hospitals care providers that the right people get access to the right equipment uh one of these things that we have started in India for instance is um
(25:43) screening uh for people with heart disease to get them to diagnostic Centers and then refer them to tier 2 and tier three cities uh to get image guid therapy for catheters and Sten and these kinds of stuff so now when we started that six years AG ago I think or so um we had this discussion can we do this access to care the stuff is expensive um until we had this pivotal moment we said it's not about the cost of equipment it's about the cost of care so can we build effective referral streams and we have installed more than
(26:09) thousands of these IGT image guided Therapy Systems calabs in tier 2 and tier three cities in India since so that is something that seems to be working I think the second one uh is really um finding uh and developing also new um models of of reaching out to communities um so really building the stuff um let me condense it for the sake of time but I think um the other two important points that I wanted to make is really um building um groups of people in alliances that bring different assets and capabilities to solve a given
(26:39) problem for instance we have set up a group that's called the digital connected Care Coalition now everything is digital connected these days but it goes five years back or so where we said can we build together blueprints that are scalable and sharable to solve a given problem uh one of the projects that came out with VOD antivir virus outbreak detection Network in in Africa uh where more than 14 countries are participating in it which is fantastic to share data and and prepare on these kind of things so that seems to be
(27:05) working because you have people that bring technology connectivity uh clinical data uh money and so forth so it's a given problem um that we try to solve with different capabilities around it and then the other thing um is also working with the Philips Foundation uh which has an investment group where we invest in Social entrepreneurs I saw one of them in the room here um because social entrepreneurs really have this strive I think they can build or contribute to what said bottom up basically in these countries build
(27:31) resilient systems and ecosystem not making them the countries more dependent on the systems on on on aid from Forum but but really building it what up let me stop yeah the impact investing angle um all right so let's open it up for a couple of questions please uh raise your hand and my um lovely colleague will come around and we'll get a couple of questions in sure so thank you very much for your uh for your thoughts and insight on this very really really good to hear especially your experiences I'd like to ask a little bit
(28:08) about patient or just individual education regarding health care uh resilience and Equity us doctors know that when someone is educated or have a better understanding of the condition that they they're facing or they could face they have a better appreciation of it they're more likely to be compliant they're more likely to take measures either preventative or or secondary care after they've got the the uh the condition what has been your experience with with that in your communities and what would you Advocate and what
(28:40) evidence do you have that that helps and works I think it's incredibly important to and you know I teach medical students in residents and oftentimes when they're discharging a patient you shall you use all this medical jargon and then just kind of print out their 20 Page discharge summary and just give it to the patient oh yeah buy it you really expect they're going to like do what they're supposed to do and so I think it's important that the healthc Care Community actually thinks about organizational health literacy and take
(29:12) the onus off of the patient we're supposed to be I went into healthc care because I want to serve right not because I want people to understand all my medical jargon so I think the onus is on the Health Care Community to actually be able to simplify their language and make sure it is our duty to make sure our patients understand what their disease is how they can prevent PR progression I would also say um I'm an African-American woman um during the cover response I was on TV just about every single day while I was also
(29:43) practicing in the emergency uh Rome in the city of Detroit and it is not lost on me and my patients still there are you Dr J know that was Dr J Michigan it's not lost on me how important it was to the city of Detroit which is 80% African American that there was an African-American physician on TV every day talking about vaccines and you know get the test and we're not trying to kill you it was incredibly important and I've had patients tell me I didn't care what those other people were saying on TV I knew that you were one of us and I
(30:16) trusted you and that's why you know I wore my mask and I think you saved my life and my family's life and you decrease my anxiety and it's not about me it's about what I represented when I was there and so the messeng is incredibly important and I would say that in the United States we have a real problem with lack of diversity in our Healthcare uh Workforce which we need to also think about not just Physicians I can go on and on but community health workers nurses we need to think Beyond The Physician Workforce and think about
(30:45) the entire Healthcare Workforce and what that means when it comes to educating our patients can I add to this um that was a very good question and uh that's that's perfect I totally agree it's Wonder when you can prepare your communities your students your patients but also we have to remember that very often the resilience is formed when you something bad happens the turbulent times happen you do not have time to think through to prepare yourself and you have to start acting immediately and that's your ability to adapt your
(31:20) flexibility that's your internal resources uh external resources and that's when the Partnerships come together that's when the motivation and inspiration come together and of course the practice and the model I totally agree with you that it's very important the messenger is very important and people do tend to trust if the messenger is one of them that's I I've heard this every way in Ukraine and uh all over post Soviet um Union that that's the total uh truth but I just want us to remember that sometimes often we cannot
(31:54) prepare for that and I just want to say because it's this week and Davos and if we don't mention AI before the end of this panel I think we all spontaneously combust um I want to say you know I I I see some folks that I was speaking with this morning about Ai and Healthcare I came to Davos last year as an AI skeptic um and I'm now much more middle ground and I think there are targeted places where it can be incredibly useful I think this is one I think we can train Physicians you and I can beat our heads against the wall about telling people to
(32:22) talk to patients in a way that makes sense that they understand the reality is is that we just don't do a good job of that so I've seen really promising work on translating discharge instructions or really complicated health information into a fifth grade reading level which is probably the level that many of our patients um are at and so I think that there are solutions that can be integrated that can be helpful um and someone make sure we talked about AI at least once good afternoon my name is Dr sfia George I'm president of the University
(32:55) of the Virgin Islands and so one question I had great Channel by the way is what do the Colombians call those care blocks in Spanish just so I can get a context around how you were able to um destigmatize it and then I know that Cuba has some similar supportive preventive um Healthcare models um similar to what was discussed uh having in Bogota so my other question that leads me to then is tell me a little bit about your thoughts on accountability of healthc care providers in this country I'm a healthcare provider myself so not
(33:28) throwing in any shade as well as accountability for those payers insurers um states countries and not just patients I know patients have their part to do but they're also barriers as we all know and then you mentioned the partnership and the framework that you're using which with Robert Johnson Foundation which is essentially about creating a culture of Health which I'm a fan of so how do we do all our part across the globe in creating a better culture of Health in Partnership and what other strategies what we think
(34:00) about in helping to create that culture of Health too well maybe a different perspective I happen to be also engaged in the metropolitan region and in the Netherlands the Metropolitan region of Amsterdam um so it is a different setting but in terms of trading culture of Health one of the things that we have worked with uh between Academia the heads of the universities are part of the between civil Society the governments and businesses to really think about what do we want the city to look like in 20 years from now and we
(34:35) have come to the conclusion that GDP is an awfully bad measure for that so agreeing on uh on a common understanding of broad welfare including healthare and setting specific targets and saying okay we want to ensure that average Health INSP expectancy is increased with at least two quality adjusted life years across the city and then working backwards what does it mean how do you translate it into preventative program what can we do on cardio care in that space how can you use technology but how can you use also existing um social
(35:03) networks organizations to incre increase he literacy and so I think that's that's an approach that brings to together let's say a lot of Engagement and interest from different groups but also provides a little bit of a top- Down framework for accountability and keeping track on it and providing let's say political cover and an economic interest where um that is normally caught up in just uh in GDP fing May I'll just add um having worked for in the US a paay in the past I would say that unfortunately the US Health
(35:38) Care system is a for-profit it's a business right and so payers will do those things that help them be profitable and if it it often it can be related to health but if the health the improved Health outcome is not related to making money then the accountability is not there so I would say that we need to to hold payers accountable than folks like in the United States CMS that kind of overseas Medicaid Medicare largest insur in the country needs to um and we won't get into current politics here but should really be thinking about how do
(36:13) we hold the broader Health Care System accountable for identifying and decreasing disparities what if payers didn't get paid if they were in a community for a certain amount of time and the health care outcomes for the broad community did not improve what what would that mean right and so I think there's a lot that uh a big role that government has to play to hold uh organizations accountable particularly in the United States hi everybody Josh Ren from Good Life Rwanda also our Rwandan citizen actually uh just two things I wanted to
(36:47) address I mean one is yes rwanda's done an amazing job on its Public Health Care system and now today we actually have a different problem we have people who are starting to earn money in the private sector and they're leaving the Public Health Care system and getting lower quality Care in the private Health Care system and that's something we're trying to address and then Craig just to your point um you are absolutely right Rwanda did everything correctly and the US government decided to put travel restrictions on Rwanda which it actually
(37:18) ratcheted down just a couple weeks ago but still if you go on the US State uh Department website it'll say if you're traveling to Rwanda beware of marberg so it's really difficult as Dr J noted not to bring politics into this because politics are impacting this politics are impacting Equity around the globe and when countries do everything correct and then get knocked down and have their tourism industry impacted um that has further public health impact so anyway thanks for shining a light on Rwanda well thanks for putting that and Jos all
(37:52) your work that I know you've been doing um in Rwanda for a long time you point out the Rwanda Le in how the US did come out and actually I was quite impressed with the US's reaction this time because two years ago I yelled at the White House for doing something different in that they came out with travel restrictions on Uganda without at the same time saying this is also what we're doing in the country to help I said if you're going to do one you need to do the other and we saw what happened then there was an attempt to try to cover up
(38:19) cases for quite some time we weren't getting the transparency look what's happening right now in Tanzania a week ago there was reports of aarberg outbreak and then there wasn't and now um the head of the who is not only having to manage the US withdrawal but is trying at the same time to COA the Tanzanian government for exactly this reason tour tourism is a massive part of this countries are not stupid look what happened to South Africa the day after the Omicron variant was reported hundreds of millions of dollars
(38:49) were impacted for no good reason we know that at this point covid was the Omicron variant was brought into the African continent more than it was exported out because it was in places like London it was in Brussels places that weren't affected by travel bands the way that we think about and externalize threats that's coming from people in places over there while undermining our own health systems um is the shest way to continue to remain unprepared pulling out of transnational organizations I work for Doctors Without Borders I have no
(39:20) shortage of problems with the World Health Organization but let me tell you do we need it more than I think people are are are unfortunately going to recognize the next couple years so thank you for pointing that out we need to think about what are the lessons from Randa and this is where everywhere I go I say rwanda's not perfect there were actually some issues with the way the outbreak was managed with the survivors but like it's not going to be perfect but we need to we need to highlight these wins there are very few of them
(39:44) and very often we Overlook them in places when they go well because no one in the US had to worry about it it wasn't splashed across the front pages of the New York Times that we have marberg in New York City whatever it is people don't worry people don't know the Stak so thank you for pointing it out well that went by fast quickly uh I have one last question for our panelists and I think of all of us as stewards of our health care System we all live in communities we're part of countries what happens in one side of the world we're
(40:10) all interconnected we saw that with covid-19 and so I don't think the onus of building resilient Health Care System systems rests on our our Healthcare infrastructure I think it rests on all of us and so a question for you all and Natasha maybe we'll start with you is as we as we uh end this session final thoughts on on how do we continue to prioritize resilience we know more crises are coming unfortunately climate change is coming but any parting thoughts or advice um as we as people go back to their own communities and
(40:40) building resilience I I would say that's okay it's working thanks I would say we uh stick together and we work together we continue to inspire each other and motivate each other and pay atten ention to the uh most urgent needs of our own communities and also if we can help other communities we reach out to them as well and go there and I think the question is how willing are we to get out of our comfort zone and I think that's what all of us should do the more we get out of the comfort zone the better the world would
(41:21) be I'll just quickly say resiliency requires respect respect for others respect for this issue of equity it means more than just a tagline at Davos um to go back to my earlier example of Abola there are two approved Abola treatments neither of which I received because they didn't exist um the US has put 750 million into the development of two treatments that now exist um one is owned by regeneron one is owned by ridgeback they have the full licensing they sit in the United States strategic National stockpile so anytime that there
(41:50) is an ebola outbreak countries have to go begging and pleading to the United States government as opposed to there existing a stockpile like there is for a of vaccines so we need to think about resiliency requires respect respect to say we're including people in this respect to say when people need us and need the resources that we have developed that we're willing to share with them not asking people to come to us to beg for them yeah I think that's a NE deeply human thing that both of you pointed out uh let me add to that not because I
(42:20) think it's more important but I think it can help uh technology can also help indeed but only if it's um The Innovation is not in technology itself needs to be developed with the communities with the practitioners in the field to be meaningful and then it can help to increase resiliency of the system and supporting the people that are actually connecting and facing it every day thank you I think it's a similar theme here I would say whoever you are whatever organization whatever title you have when you go back to your
(42:47) office ask yourself the question how is my ego showing up in the work that I'm doing it could just be your next meeting do you actually have to be at the head of the table a meeting do you have to because you have the money or whatever do you have to be the lead of the whatever the thing is that you're trying to roll out ask yourself that question how is my ego showing up in this next meeting let alone your big program okay and the next thing is ask yourself the question what group is being left behind just pause you don't even have to do
(43:18) don't make it a big thing just ask yourself the question what group might be left behind in the work that I'm doing I don't care if it's AI whatever the program is who's been being left behind I think we're not even pausing to even think about it and ask ourselves a question if we just started with that I think we'd see more progress all right well thank you everyone if you can help me um thank our wonderful panelists [Applause] um so we will have a short break now for 15 minutes um there was a comment made that how do we not talk about AI at a
(43:55) davo session but we have four we the next session focused on technology uh and we'll have plenty of opportunity to talk about that so we're on a break for 15 minutes thank you everyone