October 20, 2021: “ViiV Healthcare announced the release of Achieving health equity: a roadmap to eliminating disparities, a new report conducted by Economist Impact, a division of The Economist Group, that explores the opportunities that could be created by eliminating health disparities in the UK and US over the next 20 years, while charting a bold course for unified action.
The report, sponsored by ViiV Healthcare, the global specialist HIV company majority owned by GlaxoSmithKline plc (GSK), with Pfizer Inc. and Shionogi Limited as shareholders, breaks from previous efforts by laying out a roadmap that identifies the role of individual groups in achieving health equity and describes the concrete actions they can take to address disparities.
Healthcare disparities are defined as avoidable and unfair differences in the health of people or particular groups that negatively impact their quality of life and life expectancy. Research has shown that clear disparities exist in relation to HIV and other sexually transmitted infections (STIs), mental health, and COVID-19, and are often connected by broader overlapping social factors.
The report, which focuses on these three disease areas, explores the opportunities that eliminating health disparities over the next two decades could create and what actions are needed to achieve it in the United States and the United Kingdom – two countries with wide-ranging and ongoing health disparities in spite of radically different health systems.
Insights in the report were gathered from desk research and a literature review, followed by in-depth interviews with a range of academics, HIV experts, and other key stakeholders.
“The COVID-19 pandemic has further exposed and intensified existing health disparities, while also serving as a wake-up call to leaders, health systems, and other stakeholders to the threat that disparities pose to individuals, communities, and society,” said Vanessa Apea, Consultant Physician in Genito-urinary and HIV medicine and Research Lead for Sexual Health, Barts Health NHS Trust, who was interviewed for the report.
“Right now, these leaders know that people don’t have access to the same healthcare based on where they live, how much money they make or the colour of their skin – what we are missing is cohesive action.
This report provides a roadmap for that action, so that we can move forward from discussing disparities to implementing real change that will improve health equity.”
This report revealed several key findings that provide the motivation and the pathway for action on health disparities:
- Disparities in care are avoidable, unfair, and cost us all: Disparities create unfair economic and social circumstances for individuals, communities, and societies alike.
They create fragility and add instability to health and social systems.
- Addressing health disparities must be an urgent moral, social, and economic priority that is reliant on a shared vision: Without action, any meaningful progress on societal health and economic goals is at risk and will remain vulnerable to global health threats like COVID-19.
A shared, forward-looking vision that shows us what achieving health equity looks like is critical to success.
- Stakeholders and systems can either perpetuate or combat disparities: Inaction can be as powerful as action.
This research lays out a clear route for various stakeholders to contribute to the pursuit of health equity, and systems for accountability and measuring progress.
- Systems are slow to promote equity because they are often incentivised not to: Incentives for health and social care are often set up to perpetuate disparities in the US and UK. A greater focus on performance and targets centred on equity, stakeholders and systems would be more likely to both reduce disparities, achieve efficiency, and positive health outcomes.
Keith Rawlings, Senior Medical Director at ViiV Healthcare, said: “If we’re going to be successful in our goal of ending the HIV epidemic, a disease that is defined by inequality, it’s essential that we focus on more than just the development of innovative medicines.
We must also take a holistic approach towards reducing the disparities encountered by the many communities that are disproportionately impacted by HIV and focus on how society can take action to address them and achieve health equity for all.”
ViiV Healthcare supports Economist Impact’s recommended roadmap to achieve health equity by 2040, as prioritised by the following actions:
- Restructuring the health system to prioritise prevention for both physical and mental health: Healthcare systems are often rewarded for sticking to the status quo – a focus on treating the sick, rather than preventing illness, which contributes to worse outcomes. Payment models should prioritise prevention, equity, and sustainability in car and health systems should develop better reimbursement programs to make preventative care a priority.
- Reimagining investment beyond the upfront cost: Health systems end up spending more in dealing with the consequences of disparities than eliminating them in the first place.
Investments in health systems and individual communities should be examined over longer periods of time while developing better measurements of success to understand the social, health, and monetary value of eliminating disparities.
- Making practical changes that improve collaboration: Individuals can make a difference, but their impact alone is limited without the ability to share information with others.
Practical changes that improve collaboration, like improved data sharing practices, more efficient referral processes, and better communication between initiatives and health providers could help prioritise and realign goals around improving equity.
- Improving our knowledge of how to best reach certain populations: Many health systems continue to use largely unchanged, outdated methods to engage stakeholders or rely on community partners to pick up the slack.
Incorporating new best practices from outside the health sector in planning and organisational structure could expand the current knowledge of how to best reach key populations.”