Sandra Buttigieg, Associate Professor and Head, Department of Health Services Management, Faculty of Health Sciences,
University of Malta
In your opinion, what should the priorities be for Biovision this year? What are your main expectations?
Biovision has identified Academia, Civil Society, Policy Makers and Private Sector as the major stakeholders, that when brought together can provide more clarity and less chaos when formulating strategies for health. Biovision’s priorities should be to bring the different stakeholders, sectors, professions, scientific and non-scientific communities together to identify challenges facing health today, be able to debate on which challenges to prioritise, and identify convergent, as well as divergent viewpoints. Advances in medicine has led to a strong belief that technology is the solution. There are of course cases where technology has its pure and clear value — better imaging (e.g. PET-CT scans; new generation MRIs), better surgery (e.g. keyhole), better tests (e.g. rapid test kits). However, this is just the means to an end…the end being optimal quality in healthcare delivery across disciplines and sectors. Unfortunately, the traditional disciplines often think in silos and not in systems terms. For example, across Europe we see hospital key performance indicators showing that people do not get discharged in a timely manner from hospitals. Now the disciplinary approach is to blame the hospitals for bad management and inefficiency and the technological solution would be to have better processes/software/more rapid tests, etc. But experiences across countries are now revealing that the problems are far more complex…when you start digging a bit deeper it is revealed that there aren’t any alternatives for people to go to — not enough care home beds, not enough family support, not enough home care, not enough social workers, etc. Hence, what seems to be at first sight a health care management problem starts to show structural deficiencies in social care provision as well as societal problems in that people are isolated and often need to rely on such services 100%. Consequently, a systems-based, integrated approach is needed which goes far beyond traditional medicine. I therefore expect lively exchanges, which if well moderated can lead to fruitful discussions and plans.
• “To act and interact” marks an evolution in the format of the Biovision conference. In what way could this change the nature of Biovision’s contributions in global health?
There should be convergence of terms/constructs used by different professions with somewhat similar aims. Terms such as Global Health, Planetary Health and One Health are used, often by disciplines leading to different actions. Do these have the same aims? Are they reinforcing each other? or are they hindering each other? This will help actionable solutions to be planned and implemented across sectors, disciplines and communities. Finally, I expect that environmental science, scientists, planners etc. to be involved in the processes otherwise we cannot define the initiatives as One Health. Indeed, One Health provides the ideal platform for collaboration between Human Health, Animal Health, Environmental Health and Ecological Health. One Health goes beyond Antimicrobial Resistance, and would involve traditionally public health issues example Obesity, nature based solutions, human-animal bond benefits, food safety, security and many more issues. Therefore, it may be limiting to discuss GH to OH based on AMR, albeit an enormously crucial issue with which society is still struggling.
• Do you believe that creating a more collaborative setting for this meeting of global health stakeholders would increase the impact of the Call to Action?
The Biovision Forum is in a perfect position to emphasise the importance of shared leadership and transdisciplinarity in the quest for translating innovative ideas into actionable solutions for the benefit of citizens. This means that disciplines and professions need to move out of their comfort zones and share knowledge, expertise, skills and experiences to solve complex ‘wicked’ problems for example Obesity, Cancer, Zoonoses, Emerging infectious diseases, Antibiotic Resistance etc…Moreover, transdisciplinarity would mean involving not just the different disciplines and therefore the scientific community but also the non-scientific communities as well.
• In terms of new and emerging driving forces of innovation, what place is there for entrepreneurs in health systems? Which means do they have to be innovative?
Since the 2008/2009 financial and economic crisis, we often debate about resilience of health systems and sustainability of health systems. For these to be ensured, we need innovation — often simple forms (Example check lists, Electronic case summaries etc…) have revolutionised health care alongside more sophisticated ones like genomics. We need to be smart in the way we use the limited resources we have while embracing new technologies. So yes, there is a place for people with entrepreneurial mind-sets in healthcare. Innovation should also embrace the disruptive forms which may assist in saving money and ensure better accessibility. Additionally, the end-users of technologies must be at the origin of the need for technological development and action, and therefore innovation should be truly transdisciplinary and not just interdisciplinary in order to promote economic activity.
