Franco Sassi, Professor of International Health Policy and Economics, talks to Charlotte Whitelaw about the increase of chronic diseases in high-income countries, the launch of the new Centre for Health Economics and Policy Innovation (CHEPI) at Imperial College Business School, and developing a global health innovation index for every country in the world.
Your presentation at the Science20 Dialogue Forum in March was all about the economic impact of disease in G20 countries. How does this tie in with the work you’re doing at the new Centre for Health Economics and Policy Innovation?
In G20 countries, infectious diseases have almost disappeared in the last 20 years. But chronic, non-communicable diseases are on the rise. I explored the cause of this increase, and what governments can do – what types of policies can they put in place to address the consequences of chronic disease?
Chronic diseases particularly affect older people, but they are also becoming a problem for younger people entering the workforce. Chronic diseases are a burden on healthcare systems, because they require significant expenditures to treat and diagnose. They are a burden on the economy in general, because they are associated with poor labour market outcomes – people suffering from chronic disease are less likely to be employed, and those in employment take more days of sick leave, are less productive, and earn lower wages.
What determines the burden of chronic disease? Our research tells us that the causes are mostly behavioural – excessive alcohol consumption, tobacco use, poor nutrition, obesity, and a lack of physical activity. But these behaviours are clearly not just a result of individual choices – they are also the result of the influences people are subjected to in their environment, which make a major difference in the decisions they then make in their daily lives.
Governments can address these issues and potentially improve population health by implementing effective policies that are also extremely affordable – costing a fraction of what G20 countries are spending on healthcare today. This discussion will be a primary focus of our conference, and our ongoing work at the Centre for Health Economics and Policy Innovation.
How did the Centre for Health Economics and Policy Innovation come into fruition?
We established the new research Centre within the Business School to build on our existing and longstanding work on health economics, policy and management. This research area is by nature very multi-disciplinary, so we wanted to leverage the strengths of Imperial College – a strong business school closely linked with a school of medicine, school of public health, and natural science faculties – and horizontally harness this research capacity to focus on the major health challenges facing society today, which cut across different areas of government policy and business.
What do you hope it will achieve?
By bringing together academics who work on very different aspects of health and healthcare issues, we will produce an analysis to help governments worldwide make better policies in health and healthcare improvement. It’s not just a healthcare issue; it’s about improving all aspects of government policy that impact on population health.
We are developing a global health innovation index – one of the centrepieces of our work at the Centre. This index will measure and take into account the number of dimensions and parameters reflecting a country’s ability to innovate in public health and healthcare, and we will calculate this index for every country in the world. This will enable policymakers to understand where their country fits in terms of innovation capacity, relative to other countries.
The Centre launches on 31 May with the conference New Frontiers in Health Policy: Innovation and Incentives in Public Health and Health Care. What’s on the agenda?
The conference will give an idea of the breadth of the work that the Centre covers. Broken into three main sessions, the first will focus on innovation – in healthcare, and specifically in the pharmaceutical sector. Ministers, leading policy makers and academics will discuss the factors that may enable – or present barriers to – innovation in different countries. What we can do to improve the rate in which these countries innovate, and the way they deliver healthcare in their unique settings?
The second will take a broader perspective on health improvement – focusing on maintaining good health, rather than treating diseases when they occur. We’ll be examining issues typical of high-income countries, including UK-based research on the health impacts of air pollution, and how we can address these impacts. We will also examine European research on the determinants of chronic diseases, how European countries can address their expected growth, and effective policies that will prevent a heavy burden of chronic diseases in the future.
A panel of experts, including a senior representative from the World Health Organisation, will also discuss global-level research that focuses on lower-middle income countries, using big data approaches to see which determinants have the biggest impact on health.
The final session will focus on incentives. Speakers from the World Bank, the Global Fund, and senior academics from various universities will address how governments can provide more effective incentives for healthcare providers to improve the efficiency and quality of healthcare.