In conversation with Heba Fouad, regional advisor for NCD surveillance, monitoring and evaluation, WHO Regional Office for the Eastern Mediterranean.
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Health
Undetected and undertreated: shaping policy on atrial fibrillation in Saudi...
Among the diseases referred to as silent killers, atrial fibrillation (AF) is an increasingly important public health problem, with incidence expected to double over the next three decades. The global incidence of AF has increased by approximately 30% over the past 20 years, and more than 37m people are estimated to be living with AF, significantly impacting health, mortality risk and quality of life.
Patients with AF are at higher risk for concurrent stroke, heart failure, hypertension and other cardiovascular diseases. Owing to its asymptomatic presentation in a significant proportion of patients, approximately 30%, many people with AF currently go undetected and therefore untreated, with potentially lethal consequences.
The complex interplay between AF and other underlying and comorbid conditions makes the actual burden of AF difficult to untangle. For example, AF accounts for 25% of the global stroke burden. Approximately 20% of patients who experience a stroke associated with AF are first diagnosed with AF at the time of the stroke.
Undetected and undertreated: shaping policy on atrial fibrillation in Saudi Arabia is an Economist Impact report, supported by Johnson and Johnson. The report explores the burden of atrial fibrillation (AF) in Saudi Arabia, particularly key barriers to care across current patient pathways and the local policy environment. The report also presents best practices in AF prevention, screening, diagnosis, treatment and management relevant to Saudi Arabia, and assesses how stakeholders in the Kingdom can work together to enhance awareness, prevention and control of AF.
The rising tide of AF in Saudi Arabia
Saudi Arabia is confronting an epidemic of chronic disease with alarming rates of obesity, hypertension and diabetes—all significant public health problems and risk factors for AF. This, combined with a rapid growth in the older population means that AF will continue to be a major disease in Saudi Arabia in the next 20 years. The high prevalence of chronic disease may explain the earlier onset of AF in the region. Increasing age as a risk factor for AF is especially critical for a country like Saudi Arabia, where the population aged over 65 is projected to increase by almost 600% over the next two decades, from over 1m in 2023 to 5.7m by 2040.
The Saudi healthcare sector is undergoing extensive reforms in line with the country’s Health Sector Transformation Programme, as part of Vision 2030, the country’s national development plan. Identifying the prevalence of non- communicable diseases in the country as a major public health concern, Vision 2030 explicitly targets the management of heart disease, stroke and diabetes.
The following key takeaways and proposed solutions are intended to guide successful policy implementation and long-term action on AF in Saudi Arabia, ultimately improving AF prevention, diagnosis and care, and enhancing quality of life for AF patients.
Data and Research: Maintain and expand AF patient registries and prioritise AF and CVDs as part of the national research agenda.
Primary and secondary prevention: Prevent the onset and progression of AF by way of lifestyle intervention, education campaigns, early detection through increased clinical awareness and effective management of comorbid chronic conditions.
Early detection: Determine appropriate guidelines for AF detection and screening unique to the population demographics, health system capacity, and financing structure.
Care pathways: Standardise care pathways through adopting an integrated model of AF care with an established referral system and raising awareness of AF among diverse medical disciplines.
Digital: Prepare the health system to adopt emerging digital health technologies, leverage electronic health records (EHRs) to support population screening and monitoring and expand equitable access to AF care through telehealth.
Patient Engagement: Engage patients in treatment decisions and empower them with the tools to proactively manage their condition and ensure higher treatment adherence.
Do no harm: Healthcare professionals address sustainability and climate cha...
In a survey of hospital doctors and nurses in France, Germany and the UK, many agreed they need to better prepare patients and adapt their healthcare systems to be more sustainable.
Executive summary
Healthcare professionals (HCPs) are actively treating an increasing number of patients affected by climate change factors. But healthcare facilities, activities and supply chains are a large contributor to climate change, unintentionally reinforcing the very problems they aim to solve. In total, healthcare represents 4-5% of total global carbon emissions.
Fortunately, the healthcare sector is starting to understand the significant role it can play in decarbonisation efforts to better protect patients and the planet from climate change. How then, can healthcare move forwards in the best interests of its patients and the planet?
This topic is gaining traction across Europe, and globally. At COP26 in Glasgow in 2021, the Health Programme was extensive. Proposals to build climate resilient and low-carbon, sustainable health systems were presented. Initiatives were raised around research for healthcare adaptation and inclusion of health priorities in Nationally Determined Contributions. Raising the voice of HCPs as climate change advocates was also highlighted.
To bring new insight to this conversation and help decision-makers navigate the big issues, Economist Impact, with sponsorship from Johnson & Johnson, spoke with subject experts and surveyed hospital doctors and nurses in three major carbon-emitting countries in Europe—France, Germany and the UK. They shared their perspectives on how healthcare systems and professionals can play a role in decarbonisation and better support patients.
The results highlight a passionate reaction from HCPs, who are deeply concerned about the growing impact of climate change and eager to see sustainability rise on the agenda in their workplace and at a national level. Additionally, interviews with senior experts shed light on priority issues, and how healthcare bodies can better overcome common roadblocks.
Notable findings include:
HCPs say they want to educate patients about climate change—but first, they need more education themselves. When asked what personal responsibility they’d like to take around sustainability, most selected the role of educator to patients around sustainable lifestyles (33%) and various climate risk factors (25%). However, sustainability education is not part of HCP’s core responsibility, so it is unsurprising that others expressed that they lacked the time and resources (12%) and education (9%) to do this effectively. Most (74%) said that thus far they have not been supported in green literacy efforts.
HCPs might be more proactive if they had more support and incentives. On the theme of personal responsibility, following educating patients, HCPs gave a moderate response to taking proactive personal responsibility. For example, 18% said they would like to help redesign clinical pathways to be more sustainable. This is disappointing, as HCPs can be a powerful force in addressing the climate footprint of their practice across all emission areas. To change this, particularly in areas where national plans are absent, incentives and a greater sense of empowerment and support will be needed, ideally coming from their employers.
Small changes add up, and the healthcare ecosystem will transform. To reach zero carbon emissions (net zero) across the value chain of hospitals, change needs to happen at every level. Several experts we spoke with are calling on HCPs to push for sustainable changes in clinical pathways, models of care, the types of prescriptions they give patients and beyond. To reach ambitious sustainability goals, the system will be much different than it is today—and nobody is quite sure what that outcome will look like.
Healthcare systems protect patients but are also major producers of carbon. In our survey, hospital doctors and nurses confirmed that they are already seeing patients impacted by climate change factors, and they expect to see a rise in those visits in the decade ahead. Yet the European region’s healthcare system produces nearly 5% of the region’s carbon footprint. Making healthcare systems more sustainable is now paramount to reaching national net-zero goals and to the wellbeing of populations.
Emissions need to be addressed across healthcare’s entire value chain. There is a collective rise in consciousness around the issue of sustainability in healthcare, but much of the attention is landing on Scope 1 and Scope 2 areas (direct emissions and indirect energy). When asked to identify priority sustainability areas in their practise, only about a third (31%) of healthcare professionals in our survey name Scope 3 (medical supply chain). However, Scope 3 is where the bulk of emissions come from. Education is needed to raise collective awareness of all emission sources and how they can be jointly reduced.
National plans to address the system’s sustainability vary across Europe. Of the three countries studied for this report, only the UK has a detailed plan for reaching net zero in the healthcare sector. Germany and France lack commitments and roadmaps for this. Even so, grassroots actions may be under way, as many (63%) HCPs surveyed are aware of some form of sustainability plan in place or soon to be in place at their hospital. Still, HCPs are sensitive to direction from above, and the absence of national plans (other than in the UK) is likely delaying progress.
Conclusion
Big, systematic change is time-consuming and often slow. And health services are already resource constrained. But there is no time to wait. The climate emergency is only worsening.
Our survey confirms that HCPs are already aware of the impact of climate change on the health of the populations they serve. However, they would benefit from:
More information and more support at all stages of their educational and employment journey to better understand the risks to their patients.
Help and support in putting advocacy into practice in their healthcare institutions or clinical settings.
Support for proposed changes to clinical pathways that can help reduce any unnecessary medical production and waste in patient treatment and long-term care.
From a clinical perspective, further evaluation to support mitigation and adaptation initiatives is required. This includes:
Establishing an evidence base to support any changes to clinical activities and ensure that there is no ambiguity that doing the right thing for the climate is also the best thing for the patient.
Understanding how clinical practices could change to help patients and especially target vulnerable groups (eg, elderly and chronically ill people) adapt to climate risk.
Out of the three European countries assessed (France, Germany and the UK), only the UK is showing leadership in measuring healthcare emissions and setting targets. For further effectiveness, healthcare systems need to:
Measure their emissions on a regular and systematic basis (including indirect Scope 3 emissions from the supply chain, a major contributor).
Bring in well-thought-out activation plans with key roles specified for HCPs, consider resourcing changes with local healthcare sustainability leaders, and transforming industry production lines and supply chains.
Methodology
This research was undertaken in three phases, starting with a literature review of how healthcare systems in France, Germany and the UK are responding to climate change and the role of healthcare professionals (HCPs), followed by a survey of 75 doctors and 75 nurses working in hospitals in France, Germany and the UK in February and March 2022. We also interviewed experts from government, hospitals, medical professional associations and NGOs to build on the research and shed light on our survey findings.
Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
In conversation with Adel Alhazzani, vice-president of MENA Stroke Organization; professor of neurology, consultant and vascular neurologist, Neuroscience Center, Section of Neurology, King Faisal Specialist Hospital and Research Center, Riyadh.
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Health
Undetected and undertreated: shaping policy on atrial fibrillation in Saudi...
Among the diseases referred to as silent killers, atrial fibrillation (AF) is an increasingly important public health problem, with incidence expected to double over the next three decades. The global incidence of AF has increased by approximately 30% over the past 20 years, and more than 37m people are estimated to be living with AF, significantly impacting health, mortality risk and quality of life.
Patients with AF are at higher risk for concurrent stroke, heart failure, hypertension and other cardiovascular diseases. Owing to its asymptomatic presentation in a significant proportion of patients, approximately 30%, many people with AF currently go undetected and therefore untreated, with potentially lethal consequences.
The complex interplay between AF and other underlying and comorbid conditions makes the actual burden of AF difficult to untangle. For example, AF accounts for 25% of the global stroke burden. Approximately 20% of patients who experience a stroke associated with AF are first diagnosed with AF at the time of the stroke.
Undetected and undertreated: shaping policy on atrial fibrillation in Saudi Arabia is an Economist Impact report, supported by Johnson and Johnson. The report explores the burden of atrial fibrillation (AF) in Saudi Arabia, particularly key barriers to care across current patient pathways and the local policy environment. The report also presents best practices in AF prevention, screening, diagnosis, treatment and management relevant to Saudi Arabia, and assesses how stakeholders in the Kingdom can work together to enhance awareness, prevention and control of AF.
The rising tide of AF in Saudi Arabia
Saudi Arabia is confronting an epidemic of chronic disease with alarming rates of obesity, hypertension and diabetes—all significant public health problems and risk factors for AF. This, combined with a rapid growth in the older population means that AF will continue to be a major disease in Saudi Arabia in the next 20 years. The high prevalence of chronic disease may explain the earlier onset of AF in the region. Increasing age as a risk factor for AF is especially critical for a country like Saudi Arabia, where the population aged over 65 is projected to increase by almost 600% over the next two decades, from over 1m in 2023 to 5.7m by 2040.
The Saudi healthcare sector is undergoing extensive reforms in line with the country’s Health Sector Transformation Programme, as part of Vision 2030, the country’s national development plan. Identifying the prevalence of non- communicable diseases in the country as a major public health concern, Vision 2030 explicitly targets the management of heart disease, stroke and diabetes.
The following key takeaways and proposed solutions are intended to guide successful policy implementation and long-term action on AF in Saudi Arabia, ultimately improving AF prevention, diagnosis and care, and enhancing quality of life for AF patients.
Data and Research: Maintain and expand AF patient registries and prioritise AF and CVDs as part of the national research agenda.
Primary and secondary prevention: Prevent the onset and progression of AF by way of lifestyle intervention, education campaigns, early detection through increased clinical awareness and effective management of comorbid chronic conditions.
Early detection: Determine appropriate guidelines for AF detection and screening unique to the population demographics, health system capacity, and financing structure.
Care pathways: Standardise care pathways through adopting an integrated model of AF care with an established referral system and raising awareness of AF among diverse medical disciplines.
Digital: Prepare the health system to adopt emerging digital health technologies, leverage electronic health records (EHRs) to support population screening and monitoring and expand equitable access to AF care through telehealth.
Patient Engagement: Engage patients in treatment decisions and empower them with the tools to proactively manage their condition and ensure higher treatment adherence.
Do no harm: Healthcare professionals address sustainability and climate cha...
In a survey of hospital doctors and nurses in France, Germany and the UK, many agreed they need to better prepare patients and adapt their healthcare systems to be more sustainable.
Executive summary
Healthcare professionals (HCPs) are actively treating an increasing number of patients affected by climate change factors. But healthcare facilities, activities and supply chains are a large contributor to climate change, unintentionally reinforcing the very problems they aim to solve. In total, healthcare represents 4-5% of total global carbon emissions.
Fortunately, the healthcare sector is starting to understand the significant role it can play in decarbonisation efforts to better protect patients and the planet from climate change. How then, can healthcare move forwards in the best interests of its patients and the planet?
This topic is gaining traction across Europe, and globally. At COP26 in Glasgow in 2021, the Health Programme was extensive. Proposals to build climate resilient and low-carbon, sustainable health systems were presented. Initiatives were raised around research for healthcare adaptation and inclusion of health priorities in Nationally Determined Contributions. Raising the voice of HCPs as climate change advocates was also highlighted.
To bring new insight to this conversation and help decision-makers navigate the big issues, Economist Impact, with sponsorship from Johnson & Johnson, spoke with subject experts and surveyed hospital doctors and nurses in three major carbon-emitting countries in Europe—France, Germany and the UK. They shared their perspectives on how healthcare systems and professionals can play a role in decarbonisation and better support patients.
The results highlight a passionate reaction from HCPs, who are deeply concerned about the growing impact of climate change and eager to see sustainability rise on the agenda in their workplace and at a national level. Additionally, interviews with senior experts shed light on priority issues, and how healthcare bodies can better overcome common roadblocks.
Notable findings include:
HCPs say they want to educate patients about climate change—but first, they need more education themselves. When asked what personal responsibility they’d like to take around sustainability, most selected the role of educator to patients around sustainable lifestyles (33%) and various climate risk factors (25%). However, sustainability education is not part of HCP’s core responsibility, so it is unsurprising that others expressed that they lacked the time and resources (12%) and education (9%) to do this effectively. Most (74%) said that thus far they have not been supported in green literacy efforts.
HCPs might be more proactive if they had more support and incentives. On the theme of personal responsibility, following educating patients, HCPs gave a moderate response to taking proactive personal responsibility. For example, 18% said they would like to help redesign clinical pathways to be more sustainable. This is disappointing, as HCPs can be a powerful force in addressing the climate footprint of their practice across all emission areas. To change this, particularly in areas where national plans are absent, incentives and a greater sense of empowerment and support will be needed, ideally coming from their employers.
Small changes add up, and the healthcare ecosystem will transform. To reach zero carbon emissions (net zero) across the value chain of hospitals, change needs to happen at every level. Several experts we spoke with are calling on HCPs to push for sustainable changes in clinical pathways, models of care, the types of prescriptions they give patients and beyond. To reach ambitious sustainability goals, the system will be much different than it is today—and nobody is quite sure what that outcome will look like.
Healthcare systems protect patients but are also major producers of carbon. In our survey, hospital doctors and nurses confirmed that they are already seeing patients impacted by climate change factors, and they expect to see a rise in those visits in the decade ahead. Yet the European region’s healthcare system produces nearly 5% of the region’s carbon footprint. Making healthcare systems more sustainable is now paramount to reaching national net-zero goals and to the wellbeing of populations.
Emissions need to be addressed across healthcare’s entire value chain. There is a collective rise in consciousness around the issue of sustainability in healthcare, but much of the attention is landing on Scope 1 and Scope 2 areas (direct emissions and indirect energy). When asked to identify priority sustainability areas in their practise, only about a third (31%) of healthcare professionals in our survey name Scope 3 (medical supply chain). However, Scope 3 is where the bulk of emissions come from. Education is needed to raise collective awareness of all emission sources and how they can be jointly reduced.
National plans to address the system’s sustainability vary across Europe. Of the three countries studied for this report, only the UK has a detailed plan for reaching net zero in the healthcare sector. Germany and France lack commitments and roadmaps for this. Even so, grassroots actions may be under way, as many (63%) HCPs surveyed are aware of some form of sustainability plan in place or soon to be in place at their hospital. Still, HCPs are sensitive to direction from above, and the absence of national plans (other than in the UK) is likely delaying progress.
Conclusion
Big, systematic change is time-consuming and often slow. And health services are already resource constrained. But there is no time to wait. The climate emergency is only worsening.
Our survey confirms that HCPs are already aware of the impact of climate change on the health of the populations they serve. However, they would benefit from:
More information and more support at all stages of their educational and employment journey to better understand the risks to their patients.
Help and support in putting advocacy into practice in their healthcare institutions or clinical settings.
Support for proposed changes to clinical pathways that can help reduce any unnecessary medical production and waste in patient treatment and long-term care.
From a clinical perspective, further evaluation to support mitigation and adaptation initiatives is required. This includes:
Establishing an evidence base to support any changes to clinical activities and ensure that there is no ambiguity that doing the right thing for the climate is also the best thing for the patient.
Understanding how clinical practices could change to help patients and especially target vulnerable groups (eg, elderly and chronically ill people) adapt to climate risk.
Out of the three European countries assessed (France, Germany and the UK), only the UK is showing leadership in measuring healthcare emissions and setting targets. For further effectiveness, healthcare systems need to:
Measure their emissions on a regular and systematic basis (including indirect Scope 3 emissions from the supply chain, a major contributor).
Bring in well-thought-out activation plans with key roles specified for HCPs, consider resourcing changes with local healthcare sustainability leaders, and transforming industry production lines and supply chains.
Methodology
This research was undertaken in three phases, starting with a literature review of how healthcare systems in France, Germany and the UK are responding to climate change and the role of healthcare professionals (HCPs), followed by a survey of 75 doctors and 75 nurses working in hospitals in France, Germany and the UK in February and March 2022. We also interviewed experts from government, hospitals, medical professional associations and NGOs to build on the research and shed light on our survey findings.
Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
In 2022 the total fertility rate in the EU was 1.46 live births per woman, far below the replacement rate of 2.1. The implications of this demographic shift are large, as it leads to an ageing population and a rising old-age dependency ratio, putting pressure on public services and countries’ economies.
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Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
Breast cancer patients and survivors in the Asia-Pacific workforce
With more older women also working, how will the rising trend of breast cancer survivorship manifest in workplace policies, practices and culture? What challenges do breast cancer survivors face when trying to reintegrate into the workforce, or to continue working during treatment? How can governments, companies and society at large play a constructive role?
This series of reports looks at the situation for breast cancer survivors in Australia, New Zealand and South Korea. It finds that while progress has been made, more needs to be done, particularly in South Korea, where public stigma around cancer remains high.
Cardiovascular diseases levy a substantial financial toll on individuals, their households and the public finances. These include the costs of hospital treatment, long-term disease management and recurring incidence of heart attacks and stroke. They also include the costs of functional impairment and knock-on costs as families may lose breadwinners or have to withdraw other family members from the workforce to care for a CVD patient. Governments also lose tax revenue due to early retirement and mortality, and can be forced to reallocate public finances from other budgets to maintain an accessible healthcare system in the face of rising costs.
As such, there is a need for more awareness of the ways in which people should actively work to reduce their CVD risk. There is also a need for more primary and secondary preventative support from health agencies, policymakers and nongovernmental groups.
To inform the decisions and strategies of these stakeholders, The Economist Intelligence Unit and EIU Healthcare, its healthcare subsidiary, have conducted a study of the prevalence and costs of the top four modifiable risk factors that contribute to CVDs across the Asian markets of China, Australia, Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand.
The country policy profiles included below for Germany, Japan, and the United States provide an overview of the current policy landscape of MASLD and MASH in each country. The profiles provide a top-level overview of the current state of MASLD and MASH care, with key policy takeaways and opportunities to enhance MASLD and MASH care in the future.
Country profiles
Germany
18313
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Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
Breast cancer patients and survivors in the Asia-Pacific workforce
With more older women also working, how will the rising trend of breast cancer survivorship manifest in workplace policies, practices and culture? What challenges do breast cancer survivors face when trying to reintegrate into the workforce, or to continue working during treatment? How can governments, companies and society at large play a constructive role?
This series of reports looks at the situation for breast cancer survivors in Australia, New Zealand and South Korea. It finds that while progress has been made, more needs to be done, particularly in South Korea, where public stigma around cancer remains high.
Cardiovascular diseases levy a substantial financial toll on individuals, their households and the public finances. These include the costs of hospital treatment, long-term disease management and recurring incidence of heart attacks and stroke. They also include the costs of functional impairment and knock-on costs as families may lose breadwinners or have to withdraw other family members from the workforce to care for a CVD patient. Governments also lose tax revenue due to early retirement and mortality, and can be forced to reallocate public finances from other budgets to maintain an accessible healthcare system in the face of rising costs.
As such, there is a need for more awareness of the ways in which people should actively work to reduce their CVD risk. There is also a need for more primary and secondary preventative support from health agencies, policymakers and nongovernmental groups.
To inform the decisions and strategies of these stakeholders, The Economist Intelligence Unit and EIU Healthcare, its healthcare subsidiary, have conducted a study of the prevalence and costs of the top four modifiable risk factors that contribute to CVDs across the Asian markets of China, Australia, Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand.
In 2024, Economist Impact convened an international Advisory Council to reach a consensus on how long Covid should be defined, understood and addressed globally. Guided by the findings of An incomplete picture: understanding the burden of long Covid, the Advisory Council set out to:
18311
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Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
Breast cancer patients and survivors in the Asia-Pacific workforce
With more older women also working, how will the rising trend of breast cancer survivorship manifest in workplace policies, practices and culture? What challenges do breast cancer survivors face when trying to reintegrate into the workforce, or to continue working during treatment? How can governments, companies and society at large play a constructive role?
This series of reports looks at the situation for breast cancer survivors in Australia, New Zealand and South Korea. It finds that while progress has been made, more needs to be done, particularly in South Korea, where public stigma around cancer remains high.
Cardiovascular diseases levy a substantial financial toll on individuals, their households and the public finances. These include the costs of hospital treatment, long-term disease management and recurring incidence of heart attacks and stroke. They also include the costs of functional impairment and knock-on costs as families may lose breadwinners or have to withdraw other family members from the workforce to care for a CVD patient. Governments also lose tax revenue due to early retirement and mortality, and can be forced to reallocate public finances from other budgets to maintain an accessible healthcare system in the face of rising costs.
As such, there is a need for more awareness of the ways in which people should actively work to reduce their CVD risk. There is also a need for more primary and secondary preventative support from health agencies, policymakers and nongovernmental groups.
To inform the decisions and strategies of these stakeholders, The Economist Intelligence Unit and EIU Healthcare, its healthcare subsidiary, have conducted a study of the prevalence and costs of the top four modifiable risk factors that contribute to CVDs across the Asian markets of China, Australia, Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand.
Thyroid disease is a major public health concern for the Asia-Pacific region (APAC), requiring urgent action. The most common form—hypothyroidism—affects an estimated 11% of adults, compared with 2-4% of adults elsewhere.
18309
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Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
Breast cancer patients and survivors in the Asia-Pacific workforce
With more older women also working, how will the rising trend of breast cancer survivorship manifest in workplace policies, practices and culture? What challenges do breast cancer survivors face when trying to reintegrate into the workforce, or to continue working during treatment? How can governments, companies and society at large play a constructive role?
This series of reports looks at the situation for breast cancer survivors in Australia, New Zealand and South Korea. It finds that while progress has been made, more needs to be done, particularly in South Korea, where public stigma around cancer remains high.
Cardiovascular diseases levy a substantial financial toll on individuals, their households and the public finances. These include the costs of hospital treatment, long-term disease management and recurring incidence of heart attacks and stroke. They also include the costs of functional impairment and knock-on costs as families may lose breadwinners or have to withdraw other family members from the workforce to care for a CVD patient. Governments also lose tax revenue due to early retirement and mortality, and can be forced to reallocate public finances from other budgets to maintain an accessible healthcare system in the face of rising costs.
As such, there is a need for more awareness of the ways in which people should actively work to reduce their CVD risk. There is also a need for more primary and secondary preventative support from health agencies, policymakers and nongovernmental groups.
To inform the decisions and strategies of these stakeholders, The Economist Intelligence Unit and EIU Healthcare, its healthcare subsidiary, have conducted a study of the prevalence and costs of the top four modifiable risk factors that contribute to CVDs across the Asian markets of China, Australia, Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand.
Cardiovascular disease (CVD) is the leading global cause of mortality, causing 17.9 m deaths in 2019 and 38% of premature deaths from noncommunicable diseases.1 Urbanisation is known to be associated with an increase in risk factors for CVD, including unhealthy diet, inactivity, smoking and alcohol use.2 With over 55% of people living in cities as of 2022, global CVD prevention will require strategies tailored for urban settings, involving the promotion of healthy beha
18267
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Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
Breast cancer patients and survivors in the Asia-Pacific workforce
With more older women also working, how will the rising trend of breast cancer survivorship manifest in workplace policies, practices and culture? What challenges do breast cancer survivors face when trying to reintegrate into the workforce, or to continue working during treatment? How can governments, companies and society at large play a constructive role?
This series of reports looks at the situation for breast cancer survivors in Australia, New Zealand and South Korea. It finds that while progress has been made, more needs to be done, particularly in South Korea, where public stigma around cancer remains high.
Cardiovascular diseases levy a substantial financial toll on individuals, their households and the public finances. These include the costs of hospital treatment, long-term disease management and recurring incidence of heart attacks and stroke. They also include the costs of functional impairment and knock-on costs as families may lose breadwinners or have to withdraw other family members from the workforce to care for a CVD patient. Governments also lose tax revenue due to early retirement and mortality, and can be forced to reallocate public finances from other budgets to maintain an accessible healthcare system in the face of rising costs.
As such, there is a need for more awareness of the ways in which people should actively work to reduce their CVD risk. There is also a need for more primary and secondary preventative support from health agencies, policymakers and nongovernmental groups.
To inform the decisions and strategies of these stakeholders, The Economist Intelligence Unit and EIU Healthcare, its healthcare subsidiary, have conducted a study of the prevalence and costs of the top four modifiable risk factors that contribute to CVDs across the Asian markets of China, Australia, Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand.
Vaccines are among the most powerful inventions in history, making once-feared diseases preventable,” declared Dr Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization (WHO), in April 2024. The latest figures reveal that vaccines have saved 154 million lives over the past 50 years.
At the same time, sustainability has risen dramatically on the sociopolitical agenda to become an undercurrent to all global development.
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Biopharma’s evolution: learnings from the pandemic for a revived regulatory...
By December 2020, several potential covid-19 vaccines were showing promise in clinical trials. And by the middle of 2021, a vaccine was available to the public. Very few people had been optimistic that such a feat could be achieved. In many ways, it was a perfect storm. The fast development of covid-19 vaccines benefited from years of previous research on related viruses and vaccine trials that used mRNA. It’s said the research matured at just the right time, and that mRNA technology would not have been ready even five years ago.
But the time-consuming part of bringing a vaccine to market is not necessarily the initial research, but everything that follows, including rigorous clinical trial testing, regulatory application approval, manufacturing and communication. On average, this takes just shy of a decade. But advanced digital tools and regulatory levers for faster approvals were at the ready, giving stakeholders the means to move at—relatively—lightspeed. The process was a whirlwind that is likely to affect regulatory practices for years to come, prompting new mindsets and applications of tools to the wider biotherapeutic landscape.
We asked experts in regions with advanced regulatory systems—the UK, the US, the EU and Japan—what happened and what changes are likely to stick. The most significant takeaways are highlighted in this report.
Notable findings include:
• Co-operation and collaboration between the industry, regulators, governments, clinical investigators, academic scientists and non-government organisations (NGOs) has been unprecedented. For many, this was seen as the most effective tool in bringing the covid-19 vaccine to market so quickly. This could set the stage for further alignment in decision-making, de-risking for research and development (R&D), and establishing plans for programmes and standards across the biotherapeutic regulatory landscape. But for this to carry forward successfully, elements of nationalism and competition need to be revisited.
• Rolling reviews and Emergency Use Authorisation (EUA) were essential tools for speed. Coupled with an all-hands-on-deck mindset from industry and regulators, processes that typically took years instead took months, and those that took months accelerated into weeks. Post-pandemic, our experts think a middle ground can be found. Where the balance lies, of course, may be conditional for years to come. Some believe that such measures may be best for crisis situations, but others feel that these efficiencies can trickle down to the wider pool of biotherapeutic therapies.
• Digital tools—onwards and upwards. Digital tools adopted in the pharmaceutical sector have soared. Decentralised and remote clinical trials, remote inspections, digital submissions to regulators, and more data-driven discovery were always likely to be part of the future, but the pandemic sped up that eventuality. Many of these tools were already there for the taking but underutilised due to concerns about introducing risk to process and regulatory approval. There’s little turning back now. Many regulators have been quick to offer guidance in these areas and show willingness to engage with industry to expand on them as needed.
• Too often, manufacturing is an afterthought. The high demand for drug manufacturing, and general shortfall of manufacturers available to produce new or additional drugs, means that, even if the rest of the pharmaceutical ecosystem sped up drug development and approvals, a bottleneck could slow time to market. Covid-19 put a spotlight on the issue, as well as supply chain challenges, and the need for flexible manufacturing procedures to allow for more parallel planning with drug development. These needs may help speed the adoption of continuous manufacturing processes, which offer more flexibility than batch manufacturing and faster delivery times.
• Global standards are in the pipeline. Operating in multiple jurisdictions often introduces all manner of complications from a compliance and regulatory perspective, as well as data standards. Consortiums of global regulators and industry bodies have long tried to harmonise standards to ease the increasing number of global R&D initiatives and streamline applications for marketing approval. Progress was slow, but it helped lay the groundwork for the global collaborations that came to light during the pandemic. This momentum, stakeholders say, has continued, helping them carry on developing for the future benefit of global efficiencies.
Do no harm: Healthcare professionals address sustainability and climate cha...
In a survey of hospital doctors and nurses in France, Germany and the UK, many agreed they need to better prepare patients and adapt their healthcare systems to be more sustainable.
Executive summary
Healthcare professionals (HCPs) are actively treating an increasing number of patients affected by climate change factors. But healthcare facilities, activities and supply chains are a large contributor to climate change, unintentionally reinforcing the very problems they aim to solve. In total, healthcare represents 4-5% of total global carbon emissions.
Fortunately, the healthcare sector is starting to understand the significant role it can play in decarbonisation efforts to better protect patients and the planet from climate change. How then, can healthcare move forwards in the best interests of its patients and the planet?
This topic is gaining traction across Europe, and globally. At COP26 in Glasgow in 2021, the Health Programme was extensive. Proposals to build climate resilient and low-carbon, sustainable health systems were presented. Initiatives were raised around research for healthcare adaptation and inclusion of health priorities in Nationally Determined Contributions. Raising the voice of HCPs as climate change advocates was also highlighted.
To bring new insight to this conversation and help decision-makers navigate the big issues, Economist Impact, with sponsorship from Johnson & Johnson, spoke with subject experts and surveyed hospital doctors and nurses in three major carbon-emitting countries in Europe—France, Germany and the UK. They shared their perspectives on how healthcare systems and professionals can play a role in decarbonisation and better support patients.
The results highlight a passionate reaction from HCPs, who are deeply concerned about the growing impact of climate change and eager to see sustainability rise on the agenda in their workplace and at a national level. Additionally, interviews with senior experts shed light on priority issues, and how healthcare bodies can better overcome common roadblocks.
Notable findings include:
HCPs say they want to educate patients about climate change—but first, they need more education themselves. When asked what personal responsibility they’d like to take around sustainability, most selected the role of educator to patients around sustainable lifestyles (33%) and various climate risk factors (25%). However, sustainability education is not part of HCP’s core responsibility, so it is unsurprising that others expressed that they lacked the time and resources (12%) and education (9%) to do this effectively. Most (74%) said that thus far they have not been supported in green literacy efforts.
HCPs might be more proactive if they had more support and incentives. On the theme of personal responsibility, following educating patients, HCPs gave a moderate response to taking proactive personal responsibility. For example, 18% said they would like to help redesign clinical pathways to be more sustainable. This is disappointing, as HCPs can be a powerful force in addressing the climate footprint of their practice across all emission areas. To change this, particularly in areas where national plans are absent, incentives and a greater sense of empowerment and support will be needed, ideally coming from their employers.
Small changes add up, and the healthcare ecosystem will transform. To reach zero carbon emissions (net zero) across the value chain of hospitals, change needs to happen at every level. Several experts we spoke with are calling on HCPs to push for sustainable changes in clinical pathways, models of care, the types of prescriptions they give patients and beyond. To reach ambitious sustainability goals, the system will be much different than it is today—and nobody is quite sure what that outcome will look like.
Healthcare systems protect patients but are also major producers of carbon. In our survey, hospital doctors and nurses confirmed that they are already seeing patients impacted by climate change factors, and they expect to see a rise in those visits in the decade ahead. Yet the European region’s healthcare system produces nearly 5% of the region’s carbon footprint. Making healthcare systems more sustainable is now paramount to reaching national net-zero goals and to the wellbeing of populations.
Emissions need to be addressed across healthcare’s entire value chain. There is a collective rise in consciousness around the issue of sustainability in healthcare, but much of the attention is landing on Scope 1 and Scope 2 areas (direct emissions and indirect energy). When asked to identify priority sustainability areas in their practise, only about a third (31%) of healthcare professionals in our survey name Scope 3 (medical supply chain). However, Scope 3 is where the bulk of emissions come from. Education is needed to raise collective awareness of all emission sources and how they can be jointly reduced.
National plans to address the system’s sustainability vary across Europe. Of the three countries studied for this report, only the UK has a detailed plan for reaching net zero in the healthcare sector. Germany and France lack commitments and roadmaps for this. Even so, grassroots actions may be under way, as many (63%) HCPs surveyed are aware of some form of sustainability plan in place or soon to be in place at their hospital. Still, HCPs are sensitive to direction from above, and the absence of national plans (other than in the UK) is likely delaying progress.
Conclusion
Big, systematic change is time-consuming and often slow. And health services are already resource constrained. But there is no time to wait. The climate emergency is only worsening.
Our survey confirms that HCPs are already aware of the impact of climate change on the health of the populations they serve. However, they would benefit from:
More information and more support at all stages of their educational and employment journey to better understand the risks to their patients.
Help and support in putting advocacy into practice in their healthcare institutions or clinical settings.
Support for proposed changes to clinical pathways that can help reduce any unnecessary medical production and waste in patient treatment and long-term care.
From a clinical perspective, further evaluation to support mitigation and adaptation initiatives is required. This includes:
Establishing an evidence base to support any changes to clinical activities and ensure that there is no ambiguity that doing the right thing for the climate is also the best thing for the patient.
Understanding how clinical practices could change to help patients and especially target vulnerable groups (eg, elderly and chronically ill people) adapt to climate risk.
Out of the three European countries assessed (France, Germany and the UK), only the UK is showing leadership in measuring healthcare emissions and setting targets. For further effectiveness, healthcare systems need to:
Measure their emissions on a regular and systematic basis (including indirect Scope 3 emissions from the supply chain, a major contributor).
Bring in well-thought-out activation plans with key roles specified for HCPs, consider resourcing changes with local healthcare sustainability leaders, and transforming industry production lines and supply chains.
Methodology
This research was undertaken in three phases, starting with a literature review of how healthcare systems in France, Germany and the UK are responding to climate change and the role of healthcare professionals (HCPs), followed by a survey of 75 doctors and 75 nurses working in hospitals in France, Germany and the UK in February and March 2022. We also interviewed experts from government, hospitals, medical professional associations and NGOs to build on the research and shed light on our survey findings.
Climate change and its impact on lung health: a focus on Europe
Climate change is a health issue with particular effects on respiratory health. This research summarises the direct and indirect evidence that links climate change to lung health and maps out policy priorities to prevent and curb the effects of climate change on lung health.
This independent report is the result of multiple research phases. First, we conducted a pragmatic literature review of the evidence and policy frameworks across the academic and grey literature to develop an initial set of policy priorities. Second, we convened an advisory board on May 19, 2021, drawn from the academic, climate change, environment and healthcare sectors, whose advice shaped the priorities of the study and the content of the report. Third, we conducted 12 interviews with respiratory clinicians, academics, policymakers and climate change and health experts to obtain an in-depth view of the issues involved. Finally, supporting the research, and feeding into this publication, has been substantial desk research.
There is evidence that emissions linked to global warming have an adverse impact on respiratory health, in particular emissions from combustion of fossil fuels and biomass by power stations, industry, homes and vehicles.
The need for action is recognized by the environmental sector and increasingly by the heath sector and the European general public, who are also beginning to demand tougher action. More awareness of climate change’s impact on lung health among these groups is vital for effecting change.
There is only so much one engaged individual can do in terms of cutting emissions and living sustainably. Mass change is needed, and most importantly the policies and systems in societies—controlled by governments and public authorities—need to support efforts to reduce emissions and tackle climate change.
Increasing awareness among the health sector and the general public of the need for urgent action on climate change is the path to achieving it by putting pressure on politicians to act.
Our thanks are due to the following for their time and contribution (listed alphabetically by surname):Advisory board members
Isabella Annesi-Maesano, research director at the French NIH (INSERM) and deputy director of the Desbrest Institute of Epidemiology and Public Health (IDESP), INSERM and University of Montpellier, France
Nicholas Hopkinson, National Heart and Lung Institute, Imperial College London, UK
Dan McDougall, senior fellow, Climate and Clean Air Coalition
Mariam Maglakelidze, dean of the School of Medicine, Petre Shotadze Tbilisi Medical Academy, Georgia
James Milner, assistant professor, London School of Hygiene and Tropical Medicine, UK
Susanna Palkonen, director, European Federation of Allergy and Airways Diseases Patients Association
Gerardo Sanchez Martinez, expert in the environment, health and wellbeing, European Environment Agency
Paul Wilkinson, professor of environmental epidemiology at the London School of Hygiene and Tropical Medicine, UK
Interviewees
Isabella Annesi-Maesano, research director at the French NIH (INSERM) and deputy director of the Desbrest Institute of Epidemiology and Public Health (IDESP), INSERM and University of Montpellier, France
Nathan Borgford-Parnell, scientific affairs co-ordinator, Climate and Clean Air Coalition
Nicolás González Casares, MEP, Spain (Spanish Socialist Worker’s Party, Group of the Progressive Alliance of Socialists and Democrats); member of the Special Committee on Beating Cancer
Sandra Cavalieri, urban health initiative coordinator, Climate and Clean Air Coalition
Tiy Chung, communications officer, Climate and Clean Air Coalition
Gennaro D’Amato, professor of respiratory medicine, University of Naples Federico II; director, division of respiratory diseases and allergy, High Specialty Hospital A. Cardarelli, Napoli, Italy, and member of the G7 International Committee on Climate Change and Health
Vijoleta Gordeljevic, health and climate change coordinator, The Health and Environment Alliance
Frank Kelly, Battcock Chair in Community Health and Policy, Faculty of Medicine, School of Public Health, Imperial College London
Sean Kelly, MEP, Ireland (Fine Gael, Group of the European People’s Party); member of the Lung Health Group
James Milner, assistant professor, London School of Hygiene and Tropical Medicine, UK
Gerardo Sanchez Martinez, expert in the environment, health and wellbeing, European Environment Agency
Anne Stauffer, director for strategy and campaigns, The Health and Environment Alliance
Join us for a webinar to discuss the report findings:
Cardiovascular disease (CVD) remains a significant global health challenge, accounting for 20.5m deaths in 2021. This umbrella term includes various heart and blood vessel disorders, with atherosclerotic CVD (ASCVD) responsible for nearly two-thirds of these fatalities. Consequently, the economic impact is profound, with direct and indirect costs in the United States totaling $422.3bn between 2019 and 2020, costing Americans nearly $4,423 per year in out-of-pocket expenses. Early diagnosis and risk assessment are crucial to make a dent in the future burden of CVD.
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Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
Breast cancer patients and survivors in the Asia-Pacific workforce
With more older women also working, how will the rising trend of breast cancer survivorship manifest in workplace policies, practices and culture? What challenges do breast cancer survivors face when trying to reintegrate into the workforce, or to continue working during treatment? How can governments, companies and society at large play a constructive role?
This series of reports looks at the situation for breast cancer survivors in Australia, New Zealand and South Korea. It finds that while progress has been made, more needs to be done, particularly in South Korea, where public stigma around cancer remains high.
Cardiovascular diseases levy a substantial financial toll on individuals, their households and the public finances. These include the costs of hospital treatment, long-term disease management and recurring incidence of heart attacks and stroke. They also include the costs of functional impairment and knock-on costs as families may lose breadwinners or have to withdraw other family members from the workforce to care for a CVD patient. Governments also lose tax revenue due to early retirement and mortality, and can be forced to reallocate public finances from other budgets to maintain an accessible healthcare system in the face of rising costs.
As such, there is a need for more awareness of the ways in which people should actively work to reduce their CVD risk. There is also a need for more primary and secondary preventative support from health agencies, policymakers and nongovernmental groups.
To inform the decisions and strategies of these stakeholders, The Economist Intelligence Unit and EIU Healthcare, its healthcare subsidiary, have conducted a study of the prevalence and costs of the top four modifiable risk factors that contribute to CVDs across the Asian markets of China, Australia, Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand.
Immune-mediated inflammatory diseases (IMIDs) affect up to 7% of the global population, often striking during the prime of life.1 These complex conditions not only cause significant disability but also increase the risk of developing other IMIDs and systemic comorbidities like heart disease and mental illness. The impact on patients' quality of life is severe, and the burden on healthcare systems is immense.
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Health
Value-based healthcare in Sweden: Reaching the next level
The need to get better value from healthcare investment has never been more important as ageing populations and increasing numbers of people with multiple chronic conditions force governments to make limited financial resources go further.
These pressures, along with a greater focus on patient-centred care, have raised the profile of VBHC, especially in European healthcare systems. Sweden, with its highly comprehensive and egalitarian healthcare system, has been a leader in implementing VBHC from the beginning, a fact that was underscored in a 2016 global assessment of VBHC published by The Economist Intelligence Unit.
This paper looks at the ways in which Sweden has implemented VBHC, the areas in which it has faced obstacles and the lessons that it can teach other countries and health systems looking to improve the value of their own healthcare investments.
Breast cancer patients and survivors in the Asia-Pacific workforce
With more older women also working, how will the rising trend of breast cancer survivorship manifest in workplace policies, practices and culture? What challenges do breast cancer survivors face when trying to reintegrate into the workforce, or to continue working during treatment? How can governments, companies and society at large play a constructive role?
This series of reports looks at the situation for breast cancer survivors in Australia, New Zealand and South Korea. It finds that while progress has been made, more needs to be done, particularly in South Korea, where public stigma around cancer remains high.
Cardiovascular diseases levy a substantial financial toll on individuals, their households and the public finances. These include the costs of hospital treatment, long-term disease management and recurring incidence of heart attacks and stroke. They also include the costs of functional impairment and knock-on costs as families may lose breadwinners or have to withdraw other family members from the workforce to care for a CVD patient. Governments also lose tax revenue due to early retirement and mortality, and can be forced to reallocate public finances from other budgets to maintain an accessible healthcare system in the face of rising costs.
As such, there is a need for more awareness of the ways in which people should actively work to reduce their CVD risk. There is also a need for more primary and secondary preventative support from health agencies, policymakers and nongovernmental groups.
To inform the decisions and strategies of these stakeholders, The Economist Intelligence Unit and EIU Healthcare, its healthcare subsidiary, have conducted a study of the prevalence and costs of the top four modifiable risk factors that contribute to CVDs across the Asian markets of China, Australia, Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand.
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