While the COVID-19 pandemic has seen some nations reply nicely to the ongoing health disaster for their very own populations, it has additionally – regardless of a long time of growing and accelerating globalisation – proven how shortly nations can flip inwards. As nations round the world entered states of emergency and enacted extraordinary measures to include the unfold of COVID-19, they’ve in lots of situations additionally reverted to a ‘metropolis-state’ logic, strictly limiting their consideration inside their borders and never daring to choose into widespread options that very possible would have been higher, which shall be mentioned in additional element at the HIMSS & Health 2.0 European Digital Event in September.
Disappointingly, our leaders and worldwide political establishments have each failed to stand collectively and supply robust frameworks for collaboration all through the COVID-19 disaster, whereas different organisations and actors like companies and researchers have in some ways labored to intensify and deepen cross-border collaboration. As we glance cautiously to the finish of the first wave of the disaster in some elements of the world, we should think about how sustainable these cross-border relationships are, who can and may take the lead in defending and cultivating them, and what advantages they can present for the future of healthcare – notably in relation to the rising personalised health paradigm. Given the current expertise, the notion that states will lead this cost could also be met with a level of scepticism.
The nation state as a ‘work in progress’
We ought to take into consideration that the nation state and the Westphalian – i.e., nation state – system are social constructs that can be dated again to the 1648 Peace of Westphalia, however in actuality solely start to manifest as we all know them immediately in the wake of World War II with decolonisation and the institution of the United Nations. This is to say that the constructs we count on a lot of are fairly new and never very steady.
The pandemic means that the fragile system of fragmented nation states is probably not outfitted to deal with a world that’s turning into exponentially extra related. A rethinking of this method, particularly because it relates to health, is overdue.
We know that as a world neighborhood we want to ship on a higher imaginative and prescient for healthcare in the wake of COVID-19. Doing this will require a nice deal of adaptive and transformative pondering – to the extent that we’d like to think about if it’s not states, however sure non-state actors, organisations and residents which might be finest outfitted to develop the framework for this imaginative and prescient, with the states as an alternative taking part in a supporting function additional down the line.
Affirming health as a world problem and the 90/10 mannequin
A vital step in delivering on a greater imaginative and prescient for health is constructing a world consensus round the notion that health is certainly a world problem for which we’re all accountable, not merely an obligation of particular person nation states that usually lack the capability to ship sufficient care on a nationwide and native degree. A sensible level of departure on this effort could possibly be reaffirming and increasing the mandate of UN Sustainable Development Goal 3, which goals to guarantee wholesome lives and promote wellbeing for all in any respect ages. By leveraging an current world consensus with classes from COVID-19, proactive leaders can assist propel a extra strong, world imaginative and prescient for health that emphasises fairness, outcomes, and proof-based mostly choice making as an alternative of obscure ensures and legislative or regulatory benchmarks. By encouraging and empowering leaders and choice-makers outdoors of the state, the shut cross-border collaboration that’s elementary to attaining SDG Three could also be inside attain prior to we expect.
To make clear, this isn’t to say that states can not or won’t be essential to the enchancment of health in the lengthy-time period. While states have struggled to work adaptively and collaboratively in the midst of the pandemic, it’s clear that states are drawing a lot-wanted classes from the harrowing expertise of the previous few months. Although extra numerous constellations of actors and organisations have proven a capability to work extra flexibly all through the disaster – maybe as a result of they aren’t almost as encumbered by gradual and sophisticated political processes – than states and state establishments, states can nonetheless play a useful function as conveners and agenda setters if the enough institutional studying takes place in the wake of the disaster.
At the similar time, taking a broader world strategy to health that welcomes a extra numerous swathe of personal contributors must also entail a stronger dedication to supporting developments which might be helpful for and accessible by the overwhelming majority of individuals, not simply the wealthiest segments of the inhabitants. This strategy is what we at the Copenhagen Institute for Futures Studies have termed the ‘90/10 logic’, a mindset that advocates investing in and creating options that can enhance health outcomes and wellbeing for all, together with the different 90% of the inhabitants moderately than simply the high 10%. Supporting options that emphasise equality, fairness and utility is one other space to which states can contribute as regulators.
The Humanome: The fruit of cross-border collaboration in personalised health
At the Copenhagen Institute for Futures Studies, we now have been constantly monitoring challenges, alternatives, and developments in the ongoing transition in direction of extra personalised and preventive approaches to health and healthcare. On this foundation, we now have additionally envisioned what elevated cross-border collaboration in health may produce in the future. At CIFS, we now have developed an idea often known as the ‘Humanome’ along with different Nordic stakesholders in Nordic Health 2030, during which we suggest as a really perfect mannequin for personalised health, and which shall be explored in better depth at the HIMSS & Health 2.0 European Digital Event.
The Humanome (see illustration under) is an idea that offers a holistic image of a person’s health. It relies on knowledge from each private and non-private sector sources, which all affect private health. These knowledge fall into totally different classes of situations and influences on health and are to a various diploma fastened or changeable. Some of the knowledge span over a number of classes, illustrated by the gradients in the mannequin.
The Humanome requires a transformative new method of approaching health and the way we work collectively. Some situations which might be wanted to realise the Humanome are elevated belief, interoperable requirements, cross-border collaboration, dynamic knowledge fashions, and an emphasis on prevention as service on the path in direction of higher high quality of life and wellbeing.
The outermost layer of the Humanome is the ‘knowledge management and contracts’ class, which has to do with how knowledge is dealt with by people, private and non-private establishments and actors, in addition to the infrastructures that enable for the storage and switch, and sharing of knowledge. The constructing represents the hospital and established health system which holds medical information containing all the conventional scientific, biobank, health information and applicable knowledge on health manufacturing.
As a instrument for organising and figuring out relationships and patterns in health-relevant data, the Humanome qualifies individuals to make knowledgeable choices and permits acutely aware interactions relating to their health based mostly on actual-time, actual-world knowledge over their lifespan.
As the Humanome is based on and, certainly, fully dependent upon cross-border collaboration, dynamic sharing of data, new sorts of public-personal partnerships, and a preventive health mindset, it’s a mannequin that’s constructed for a world during which the burden of illness is turning into extra diversified and during which health each transcends nationwide borders and is more and more individualised. The Humanome is, due to this fact, a mannequin for the future of health.
Hear extra from HIMSS Future50 chief, Bogi Eliasen, at the HIMSS & Health 2.0 European Digital Event going down 7-11 September 2020.
