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Pfizer Upjohn hosted a first-of-its-kind Partnerships for Change summit for partners to gather insights and share best practices in NCD management.
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Partnerships in healthcare

Pharmaceutical division of Pfizer, Upjohn, is tapping its strengths and connections to alleviate the burden of non-communicable diseases in emerging markets
Feb 14, 2020 5:50 AM

While the quality of life in many developing countries has improved with growth in the past few decades, there has also been a rapid increase in the level of non-communicable diseases (NCDs) in these countries.

What are NCDs?

A non-communicable disease (NCD) is a disease that is not infectious or directly transmissible from one person to another. Also known as chronic diseases, the five main types of NCDs are cardiovascular diseases, cancers, chronic and respiratory diseases, diabetes and mental health conditions.

NCDs are responsible for 41 million deaths worldwide every year; 15 million of the people who die from an NCD are between 30 and 69. The majority of these so-called "premature" deaths occur in lower- and middle-income countries, according to the World Health Organization. 

To help the United Nations progress towards a one-third reduction of premature mortality due to NCDs by 2030 – one of its 17 Sustainable Development Goals, Upjohn has tapped its deep expertise and wide network to partner various stakeholders from the emerging markets’ healthcare industry to ignite change in three areas: policy and advocacy, clinical practices and health literacy.

On Jan 17, Pfizer's pharmaceutical division Upjohn hosted a first-of-its-kind Partnerships for Change summit to gather insights for partnership strategies and provide a platform for various countries to exchange tips on best practices in NCD management. The forum was attended by 23 delegates from Pfizer Upjohn's 18 partner organisations from Asean, Latin America, Africa and Middle East countries.

18 partner organisations from Asean, Latin America, Africa and Middle East countries attended the summit on Jan 17. Photo: PFIZER UPJOHN

Hear how Upjohn is working with different partners to ease the burden of NCDs in emerging markets at the Partnerships for Change Summit.

We take a closer look at how some of these partnerships are helping to ease the burden of NCDs on emerging markets.

Driving data to policy-makers 

At Duke-NUS Medical School in Singapore, NCD researchers use systems thinking methods to analyse real-world data to aid evidence-based decision-making for NCD policies. The school's partnership with Upjohn is aimed at enhancing the capability of its policy makers and analysts, and standardising research methods in the Asean region.

Dr David Matchar, professor of Programme in Health Services and Systems Research from Duke-NUS Medical School, says: "The support from this partnership will educate policy-makers and technical analysts to use systems thinking combined with real-world evidence to make better, more informed choices by asking the right questions like 'How do we balance the priorities of the various stakeholders in achieving optimal health outcomes in ways that are practical to implement and are economically sustainable?'"

At New York University Abu Dhabi (NYUAD), researchers are running a study, known as the UAE Healthy Future Study, to understand key risk factors that cause NCDs and possible prevention methods.

In the United Arab Emirates, NCDs account for 77 per cent of all deaths. "We are already working with the government with our findings," says Dr Raghib Ali, director of Public Health Research Center and associate professor at NYUAD. "Our aim is to reduce the impact of these diseases in the long term."

Upjohn’s collaboration has a holistic vision that will continue to evolve over the short, medium and long term to achieve the UAE vision 2021 of establishing the UAE as a pioneer in healthcare. 

"Upjohn lends us its expertise in biostatistics and chronic diseases in this partnership. More importantly, they have the network and can deliver our research findings across borders. It’s something academic institutions and even governments can't do," says Dr Raghib.

Filling the gap in primary care practice

In emerging markets, primary care physicians in private clinics play a more crucial role than specialists in hospitals in managing NCDs among the local population.

Often the first point of contact and care for patients, these primary care physicians need to be vocationally trained and be able to detect early symptoms of chronic diseases. It not only helps to prevent complications from escalating into secondary and tertiary care issues, but also keeps overall costs low for the patient. 

In Malaysia, iManage, a structured alliance of seven health associations including the Academy of Family Physicians and Malaysian Pharmaceutical Society, was formed to partner Upjohn to achieve a common goal: To improve NCD care by first ensuring that general practitioners and pharmacists received accredited training.

"I hope the iManage partnership will be the template of cooperation and collaboration among the seven associations," says Dr Mohammad Husni Jamal, president of Academy of Family Physicians of  Malaysia. 

Upjohn is also working with the Philippine Society of Hypertension and Department of Health to simplify a government-designed cardiovascular risk protocol that would entice private practitioners to screen at least 300 patients this year. 

"If the project in Cavite is successful, we have plans to extend it to Batangas, Laguna and Rizal. These provinces have some of the largest populations," says Dr Alberto Atilano, cardiology consultant and former president of Philippine Society of Hypertension.

Raising patient awareness and health literacy

At the end of the day, these NCD-related policies and programmes are designed to help the patients. No targets can be met without the patients’ involvement in every stage of planning, designing and delivering, says Dr Ratna Devi, board chair of International Alliance of Patients' Organizations (IAPO).

To ensure the patient voice is heard, patient-member organisations like the IAPO have "expert patients" who have lived their disease condition, are educated about the scientific aspects of it and are given the opportunity to sit with pharmaceutical or government agencies to contribute their views.

A new partnership between IAPO and Upjohn was announced during the summit on Jan 17, where both parties signed a letter of intent to collaborate and build a sustainable patient-centred approach to the care of NCDs.

IAPO and Upjohn signed a letter of intent for its new partnership to collaborate and build a sustainable patient-centred approach to the care of NCDs. Photo: PFIZER UPJOHN

"In many emerging markets, health literacy is a major problem. Patients either don't reach the healthcare system early enough to prevent complications or don't understand care management. With this new partnership, we will hopefully be able to run some health literacy programmes with Upjohn to benefit the patient community and eventually reduce the complications and burden of disease," says Dr Ratna.

In Mexico, cardiovascular diseases, obesity and diabetes are major health concerns among the population due to diet and lack of exercise. Dr Abel Pavia, deputy secretary-general of Society of Interventional Cardiology of Mexico, cites patient awareness as a main concern. He shares that many people do not go for regular health checkups because they think they are in "good shape" if they "feel good".

With Upjohn's support in sponsorship, training and logistics, the Rescue Heart Program in Mexico will be setting up kiosks in shopping malls and offices to screen 30,000 to 60,000 people for cardiovascular risks. On top of calculating each person's risk factors and vascular age, representatives will hand out small information booklets covering both health tips for disease prevention and the importance of adherence to current illnesses. 

An innovative partnership programme that has already taken flight is a holistic healthcare education initiative by Emirates Airline. Upjohn put together a team to create short animated videos that cover topics from happiness to heart disease; the videos are shown inflight to over a million passengers every week.

"We wanted to offer passengers the opportunity to take some health advice in a comfortable non-clinical setting," says Dr Richard Jenkins, vice president of Emirates Group Medical Services. He shares  that the response from passengers has been good. 

Dr Jenkins adds: "Even diabetes patients learnt something about the disease and have commented that the information is made very accessible to all."

What happens if we ignore the burden of NCDs?

NCDs are complex to address due to various factors ranging from the lack of care facilities and capacity for screening to limited emphasis on health promotion. But shelving the issue aside is not an option.

According to a World Economic Forum and Harvard School of Public Health study, not prioritising NCDs would cost lower- and middle-income countries more than US$7 trillion.

"The balance between quality healthcare, good patient outcomes, and managing budgets is the existential question of our time. Both studies and logic tell us that healthier people are more productive. They contribute to economic growth and lead happier and more productive lives," says Ms Linda Bedran, global lead of corporate affairs at Pfizer Upjohn.

"Patients are at the heart of our work at Upjohn, and we are committed to working with global stakeholders to relieve the burden these devastating diseases have on patients, families and our communities," she says. The company aims to reach 225 million more patients by 2025. 

She adds: "Effectively engaging with patient advocacy groups, healthcare professionals, government officials, and other organisations is critical to our mission. As we embark together on this journey, we believe partnerships can create a bigger impact on patients and we feel very committed to lead the conversation and drive change."

Relieving the burden of NCDs

"We are facing a global health crisis: Every two seconds, someone aged 30 to 70 dies prematurely from a non-communicable disease (NCD). Emerging economies have an even greater burden, with 85 per cent of premature deaths occurring in low- and middle-income countries. 

Despite NCDs being responsible for 71 per cent of all deaths worldwide, more than 50 per cent of countries lag behind the World Health Organization’s Sustainable Development Goal to reduce premature mortality from NCDs by one-third by 2030 – and low-resource countries are unlikely to reach this target even by 2040.

Civil society organisations, governments, multilateral organisations, the private sector, healthcare professionals and academia have a shared interest in reducing the global burden of NCDs. A dynamic interplay between these stakeholders can help optimise the delivery of interventions targeting NCDs. Therefore, any solution must involve a multi-sectoral approach that focuses on NCD control, NCD prevention through risk factor mitigation, and social determinants of health. 

Upjohn has established a partnership framework to collaborate with diverse stakeholders who share our purpose and passion of relieving the burden of NCDs. This framework is based on a five-step patient journey – from awareness to adherence – and proposes to target NCDs by focusing on the person as a whole and advocating health, versus a current focus on disease and a person as a patient.

In collaboration with local and national partners, Upjohn is piloting projects to prove that the concept of local solutions, which based on viability, can be operationalised by country stakeholders.

Upjohn has cultivated multiple strategic NCD partnerships across emerging economies using this patient journey framework, which focus on three themes: policy and advocacy, practice improvement, and patient awareness. 

NCDs are a threat to all of humanity, and we need to catalyse solutions at the local level. Upjohn is committed to working with multi -sectoral stakeholders on the frontlines to develop customised, tailored solutions that can meaningfully advance national NCD agendas and targets. By addressing the considerable variability that exists in the burden of NCDs across nations – and in corresponding intervention strategies – we can improve and save lives."

Dr Amrit Ray, Global president of research, development and medical at Pfizer Upjohn