In 1913, John D Rockefeller famously argued that “disease is the supreme ill in human life.” Plights such as obesity and cancer are posing new challenges for scientists and healthcare donors alike, as they become bigger killers than infectious diseases.
Health and medicine consistently rank as the second largest area of giving after education, mobilising over USD 20 billion a year in the US alone. “With an endowment over USD 40 billion and annual expenditure on health over USD 2 billion, the world’s largest health-centred philanthropy, the Bill and Melinda Gates Foundation, spends more on health programmes than many national governments,” remarks Karl Auersperg-Breunner, from our London office.
Funding and creativity are needed. In 1913, John D Rockefeller famously argued that “disease is the supreme ill in human life.” Plights such as obesity and cancer constantly pose new challenges, as they become bigger killers than infectious diseases.
Driven by three megatrends, we currently live through a fascinating re-configuration of health philanthropy:
- The adoption of a holistic view of the social determinants of health;
- Amazing new personalised health solutions stemming from advances in biotechnology, nanotechnology, robotics and the information revolution; and
- A major demographic transformation with a higher number of older people than ever before in history, as well as a clearer view of healthcare needs in the developing world.
“For health-focused philanthropists, there are powerful new possibilities to engage. At Lombard Odier, we are fortunate in having a long record of supporting them and their initiatives,” remarks capital partner Bart van Leemput.
The “Social Determinants of Health” is expanding the scope of health philanthropy. Established ways to engage in health philanthropy include funding research, new hospital wings, new healthcare technologies, or expanding outpatient services. Yet in 2003, the World Health Organisation (WHO) cast the net much wider. Its new concept of “social determinants of health” (SDOH) expanded the focus to include the economic and social conditions of a population as factors that influence differences in health status.
This perspective provides enlightening insights: access to healthcare and the quality of care contribute roughly one-fifth to health outcomes. Four-fifths of outcomes are influenced by socioeconomic factors (40%), health behaviours such as tobacco use or diet (30%), and the physical built and general environment (10%). The implications are straightforward: it is important to engage both “upstream” in factors co-determining health outcomes, as it is to engage “downstream,” in the provision of health solutions.
Four engagement models
Today, health philanthropies generally fall into one of the following categories:
- Responsive grant-makers, financing the best health care organisations they can find;
- Initiative-based grant-makers; they develop specific health programmes, set objectives, and then select charitable recipient organisations to implement the programmes;
- Capacity-builders that support healthcare institutions to modernise them or otherwise build out their capacity; and
- Operating grant-makers that design and execute healthcare programmes themselves.
The advent of healthcare 2.0
- Next to the WHO’s wider scope, the “Fourth Industrial Revolution’s” combination of analytics, data and technology has also begun to completely transform what’s possible in healthcare.
- Powered by the easy availability of digitalised medical records, healthcare will focus more and more on preventive medicine.
- The medical profession will change in fundamental ways: data and e-health will revolutionise the way doctors diagnose disease and treat patients.
- The “Internet of Things” will provide easy delivery of bespoke healthcare, with service robots becoming more central to its delivery (while also raising new questions around fairness, privacy, security, and societal impacts). Benoît Smets from our Brussels office also serves on the board of Handicap International and remarks: “To empower disabled people living in situations of conflict or natural disasters, projects on the ground have started to use 3D printers to prepare optimally fitted prostheses. That’s the future.”
- We will also see new forms of collaborations emerge. They will connect previously “siloed” medical experts so researchers, healthcare organisations and other industry players can jointly diagnose and cure disease.
According to the WHO, cancer is now the leading cause of death globally, taking more than seven million lives annually. “With Fondation Philanthropia, we are directly engaged in bringing the possibilities of the Fourth Industrial Revolution to bear on shifting out the frontiers of healthcare,” remarks managing partner Denis Pittet, the Foundation’s President. To fulfil a client’s wish to support the development of new therapies, training and knowledge-sharing for the fight against cancer in France, Fondation
Philanthropia has been the largest private donor to Gustave Roussy, Europe’s leading cancer centre, since 2013.
Thanks to Fondation Philanthropia’s support, Gustave Roussy is one of the first healthcare establishments in Europe to purchase the latest version (XI) of the Da Vinci, an ultra-modern surgical robot. “This robot represents a real technological revolution,” explains Dr Françoise Rimareix, a plastic surgeon and head of the breast surgery unit: “It is the only one in France which avoids scarring and prevents lymphatic sequelae. This will alter and considerably improve patients’ comfort and quality of life and really change their view of this operation.”
Public funding does not finance such equipment. The Foundation’s support has allowed Gustave Roussy to undertake new research for the use of the robot, leading to two breakthroughs in 2016: a minimally invasive procedure to remove tumours and reconstruct the breast, and one for thyroid cancer using a passage behind the ear. Both procedures leave patients with only a small discreet scar, and a shorter (and less painful) recovery period. Moreover, the intervention is more cost effective.
“Many of our clients (and colleagues) are concerned that a lot still needs to be done in the fight against cancer,” highlights Nathalie Rossiensky, from the Paris office. Our philanthropic footprint and relationships with organisations such as Gustave Roussy add an engaging new dimension to the client experience.”
Both the developing and developed world matter
Around the world, the critical shortage of skilled personnel is one of the greatest challenges. According the WHO, the current deficit of about 7.2 million skilled health care workers globally will likely increase to 12.9 million by 2035.
Thanks to the will of a donor, Fondation Philanthropia has supported various Union for International Cancer Control (UICC) projects. For example, financing the recruitment of three extra staff has allowed UICC to better share tools across its network. Fondation Philanthropia is currently also supporting UICC to design networking and training opportunities for members such as national cancer leagues, physicians’ societies and patient support groups, starting with North and West Africa.
To the client’s satisfaction, this first grant is now supplemented by support from the Foundation Cheikh Khalifa Ibn Zaid of the Moroccan royal family, with a focus on West Africa. During the UICC global conference recently held in Paris, a new programme dedicated to chief executives of member organisations brought home the benefits of such systematic knowledge-sharing between members in advanced and developing countries.
Changing demographics will keep upsetting the apple cart
The re-configuration of healthcare opens up tremendous new opportunities for health philanthropy – while raising the stakes regarding the need to achieve success. Today, ageing brings complex health problems such as chronic illnesses. There are 11 million people over the age of 80 in America, and that number will double by 2025. In Switzerland, the share of people over the age of 80 is forecast to double from 5% (2015) to 10% in 2045. Thus far, most of the world’s medical systems are poorly prepared to provide the right solutions in scale, and at affordable cost.
Managing partner Christophe Hentsch remarks: “Next to the thematic investments we offer around the ageing demographic, I am proud that we are also helping our clients to make a real difference through their philanthropy, leveraging our competences and relationships.”
As we rethink everything, it’s important to also have other pathways for impact on the radar. Take the Global Tobacco-free Pledge, where specialised non-governmental organisations (NGOs) engage in advocacy to advance tobacco-free investment by eliminating tobacco from investment portfolios across the globe. Thus far, they have managed to persuade 35 pension funds in Australia to disinvest from tobacco, for a total of USD 2 billion; in May 2016, AXA decided to divest tobacco industry assets valued at 1.8 billion euros (EUR). Certainly, a lot of work remains ahead in healthcare. Given the many advances and innovations, one can only be optimistic.
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