Creating a blueprint for universal healthcare

Novartis has entered an innovative public-private partnership with the Vietnamese government, Harvard Medical School and the World Economic Forum (WEF) to strengthen the country’s healthcare system. If the partnership proves successful, it could become a blueprint for other countries in their quest to achieve universal healthcare.

Text by Patrick Tschan, photos by Linh Pham

Healthcare specialists at regional hospital centers are instrumental to make universal healthcare a reality.

Table of contents

Deep expertise

Robust, but challenging healthcare situation

Measuring impact

Published on 17/08/2020

For Le Thi Ban it was a small step when the experienced NGO healthcare specialist joined Novartis earlier this year for an innovative healthcare project with the Vietnamese government. For Novartis, meanwhile, Ban’s move was another huge leap in its efforts to establish itself as a trustworthy private healthcare partner to strengthen global health and help make universal healthcare a reality.

“My decision to join Novartis was due to the prospect of creating a win-win impact between private and public partners and strengthening primary healthcare for people in rural areas in Vietnam,” said Le Thi Ban, who joined Novartis from FHI 360, an international and well-reputed NGO. “In such a situation, the move to a trusted private-sector company was an easy decision.”

As part of her new assignment, she is working in a primary healthcare project initiated by the Vietnamese Ministry of Health, which has invited Novartis, the Harvard Medical School and the WEF to strengthen public primary healthcare in Vietnam. Novartis has committed itself for the partnership for the next three years – to start with.

The goal is to help the country achieve universal healthcare coverage by 2030 as outlined by the United Nations in 2015, when all 193 member states agreed on the Sustainable Development Goals and set out an ambitious agenda for a safer, fairer, and healthier world.

One of 13 000 community healthcare stations in Vietnam, which are designed to offer increased services.

Deep expertise

Each partner has pledged to contribute crucial assets and capabilities to this innovative collaboration. Novartis, for example, will use the expertise of its Novartis Social Business unit, which includes projects such as Healthy Family in India, Vietnam and Kenya, to strengthen health stations and communities across the country. The WEF, on the other hand, will bring its networking power to the table to connect people and organizations from the public and private sector.

The Harvard Medical School, meanwhile, will throw in its academic process. “The Harvard Medical School will contribute technical expertise in the area of developing and financing high-quality primary healthcare delivery systems, bringing the best evidence-based practices to Vietnam and working with partners to adapt it to the local context,” says David Duong, who is leading the project for the Harvard Medical School.

To promote public primary healthcare in developing countries such as Vietnam, experienced and diverse partners are required. “Harvard Medical School research has shown that many strong stakeholders are needed for the success of public primary healthcare,” said Duong, who is originally from Vietnam and grew up in the United States. He is convinced that with the current partnership structure, the Vietnamese government will be able to strengthen the country’s 13 000 community healthcare stations and give a boost to its medical infrastructure.

Novartis will play a crucial part in this. “Novartis has proven to be extremely strong in raising health awareness, in particular for non-communicable diseases,” Duong says. “Furthermore, through its Social Business and Novartis Foundation experience it has strong know-how regarding education and training for healthcare workers.”

Bringing public and private partners together

Roland Roelofs and Le Thi Ban during a field trip in Vietnam in 2019.

Robust, but challenging healthcare situation

Vietnam has one of the most advanced healthcare systems in the emerging markets of East Asia as almost 88 percent of the Vietnamese population benefit from some form of health insurance.

But there are many challenges: The insurance does not cover all costs and the out-of-pocket share can easily consume a worker’s monthly paycheck. In addition, many healthcare workers are inadequately trained and there is a scarcity of drugs, especially in rural areas.

“The question I keep asking myself after visiting community health stations, districts, provincial and central-level hospitals across Vietnam is what can be done?” says Novartis Country President Roeland Roelofs, who regularly travels to healthcare stations across the country to see how the challenging healthcare situation can be mended. “The problem is clear: Higher-level hospitals, which should be caring for more severe cases, are overwhelmed by patients, many of whom should be managed in primary care. How can Novartis help people access good quality healthcare at lower-level facilities?”

To address this mismatch, the government, with support from World Bank and Asia Development Bank, is upgrading infrastructure, capabilities and services at the 13 000 local community health stations throughout the country. This will help alleviate the heavily overburdened central and provincial hospitals in the country.

In a first phase, 26 health stations, each of which caters to between 4000 and 12 000 patients, will be turned into demonstration sites. They will be analyzed as to how they handle the triage of patients and what kind of upskilling is needed to curb demand for specialized hospitals.

Novartis, Roelofs said, will collaborate to educate healthcare staff, upgrade diagnosis and medical services and work towards solutions to raise awareness for widespread noncommunicable conditions such as hypertension and diabetes as well as heart failure. It will also screen and educate community members to help them adopt preventive health behaviors.

In addition, Novartis will collaborate to digitize health records and ensure that those patients who needed to rely on higher-level hospitals temporarily are referred back to the community health stations. In order to do so, the team is bringing together local and global experience from Social Business, Novartis Foundation and the Innovative Medicines country organization. “The key thing from our point of view is that, in order to make the collaboration work and support the Vietnamese government, we need to bring in the whole arsenal of our expertise and skills into this program.”

In general, trust in in the community healthcare stations should be increased through such measures. “If people have more faith in the stations, they will travel less frequently to hospitals, and their out-of-pocket costs will be reduced,” Roelofs says, adding that Novartis aims to demonstrate that investing in primary care will not only improve the health status of community members, but will also reduce financial hardship on individuals and prove more cost-effective than investing in hospitals.

Transforming primary healthcare for people in Vietnam

A nurse is providing essential healthcare services for the rural population – her service is valuable as it saves patients’ time by avoiding long travels to the city.

Measuring impact

As part of the public-private partnership, Novartis and other partners will continually measure and evaluate the health outcomes of the project in the 26 communities and look into the cost-effectiveness of the project.

After three years, a final assessment will be made to document the key lessons learned. The evaluation, it is hoped, might create evidence to scale up interventions at the national level and make Vietnam a model for other low- and middle-income countries.

“This unique cooperation between Novartis, Harvard Medicine School, the WEF and the Ministry of Health gives Vietnam the chance to create a highly effective health system that could become a model for many countries,” says David Duong.

Deborah Gildea, Head of Novartis Social Business Asia, agrees: “This is the first time Novartis has worked directly and closely with a Ministry of Health on this type of public-private partnership. Not only does this strengthen our reputation, but this unique project could also serve as a model for us to use in other countries. Many countries face similar challenges in implementing Universal Health Coverage for all.” But before this can happen, a lot of work still has to be done and the goodwill of all stakeholders is needed. “It takes close cooperation among partners to provide the necessary capacity to help people in a simple but effective way so that they have easy and cheap access to medical services,” Roelofs says. “Only in this way can all involved parties gain the confidence of the population and convince them to first visit the local health stations.”

Creating a blueprint for universal healthcare

Your privacy is important for us.

Strictly necessary cookies

Performance cookies