Dear Readers,

For more than half a century, Novartis and its predecessor companies have been working on innovative access models to improve the ways in which underserved patient populations receive healthcare and medicines.

Starting in the 1950s, it was our predecessor company J.R. Geigy that laid the foundations for these public and social activities. From the humble beginnings that were centered on a small malaria research and treatment station in Tanzania, we have since launched many local as well as global access programs that have made a difference for millions of patients worldwide.

Among the most notable efforts are our endeavors to eradicate malaria, leprosy, and sickle cell disease – areas in which we are also investing time and money to develop new treatments. In malaria, for example, we are testing an innovative compound that could help fight growing resistance to existing treatments. In the sickle cell disease space, we are collaborating with the Bill & Melinda Gates Foundation to develop an in vivo gene therapy together with local partners in Africa.

For most of the time, our access efforts focused on low- and middle-income countries in Africa, Asia, and Latin America. The main thrust lay on the provision of essential medicines for both infectious and chronic diseases. Over time, we also tested more holistic approaches that included strengthening healthcare systems by providing patient education and screening services, among other things.

It took a while before we started to understand that underserved patient populations also need our support in industrialized countries. We were not alone with this initial bias. When Nobel Prize winner Mohammad Yunus was invited to the United States to introduce his social business model in the early 2000s, there was a misunderstanding as to who would benefit most from his microfinance idea. No one really admitted that there were severely underserved communities.

This has changed. Medical experts, economists, and a growing number of politicians and businesspeople have since realized that structural deficiencies are impacting millions of Americans, barring them from economic opportunities and from existential healthcare services. Many of them belong to minority groups such as Hispanics and African Americans – but not exclusively.

Against this background, Novartis has started a series of projects in the United States that focus on local efforts aimed at closing these gaps. One of them, Beacon of Hope, seeks to address health and education inequities and to create a fairer R&D ecosystem. In another project, we are collaborating with Rush University Medical Center to support an outreach program in Chicago.

As a Novartis Board Member, I am super proud of and motivated by the work our company does around access to medicines. I am especially excited about the work we are doing in service of marginalized communities in the United States – both Beacon of Hope and Engage with Heart. In my view, both efforts seek to create change by listening to and working with community leaders versus prescribing solutions from outside the community. This is the best way to build trust and to promote sustainable behavior change that is rooted in education.

As the co-founder of the Shirley Proctor Puller Foundation, my work in addressing inequity in education for underserved youth, aged 5 through 15, also relies on listening, building trusted community relationships, and a sustained presence. Our belief is that this work will drive better life outcomes including better jobs and better health. In my view, it is virtually impossible to address economic and health disparities without enhancing the education of the people.

The launch of Engage with Heart by Novartis, in collaboration with the Global Coalition on Aging to build a holistic healthcare ecosystem, follows this logic. By working together with Black Churches, community centers, urban farmers, and professional nurses from Johns Hopkins, among many others, the project can help not only improve heart health in Baltimore but also provide a blueprint for other cities in the United States and elsewhere.

As this issue of live magazine shows, these efforts rely heavily on the ability of all partners to build trust and create an environment in which each partner brings in his or her voice. Here, too, education plays a pivotal role. For the changes that Engage with Heart seeks to achieve are not just aimed at informing people what needs to be done to improve heart health. They also intend to trigger behavioral changes that can have a lasting and sustainable effect. Education builds the basis for this.

As a leading science-based pharmaceuticals company intent on discovering and developing innovative medicines, Novartis also needs to reimagine the way its medicines can reach patients most effectively. Sometimes, these barriers are financial in nature, at other times trust might be the issue hindering people from seeking the best treatment forms. To address these barriers, we need to think outside the box, but also include others in how we want to set up innovative access programs that are inclusive and help create more equitable healthcare systems. Engage with Heart does exactly that.

Bridgette Heller
Member of the Novartis Board of Directors