Approaching health equity from all angles

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: David Fredrickson, Executive Vice-President, Oncology Business Unit, AstraZeneca

• Pharmaceutical companies have a role to play in ensuring a better future for all.
• Medical advances are essential in building health equity across the globe.
• A holistic approach across public and private sectors is needed to drive change at a local and global level.

Imagine a world where everyone is able to achieve optimal health. A world where prevention, early detection and delivery of healthcare are well connected end-to-end. A world where people can access highly personalized treatment, at the right time, in the right place. A world where we collectively achieve health equity.

In 2022, this isn’t a ground-breaking intention. And yet across the globe, we recognize translating our intention into action to make this reality is where our work lies.

The pandemic has catalysed the global conversation around health equity and stakeholders have garnered their collective energy to combat challenges we’ve been grappling with for years. We can no longer ignore the increasing gaps in healthcare for underserved and disenfranchised populations.

With diversity, equity and inclusion imperatives, what can the pharmaceutical industry do to realise a better future for all?

The intersectionality of health equity

Put simply, health equity means that everyone has an equal opportunity to lead the healthiest life possible. This requires addressing social determinants of health and their consequences – poorer health outcomes caused by lack of access to quality healthcare, education, housing and safe environments, etc.

The healthcare industry cannot fully realize its mission to deliver new, life-changing medicines to patients without embedding a health equity lens from the beginning in all that we do. This includes working collaboratively to address unmet medical needs and access barriers, increasing the speed and breadth of patient access, driving excellence in product life cycle management and understanding the real-world implications of delivering scientific advances.

Together we must look upstream, understand the fundamental changes required from scientific discovery through drug delivery and change the way work with urgency.

Clinical trial diversity is a must

Currently, one in five new drugs approved by the U.S. Food and Drug Administration (FDA) show differences in effectiveness across ethnic groups. Clinical trials must accurately reflect the patient populations we aim to treat, from the conditions they face to the environments in which they live.

Clinical trial diversity is no longer a ‘nice to have,’ but a must. As regulatory bodies begin to expect trial participation to mirror real-world patient populations, we will meet this challenge and partner to ensure that we meet that expectation for all patients.

At AstraZeneca, we are actively contributing to industry and non-profit partnerships to advance clinical trial diversity and we are growing and building inclusive local partnerships that are trusted by the communities we need to reach. By the end of 2022, we will also implement our bespoke diversity measurement tool, built on updated data systems and infrastructure, in all new trials.

It’s now time to go further

If we want to truly build equity into healthcare, increasing diversity in clinical trials is not enough to untangle centuries of systemic issues. We need to apply the health equity lens to every phase of the medicines lifecycle– from drug discovery and development to manufacturing, to delivery of our medicines. This means incorporating the principles of diversity, equity and inclusion when recruiting our scientists, when identifying novel drug targets, when selecting clinical trial sites, and when identifying patients for our studies.

Better health outcomes can start with workplaces and workforces that are reflective of the communities in which we operate and the patients we serve. Employees that represent a diversity of experiences, backgrounds and skills are a business-critical foundation. Racially diverse teams, for example, report a 35% increase in performance compared to those less diverse.

As both individual and collective power is needed to build equitable, just and representative workplaces, AstraZeneca is proud to be a founding partner of the World Economic Forum’s Partnering for Racial Justice in Business initiative. This coalition of 48 organisations representing 13 industries is committed to eradicating racism in the workplace and setting new global standards for racial equity in business.

A holistic approach to health equity with public-private partnerships

The industry is making progress, but there is much more to do. Improving health equity in the real world requires working together to share insights and forge more public-private partnerships that tackle this issue locally.

An excellent example of this is the Lung Cancer Collaboration, borne from the partnership between the World Economic Forum and the Lung Ambition Alliance (LAA), of which AstraZeneca is a founding member. The Collaboration – whose membership spans healthcare delivery, research, diagnostics, biopharma, patient advocacy and non-governmental organisations – was shaped in September 2021 around the shared, urgent ambition to double 5-year survival in lung cancer by 2030. Over the last six months, representatives from over 30 member organizations have convened regularly to develop and align on actionable recommendations on the services governments must prioritize in their National Cancer Control Plans to improve lung cancer survival. Alongside the World Health Assembly this week, the Collaboration will launch these recommendations in the report: Urgent, coordinated global action on lung cancer.

Another example is PUMUA, a multi-stakeholder initiative in Africa committed to closing gaps in asthma care. To address health equity across all elements of the patient pathway, strengthen local health systems, and improve access to asthma treatments, AstraZeneca is working with in-country governments and healthcare professionals on the ground. The programme has thus far partnered with over 20 local health systems, reached nearly 2000 physicians and, importantly, expanded needed access to asthma treatments in key markets. So far, the collaborative approach has benefited 700 public government hospitals and faith-based facilities.

Local partnerships are also essential to restore trust among different communities as we seek to support equitable access to medicines and care. That’s why AstraZeneca has launched programmes like Accelerating Change Together (ACT) on Health Equity in the U.S., which brings together expert insight, strategic collaboration and employee engagement to create urgent and sustainable change. Since the programme’s launch, we have established a Health Equity Advisory council to provide ongoing external expertise, as well as contributed more than $4m in new strategic collaborations with non-profits advancing health equity.

Inclusion is a right, diversity is a strength and equity is a necessity. As part of the healthcare industry, we must work collectively and without delay, until these words are no longer words – but a given reality. Sustainable and meaningful change must be employed across our roles as employers, science-led businesses, commercial manufacturers, and as public health partners.