In conversation with André Hoffmann

As an environmentalist, Hoffmann has taken senior roles at international organisations, including the World Wide Fund for Nature (WWF), where he served as vice-president for ten years; and as president of the MAVA Foundation, a position he has held since 2010. Hoffmann has also served on the boards of Wetlands International, Global Footprint Network and FIBA.

Mr Hoffmann recently sat down with Reuters to discuss the challenges facing people today when it comes to access to healthcare, what can be done to ameliorate them, and what drives him to keep working on these issues.

What do you see as the key challenges to healthcare today and into the future?
There are enormous challenges in healthcare - all over the world - from how we bring access to healthcare to patients in lower income countries, to how we get policymakers to view healthcare as an investment, rather than a cost.

Today we are living in particularly trying times. Governments around the world are counting the cost of the COVID-19 pandemic, with billions spent on keeping economies going during lockdowns. The pandemic shone a light on the importance of healthcare, but with the war in Ukraine and the cost-of-living crisis that is hitting billions of people around the world, we’re already seeing healthcare budgets being impacted. All of this has the potential to negatively impact the health of populations in every corner of the world.

In addition to these very real and relatively new difficult circumstances, there are longstanding challenges in global healthcare that will only be exacerbated by these developments. For example, in many low- and middle-income countries, there are significant barriers to people accessing quality healthcare. We know from a report by the World Bank, for example, that almost half of the world’s population, over 3.5 billion people, still cannot access essential health services. Another report from the Lancet found that countries in sub-Saharan Africa have an average of 6.4 clinical oncologists for their whole population. While the lack of healthcare workers is a particularly acute problem in lower income countries, it also affects some of the world’s richest countries.

Roche’s approach to improving access is based on the deep understanding that solutions necessarily need to differ from country to country. The company is also convinced that solutions always must be found by a number of groups coming together as partners. That’s why Roche works closely with governments, third sector organisations and others in countries around the world.

In Kenya for example, Roche is working with EMPOWER, a partnership between public, private and non-profit organisations which aims to overcome health system challenges by establishing clinics that provide integrated care for breast and cervical cancer. Since it first launched in 2019, 16 clinics have been established across Kenya with over 25,000 women screened for breast and cervical cancer alongside hypertension and diabetes screening. Partnerships that combine knowledge and expertise like EMPOWER are key to finding solutions that address inequities, and will help improve women’s health.

How have they evolved over time?
We are starting to see some shifts in healthcare - particularly a recognition of the preventable nature of many diseases. Science and digital technologies are also allowing us to dig deeper and deeper and develop precise diagnostics and targeted medicines that allow more personalised approaches to treating patients. While these advances are important to improve healthcare, they are not sufficient. Healthcare is rarely viewed as an investment in the same way as, for example, education - and we are seeing the impact of this in areas like the number of places in medical schools or midwife training and the underinvestment that has led to the backlogs post Covid.

My desire would be to see innovations being made more widely and equitably available to society. At the same time, we should focus on moving from ‘sick care’ to ‘health care’, with particular emphasis on prevention and early screening.

The current introduction of digital innovation in healthcare systems with the accompanying heavy use of artificial intelligence will be of great strategic value. Data analysis could help to remove some of the barriers to innovation and allow for better cost management. But here as well we will need a partnership between different actors in the system to really seize the opportunity for the benefit of the patient.

Health data has the potential to bring significant opportunities to improve patients’ health by enabling earlier and more accurate diagnosis, earlier treatment and the use of more personalised approaches to offer treatment that is better suited to patients’ needs. Of course, we must ensure that people’s private data is protected. And it is critical that data infrastructures are connected so that the opportunity can be used to its fullest potential. However, the potential to improve both the health of individuals and of populations is significant.

How can we solve the healthcare equity divide?
I would suggest that we need to do three things. First, we need to be open about the fact that there are inequalities in access to quality healthcare. If you ask the right questions, you are more likely to get the right answers. This divide between those with access and those without is not necessarily here by design but it is very real and needs to be addressed as such. Secondly, we need to understand the reason for the divide. Are these caused by historical or contemporary factors? Finally, we need to work together to find solutions. We have an opportunity to act as global citizens, with business as a force for good, in partnership with health systems. Reducing the divide is a very real opportunity for lower income countries to help realise their economic potential, which in turn can have significant societal benefits. It could be a win-win for all.

Where does your passion lie?
I feel passionately that we will not be able to tackle human health issues if we do not also address human pressures on the environment, such as over-exploitation of natural resources and the daily exceeding of planetary limits. We need to view human diseases in a broader context. Humanity is only a small part of the planet. The recent global pandemic, as well as those anticipated in the future, are best explained by our impact on ecosystems. When we talk about natural destruction, we traditionally look at forests and large mammals. But humanity’s footprint is also noticeable in micro-communities, which is the origin of a number of sadly famous pathogens.

An active way of protecting human health is to strengthen planetary stability. Human health and the health of our environment are inextricably linked. Our collective resilience, well-being, nutrition, and ability to avert disease, is fully connected to the food we eat, the water we drink and the air we breathe. It is important to integrate this thinking into our plans and actions. Innovation is only meaningful if it reaches the people who need it. This is Roche’s firm conviction, and I give it my full support and attention. Our family, which has been committed to Roche for 125 years, has always taken a long-term view on improving access to healthcare. We believe that reducing inequities in access to healthcare is the right thing to do from both a societal and business point of view.

Ensuring healthcare is viewed as investment not a cost. Find out more here.