2007/SOM2/LSIF2/017 APEC Life Sciences Innovation Forum: Investing in Health

Transcription

1 27/SOM2/LSIF2/17 APEC Life Sciences Innovation Forum: Investing in Submitted by: La Trobe University Fifth Annual APEC Life Sciences Innovation Forum Adelaide, Australia 19-2 April 27

2 APEC LSIF: INVESTING IN HEALTH Vivian Lin Professor of Public La Trobe University, AUSTRALIA OVERVIEW How health gains have been achieved Return on investment on public health interventions The need for investment in infrastructure and capacity New challenges and approaches to tackling them 1

3 1% Deaths, By Broad Cause Group and WHO Region, AFR EMR SEAR WPR AMR EUR Noncommunicable conditions Injuries Communicable diseases, maternal and prenatal conditions and nutritional deficiencies Tuberculosis Year Respiratory TB death rate Death rate per million bacillus identified chemotherapy vaccination year 2

4 Engineering in Notifications of H.influenzae Notifications Total notifications Rate per 1, in <5 yrs Vaccine introduced Infant vaccine licensed, public programme introduced Notifications in <5 yrs

5 Immunisation 18 Deaths from measles since commencement of subsidised immunisation, Australia Source: Applied Economics 21 Adult smokers in Australia Percent of adult population 8 Male 7 Female Year Source: Anti Cancer Council of Victoria; 4

6 HIV/AIDS Estimated annual HIV incidence, Australia , 2,5 2, 1,5 1, Source: Applied Economics 21. Returns on Investment in Public Costs and benefits of public health programs to reduce coronary heart disease, Australia ($million) $1, $9, $8, $7, $, $5, $4, $3, $2, $1, $ Costs Benefits gains sector savings Source: Applied Economics 21 5

7 Returns on Investment in Public Costs and benefits of public health programs to reduce tobacco consumption, Australia ($million) $9, $8, $7, $, $5, $4, $3, $2, $1, $ Costs Benefits gains sector savings Source: Applied Economics 21 WHO Promotion Capacity Mapping Tool = Questionnaires x 2 (short, expanded): Domain 1 National policies and plans Domain 2 Core of expertise Domain 3 Collaborative mechanisms within government Domain 4 Program delivery Domain 5 Partnership among NGOs/civil societies, private sector and government Domain Professional development Domain 7 Information systems Domain 8 promotion financing

8 Relationship between HP capacity and expenditure on health as % of GDP- HP capacity appears to increase slightly as expenditure on health as a % of GDP increases, although that relationship is not very strong Relationship between health promotion capacity and expenditure on health as % of GDP Expenditure on heealth as % of GDP Country score Relationship between HP capacity and GDP - HP capacity tends to increase with GDP of a country Relationship between health promotion capacity and GDP Index GDP Index Country score 7

9 Relationship between HP capacity and human development - HP capacity tends to be higher in countries with higher levels of development (as indicated by the Human Development Index) Relationship between health promotion capacity and human development index 1.9 Human development index Country score Australia 1 Policies 8 Financing 7 Information Expertise 3 Collaboration Prof devpt 4 Program 5 Partnership 8

10 Singapore 1 Policies 8 Financing 7 Information Prof devpt 3 2 Expertise 3 Collaboration 4 Program 5 Partnership China 1 Policies 8 Financing 3 2 Expertise 7 Information 3 Collaboration Prof devpt 4 Program 5 Partnership 9

11 Viet Nam 8 Financing 1 Policies 3 2 Expertise 7 Information 3 Collaboration Prof devpt 4 Program 5 Partnership Philippines 1 Policies 8 Financing 3 2 Expertise 7 Information 3 Collaboration Prof devpt 4 Program 5 Partnership 1

12 New Zealand 1 Policies 8 Financing 3 2 Expertise 7 Information 3 Collaboration Prof devpt 4 Program 5 Partnership Diabetes Predicted direct health care costs attributable to diabetes (diagnosed cases) in Australia: ,5 Minimum cost estimate Maximum cost estimate 2,75 2,3 2, 1,85 $ (m illions) 1,5 1, 1, Source: McCarty DJ, Zimmet P et al, 199, The Rise and Rise of Diabetes in Australia,

13 Cost of Obesity Estimated increases in health system costs of obesity, Millions ($) Source: AusDiab report, 21; NHMRC,1997, Acting on Australia s weight Scope for Chronic Disease Prevention - a Lifecourse Approach Development of chronic disease Foetal Life Maternal nutritional status; birth weight Infancy and childhood Childhood diseases; growth rate Adolescence Smoking, poor diet, physical inactivity, substance abuse Adult Life Smoking, alcohol, obesity, physical inactivity, use of preventive services Older age High Range of accumulated risk with and without intervention Low Source: adapted from WHO, 22 Age 12

14 From clinical to population health Proactive Population Population Public Preventive Care Clinical Care Individual Reactive URBANISATION TRENDS YEAR /7 23 Urban population in the world 29.1% 37.3% 5%.8% 13

15 ANNUAL RATE OF URBAN GROWTH, Region African Asia Latin America and Caribbean Europe North America Growth rate 4.21% 3.47% 2.7%.8% 1.32% MATERIAL AND PSYCHOSOCIAL FACTORS 14

16 LIFE COURSE APPROACH SOCIOECONOMIC POSITION Intra-uterine conditions Education & Environmenta l Conditions Working Conditions & Income Income & Assets BIRTH CHILDHOOD ADULTHOOD OLD AGE Low Birth Weight Growth Retardation Smoking Diet Exercise Job Stress Inadequate medical care Atherosclerosis CVD Reduced Function from Lynch, J. & Kaplan, G (2) Socioeconomic Position in L. Berkman & I. Kawachi (eds) Social Epidemio logy, O xford U niversity Press, Oxford. CONCLUSION Triple burden of disease Attention needed to environment, lifestyles, healthcare, and genetics Integrated and balanced investment can make a difference 15