Americas Quarterly Launch: How Business and Technology Are Expanding Access to Health Care

Speakers:

• Fernando Álvarez del Río, Head of Economic Analysis Unit, Secretariat of Health, Mexico
• Walter H. Curioso, Specialist in Biomedical and Health Informatics, Universidad Peruana Cayetano Heredia
• Jason Marczak, Senior Editor, Americas Quarterly; Director of Policy, AS/COA (moderator)
• Gustavo Menéndez-Bernales, Managing Director, Internet Business Solutions Group, Cisco Systems Inc.
• Robert Simpson, Director of Latin America Public Affairs and Policy, Pfizer, Inc.
• Patricio Villareal, Co-Founder and Vice President, Imagen Dental; Co-Founder and Vice President, Alivio Capital
• Christopher Sabatini, Editor-in-Chief, Americas Quarterly; Senior Director of Policy, AS/COA (moderator)

Summary

On October 28, 2010, the Americas Society and Council of the Americas launched the health care issue of Americas Quarterly with a program on how business and technology are expanding access to health care in Latin America. The discussion centered on the sector’s changing landscape witth a focus on Mexico, the effect of technology use on health care access, and the importance of inter-sectoral collaboration and partnerships in harnessing technology’s potential.

The Changing Landscape of Health Care in Latin America – The Case of Mexico

Latin America is in the midst of a dramatic transformation with respect to its health care needs and access. Dr. Fernando Álvarez del Río of the Secretariat of Health of Mexico noted that his country’s primary focus involves achieving universal health care. Mexico’s universal health care initiative, Seguro Popular, was implemented in 2003 in order to provide a health care option for all Mexicans without medical insurance. The voluntary scheme has grown popular, with rates of affiliation currently at about one million people per month.

But the program faces important challenges, including resource distribution. The Health Secretariat coordinates and oversees the initiative, but funding is implemented at the state level. The result is a high incidence of cross-state coverage that goes uncompensated as well as a lack of common standards across states. Álvarez stressed that the next step for Seguro Popular is vertical integration of the system. This would facilitate the interchange of services, encourage the efficient use of resources, and increase interstate and health provider collaboration.

Álvarez added that the decentralized structure of Seguro Popular allows support across party lines. Pfizer’s Robert Simpson noted that efforts toward achieving universal coverage—as is the goal with Seguro Popular—are not only seen in Mexico but across the region. In many of these cases, health care access is a theme that transcends party politics and ideology. Simpson also noted that we are witnessing a shift in emerging market health challenges from communicable and infectious diseases to chronic diseases, such as cardiovascular disease and obesity. This shift is driving public sector focus on universal health care.

The private sector is also responding to these new health dynamics, and governments are holding companies accountable for products and marketing strategies. One such response is from the International Food and Beverage Alliance (IFBA), which works with governments to address the rise in chronic diseases. IFBA members have implemented a “Five Commitments in Five Years” initiative to promote balanced diets and healthy lifestyles among consumers. However, multinational food and beverage companies account for only 15 percent of the market; governments must also hold accountable the small, medium, national, and informal food and beverage suppliers. Álvarez acknowledged the challenge and the lack of an easy solution. He emphasized the need for a complete overhaul of the food and beverage industry in the face of current health concerns.

Searching for Efficiency

As Latin America’s health care needs evolve, the region is experiencing a revolution in its access to technology, particularly mobile technology. Walter H. Curioso of the Universidad Peruana Cayetano Heredia pointed out that just 10 years ago people in developing countries owned just 15 percent of the world supply of mobile phones. Today, nearly 85 percent of mobile phones are concentrated in developing countries.

Curioso highlighted that mobile health, or mHealth, exemplifies the rising convergence of health care and technology at the individual level. Cisco’s Gustavo Menéndez-Bernales summarized the ultimate promise and goal of using technology to revolutionize health care access: the search for efficiency and the ability to decipher how to maximize the use of resources. The increase in access to mobile technology has led to many pilot projects the use of technology to enhance health care access. Menéndez-Bernales sees the key to harnessing the full potential of technology as a process where the effectiveness of technology is first established and then steps are taken to scale up from the pilot stage. Curioso added that many pilot projects are simply never scaled up.

Imagen Dental Co-founder and Vice President Patricio Villareal explained how technology serves as an integral component of his business model, which provides affordable health care services for those that couldn’t otherwise afford it. The use of technology has reduced Imagen Dental’s operation costs, allowing for affordable rates, and also improved the quality of the health services. Villareal’s clinics can now offer quicker and more accurate results and more effectively collaborate with other doctors. Furthermore, technology facilitates patient education and increases doctor-patient trust. For example, through technology, his patients can now instantly see digital x-rays and understand the need for treatment.

Collaboration and Partnerships: Governments, Private Sector, and Academia

The speakers agreed that inter-sectoral collaboration and partnerships are vital to move forward from the pilot stage toward economies of scale. Simpson stressed the need for a holistic approach that engages suppliers, entrepreneurs, distributers, governments, insurance companies, patients, and providers.

In Haiti, Digicel works closely with academic and government institutions, NGOs, and manufacturers in their operations to address the country’s post-earthquake needs. Working with relatively simple mobile technology, the company has implemented population-tracking programs and mobile application development for the delivery of information and education on health threats and procedures. The simplicity of the technology implies an incredible potential to develop similar projects.

Policymakers may question using technology for health care, but Curioso emphasized that many new health care initiatives employ simple and widespread technology (such as mobile phones) but the problem remains that policymakers are not aware of their potential. Greater collaboration across countries and among academics, technology companies, and the government may solve some of these issues. Villareal agreed that this is crucial, saying governments could help increase the benefits of technology by decreasing procedural barriers and financing health care projects. Furthermore, he suggested that collaboration with logistics experts is critical for maximizing the health care benefits of technology.

Speakers ultimately agreed that technology cannot replace doctors; health care will remain a human service with technology as an essential complement.