Celebrating Global Health Equity Week

By Greg Reh, Deloitte Global Life Sciences & Health Care leader

Over the past few years, the Healthcare Information and Management Systems Society (HIMSS)—along with the health IT sector—has highlighted the role technology plays in making health care more accessible and equitable. In the United States, health inequities add about $320 billion a year to annual health care spending. But this issue is not unique to the U.S. Health inequities cost European countries more than $1 trillion (€980 billion) a year, and countries in Africa collectively lose about $2.4 trillion a year to poor health and premature death (see our report, on the Economic cost of health disparities).

In 2022, Deloitte U.S. committed $1.5 billion over the next decade to improve equity in education and workforce development, finance, and health.¹ Globally, we have committed a total of $3 billion over 10 years to help improve these societal issues. Deloitte Global is also a founding signatory of the Zero Health Gaps Pledge, a global, multi-sector, CEO-level commitment to help advance health equity. The Pledge was launched by the Global Health Equity Network at the 2023 World Economic Forum Annual Meeting in Davos, Switzerland.

Over the past year, we have launched Deloitte Health Equity Institutes in Europe and Spanish Latin America to complement established Institutes in Africa, India, and the U.S. The Institutes provide funding and pro bono work to community organizations to create coalitions that can address inequities. In recognition of HIMSS’s Global Health Equity Week, which began October 23, I reached out to all of the Institutes’ leaders to discuss their mission and some of the insights they have gained. Here is an overview of their comments:

Greg: What have you learned since joining your Deloitte HEI?

• Harsh Kapoor, partner, Monitor Deloitte India and India DHEI leader: Our Institute is focused on India, especially its villages where accessibility, affordability and availability of quality health care is often a challenge. In addition, gender disparities in society also trickle down to health care. As a result, women and children often end up paying the heavy price of poor health. Lack of awareness and availability of good nutrition and sanitation facilities compound the problem. One of the biggest lessons we’ve learned is that low-cost care-at-home models—with technology oversight that dove-tails with existing government programs—can help improve health outcomes. Villagers are often hesitant to visit health facilities for multiple reasons such as lack of infrastructure, distance, and long waiting times. One of our focus areas is women and child health, with a special focus on anemia. This is one of the most common, yet preventable, causes of maternal deaths. The losses associated with iron-deficiency anemia amount to about 1.2% of GDP in India.¹
  
• Jay Bhatt, managing director, U.S. DHEI leader: I am coming up on my second year leading the U.S. Institute. As a primary care physician in a historically underserved community health center, I draw on the experiences of my patients and their lives. Other members of our team draw on their own lived experiences to help foster relationships with collaborators. Every organization can play a role in advancing health equity among their employees and throughout their communities. The Chicago Bulls won six NBA championships in the 1990s. They had Michael Jordan, arguably the greatest basketball player of all time, but they also had a system that allowed other players to contribute and shine. That is how we improve health equity. The life sciences and health care sectors should work closely with local employers, community-based organizations, and government agencies toward a common goal.
  
• Ashleigh Theophanides, chief sustainability officer, Deloitte Africa, and executive director, Africa DHEI: I have learned that many African countries face similar issues including fragmented health systems, a divide between public and private health care, and socioeconomic conditions that can put health care beyond the reach of many. Our Institute was set-up during the COVID-19 pandemic to help respond to inequalities in accessing health care throughout the continent. We focused on leveraging data and analytics to assist with evidence-based planning and worked with collaborating organizations to help manage oxygen, beds, and vaccines. As we move beyond COVID, we are leveraging technology and data to expand access to mental health.
  
• Claudia Restrepo, Sustainability and Climate Change partner, Deloitte Mexico, and executive director, Spanish Latin America DHEI: It is impossible to address the challenge of inequality as a single organization working independently. This work needs to be integrated—connected with multiple groups—to generate coherent interventions within the population. In consequence, we can generate a greater impact and, at the same time, optimize resources.
  
• Liz Hampson, partner, Deloitte UK, and executive director, European DHEI: In Europe, our most recent research is based on discussions with 40 different stakeholders across the life sciences and health care ecosystem. Cross-sector collaboration is vital, and many organizations are early in their maturity curve. We can help make connections and support collaboration across multiple stakeholders, which all have different strengths. We have learned that digitalization can help address health inequities but bias in solutions like AI could exacerbate existing systemic inequalities and further drive the divide, for example, between socioeconomic groups, ethnicities, genders.
  

Greg: All of the Health Equity Institutes collaborate, provide funding, and support various organizations that are trying to have an impact. How have these collaborations influenced the work you do?

• Ashleigh: The Africa DHEI brings together government representatives, NGOs, private-sector executives, and society to advance health equity on the continent. I believe in the multiplier effect. This is the ability to collaborate with other organizations in an ecosystem to drive success. We need to ensure that all stakeholders are working toward the same outcome as projects and initiatives develop. It can be difficult to create a level of alignment without clear focus. This is often why people become disillusioned or frustrated by how long it can take to see results.
  
• Harsh: We have learned that encouraging medical students to volunteer is a great way to bring down costs and improve efficiency in the health equity space. Identifying the gaps in the existing model—and addressing those gaps—has helped our DHEI to create an impact that lasts. In this program, we realized that the clear focus on addressing iron deficiency anemia, and using Hb levels as an indicator, helped to frame the program effectively among all the stakeholders and bring about a common objective to work toward.
  
• Claudia: Our focus is to help our Life Sciences and Health Care clients meet their ambitious goals around equity, access, and accessibility to medical treatments for vulnerable populations. We work mainly to develop sustainable and multi-actor financing mechanisms to address various diseases. We have learned that, although the path is slow, the participating organizations want to be involved in projects that are measurable and have clear key performance indicators [KPIs] that track results in the reduction of inequalities. We have found that some organizations have funding but cannot find the projects that align with their ambitions and needs. While other organizations have well-structured projects, they cannot find funding. This understanding allows us to make our DHEI a platform for connecting various needs to different organizations.
  

Greg: How are you taking the lessons you’ve learned and sharing it with the other Institutes?

• Jay: The Institutes share experiences about our work with each other. There is a common thread around mental health and maternal health. We have all been discussing how virtual and digital health might be used to make care more accessible and where the Institutes can invest to have the biggest impact. We used to have to seek out collaborators, and we still do. But as we build a reputation in this space, more organizations are coming to us and asking how we might work together.
  
• Liz: Many of the organizations we’ve spoken to have a global interest and our research is relevant to Health Equity Institutes around the globe. We are working together to understand global trends, which are shaping our propositions. And we are developing local collaborations, which can bring fresh insights and shape the way we collaborate in the global network.
  
• Claudia: We are creating a synthetized scorecard, which will be used to communicate the results of our contraception and diabetes projects, for the community we are working in. This scorecard will be adapted to measure and to help communicate results related to other pathologies—such as cardiometabolic and breast cancer—that we are just beginning to work with. We share our experiences with the other HEIs.
  

Greg: Last February, Deloitte Global joined 38 other organizations in signing the Global Health Equity Network Zero Health Gaps Pledge. Today, about 80 organizations have pledged to help advance health equity and support better health outcomes. Where do the Institutes fit into that?

• Claudia: Our work is fully connected and aligned to those goals, which are focused on providing access to diagnoses, treatments, and medications for vulnerable populations. We help organizations identify the root causes of health inequities. While designing the specific project for each organization, we include a component to measure the impact. We then encourage these organizations to share their knowledge and their progress with other organizations.
  
• Ashleigh: Our ability to encourage and nudge other organizations to sign up for the Pledge—and to initiate programs that support Health Equity, especially for the marginalized groups—could provide the multiplier impact we are looking for to address health equity across the African continent.
  
• Jay: We provide subject matter specialization and funding support to the Global Health Equity network, which is now in year three. There are parallels between the Zero Health Gaps Pledge and attaining a Zero-Carbon footprint. Organizations have signed on to this initiative to improve health outcomes in communities around the globe. Large life sciences and health care organizations, NGOs, and several government organizations have signed on to the pledge. The momentum is making it easier for us, in the US, to have conversations about health equity with our collaborators and with our clients. It is helping us to think differently about how to approach health inequities.
  

Greg: Looking ahead five years from now, what progress do you want your Institute to have made?

• Claudia: This Institute is still new, but I would like to look back five years from now and see that our projects remain agile and concrete and have tangible results. We want to look back and see the real change we have made in the communities we work with, and that the impact made is sustained and systemic.
  
• Harsh: Extending our anemia program to the whole nation could help address a crucial health challenge in India. We would also like to consolidate our learnings into actionable insights that can be implemented globally to help marginalized communities achieve better health outcomes through focused intervention programs that address specific health gaps that exist in those communities.
  
• Jay: Health equity is becoming embedded in our conversations with clients. We are helping to equip key decision makers with information and tools to advance health equity. We're bringing fragmented stakeholders and communities together, and we're catalyzing innovation and health equity. Some say the redwoods in California have stood there for thousands of years, despite having surprisingly shallow roots. They are able to withstand extreme weather because their roots are interconnected. The trees help each other stand tall and endure. I see parallels to health equity. An interconnected system of stakeholders can make each individual organization stronger.
  
• Liz: Our vision is for our people and teams to have a deep understanding of what health equity is and to be empowered to consider health equity in all their client work. To be working with collaborators across the ecosystem to advance health equity and apply this lens across all our health and life sciences work. And for Deloitte to be recognized as a key player in health equity in the external community.
  

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Endnote:

^{1_{Is the burden of anaemia among Indian adolescent women increasing?, PLOS Glob Public Health, September 6, 2023}}

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