Forum Tied to UNGA Meeting Focuses on Innovation, Health Care Workforce; WHO Releases Report on HTN

The ACC, NCD Alliance and World Heart Federation (WHF), with support from Viatris, brought together leaders in global health and technology for an "Enhancing the Health Workforce Through Innovation," forum in New York on Sept. 19. The event was held in advance of the 78th session of the UN General Assembly (UNGA) discussion on the need for universal health coverage to improve global access to care and reduce the out-of-pocket burden of rising health care costs.

"The ACC, working with the NCD Alliance, WHF and other stakeholders, has been committed to improving health care for all globally by engaging in global health advocacy and supporting clinicians and health care professionals to better manage noncommunicable diseases (NCDs)," said ACC President B. Hadley Wilson, MD, FACC. "Leveraging innovation to help enhance the workforce is an important part of these efforts."

According to the World Health Organization (WHO), NCDs are the leading cause of death globally, with cardiovascular diseases accounting for 32% of all global deaths in 2019. Over 75% of those deaths occur in low- and middle-income countries, where people often struggle with significant out-of-pocket health care costs. A large portion of health development expenditures globally has focused on communicable disease, but the burden of disease cost from NCDs is significant and growing as the world's population ages.

The ACC, NCD Alliance, WHF and Viatris, organized the event to illustrate that health coverage alone does not guarantee access to care and highlighted the need for attention to the health workforce; share examples of how technology is supporting global health workforce training; highlight case studies of how successful implementation of technology at the front lines of care delivery can support better management of NCDs in communities; and provide policymakers with concrete ideas of how workforce issues can be addressed through task shifting, training and supportive technology.

The event was moderated by ACC's Chief Innovation Officer Ami Bhatt, MD, FACC, and featured keynote speakers Rebecca Bunnell, PhD, MEd, acting principal deputy U.S. Global AIDS Coordinator for PEPFAR, and Tom Frieden, MD, MPH, president and CEO of Resolve to Save Lives, who discussed how digital health can support a more robust health care system.

"Team-based care—with doctors, nurses, pharmacists, social worker, and community health workers collaborating to support patients—is the most effective way to improve care and save lives," Frieden said. "Digital tools that are created to support health care workers through user-centered design can accelerate progress."

Other speakers included perspectives from people living with NCDs and panelists from across health care and the tech sector envisioning the future of a global health workforce that is built to enact universal health coverage, and an opportunity for Q&A.

"Advances in technology have democratized banking, transportation, education and commercial shopping throughout the world allowing people to solve many of their problems outside of the traditional brick and mortar system," said Tom A. Gaziano, MD, MSc, FACC, chair of WHF's Science Committee. "Health care is the one sector that has not adequately adopted the technology to increase access to care and allow patient empowerment often from within their own homes. However, the tools are there for the taking, we just need to mobilize to adopt the technology and free ourselves from the model that solely revolves around the clinic and the hospital."

During a discussion on how global organizations, countries and localities can stand up integrated, digitally enabled programs, Lobna Salem, MD, highlighted how access is fundamental to Viatris' mission of empowering people worldwide to live healthier at every stage of life. She added: "Crucial to advancing access is a stable health care workforce; without it, countries will not be able to meet the individual needs of their populations and communities. We believe education and outreach through programs like the NCD Academy are a critical mechanism to help health care professionals prevent, diagnosis and treat cardiovascular disease, diabetes, cancer and other important chronic conditions."

Meanwhile, in a separate UNGA side event, the WHO released its first-ever report on the devastating global impact of hypertension, along with recommendations for reversing this devastating trend.

According to the WHO, the number of people living with hypertension doubled between 1990 and 2019, from 650 million to 1.3 billion. In addition, nearly 50% of people with hypertension globally are currently unaware of their condition and more than three-quarters of adults with hypertension live in low- and middle-income countries.

According to the report, an increase in the number of patients effectively treated for hypertension to levels observed in high-performing countries could prevent 76 million deaths, 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure between now and 2050.

The report underscores the importance of implementing WHO-recommended effective hypertension care to save lives, which include the following five components:

  1. Protocol: practical dose- and drug-specific treatment protocols with specific action steps for managing uncontrolled blood pressure can streamline care and improve adherence.
  2. Medication and equipment supply: regular, uninterrupted access to affordable medication is necessary for effective hypertension treatment; currently, prices for essential anti-hypertensive medicines vary by more than ten-fold between countries.
  3. Team-based care: patient outcomes improve when a team collaborates to adjust and intensify blood pressure medication regimens per doctor orders and protocols.
  4. Patient-centered services: to reduce barriers to care by providing easy-to-take medication regimens, free medications and close-to-home follow-up visits, and making blood pressure monitoring readily available.
  5. Information systems: user-centered, simple information systems facilitate rapid recording of essential patient-level data, reduce health care worker data entry burden, and support rapid scale-up while maintaining or improving the quality of care.

"Hypertension can be controlled effectively with simple, low-cost medication regimens, and yet only about one in five people with hypertension have controlled it," said Tedros Adhanom Ghebreyesus, MD, WHO Director-General. "Hypertension control programs remain neglected, under-prioritized and vastly underfunded. Strengthening hypertension control must be part of every country's journey towards universal health coverage, based on well-functioning, equitable and resilient health systems, built on a foundation of primary health care."

Keywords: ACC International, Cardiovascular Diseases, World Health Organization, Communicable Diseases

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