Building Sustainable Health Systems in Asia: A Path Forward for World Sustainability Day

October 25, 2024 | Friday | Analysis

By Sylvia Varela, Area Vice President, Asia at AstraZeneca

On World Sustainability Day, it is crucial to reflect on one of Asia’s most pressing challenges: ensuring the sustainability of its health systems. Home to nearly 60% of the world’s population, Asia faces a unique set of pressures that threaten the resilience and effectiveness of its healthcare infrastructure. Addressing these challenges is not just a necessity for health but a critical element in the broader quest for global sustainability.

Asia’s health systems are currently grappling with a multitude of issues, battling a rising tide of non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes, and cancers, which are responsible for approximately 8.5 million deaths annually. Compounding these health concerns are the adverse impacts of climate change. Air pollution alone accounts for four million deaths each year, while extreme heat, which can worsen chronic conditions, has been linked to around half a million deaths annually since 2000. Recognising the growing burden, governments across the region have made huge strides in working to address the significant impact of NCDs, but we have a long way to go in transforming outcomes. 

Meanwhile, demographic shifts are set to impose additional strains on healthcare systems. By 2030, Asia is expected to be home to 60% of the world’s population above the age of 65, placing unprecedented demands on healthcare services. These pressures not only highlight existing inequities but also threaten to deepen health disparities, particularly among vulnerable populations.

During COVID-19 pandemic we witnessed just how vulnerable our healthcare systems are when critical routine healthcare was severely disrupted. We need to change how we view healthcare and see it as an investment, not a cost to be contained, and build systems resilient to future pressures.

Transforming Healthcare Delivery for Sustainability

A fundamental aspect of creating sustainable health systems lies in transforming healthcare delivery. This starts with prioritising early detection and diagnosis which can dramatically alter disease trajectories and reduce the burden on healthcare systems. For instance, in chronic kidney disease (CKD), a delay in diagnosis by just one year can increase the risk of disease progression by 40% and the need for dialysis by 63%. Similarly, early detection of lung cancer, where over 50% of patients are diagnosed at a metastatic stage, is crucial for improving survival rates.

Efforts in Southeast Asia illustrate the potential of early detection AstraZeneca’s partnership with the Ministry of Health in Vietnam and key patient groups for example, almost 800,000 people will have been screened by the end of 2025 as part of efforts to drive early CKD detection. In Thailand, where CKD ranks as the fourth leading cause of mortality, an advanced digital tool known as the "CKD Risk Score" is being leveraged to identify at-risk individuals. This facilitates early interventions that enable patients to access optimal treatment, thereby delaying disease progression and the need for costly and invasive kidney dialysis.

Meanwhile, for the early detection of lung cancer, AI-assisted chest X-rays are being used to identify individuals with suspicious lung markers in less than a minute so they can be referred on for diagnosis. It’s estimated that early lung cancer screening programmes and timely intervention could increase the five-year survival rate of patients by 73% in the first year of implementation, showing what’s possible through innovation.

Going beyond reactive “sick care” to proactive preventive care is another crucial step. Education and awareness programmes can significantly reduce disease incidence by empowering individuals with knowledge. In countries like India, Indonesia, and Vietnam, youth education on NCD risk factors has led to impressive outcomes, such as a 58% decrease in smoking in India, a 40% increase in young people visiting community health clinics in Indonesia, and a 63% increase in healthy dietary behaviours in Vietnam . These efforts underscore the importance of preventative measures in fostering long-term health improvements.

Addressing Equity Gaps for a Sustainable Future

Equity is at the heart of a sustainable health system. Unfortunately, healthcare gaps persist, with many individuals remaining undiagnosed or receiving inadequate care due to factors like geography, gender, and income. Emerging markets within Asia are particularly vulnerable; these systems often operate with limited resources making it difficult to provide comprehensive care. As Asia’s population grows older and larger, the associated costs and healthcare needs will only increase, straining already overburdened systems.

Take South Korea, for instance. Despite having one of the highest life expectancies, the country faces significant challenges related to aging. Chronic diseases have accounted for almost 80% of all deaths in South Korea since 2021, and related health expenditure increased more than twofold between 2009 and 2020. This is compounded by an astonishingly low birth rate which ministers have described as a “national emergency” as the demographic crisis deepens.

In other emerging markets, geographical issues such as rural populations, extreme poverty and limited access to sanitation further add to the complexity of equitable healthcare, heightening the impetus of innovative solutions are needed to close these gaps.

A Collective Effort for a Sustainable Future

Achieving sustainable health systems requires a collective effort from all stakeholders—overnments, policymakers, healthcare providers, and communities. Building resilience into health systems involves comprehensive health reform and capability enhancement, which must be approached collaboratively. The Partnership for Health System Sustainability & Resilience, launched at the height of the COVID-19 pandemic, exemplifies what can be achieved through collaboration across the healthcare landscape. By bringing together expertise in health research, policy, and innovation, the partnership has driven over thirty policy changes worldwide, improving health systems and patient outcomes. In Asia PHSSR reports were launched at such markets as South Korea, Taiwan, Vietnam and Malaysia.

Innovation and collaboration are key to bridging care gaps and preparing for future challenges. Embracing digital technology and data-driven policies can enhance healthcare delivery and make systems more resilient while active engagement in partnerships and the adoption of innovative solutions will help drive improvements in patient outcomes and strengthen health systems.

By focusing on early detection, preventative care, and equity, and by fostering innovation and partnerships, we can build resilient health systems that can deliver equitable, effective and sustainable care for all.

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