 Good morning everyone here in the room and on the live stream and welcome to this press conference on the future of health as a global challenge. You're joining this press conference at the annual meeting of the World Economic Forum 2016 which you might have taken the hint from the subtle branding in our back. The forum is very excited about this press conference because we're launching today the global challenge future of health. So far the forum had nine global challenges so areas where we believe that public-private cooperation can produce beneficial results and we're adding today and officially launching here today the 10th global challenge the future of health. And I'm joined today by a fantastic panel. I'll start with the introductions right from the end of the panel. We're joined by Mark Sosman who's the president for global policy advocacy and country programs at the Bill and Melinda Gates Foundation. Thank you for joining us. Right next to him we have Omar Ishrak the chairman and chief executive officer of Metronik. Right in the middle we have Franz van Houten who's the CEO and chairman of Royal Philips and next to him we have Arif Nagvi the founder and group chief executive of the Abraash group based in the United Arab Emirates and last but definitely not least we're joined by my colleague Arnaud Bernal who's the head of global health and healthcare industries at the World Economic Forum who will also be responsible for this global challenge at the World Economic Forum. And without further ado Arnaud tell us what is this global challenge about why is the forum active in the field of health. Yes thank you Giorgio. So about the challenge which we will be launching officially today and in effect in practice with our potential global challenge partners and potential trustees on Friday at one o'clock. About the challenge this is a recognition that as much as we have a very very strong healthcare industry community we think that the healthcare industry community in public private partnerships in collaboration with the public sector and the civil society has to focus on access to care and value-based healthcare so meaning that when we talk about the 7 trillion of healthcare spending globally of which we think 30 percent is being wasted for outcomes that are in a way insufficient this is where our healthcare industries need to work very closely with policy makers to create incentives to make better delivery of care care delivery healthcare. Now what about health that's some things that we want to address as a complement to our industry program and that's where we create this additional community of partners and trustees because we believe the health challenge can be addressed only as a cross sector initiative way beyond the healthcare sector think about healthy nutrients think about mobility think about exercise think about designing cities that are prone to aging gracefully at home that's all the areas that the global challenge will address that's talking about keeping individually individuals healthy in the first place so that they don't have to actually utilize those highly expensive healthcare systems that's all about health health at the level of the individual health as a way to actually enjoy healthy lifestyles and age gracefully and also health at the level of populations always in the field of prevention again think about the pandemics think about resistance to antibiotics think about everything we have seen and we have learned from the Ebola crisis those populations are currently exposed to major global health security risks and that's also an area that's going to be covered as part of the global challenge so in summary you know we have seen decades of improvement in healthcare and we have seen decades of improvement in the way populations are seeing longevity increase now but no we are almost at a turning point where all this progress is at risk of being destroyed in a way all this progress is at risk because of non-communicable diseases because of 34 million people dying annually from non-communicable diseases many of them could have been saved with healthy lifestyles we'll see re-emergence of some diseases polio being one of them we'll see risks of pandemics and we see also the role of the World Economic Forum as a catalyst to public private partnership as an instrument to actually make sure that populations can stay healthy in the first place and we have proof points this is not new we have done that in the past I mean think when Gavi was formed in 2001 think when the actually the global fund was presented in Davos in 2002 those are the type of things we want to do again with partners as we connect with the policy makers and we'll talk a lot about that in the next few days. Thank you Arnaud, Arif from a non-experts perspective you're probably the most surprising candidate on this panel because the Abraaj fund is not one of the usual suspects but you're still very involved in the global challenge so tell us how can private capital contribute to solving and to countering this global health challenge? Thank you well I'm very proud that I'm on this panel and having this conversation because contrary to what you may think the Abraaj group actually is very involved in health care and has been since inception so we've invested over a billion dollars in close to 30 companies across the last 10 years in this sector all the while learning and all the while understanding what it takes to make health care efficient and health care accessible and affordable to the vast band of humanity that occupies what a lot of people call the emerging markets we call the global growth markets because these are the markets where the world is going to experience significant economic growth in the decades to come two-thirds of global consumption is going to come from there two-thirds of the middle classes reside there and urbanization which is a big trend across the world is actually more prevalent in those markets than anywhere else but if that is going to be realized if that promise is going to be realized then one of the most critical things that we have to address is the lack of high quality health care which in effect is actually a deterrent to all of that growth as well so when we looked at the opportunity that private capital can play in pulling together a very effective response to what often is a failing on the part of governments across those markets what we realize is that private equity which traditionally has not been known to invest in longer term and longer gestation projects we decided to look at adaptation of the model what I like to call private equity 3.0 and that is if you like a very strong emphasis on partnership capital on alliances and what do I mean by that so obviously there's a dual purpose the first is to make money for investors and to provide a return on capital but equally importantly when we refer to partnership capital what I'm talking about is the people on this panel and people around the world that have different elements to contribute to helping making health care is sustainable and a viable option available to more and more people and so the Abraaj group has worked very hard over the years to pull together these alliances to pull together for example our global health care fund in which you know the Bill and Melinda Gates Foundation Phillips Metronics are key value-add partners and each of us has a role to play in the development of having affordable health care available to our to our marketplace but equally importantly the capital that we deploy is then used to build alliances in other words if we were to invest as we just have all of us collectively into India's fifth largest hospital business which is called care which operates in second and third tier cities across India and there you have a cadre of doctors and health care technicians that are actually world class and if we can use that expertise in that training and apply it across Africa everybody is a winner if we can apply learnings in one area into another everybody's a winner so this alliance based approach is actually going to work very effectively in health care and we hope that all of us have a role to play in making more and more people aware of that thank you very much a leaf France the theme of the of the annual meeting this year is the fourth industrial revolution and it definitely affects the health sector as well Phillips is at the forefront at looking what is happening there if the individuals take more control of their health through technology how will it affect the how will it affect your sector yeah that's indeed a trend and very important so let me expand a little bit and then come back to your point if we look at the world was growing population an aging population a world with more chronic disease where actually health care is already close to nine trillion US dollars and even so not everybody has access and not all those dollars are well spent and have the right outcomes and much of that spend is in fact targeted towards acute and episodic care and if you're a little bit blunt and it means it's it's reactive it waits until a patient is truly sick and and therefore we are in a crisis as a health industry we need to reinvent ourselves in how we deliver health and not just health care we see health as the investments as the economic driver of the future it makes people happy but you can no longer just look at health care in a way it's traditionally being delivered so we talk about a concept called the health continuum where you can see what does have to happen to keep healthy people healthy what can you do to prevent disease to happen or to to aggravate and how can you do diagnostics that's first time right how can you do treatment that is first time right therefore taking the waste out of the system and how can you help people to live with chronic disease in an acceptable manner while keeping a good life I probably outside of the four walls of the hospitals but in the comfort of their own community and home and big data and the industry and the fourth industrialization and give us huge tools to do that I think it is very exciting provided that we also allow ourselves to reinvent how we engage with patients with consumers and we feel that consumers will have to take more accountability of their own health and data will play a big role in that by providing a closed loop data and environment where consumers are given feedback on their health where they can measure monitor and motivate to take lifestyle changes we think that we can change the paradigm this is often referred to as population health and big data but we need to be cautious because population health when it is only about analytics is not a solution in the end we need to touch people's lives and that's where every consumer is an individual and every doctor will have an individual relationship with the patient and in our view population health will have to evolve towards impacting people's lives and enabling them to stay healthy to do preventative care to be diagnosed first-time right to have treatment that is hopefully minimally invasive first-time right and allows you to go back to your community and support you to live as chronic disease so I I believe that the internet big data sensor technology it will be able to connect care providers and consumers in a new way giving consumers more accountability of their health changing the economics I'm very hopeful that that's possible but we also need to be realistic that there are quite a few hurdles to overcome money streams may have to be redirected to new ways of extending care incentives may maybe have to be changed so that we all act in an outcome based economic model where we only are rewarded if actually lives are improved and patients do recover so I envisage the need for a collaboration between governments insurance care providers industry finance so that we reinvent over the next let's say five years maybe 10 how care is delivered and the health continuum I think will give us a good framework to do so thank you friends Omar let me let me jump to you directly from there I sense a let's say cautious optimism from France and there's there's work to be done do you share that that sense what's your perspective from metronic well let me actually start with where France finished in the sense that you know there has to be a realization between all parties that we're all on the same team and I think you know both RF and France mentioned the need for collaboration and and for that we need joint accountability for results and get rewarded for those results and anything short of that first creates mistrust and second potentially creates waste because you're building up things that are not connected properly and an efficiency is not built in so so that that's that's important now the other thing that I would say is that as you try to approach this problem of both health as defined and health care in emerging markets an alignment of structure you know that we look at three things that are essential one is awareness awareness amongst patients awareness amongst physicians the second is training of physicians at different levels all the way up there the referral chain to the actual treatment in post acute care and the third is building of infrastructure and the problem is so big in the sense that the geographies are so massive and there's so many people involved at different levels of the economic pyramid that's important to focus geographically in certain areas and build out all of those pieces the awareness the training the infrastructure so that you can have maximum impact on a population otherwise you might build all of these but you you just don't have the time to cover everybody and so you're expecting to see a result like decades later because until then all the infrastructure is not complete and so by doing it in geographic pockets and then scaling it I think is an approach that we would encourage you know governments to do to kind of adopt but also you know other other partners that we may have the final point I'll make is the connection between health and health care if you like in in our nose definition of health and health care although we fundamentally believe that the interface with the health care system for a healthy person versus a person has already been diagnosed is fundamentally different the expectations of a healthy person is not to fall ill the expectations of a person who's already ill is to get better and so the interface is different the expectations are different however there is something that that is somewhat in common which is prevention the difference being for a healthy person is primary prevention for a sick person it's a in fact secondary prevention in that you do the treatment and then you don't want them to get ill but the way you approach them is obviously different because in one case you know the condition the other case you're trying to prevent any condition however you know there's a lot of money short-term benefit to be had by addressing sick people today because you're saving immediate cost and by funding out post acute care home care social understanding which you may have commonality in both types of prevention one can perhaps enhance the investments in primary prevention so it's important to know the distinction and it's because they are different but it's also important to understand where their commonalities and how do you then utilize that commonality to to drive better efficiency in delivering care for all in whatever state they're in thank you Omar Mark you've been listening to two three gentlemen from the private sector you're representing the largest philanthropic organization with the Bill and Gates Foundation Bill and Melinda Gates Foundation what's your perspective from from your sector what are the key steps to to to face this global challenge of health and where do you agree and disagree especially with your speakers here well I think from our perspective I mean you began by mentioning some of the great initiatives that have been launched here at WEF in previous years which include the Gavi and the Global Fund to fight HIV TB and malaria both of which we were very involved in at the inception and I think those have proven kind of models of where grant managers can come together and incentivize the industry but they're more on the production and provision side of things in terms of providing the vaccines getting them out into into the field and so on what we've been talking about here on the panel and what makes us so excited to be a partner with everyone here on the Abaraj growth markets health fund is a potential for really revolutionizing maybe a little strong but that's certainly our hope in the medium term of how we look at some of the service provision going on in many of these markets and the ways you can leverage productively the private sector to markets that would include poor people in urban markets be financially sustainable and really have a ripple effect within those markets in terms of quality indicators impact strengthening the huge sort of human resource systems around health care and so I think what you've heard from my fellow panelists here about you the very specific and real opportunities we have in the space right now that we're actually acting upon as is our example in India and our hope is that this is both a really strong end in itself that will improve both quality and quantity and availability of health care in these markets but something that will really show the potential for how these markets can spread into where there is really massively growing demand in these urban centers across Africa and Asia right now so we're very optimistic about where this is headed thank you mark and before I open the floor for questions oh my you briefly touched on it we have about 40 50 heads of state here coming to Davos and about 300 ministers now imagine I'm I'm the good fairy and you have a wish to the public sector to support facing that that global challenge what would that be well the first thing is to really buy into the theme that we talked about that you know believe that we're all in the same team I think frankly there has to be trust between the private and the public sector and and that we're all trying to to achieve the same purpose of providing better care at all or cost to more people so I think that that's a starting point and the the second thing that I would say is just repeating what I said earlier is that is that focus on pockets and complete the chain rather than try to build out for everything because I think that that's just takes too long before you see any results thank you every from the financing angle what's what's your wish list there so you know what I do have to say is that I often see governments going down a route or a path that the private sector often finds incomprehensible and we can't work out quite why they're doing something but in health care I have to say that I feel governments around the world are very focused on making a difference coming together and seeing and looking always for the innovative solution and I think what we have certainly experienced in this fund the the Abraj Global Health Fund that we are putting together is that not only has the private sector taken the lead in the initiative in providing middle middle income solutions in urban environments that can actually trickle down and trickle up and different aspects of the private sector as you see on this panel but we also have received a lot of support from development finance institutions across the United States and Europe so that coming together is actually telling me that governments are alert are awake and I instructing their financial institutions and arms to work with the private sector to come up with solutions I'm very optimistic that sooner rather than later and you know France sort of put it in the context of a five to ten year horizon as part of his continuum and I actually feel that the ten years that this one will be in place should have outcomes that are going to be quite radical across Africa and the subcontinent very good thank you Francie want to add to that yeah I think we need to make a distinction between developing markets and mature markets as to what we ask those ministers and heads of states I think for mature markets we really need to tear down the silos between sources of funding policy and care provisioning and redistribute on how we connect with patients and consumers on on managing their their health because there is enough money overall it's just not it's still extended on a volume basis and I think if we together take the waste out then it should be sufficient to get people access and a better healthy life for the emerging markets it's it's more challenging there again we should collaborate but we need also to take the fragmentation out part of the urbanization challenge is because health care is only available in urban areas and what we have seen also in the Ebola crisis is the lack of infrastructure is a problem when it comes to making the community healthy and so the vaccination programs are great but if augmented with a rural health infrastructure such as our brides also is is keen and sees as a viable business model and what we have pioneered among others in Kenya with community life centers where you actually create a economically viable model for a community with clean energy with clean water and a doctor and a nurse and the education system connected to a nearby city you start creating a viable community where that attracts economic life and improves the health so you need to be contextual and different solutions for different areas and as many panelists said collaboration is the key and that will get to breakthroughs so thank you friends it's very easy for me to ask what what the wish list is you will be the one who will have to work on the multi-stakeholder effort there so you have the chance to yeah I mean the wish list is very clear is to work with partners as it was discussed in the in the panel today I would like to reflect on what Omar you were suggesting before there is in a way a massive amount of money being spent seven eight nine trillion maybe probably right being spent globally on health care and this is an area where unfortunately the incentives exist they are simply flawed they are volume-based and that's what we need to address as part of our industry agenda now the global challenge which is about health this is an area where incentives simply don't exist this is where public-private cooperation need to happen because frankly speaking if if you ask if you ask anyone where are the incentives to create vaccines for the next pathogen I'll break okay what are the incentives to actually keep populations healthy in the first place or help people manage the lifestyle to prevent diabetes what do they invent the the primary care physician is not making a penny for prevention so what what are those incentives and I think that's where the global challenge will absolutely focus those incentives realigning incentives in public private collaboration so that health can be addressed in the first place thank you Arnold and mindful of the time we might have time for one or two questions can I see a show of hands and if you could state your name and organization for the sake of our online audience sure my name is David Seroto with International Business Times this is to the whole panel there's a debate going on in the United States right now about different kinds of health care delivery systems whether it should stick with the presidents Obamacare so called Obamacare or a single-payer system I'm just curious as you look at both the United States and other other countries which kinds of systems do you believe work best should the United States be thinking about a single-payer system should other countries be thinking about a single-payer system or should they be thinking about a different model thank you David I can take a crack at that and again without getting too opinionated about the subject that the point I'll make is that you know the term single-payer is a bit of a red herring I think the real issue in health care is the move as Arnold pointed out is a successful move from fee for service to value-based and you know the UK is so to speak a single-payer system but they're a fee per service system and I think there's inefficiencies in that care delivery and so I think the nature of the payment and who holds it whether it's one entity or divided into several entities is really a secondary point and you know the politicians can decide how they want to do that but the the the usage of how a pair actually provides the funding is what's important and that has to move towards a value-based system if it moves towards a value-based system you gonna save cost and improve outcomes that's the whole point and you know depending on the nature of the country and its politics you can decide how you do it but that's the important point the most successful countries in the world simultaneously work on a supply and the demand side right supply side avoiding the wrong incentives or the perverse inventives that makes it volume-based rather incentives to take waste out and come to better outcomes but also the demand side and this is where earlier we spoke about you know keeping healthy people healthy doing early prevention doing population health providing feedback to consumers on what their lifestyle may have as consequences and and the the the internet of things is going to make that possible and we often use the expression you know you measure you manage and you motivate and if you do that on a constant basis nobody wants to get sick right so it is having the right dialogue with consumers that and that will influence the demand side right so we need to do both simultaneously and it doesn't have to do with a single-payer system or not it has to do with optimizing the ecosystem together and tweak it a bit and I think accountable care is certainly part of it but also accountable care can exist in many forms thank you the question is also developed markets luxury because when you look across the markets that we're talking about in global growth markets in the so-called emerging markets you have to remember that we're even talking about putting in place health care where it doesn't exist so the question of paying for it is a much more of a secondary down-the-road issue so for example when you take Lagos or you take Karachi or Calcutta you would be amazed at the fact that even the baseline of proper health care does not exist so our job is actually to put that in place to put in the tertiary care to put in a network of an ecosystem that can reflect the ability to pay and then we'll talk about the issues of how to pay thank you very much do we have more questions yes for the lady in the front here please microphone is coming thank you good morning my name is Harriet I work for Channel television Lagos Nigeria my question is for you Arif we talked about using private equity or capital to fund the health care could you repeat it you talked about using private capital and equity to fund them health care providers but in a situation where we see global stock markets are plummeting even in Nigeria our stock market has fallen in the last 10 days to about about by about 2 trillion Naira so we're looking at such such a way of raising capital for the health care providers what would you say is the most practical way to do it so I think I won't call it a luxury but certainly a comfort that we have is that we have committed capital in place to invest in places like Lagos where we're very active in developing the model that we are talking about right now the other thing that you have to remember is partnership capital of the nature that private equity represents in what I call PE 3.0 is very much a long-term provision of capital so we're not that affected by fluctuations in the stock market we're not that affected by immediate sentiment of negativity for us the reality is that we will be investing now and it will be a five and ten year cycle that will reap that we will reap our rewards not today or tomorrow reflected in high evaluations but over a continuum as Francis over a period of time where the fact that we put these services in play and the fact that we enable provision of health care to reach people who don't currently have it the rewards are actually financial and otherwise of a longer-term nature so I'm not uncomfortable about what's happening in the world today if anything the real estate on which we'll build hospitals will become cheaper thank you very much I was just moments ago the good ferry now have to be the bad cop and and close this press conference because we're already running over time but it's it's obvious that this is a very important discussion and and many questions do we do we work done thank you all for joining thank you for joining the live stream and and a particular thank you to my whole town thank you