 So, first of all, we wanted to talk about how technology and data are helping us as a region to work in health. And my first question is related to how much of mass data and not smart data, and how much of smart data that we have that allows us to run prevention campaigns in our countries and in our regions. Should I begin? Okay. I will speak English. The topic itself in general is fantastic. And obviously we've had some recent issues, Zika being one of them that's highly relevant to all of us here and becoming increasingly relevant. There were really three main themes from Ecolabs perspective that we wanted to inject in today's conversation. I'm actually going to start with the second one because it's highly relevant to what you put on the table. And I think that's the realization that while epidemics such as that one, other health challenges begin very local and the information around them is very, very local. We live in a global world more and more every day, a very connected world. And any such epidemic, any such challenge, any infectious disease is simply a plane right away. I think all of us are realizing that over several instances over the last decade. And so the ability to capture information, to have a public-private partnership to work with NGOs, private industry, public sector, understand information, communicate information, certainly without being crying wolf, so to speak, again the reputation of doing that in every single instance, we need to communicate quickly and really anticipate worst case scenarios so that we can mobilize faster. Okay. If I can add to the topic of data, I would say that data in healthcare has been challenged in the past and continues to be challenged. The ability to capture, record, organize and have it readily accessible so it's actionable is a challenge. It's not a challenge of the region, it's a challenge of the world. It consumes significant amount of investment and it is a significant portion of the cost of healthcare that we as individuals have to incur, but the response is not there. So we still have to find the right roadmap, the right path to be able to gather the kind of information, the kind of data that we need. And then we need to get to the real step, which is how do we make it relevant, how do we get the right insight out of it, and then take action. So in our perspective, there's a long way to go, but this is not a technology issue. This is a process issue. This is a, to some way, a regulation issue. And today, the technologies that support the massive accumulation of data have expanded so rapidly, especially in the last three or four years within memory technology, that the cost of acquiring and being able to store that data is a fraction of what it was in the past. So it's not the technology that is the roadblock. In that case, it would be a question for both of you. If it's not a technology issue, how much is there of public policies helping that information is being built from the point of view of governments? In terms of creating solutions. To allow that confidence, allow those processes, and create that regulation of what Claudia was talking about. I'll start. It's okay? Sure. You know, I think this reinforces the general theme of the workshop here, the session, that the quality of collaboration coordination between public sector and private sector is key. It told me developing solutions of quality and sustainability and effectiveness. And I think it's important to honor and respect that both groups bring tremendous assets to that type of challenge. From the private sector, obviously, the ingenuity, the ability to innovate, technologies that already exist, building on information that's available to refine those technologies and make solutions increasingly relevant. That has to be embraced and harnessed. From the public side, tremendous reach from the public sector, the platform for communication, the platform for education, again reinforcing the need to have solid information so that we communicate the right things. And so the need to coordinate that and collaborate in that way is critical in order to solve major health challenges that we have. Yeah, the issue of legislation or regulations is a very wide issue. You cannot address this in general in healthcare because it has to do with what the physician does with the patient at the office, what the governments need to do to protect the privacy of the patient. Then how do you make sure that the healthcare is available at a reasonable cost? And then obviously how do you address the larger health challenges like SICA as an example? But getting back to the basic stuff, the time that a physician spends in front of a patient cannot be challenged by having to enter data into a computer to comply with a regulation. That is in the way of really addressing the health care issue. So if regulations would make more difficult for a doctor to address what he has or she has to address, we're in trouble. That point is very interesting, Claudia, and I wanted to ask you that the Colombian government is beginning to work with some ops that begins to be a trend. It's like self-care and the other one that is called the CLEAK Health which allows Colombians to compare the prices of their medication and evaluate their service. How advanced is the region in those types of solutions where we as patients cannot still trust that type of solution and on the contrary we're exerting all the pressure on the doctor and the doctor now does not have the priority of his patient. The whole revolution of apps that goes all the way from fitness to remote diagnostics is really an emerging chapter. I don't think that this is going to be a regional thing. It's going to be global, it's already global, it's becoming readily available. And if anything, it extends the ability of a patient to understand his or her situation and work with the doctor. We're going in the direction of individualized medicine where by means of technology, obviously data and access to all these facilities, let's call them, you can have a better understanding of what is the patient's situation. And you do away from talking of, in average, this is what happened, but this is the total number of cases that we have which is in the way of being successful in curing diseases. I may be built on that a moment in the adjacency embracing this digital space and not specifically about apps, but rather about social media going back to the first comment about data and communication and so forth. We have platforms now with social media again if embraced properly between private industry and public sector to run as fast or even faster than some of these epidemics and infectious disease spreads by harnessing that, taking advantage of that and using that platform to communicate better. Again getting back to communicating the right information and good information, there has to be some control there, but leveraging a digital space and social media can actually be a benefit in running fast enough to get ahead of some of these issues. John, you have a lot of experience in this private relationship in the health issues. John, which have been some of the greatest obstacles that you have found knowing that we have a technology that allows us to do a lot of things. Greatest challenges that we face and it's probably a theme that's actually come across many of the forum discussions here in Latin America because I've participated in a few already this morning. This idea about institutions and the quality of institutions in Latin American countries and the consistency of the institutions across the countries, Ecolab works very, very hard to develop a strong regulatory framework in conjunction with public sector that can be an infectious disease control, that can be in water and foodborne illnesses, that can be in food safety in general, many other things, so having a partner there that is embracing that and willing to set a very high bar to the benefit of society in terms of what those regulations are, what those codes are, but also having the capacity and infrastructure to uphold those codes and enforce those codes, which creates an opportunity that's commercially viable for companies to innovate, to spend money and innovate and continue to get ahead and serve society better. I think that's one of the biggest challenges that we face, not just specific to Latin America, but maybe more acutely here than other places in the world. Lamentablemente son reuniones de 30 minutos, así que pararle el micrófono usted. Fortunately, it's only 30 minute meeting, so I'm going to read to you some of the takeouts that I have here. One is that we do have information that we are creating, in fact, information that we're being smart, that I see it more concentrated on the part of what, diagnosing what is happening to us, basically that is what I understand from your words. The second takeout is that in this path of controlling epidemics, the challenge is not technological, the technology is there, but the challenge is the process, these are regulations and the work methodologies. And the third one is that we still have great opportunities and if we work as a team with public and private alliances and associations, now I would like to take the opportunity of offering you the floor to ask questions from these two experts here if we have a question. I would like to ask you, what do you think is the impact of the lack of strong institutions in Latin America? For example, corruption, abuse of power, in the field of health. Great question, by the way. We work very diligently with trade organizations. For example, trade organizations that may influence products such as disinfectants or other products in hygiene, general hygiene, infection prevention, those kinds of things, food safety. So working closely with those trade organizations and ultimately with government agencies is one thing and we can develop proper codes and we can work with them to understand what are the right protocols to have to protect society and ensure safety in those areas. But if you take corruption or simply lack of infrastructure or lack of consistency country to country, it's very difficult for us to train and uphold that level country to country or even city to city. And so I think the consistency of not just developing the right codes and the right regulations, but upholding them and how that can be undermined by corruption or other things is a big issue for us. It's a big challenge. That can be in healthcare, that can be in food safety, that can be in hospitality, that can apply anywhere where public health is at risk. If I could go out to that, I would agree with John. The situation you described is across every industry and healthcare is not an exception. However, in the last two or three years we've seen a more focused interest across the region by governments, both federal and state government, to try to address the issue of applying technology, to jump start or to leave frog is the right terminology, the the issue that we have with healthcare in some of the some of the countries. So there is a better understanding and there's more appetite to have a productive discussion, including how to prevent and get ready for pandemics that we've had a fair share in the recent in the recent past, and it's something that will continue to be with us in the future unfortunately. So we're not where we have to be, but there seems to be a little bit more interest to address the issue in the right direction. Any other questions? One, two, three, four. Okay, go ahead. Good afternoon, Mariano Guerrero Rivera. Guerrero, Mariano Salud from Spain. I wanted to ask you something very important, accepting that the scientific bibliography says that over 65 percent of what we do does not contribute value in health. What do you think that new technologies, how do you think that new technologies can help solve that problem? To understand, could you please repeat your question? Many of the things that are done in the area of health in the world do not contribute any value to the health of individuals in the community. I would like to ask you here with the progress of technology, we might how we could solve this issue and save some money that we could use in this area. I give you an example. Both at the grassroots level and at the country level or region level, one that's at the grassroots level which I like to talk about because it's it's something that can be scaled, it's something that can be leveraged, it's something that we can all take action on. We work with a program called WET which is water education for teachers and we're actually very active in Mexico with that currently and that program is really about teaching teachers and their students about hygiene, basic hygiene issues as simple as the right way to wash your hands and prevent the spread of communicable diseases but also about water management, water sensitivity, general ways in which we can reduce infection, the spread of infection and that's a way where we've partnered closely with actual local communities not federal governments, not state governments but municipal governments and even school districts to engage our people in teaching teachers to teach their their students and I like that example because it's one that we can do everywhere and as as citizens of society we can take action on and spread spread quickly and so it's about education and communication. Can you give some specific examples of what technologies or services your companies have that might help reduce what's described as a collapse of services and emergency rooms? Certainly in Colombia it's a big problem, maybe elsewhere in Latin America. Do you have some technologies that can help help reduce that overflowing collapse of emergency rooms? Emergency rooms, I don't personally have a lot to talk about that on. Yeah it's not my area of expertise anyway but you know at the end of the day many of the challenges, the bottlenecks that we have in the health care system is related to processes, to the requirements of administration and the fact that we don't learn from one case to the next one. So I'm not going to be here saying that data is going to fix everything but as long as we take a very strong approach to building a data infrastructure that is actionable we're going to start seeing more relevant time dedicated to what we have to do in health care. So I don't know if that would fix emergency rooms in Medellin but definitely in many areas of health care that is the issue and in the US it is one of the biggest problems. So from a technology perspective we have a global health care business global does not include Colombia at this point it's predominantly in North America and Western Europe. In hospital applications obviously general sanitation hygiene is a big area where we develop protocol and technologies but also in the operating suite. Products and solutions and protocols to convert an operating suite after the operation to make sure that it's quickly sanitized sanitized properly and ready for the next operation with no corners being cut no shortcuts and obviously that has a big impact on the safety of patients that are in the hospital because one of the best ways to get sick is actually to be sick and be in a hospital and pick up something else so those are those are solutions application ranges that we have we just don't certainly don't currently have that reach here in Colombia but perhaps you've gotten me curious moving forward so yeah because it has been said that for the sustainability of the health industry technology is very important so that the business is sustainable okay two more questions. Buenos Aires forgive the accent so I was at MIT recently in the US and they were talking about an application that etna has developed the iHealth app and the idea etna is an insurance company they wanted to reduce the amount of wasteful visits to emergency rooms and doctors by their constituents and this app would allow you to for example put in a child's symptoms if you were on holiday and you could you know we've done this we've done that we went swimming and the air hurts blah blah blah and the app would give you a feedback relating to what the probable situation is and it would direct you to a local health center or a chemist if the treatment was less. Now I was listening to this thinking this would be a fantastic if we could develop it for developing markets but for markets where healthcare is socially provided and it's in our interest to reduce the amount of time that emergency rooms are tied up with unnecessary work for example have you done any work in those sorts of areas that may be better for you at this point yeah I'm very familiar with the the app you're talking about I actually used it myself a few times and it's very effective because many times you go to the emergency room and your symptoms are let's say you know you don't have a life challenging situation and you probably are in the way of somebody that really has a life challenging situation so so it allows you to move very fast to have diagnostics and it's not just you know you enter the app and it tells you what to do you have the ability to talk to a physician via video and get a response so so again the technology helps you and gives you another another option to to resolve and and I know this is not a related issue but but when you talk about trying to address a major health issue in a country like could be an epidemic you typically think of you know how do I get to all the cases and try to address them which is what you have to do once you you're in the reactive mode you you try to record who's sick who needs attention and and and we had we had SAP had an experience in Nigeria with Ebola where the the Nigerian government with assistance from the German government and SAP and the Hasloplatner Institute were trying to find a way to bridge this issue of getting to the cases and see how patients evolved and and what was what was working and what was not working so when we looked at this people thought that this was really a health care issue but in India being a logistics issue because you had your social workers or health first responders who were who were trying to get to this person that was sick and try to monitor how he or she was evolving every day and was actually doing that but he couldn't record on time the data to be able to learn and act accordingly to the general population so it ended up being a question of how you build a mobile app to be able to help the person that was assisting the patient so again is using technology to try to bridge the gap so sorry for diverting but I think it is a good example of on how you can fight epidemics in that context Adriana Molano from Colombia Digital we know that the issue of health care is sensitive and we know that the technology based solutions just come from the government to the citizens but given the way that technology is being used the way that it's being massified it might it be that in this case in order to obtain the big data I know that information wouldn't be easier to massify the applications or health related applications so that we can show the government the usefulness of those solutions and for for different reasons the the first one is we heard this morning President Santos and President Macri talk about relation education and technology and and that is the cornerstone of of changing our our countries so that's one element that plays very well with what you just mentioned but but then then there is this creativity that has characterized our countries in terms of bringing startups which are based in technology we tend to talk a lot about Uber and Airbnb etc etc but we have very strong cases in a region that have worked very well and you know at the end of the day and and at least the way we see it at SAP is if you look at the digital economy in Latin America and you compare it with the rest of the world and pick any statistic that you want we are 50% of what the rest of the world is if we would be able via startups of health care entrepreneurship in other in other categories to really bridge that gap we will be in the way of transforming our economies but also in the way of transforming the well-being of our citizens so there's more at stake than what we're talking so that's the way at least we modestly believe that the subject should be approached sorry for that perfect leave it at that in case there's another question great good afternoon Enrique Tapia from noticias uno we have had a problem in during the past months regarding cosmetic surgery and some professionals in that field have been uh have been announcing that they have specializations that they have not taken apparent specializations in Brazil and they're just diploma courses and they exert and they practice here as if they had really studied each specializations so what platform or application could the government use to regulate those types of specialists especially when it comes to cosmetic surgery which has made so much progress and was this doctors who are fighting right now because they are not duly trained to practice these surgeries how can i look for an application that says this doctor in fact is telling the truth this doctor in fact is specialized etc no bueno that one that that's where it's incumbent upon government to make an issue out of it and say that we want to protect the safety of of people in society and this is an area where people can get sick things can happen treatment cannot be delivered properly infectious diseases can spread etc etc but tapping into the expertise uh and the depth of knowledge that private industry has to educate how can things happen in that environment that we want to stop what is bad what does good look like how do we develop protocols and training programs to ensure that even in that environment the person that goes in and pays for the surgery is safe and the next person after them is safe etc etc so that's about diving in and tapping into the expertise that private industry has to understand the environment understand how problems can arise and what is the protocol to address that and what should be regulated and eventually enforced to ensure that to have a license to operate in that way or or to continue operating in that way you need to meet a certain threshold and i think that's where there has to be a strong partnership between the public and private sector the public sector should not be the one that has all the expertise that would be way it would be unrealistic and too cumbersome to depend on them to do that tap into private industry and help them understand where are the problems where are the potential problems and what's the best way to address them i would like to ask something else we're talking about the data that the patients provide that the health centers should provide what are data but how are the pharmaceutical companies how willing are they to also provide data that could be more productive for the region 30 seconds you have shape it as in health care solely or or environments where people are there to be treated it's not just that i mean you you can get foodborne illnesses waterborne illnesses communicable diseases can happen in many many areas and so i think it's important to think more more broadly than that and to have a standard established in society that we care about that we want to create a safe environment for our people that's where they go to eat that's the food that's produced that they eat that's the water that they drink and it's also the places that they go to receive care okay so that that would be my initial response that to broaden that i would add three conclusions we have a 50 percent gap that is spending in the region communication is key and apps seem to be becoming very interesting tools for the health sector i want to give john and claudio my thanks for for their comments in this panel thank you very much and also to you all for coming