While it remains unclear how long the pandemic (that changed everything globally) will last, it is clear that the impact of the coronavirus activity has metastasised into a burgeoning health, social sustainability and economic crisis. How exactly this crisis will still evolve – remains to be seen. But we need to have clear paths forward to begin to navigate through and into the next normal. This means, we need to recalibrate, reimagine and reform our policies and systems in order to build a better, more resilient world.
A focus on the preservation of human capital and health in order to aid the recovery and future sustainability of our economy is of paramount importance. Promoting more inclusive, socially cohesive and dynamic changes to policies and regulations is a vital part of building back together. We need to embrace those opportunities, learn from past experience and stay ahead of the curve. The overall impact will be determined by choices made today and related shifts in our socio-political outlook.
Future of healthcare & nature of Randomised Controlled Trials (RCTs)
We have witnessed healthcare systems (in most countries) on an effective war footing to manage the surge in the number of patients and lack of bed capacity, supplies, health-workers, as well as much needed medical and health supplies.
During lockdown, our healthcare resources were deployed to fight and contain the spread of infection and to help those needing urgent treatment. Lockdown and health and safety measures (all of which were and may still remain a necessity in this crisis) meant access to treatments, medical guidance and diagnosis for a host of other conditions and illnesses were severely impeded or stopped altogether.
Many of the on-going Randomised Controlled Trials (RCT) were disrupted, whilst others were continued remotely with a patient at home. Covid19 certainly marked a turning point and challenged our pre-existing ideas of what is possible, as well as the form in which clinically valid evidence may be obtained. The ongoing global digital transformation of health and care for people has been accelerated and has now become the norm. Some of the changes that are driving the healthcare revolution:
- the digital supply chain is becoming the default;
- the adoption of preventive and personalised medicine;
- implementation of digitally-enabled testing, tracking, monitoring;
- decentralised RCTs, use of technology and real-world data (collected outside of formal clinical trials) to increase the well-being of millions of people and radically change the way health services are delivered; rapid development of novel processes and protocols;
- prevention stimulation and increased opportunities for people to gain access to innovative, more efficient, personalised and non-invasive treatments and healthcare knowledge.
Public health bodies and governments’ approaches, in an interconnected and mobile world, must rethink the speed and global coordination with which they need to react and will need to determine how to meet a surge in patient volume for whatever reason, how to provide individualised care and therapies, as well as manage seamlessly across in person and virtual elements of care. This is the challenge as well as an opportunity to experiment, socially innovate and rebuild for the broader betterment of the society.
In our view, applying modern technology and science to “historical drug pipelines” is a new area which shows huge promise for development of a broad range of therapeutics in general, and for neglected areas of treatment in particular. We believe that crowdsourced (or observational, self-reported) real-world and contemporary data will be compiled and, in many cases even, analysed faster than clinical trial data. Sophisticated (yet easy to access) technologies, protocols and communication tools can empower our citizens to make better-informed decisions about their own health and provide new options for facilitating prevention, early diagnosis of life-threatening diseases, and management of chronic conditions outside of traditional care settings.
Recommended reads from Alta Flora and beyond
It is important to be reminded that technological developments in analysis and real-life insights obtained do not negate the importance of RCT data, in fact, they are essential tools and are in support of traditional clinical trials, for example, in areas such as patient recruitment and the collection of safety data.
The need for new initiatives for people in treatment, those facilitating recovery as well as unforeseen and yet unknown ‘effects’ of Covid19 related conditions, means we urgently need to have an open, ethical and rational debate in relation to the use of digital therapeutics, scientific research and data privacy and use case considerations.
Forward-looking: Science, technology and personalised outcomes focused approach
The coronavirus pandemic has had a wide-ranging and impactful effect on almost every aspect of our lives, but only when we go from ‘fire-fighting’ mode to ‘recovery’ and ‘future-proof resilience building’ mode will we have a real sense as to the deeper, far reaching impact of Covid19 (in particular, on human health, welfare and incremental healthcare costs).
Coupled with wider government and private investment – support for novel, natural and digital therapeutics, research, innovation, and the delivery of, safer, more cost-effective, scalable and individually tailored healthcare products and services will ensure the UK is not left behind. Now is the time to address the self-imposed barriers we seem to have placed on our progress in the UK.
Decisive action can prevent public health systems from being overwhelmed, and save lives. Increased life-expectancy, profound technological advancements and universal access to information enable individuals to seek innovative solutions for attaining their own “live longer better” goals.
We all benefit from large and diverse sets of interlinked information, however as a result of the missteps that some companies and organisations have made in the past around data handling and privacy, people increasingly view this benefit as being delivered at the cost of individual privacy, which is a fundamental human right. Also nested in international laws is access to the highest attainable standard of health, as a fundamental human right, and it is our strong belief that there is a tremendous value to be created by the meeting of digital technologies, natural therapeutic substances and data.
New technologies can be a huge benefit to human race and to make sure they are effective, used for the good – people need to understand them. Effective governance is a requirement. For example, applicable privacy policies must be clear, easy to read and contain prominent information about how a person’s data will be used to help people make informed decisions prior to using an app. Patient consents with regard to such data collection and access must be obtained. How we ‘collect any data’, ‘what methodologies are employed to analyse that data’ and ‘in what form and for what purpose is that information finally utilised’ considerations have to remain of utmost importance throughout this process and remain subject to periodical ethical reviews. This will help ensure data are used in a fair and transparent manner, which is crucial for fostering trust.
Real world evidence has to be taken into account in our public health related regulatory processes and used to address the gaps in knowledge that cannot be addressed by clinical trials alone.
This pandemic has brought on a seismic shift in our perceptions of the world at large. There is an increasing need for a personalised approach to health and well-being that can be delivered in a cost effective and scalable manner. Therefore, a concerted and combined effort from all stakeholders (regulators; public health bodies, medical and scientific establishment, corporations, investment community, technology and natural resources industry) is required to offer a more service orientated healthcare system that can provide its citizens with an option to integrate new treatments designed with individual patients in mind and inspired by a lived experience as well as rely on the existing resources.