How healthcare is changing in the UK and Latin America

How healthcare is changing in the UK and Latin America

On 14 November 2024, Canning House welcomed Professor Sir Mark Walport to its offices for a Business Lunch. In a thought-provoking discussion, Prof. Sir Mark, Foreign Secretary and Vice-President of The Royal Society and a former Chief Scientific Adviser to the UK Government, spoke on healthcare, technology, and the evolving challenges posed by demographic and economic shifts.

Against the backdrop of the recent Biodiversity COP16 and significant British collaboration in Latin America’s pharmaceutical sector, Sir Mark offered a wide-ranging exploration of health policy, innovation, and the intersections between the UK and Latin America.

Prof. Sir Mark opened by celebrating the progress made in global healthcare, hailing the fact that we live longer and healthier lives, all around the world. Much of this progress, he said, can be attributed much of this to public health interventions such as clean water access, vaccines, smoking cessation, and antibiotics. However, he underscored that longer lives come with a price: people now live longer periods in ill health, driving “inexorable” demand for healthcare services.

This dynamic, he argued, raises pressing questions about intergenerational equity. Almost half of a life’s healthcare expenditure occurs toward the end of life, he noted, emphasising how older populations are benefiting, at the expense of the young. With rising dependency ratios and declining economic incentives to have children, the burden on working populations is intensifying, particularly in countries with aging demographics.

On the supply side, while acknowledging extraordinary advances in biopharmaceuticals, diagnostics, and robotics, Prof. Sir Mark cautioned that these innovations often come with significant costs. Technologies such as genome sequencing, RNA vaccines, gene therapies, and GLP-1 anti-obesity medications are transformative, yet their delivery remains unsustainably expensive.

The UK’s National Health Service, Prof. Sir Mark put forward, could perhaps instead be described as a “National Disease Service,” observing that health systems like the UK’s often prioritise treatment over prevention. Public health interventions – particularly those targeting younger populations – can offer the most impactful and cost-effective outcomes, but systemic inefficiencies can overshadow these efforts. Obesity emerged as a central concern, with Sir Mark pointing to failed behavior-change strategies in environments saturated with cheap, calorific food.

Turning to Latin America, Prof. Sir Mark highlighted its demographic heterogeneity. Median ages range from 23 in Guatemala to 34 in Brazil, compared to 40.7 in the UK. However, both regions share trends such as rising obesity, and a shift in prevalence from infectious to chronic diseases like diabetes and hypertension.

Clean water access remains a critical public health issue, with stark disparities across Latin America: only 18% of Colombians have consistent access, compared to 98% in the UK.

Digital health presents a significant opportunity for both regions. With internet usage rates as high as 85% in Brazil and 70% in Colombia, there is potential to leverage technology to deliver healthcare more efficiently.

The discussion also touched on infectious diseases, such as Zika in Latin America, and the importance of learning from these outbreaks. Innovations in workforce strategies, such as Brazil’s use of community health workers, could offer lessons for the UK, where experiments with similar models are already underway.

Sir Mark concluded by addressing the political challenges posed by longer retirements and pensions, which are increasingly paid for by shrinking working populations. For politicians, he suggested, the urgency of the present often trumps the needs of the future, underscoring the difficulty of balancing immediate demands with long-term national resilience.

Questions and comments touched upon urban vs rural healthcare access; the challenge of funding many modern treatments, like GLP-1 anti-obesity medications, in Latin America; the place of traditional and Indigenous medical practices in modern healthcare; and the logistics of healthcare delivery.

Canning House extends its thanks to Professor Sir Mark Walport for his insightful presentation and to attendees for contributing to a rich dialogue on the future of healthcare, and to our audience for their engagement and interest.