The collaboration between different sectors on specific challenges has proven countless times to be source of inspiration, innovation and ground-breaking solutions. The goal of the Global Partnership for Humanitarian Impact and Innovation event, taking place on the 3rd and 4th of March, is to be a platform where different sectors, such as the humanitarian and the corporate sectors, can come together to find solutions to common challenges. Esperanza Martinez, head of the health unit at ICRC, and Ahmed Berzig, health advisor for the Corporate Partnerships unit at ICRC, discuss how partnerships can be truly transformative for health care in fragile environments.
Could you tell us about the ICRC’s current health strategy, what the focus is, where efforts are concentrated?
Esperanza Martinez: The ICRC’s health strategy has five main objectives. The first one is to enhance the delivery of services in ICRC’s core health areas: first aid and surgery for weapon wounded, health care in detention and physical rehabilitation. The second is responding to the emerging needs of populations in areas such as mental health, sexual violence and non-communicable diseases (NCDs). The other three objectives include the building of a continuum of care, good quality of services and an integrated approach with other ICRC health programs. We know this strategy is comprehensive but quite ambitious. In order to obtain results one of the key enabling actions is to develop effective and meaningful partnerships – with other members of the RCRC Movement, other humanitarian and development organisations, corporate sector, academia and Government bodies.
This year’s GPHI2 event focuses on Health care in Fragile Environments. The themes that are discussed mirror challenges identified by ICRC. Could you tell us more about these challenges? How do you expect the GPHI2 event to be instrumental?
Ahmed Berzig: The challenges that will be discussed during GPHI2 indeed mirror challenges identified by ICRC in the contexts in which the institution works: armed conflict and other situations of violence.
The development in the lifestyles of populations, particularly in low- and medium- income countries, is leading to the increase of NCDs. Up until now the response by humanitarian organisations to NCDs was limited and not structured in the right manner to properly alleviate the suffering of those affected by NCDs. For this reason the ICRC, through developing operational partnerships, is trying to structure the approach to NCDs in conflict situations and other situations of violence
Mother and Child health care is another challenge that has been identified. The fact that women and children are still dying from preventable diseases is simply not acceptable. For this reason ICRC has decided to put more emphasis on this issue in its health strategy.
Violence against health care is a crucial challenge, which unfortunately keeps on repeating itself. Attacks against health-care facilities and health personnel keep on happening and are symptomatic of the non-respect of certain armed actors towards the medical mission. This challenge is one of the priorities of the ICRC, with programs such as Health care in Danger leading the response.
The latest Ebola epidemic highlighted the limitations of the health response to epidemics in fragile environments. The biggest gaps were measured in terms of ensuring capacity, of human resources, of materials and know-how in the early stages of epidemics, all necessary to better manage the spread of the disease and reduce the mortality and morbidity among those affected. We feel that humanitarian organisations should look into more proactively engaging with other sectors, the corporate sector in particular, to increase its capacity to be better prepared and better respond to epidemics.
The use of mobile technologies is lacking in the humanitarian sector, and ICRC is not an exception to the rule. With the increase of these technologies, humanitarian actors need to further explore their use, in health care for example, in order to provide a better access to health care and to give more responsibility to patients in their own health care.
The sixth challenge identified and that will be discussed at GPHI2 regards the financing of health. Finding the best ways to finance health services in fragile environments is the crux to ensuring better quality and sustainability of health-care services, and this well after humanitarian organisations have left the context. Looking into different approaches, measures and mechanisms to ensure sustainable health financing is a key challenge that needs to be addressed together with other sectors, such as the corporate and academic sectors.
This account of health-care challenges is of course not exhaustive but they are the ones that are currently prioritised by the ICRC.
Health-care technologies are increasingly performant and precise. Do they answer the needs of the humanitarian sector though? If not, why?
Ahmed: Technology is central to the health sector and it is in continuous development. Technology applied to health care is contributing to increase the access and use of healthcare services. In the humanitarian field however, integrating technologies in the health response has been slow for many reasons, mainly linked to the insecurity, lack of basic infrastructures and the short-term nature of the humanitarian intervention. There is no doubt that new technologies applied to the health sector have an added value and could bring many benefits to the health response. However not all innovative technologies in the health sector are applicable in humanitarian settings. This is why it is important to wisely integrate these technologies, and focus especially on those that have proven to be efficient, affordable and sustainable.
Esperanza: The humanitarian needs are growing not only in number but in complexity. Simultaneously, there is a growing number of technologies available to the health sector. What GPHI2 proposes is to bring together the humanitarian and corporate/academic worlds to explore which technologies best respond to current pressing humanitarian needs. A step further, would be to determine whether or not innovative solutions actually work in the field. Responding to this question would require strong research and development partnerships.
ICRC has developed a number of partnerships with companies from the health-care sector. What is the nature of these partnerships, and how are they transformative for the ICRC?
Ahmed: When looking at the major challenges and the continuous rise in health needs in armed conflict and other situations of violence, it becomes clear that the ICRC can no longer provide effective health-care services without developing strong partnerships.
Corporate actors specialized in health care such as Philips, Novartis or Novo Nordisk, to name a few, have experience and know-how in many health and medical fields, where the ICRC and other humanitarian actors can benefit from and increase their response and the quality of the services they provide to affected populations.
Both the corporate and the humanitarian sectors share the same concern to provide access to good quality health care even though they do it for different goals and mandate. The ICRC, as shown in its 2014-2018 health strategy, has a willingness to respond better and more to the health needs of the populations it serves. We are willing to go beyond our traditional health activities, especially in areas such as NCDs and mother and child health, in which the ICRC does not necessarily have the know-how. We therefore feel that there is space to develop effective, trustful and meaningful partnerships, which can allow us to respond to emerging health needs in a win-win manner.
Esperanza: A good example is in the field of maternal, neonatal and child health with the Almanach project, which is a joint project between Swiss TPH and ICRC, where we are investigating if we can add Philips expertise and technology. The objective of this project is to develop Android tablet support to existing Integrated Management of Childhood Illnesses in fragile environments. It is currently deployed in Afghanistan and Nigeria with great success and ICRC is evaluating the possibility of expanding it to other contexts.
With other companies, pharmaceutical for example, ICRC is in the exploratory phase with the objective of addressing more effectively specific diseases.
What more could the corporate sector and academia do to support humanitarian work and health care in fragile contexts?
Esperanza: A critical aspect is sustainability. We could provide technologies and services but can they be scaled up? Can the populations and the Governments afford the innovative solutions we suggest? Are solutions sustainable on the long term? These questions need to be addressed before ICRC enters into partnerships as it is our institutional responsibility towards the communities we serve.
The corporate sector could play a key role by creating bridges between humanitarian interventions and development programs. And this is something that could be managed by corporate social responsibility structures.
Research in health, particularly in fragile settings, is essential to inform policy and practice. However, it is challenging for us to conduct it as we are often responding to very fast-paced situations. We can provide the background for invaluable field research, but we would need to do it in partnerships.
Ahmed: The academic and corporate sectors could bring an added value to the humanitarian sector by adapting their modus operandi to the field of fragile and unstable environments. Their capabilities in terms of technology and research are essential and can help us to respond to increasingly complex health needs. Through an effective partnership between humanitarians and actors from the corporate and academic sectors, new approaches and services can be developed leading to a better response to the needs of affected populations.