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‘Evolutions and revolutions’ in chronic disease care

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The London School of Hygiene and Tropical Medicine (LSHTM) has teamed up with the Novartis Foundation, the philanthropic arm of the pharmaceutical company, to test a new tack to managing the rising burden of chronic diseases in the developing world.

In an interview recorded last week at a symposium co-hosted by the pair, LSHTM director Peter Piot outlines elements of the partnership. Piot, who also heads the Foundation's board of trustees, focuses on two elements: the need for a “systems design” approach to care that puts people first, and the promise of “evolutions and revolutions” in digital technology for areas where resources are in short supply, particularly Sub-Saharan Africa.

About three quarters of patients who die from chronic conditions — some 28 million people — live in low- and middle-income countries. But with little aid money and poor existing infrastructure, health systems are often too weak to offer the diagnostics and treatments needed for conditions like cardiovascular disease, diabetes, obesity or cancers.

And there are more barriers to care: people who struggle to make ends meet often can’t afford the time or the money to visit a hospital. Many are not even aware their health is at risk.

LSHTM’s work with the Novartis Foundation draws on a lesson from the management of HIV/AIDS and other infectious diseases, according to Ann Aerts, head of the Foundation: the need to build healthcare around the reality of patients’ lives. It relies on innovation in both technology and in the way services are delivered.


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