1st Kansai Public-Private University Schools ofMedicine Symposium
Research Strategy of WHO Kobe Centre
Alex Ross, Director
6 February 2017

Introducing WKC and its Role Global WHO Center (Department of HIS Cluster), located inJapan
 Contribute to translating lessons from/to Japan
 Build evidence base; convene and leverage research
institutions
 Translate research/evidence into policy options
 Unique role in multi-disciplinary and multi-sectoral researchfor health and development
Past success in leading WHO’s global work in urban health, health systems, equity, anddeterminants of health; application to NCDs, ageing, environment and health; urban healthemergency management

Basis for WKC’s Strategy, 2016-2026
 SDGs: Equity, multisectoral action
 UHC: Comp. health services, financial protection
 WHO Leadership Priorities

Health systems and UHCAgeing
Noncommunicable Diseases (NCDs)
Multisectoral action, determinants of health 2016 G7 Health Ministers Meeting Health systems, ageing, dementia

 Understanding the landscape: unprecedented demographic andepidemiological changes


Healthy life expectancy
Quality, cost efficiency
Rapid technological change

WKC Strategy, 2016-2026

Strategic objective 1
Support cross-cutting research that leads
to transformation of health and social delivery
systems to enable the sustainability of UHC inlight of the needs of older persons
Priorities:
1: Enabling countries to plan for sustainable UHC through enhanced policy development
and coherence (includes measurement)
2: Developing comprehensive service/benefit packages for older populations under UHC
3: Supporting practical approaches to integrated/coordinated health and social delivery
systems, and community-based (non-institutional) systems (includes health workforce)
4: Increasing local preparedness and resilience of health systems in context of healthemergencies.

Strategic objective 2
Stimulate frugal social, technological andsystems innovations that help older
populations better manage functional andcognitive decline over time
Priorities:
1: Defining holistic home-based care systems to support older persons living at home/intheir community for as long as possible
2: Investigating promising innovations
3: Conducting research on health and social system enablers and strategies fortranslating/adapting/scaling up use of new innovations
4: Identifying ways to increase community engagement in design, development and use ofinnovations

Our research focus

Sustainable UHC &Ageing Populations

Technological, social systems
innovations:
Functional abilityInnovation

THE
WORLD
HEALTHSEES IN
HEALTHAPPEARSTOORGANIZATION
BE LESS PROMINENTHEALTHIN ALLDEVELOPMENTASPECTS OF THE
SDGs(SDGs)
SUSTAINABLE
GOALSNew Paradigms: UHC•Health systems transformation– financing, governance, workforce,
access to medicines and technologies,
health information systems, etc•••Integrated person centred quality
careLong term care
Prevention, health promotion,care, rehabilitation, palliative careInnovation

Universal Health Coverage & Ageing UHC is needed as countries age
 Ageing will increase health spending…
…and reduce revenue sources for health For many countries, low fertility accompanies rapid ageing UHC is still affordable for ageing, middle-income
countries…
…but financial sustainability needs to be built in from thestart11

Paradigm shifts
Existing model

FutureAcute

Chronic

Treatment

Prevention

CureCareHospitalHome

Physician-led

Self Dx./Care

Paper based

Connected healthAgeing as #Fcnl. ability

Intrinsic capacityHealthy Aging

the process of developing andmaintaining the functional ability
that enables wellbeing in older age

Presenter’s name if neededA new public-health framework for healthy ageingHigh and stable capacity

Declining capacity

Significant lossof capacity

WHO, The World report on
ageing and health. 2015
Priority areas for action
Improving measurement, monitoring
and understanding

Aligning health-services to the older
populations they now serve

Developing systems oflong-term care

Creating age-friendly
environments

Health security for all towards the achievementof the SDGs

・Strongly commit to the healthrelated SDGs as the first G7
Summit Meeting after theadoption of SDGs.

23

Reinforcing theglobal healtharchitecture
to strengthen
response to publichealthemergencies

Urge and support the WHO, which plays the central role in response to public health emergencies, toimplement its emergency and winder reforms
Welcome the establishment of funding mechanisms for emergencies, invite support of the international
community, and call on coordination among such mechanisms :・CFE for WHO’s initial response
・WB's PEF for pandemic response
Invite the international community to review, strengthen, and formalize coordination
arrangement in large-scale public health emergencies
Enhance prevention and preparedness against emergencies
・Advancing compliance with the WHO’s Int’l Health Regulations through relevant
initiatives (incl. GHSA), offering concrete assistance・Looking forward to discussions with the IOs including the WB such as IDA to mobilizefinancing for prevention and preparedness

Attaining UHC
with strong healthsystems
and better
preparedness

Promote UHC in developing countries and enhance prevention and preparedness against emergencies
・Support UHC 2030 as a strengthened international framework to coordinate effortsof relevant stakeholders and various initiatives
・Discuss with the UNSG about the idea of nominating an envoy for promoting UHC
・Commit the G7’s effort for strengthening health systems in LIC/LMICs
・Welcome the WB's and others’ efforts to promote UHC for Africa/HSS
Ensure access to health services through the life course
・Lead maternal and child health, reproductive health, immunization, polio, etc
・Promote “Active Aging” movement, incl. through the forum in Japan

Strengthening
responseto AMR

Infectious diseases pose major threats to global health security. AMR amplifies such threats due
to inappropriate use and market failure.
Propose push and pull mechanisms for developing antimicrobials in addition to“One Health Approach”

Promote R&D and innovation in all areas

1・Leveraging lessons from theEbola crisis, lead thestrengthening of response
to public healthemergencies by theinternational community.
・Further promote UHC, which
is a key to address thebroader health issues faced by
the international community.

Health Agenda

Key messages “G7 Ise-Shima Vision for Global Health”

Objectives
The G7 leaders commit to:G7 Ise-Shima
Summit in 2016

G7 health ministers meeting: KobeKeyIssues

Global health architecture – emergencies
・WHO Emergencies Programme; WHO and World Bank funding;International Health Regulations; WHO Blueprint for action against
infectious diseases

Antimicrobial Resistance (AMR) + Research
・UN General Assembly; Surveillance; - GLASS system; WHO Global Plan;
Fast track regulatory approvals
・Partnership for research; new resources, Open Science platforms,
WHO Prequalification Programme

Universal health coverage (UHC) and healthy/active ageing
・New UHC2030 global collaborative platform; “Roadmap for Healthy Systems,
Healthy Lives”; UN High-Level Commission on Health Employment andEconomic Growth,;
・Comprehensive services for older people; transformation and innovation agenda;
more data; WHO Global Plan on Ageing; NCD prevention and control;
dementia – research, new WHO Global Strategy (May 2017), age friendlly anddementia friendly initiatives

Prevailing Trends
Challenges

Technologies

Dementia

Devices, AT, medicines,diagnostics, ICT
Sensors

Health Workforce

NanoscaleInstitutional-based
health care system
Low birthrates

Personal care Mobility &Cloud

Urban/Rural

Exponential Data

Globalization

Robotics

Ageing Population
NCDsSolutionsNew ecosystem, evaluation &regulatory system
Integrated approaches: withhealth/social system
Connected health platforms
Behavioral change & Patientengagement
Remote care
Analytics – Population health
Mass customization& actionable data

New generation information technology solutions to improve health/health care
Adapted from CITRIS, www.citris-uc.org

A priority on…
 UHC planning Benefits package, transformation agenda Decision making and priority setting
 Political economy: influencing resource allocation decision Health systems strengthening and reform Social service delivery system; new models of care and support

 Contributors to healthy life expectancy
 NCDs; Dementia
 Health promotion, prevention

 Technology as an enabler
18Current ongoing research
SO 1• Measurement: J-AGES, age anddementia friendly initiatives,
OECD disability, ageing, and equity• Dementia: community outreachfor early diagnosis (Kobe)• Health workforce: planning forageing populations• Political economy of UHC• Long term psycho-social impact ofemergencies

SO 2• Community-based social
innovations for older
populations (models of care)• Technology innovation(policy, evaluation, inclusive)• Investigation of specificinnovations

Basic facts of working with WHO• Competitive calls for and review of research proposals– Several types of contracts• Platform for implementation research• Communities of practice: convening different researchers• Specific (small) contracts• Budgets are limited• Catalytic research – leverage support for larger funded research
proposals• WKC does not fund basic biomedical research – rather, publichealth oriented research• Lessons are applicable to broader set of countries.
Also: internship and volunteer opportunities at WKC

Some major issues relevant to Japan and the world
1.

Community-based health and social care models (noninstitutionalised)
2. Managing care at home, including medical adherence
3. Urban design for older populations
4. Measuring and responding to inequities/poverty
5. Managing/preventing co-morbidities in older populations
6. Dementia
7. New strategies for health and social workforce for rapidly ageingsociety
8. Managing and promoting technological innovations
9. Managing costs, and refining UHC and LTC insurance programmes
10. Responding to low birth rates

Conclusions

Opportunities to collaborate Kansai Medical University Consortium is an excellent convening forum forcollaborative research amongst the universities
 It helps to prioritize research Provides a forum for which WKC to engage
 Opportunities for joint WKC, AMED and Government of Japan approaches toresearch Special journal supplements, and global forums
 Seek opportunities for translating lessons from Japan for other countries, andvice versa, to support ageing populations, improve health outcomes andwellbeing, and to attain UHC in a sustainable way.

www.who.int/kobe_centre@whokobe

どうもありがとうございました
THANK YOU VERY MUCH