Achieving Health for All: The Power of Precision Public Health
Imagine a world where we could predict where the deadliest health challenges would occur, with a degree of precision so great that we could intervene before an emergency response were needed. What would you say if I told you this technology already exists—but that the world has yet to democratize it to the benefit of everyone?
This isn’t yesterday’s daydream or tomorrow’s innovation. This is already happening today.
A case in point is Yemen’s ongoing battle with one of the worst cholera outbreaks in the world. Although the waterborne disease is preventable and treatable if action is taken swiftly, Yemen’s cholera epidemic has killed more than 2,500 people since 2017, most of them young children.
Yet amid tragedy in Yemen, there has also been a sign of hope. BBC News and other media reported in August that the country was making important progress controlling cholera using new computer modeling that predicts outbreaks. The models mapped where rainfall would likely be highest and clean water scarcest, and helped health authorities direct health workers and resources to areas at greatest risk.
The speed and scale of impact using this approach was striking. The predictive model gave Yemen several weeks to prepare, and cholera cases were reduced 95 percent over a comparable period the year before. (Sadly, some of this progress was recently reversed due to air strikes that damaged a sanitation facility.)
I was trained as a physician and have spent much of my career working with mothers and newborns. I see great opportunity for the use of better data and predictive analytics to improve health across the board. But there is a big “if”: Data can improve health only if we can deploy life-saving insights widely and regularly, and for people who need them most.
That is why I am thrilled to be leading an interdisciplinary group of colleagues at The Rockefeller Foundation to take a closer look at the emerging field of precision public health—merging cutting-edge data science techniques with proven public health interventions. Precision public health has the potential to help overcome some of the biggest barriers to achieving universal health coverage, by ensuring that the right care gets to the right people at the right time.
Precision public health has the potential to help overcome some of the biggest barriers to achieving universal health coverage, by ensuring that the right care gets to the right people at the right time.
We know that health challenges are not evenly distributed within countries, but rather clustered in areas that we should be able to identify and prioritize—yet these clusters all too often go undetected. In Nigeria, researchers from the Institute for Health Metrics and Evaluation are taking up the challenge, building maps showing where children die and breaking down these data into 5×5 kilometer blocks. What they have found is that malaria deaths vary widely within the country, and the maps could help direct prevention and treatment efforts to where they are needed most.
Precision public health shines a spotlight on people with needs that may have previously been invisible. It is, to put it simply, an idea whose time has come.
So what is stopping more countries from taking advantage of this incredible power? There are several tensions that need to be addressed.
To start, there are major gaps in the availability of basic health data. Despite all the technological advances of the 21st century, we still lack very fundamental information—for example, the birth and death records of more than 30 million individuals. Closing these data gaps, as partnerships such as Data for Health aim to do, is a vital first step.
Novel approaches also require novel forms of collaboration. To put precision public health into action, we will need new collaborations that bridge countries and sectors, and that pair data engineers with public health actors. One such encouraging collaboration involves a software company in the United States and an NGO in Guatemala who have teamed up to use data to find communities at risk for Zika outbreaks.
This is just the beginning. Other key issues will need to be addressed, including building capacity to adopt precision public health within country health ministries and instituting essential safeguards to ensure the security and responsible use of health data. And communities must be involved in decision-making regarding precision public health—we cannot direct the public health system of the future without the critical insights communities provide.
I look forward to tackling the questions above and diving wholeheartedly into this challenge with innovators from around the world meeting in Berlin this week for the World Health Summit and the Grand Challenges Annual Meeting. You can join the conversation at #WHS2018 and #GrandChallenges.