The global economy is projected to grow at 6% in 2021 and 4.9% in 2022. After a year where a new respiratory virus left the world bruised and battered, at first glance these numbers look like the promise of a new beginning and new hope. The reality is much more nuanced and complicated, which became clear when the International Monetary Fund (IMF) revised the detail around its global economic outlook in July this year.
The overall forecast for 2021 remained unchanged, but existing global fault lines and inequities widened, demonstrated by the IMF upgrading growth expectations for advanced economies by 0.5% and downgrading the expected performance of emerging and developing economies by 0.4%.
These offsetting adjustments reflect differences in pandemic developments and policy shifts, the IMF said in its outlook document.
According to the report, vaccine access and vaccination rollout remains the most critical issue for global economic recovery.
In May this year, the World Health Organisation (WHO) Strategic Advisory Group of Experts on Immunisation convened over Covid-19 vaccines. At that meeting the group stated that inequity in vaccine availability is decreasing slightly, but pointed out that high-income countries have administered “69 times more doses per inhabitant” than low-income countries.
According to the WHO, 31.4 million doses have been administered in 50 African states, meaning only 2% of the African adult population has received a single dose.
In South Africa, at least, there are signs that the inequity is being addressed and that we are moving in the right direction, says Dr Evangelos Apostoleris, specialist urologist and consultant for Life Healthcare.
He lists various factors that are positive indicators, such as developed nations announcing that they will release more vaccines to underserved areas, commitments from manufacturers for doses earmarked for the continent as well as local manufacturing of both the Johnson and Johnson vaccine by Aspen, and the Pfizer-BioNTech vaccine by Biovac.
For Dr Apostoleris there should be urgency in speeding up the vaccine programme so that capacity can be freed to once again focus on the bigger healthcare system in South Africa.
“When you look at healthcare and moving South Africa forward in this regard, it is not only the Covid-19 related topics that should receive attention. It is also the non-Covid-19 related issues that have to be addressed. The social determinants of health, for example,” he says. “Simple things, like the conditions in which the population lives, access to running water, access to primary health care – all of this has taken the back foot.”
Dr Apostoleris will be moderating the Healthcare Industry Insights 2021 for the Gordon Institute of Business Science (GIBS), where he is an alumni, at the end of the month. Topics such as the business of vaccine manufacturing and the challenges and changes to healthcare due to Covid-19 will be discussed.
Among the topics that will come under the spotlight are these second-order effects of the pandemic and their impact on the healthcare system.
The impact and cost of mental health issues and deferred care challenges due to Covid-19 are two aspects that Dr Apostoleris believes will be unpacked and analysed for quite some time.
“In terms of the second-order effects of Covid-19, I believe mental health is a huge one. So many people have been impacted in so many different ways, more than you could have imagined,” he says.
Prevalence of anxiety increased significantly in 2020
Prevalence of depression increased significantly in 2020
McKinsey & Company has again done a study in the US warning that the likely increase in substance use disorders possibly brought on by the mental health stressors of Covid-19 could have a significant impact on health costs for treatments to assist these patients.
The consultancy extrapolates data from its surveys and research, and forecasts that a potential 50% increase in the prevalence of behavioural health conditions could lead to between $100 billion and $140 billion of additional spend in the first year post the onset of Covid-19.
“Deferred care, and how that will impact the healthcare system locally and globally, is another concern,” says Dr Apostoleris.
Patients and people who were thinking of seeking medical advice about an issue at the end of 2019 or beginning of 2020 could have deferred that visit and subsequent care, he says.
The treatment options for the underlying medical condition could be different now to what it was 18 months ago.
It has never been more important for the public and private sector to work together to address these new challenges, as well as inequalities that existed in the South African healthcare system even pre-Covid-19. It cannot just be business as usual, we need a new unique operating system to address these challenges.
“Cooperation is required to manage the care of patients as we move through the third wave,” sys Dr Apostoleris, adding that the real opportunity for partnership however lies in dealing with the backlog in general healthcare that will remain after the pandemic subsides.
“Whether it is routine screening procedures, elective surgery or scopes that are required to look for evidence of and treatment of medical conditions … There will be a significant workload that needs to be dealt with and that is where we can work together,” he says.
“It is important, you need to have a healthy nation and quality healthcare to move South Africa forward.”
For more information about the GIBS/PPS Healthcare Industry Insights 2021, please click here.
Brought to you by the Gordon Institute of Business Science (GIBS).
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