What corporations need to know about public health

Corporations are increasingly moving into the public-health domain. Companies like Amazon, Google, and Microsoft are being “pulled” by market opportunities for non-traditional actors to “disrupt” health care. Others are being “pushed” by the imperative – highlighted by events like the Covid-19 pandemic – to act as responsible community stakeholders, such as by helping to address health inequities.

When such pull and push forces intersect, there are often important opportunities to align economic and social objectives. But if strategic corporate philanthropy is to improve public health, those charged with making decisions and allocating resources must have a deep understanding of the health system, including the institutions, organisations, and resources that comprise it, and the complex interactions among them.

According to a framework established by the World Health Organisation, health systems have six pillars: Service delivery; development and deployment of a health workforce; collection, analysis, and use of critical health information; provision of essential medical products, vaccines, and other health technologies; financing; and effective leadership and governance. To meet a population’s health needs, all six must work in harmony, in an elaborate process involving inputs, activities, outputs, outcomes, and impact.

Consider Covid-19 vaccination programmes, which depend on inputs – including financial resources, workers, equipment, and the vaccines themselves – that are partly outputs from activities like medical-product development and service delivery, with all the logistics, infrastructure, personnel training, and supervision this entails. Together, all these factors lead to an outcome – getting a large enough share of the population vaccinated – with the impact being a reduction in mortality and morbidity from Covid-19.

As the WHO also explains, an effective health system is fair and equitable, both in the distribution of health goods and services and in the way it is financed. It emphasises efficiency and cost-effectiveness as well, and responds to the legitimate non-health expectations of those seeking health care, such as respect and compassion. Ultimately, an effective system ensures that anyone in need of a specific health good or service can access it and derive the relevant benefits.

This framework should guide corporations – and all stakeholders – as they engage in the public-health domain. So should the principle that any direct investment in the health system must serve to strengthen one or more of the framework’s six pillars. To this end, a clear, data-based strategy for measuring health-system performance is crucial.

Only a comprehensive monitoring and evaluating plan – identifying not only what data need to be measured, but also how, when, and by whom – can ensure that decision-makers have the information they need to plan, organise, and implement effective public-health programmes. For example, it can help to ascertain high- and low-priority areas, as well as areas where services are being duplicated, thereby improving the allocation of scarce resources. It can also show which public-health interventions are making the biggest difference, and be used to track progress in health outcomes, potentially revealing gaps between segments of the population.

Organisations seeking to engage in public health can use such data – together with a broader understanding of the health-system framework – to identify where they are best suited to make a difference, based on their competitive or comparative advantages. The better they know the terrain they are entering, the easier it will be to pinpoint unmet needs and anticipate their actions’ likely impact (including possible unintended consequences).