Tag: Prevention

September 29, 2023

Why we need to improve heart health in Europe

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Cardiovascular diseases (CVDs) are the number one killer in Europe. They cost the EU an estimated €282 billion in 2021, larger than the entire EU budget itself.[1] Sixty million people live with CVDs in the EU, while 13 million new cases are diagnosed annually.[2]

Behind this data are individual stories of suffering and loss, of lives limited and horizons lowered by, for example, heart attack and stroke. These diseases directly affect every community in every country. And they strain our health services which must respond to cardiac emergencies as well as the ongoing care needs of chronic CVD patients.

Sixty million people live with CVDs in the EU, while 13 million new cases are diagnosed annually.

Cardiovascular health is a priority not just because of the scale of its impact, but because of the scope we see for significant advances in outcomes for patients. We should take inspiration from the past: between 2000 and 2012, the death rate from CVDs fell by 37 percent in the five largest western European countries (France, Germany, the U.K., Spain and Italy).[2] This progress was achieved through a combination of medical innovations, and supported by a mix of health care policies and guidelines that propelled progress and improved patients’ lives.

New treatments can now help prevent strokes or treat pulmonary embolisms. Others can delay kidney disease progression, while at the same time preventing cardiovascular events.

Despite progress, this downward trend has reversed and we are seeing an increase in the CVD burden across all major European countries.

And the research continues. Precision medicines are in development for inherited CVD-risk factors like elevated lipoprotein(a), which affects up to 20 percent of the population.[3] A new class of anti-thrombotics promises to bring better treatments for the prevention of clotting, without increasing the risk of bleeding. New precision cardiology approaches, such as gene therapy in congestive heart failure, are being investigated as potential cures.

Despite progress, this downward trend has reversed and we are seeing an increase in the CVD burden across all major European countries.[4]

Getting the definitions right

This year’s World Heart Day, spearheaded by the World Heart Federation, comes amid the revision of the EU pharmaceutical legislation. The European Commission’s proposal of a narrow definition of unmet medical need, which could hamper innovation is causing deep concern across stakeholders.

Instead, a patient-centered definition of unmet medical need taking the full spectrum of patient needs into consideration, would incentivize more avenues of research addressing the needs of people living with chronic conditions. It would provide a basis for drafting the next chapter in the history of cardiovascular medicines — one that we hope will be written in Europe and benefit people in the EU and beyond. Not only would this inspire advances that help people to live longer, but it would also improve quality of life for those at risk of, and affected by, cardiovascular events.

Unmet medical need criteria currently included in the draft Pharmaceutical Legislation would do a disservice to patients by downplaying the chronic nature of many CVDs, and the importance of patient-reported outcomes and experience.[5] And many of the advances seen in recent decades would fall short of the narrow definition under consideration. This limited approach disregards incremental innovation, which might otherwise reduce pain, slow disease progression, or improve treatment adherence by taking account of patient preferences for how therapies are administered.

Much of the illness and death caused by CVD is preventable — in fact, 9 out of 10 heart attacks can be avoided.

At this moment it is unclear how the unmet medical need criteria in the legislation will apply to these and other situations. Policymakers should create a multistakeholder platform with the space to discuss patients’ needs, getting expert views from medical societies, patients and industry to better understand the innovation environment. The European Alliance for Cardiovascular Health (EACH), a multistakeholder network comprised of 17 organizations in the CVD space in Europe, stands ready to inform policymakers about the CVD burden and the pressing needs of patients. [6] EACH not only supports the EU´s endeavor to develop more policies on CVD, it also supports and promotes the idea of an EU Cardiovascular Health Plan to work towards better patients’ health care across the EU and more equal health standards. So far, structured discussions with such stakeholders do not sufficiently take place, and we risk missing those opportunities, and lose in both patient access as well as R&D attractiveness of the EU.

Primary and secondary prevention

As well as driving future innovation, Europe must also make the best possible use of the tools we have now. We must do what works — everywhere.

At the heart of this approach is prevention. Much of the illness and death caused by CVD is preventable — in fact, 9 out of 10 heart attacks can be avoided.[7] Primary prevention can dramatically reduce rates of heart attack, stroke and other CVDs. Secondary prevention, which includes screening and disease management, such as simple blood tests and urine tests, as well as blood pressure and BMI monitoring, has a key role to play in containing the burden of disease. [8]

Joint cardiovascular and diabetes health checks at primary care level, taking an evidence-based approach, would help diagnose and treat CVD before the onset of acute symptoms.[9] By following current treatment guidelines and protocols, health care professionals across Europe can help to prevent complications, improve health outcomes for patients and save health care costs. Also here, a multistakeholder approach is key. Policymakers should not miss out on listening to the CVD multistakeholder alliances that have already formed — at EU and at EU member countries level, as for example EACH. These partnerships are great ways for policymakers to better understand the needs of patients and to get the experts’ views.

Research-driven companies exist to meet the needs of patients in Europe and around the world. We need to create an environment that enables companies to embark on complex and unpredictable trials. That means having the rights incentives and clarity on the regulatory pathway for future treatments.

[1] https://www.escardio.org/The-ESC/Press-Office/Press-releases/Price-tag-on-cardiovascular-disease-in-Europe-higher-than-entire-EU-budget

[2] https://iris.unibocconi.it/retrieve/handle/11565/4023471/115818/Torbica%20EHJ%202019.pdf

[3] https://www.acc.org/Latest-in-Cardiology/Articles/2019/07/02/08/05/Lipoproteina-in-Clinical-Practice

[4] https://www.efpia.eu/about-medicines/use-of-medicines/disease-specific-groups/transforming-the-lives-of-people-living-with-cardiovascular-diseases/cvd-dashboards

[5] https://health.ec.europa.eu/medicinal-products/pharmaceutical-strategy-europe/reform-eu-pharmaceutical-legislation_en

[6] https://www.cardiovascular-alliance.eu/

[7] https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.024154

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331469/

[9] https://www.efpia.eu/news-events/the-efpia-view/statements-press-releases/because-we-can-t-afford-not-to-let-s-make-a-joint-health-check-for-cardiovascular-disease-cvd-and-diabetes-happen/



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September 20, 2023

Beyond forgetfulness: Why we must act on Alzheimer’s disease now

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In the face of an increasingly aging population, today’s reality reveals a harsh truth: health systems in the EU and beyond are ill-equipped to provide early and timely diagnosis of Alzheimer’s disease and embrace innovative treatments that could help to preserve memory and, with it, independence.

Recent advances suggest that timely intervention may hold the promise to slow the memory decline in Alzheimer’s disease, making early diagnosis more critical than ever before. Yet without the necessary health care infrastructure in place to diagnose and provide treatment, we risk missing the crucial early window and the opportunity to delay — and hopefully in the near future prevent — distressing symptoms for patients and heartbreaking experiences for families.

The EU and its member countries have the opportunity to be remembered for leading in this space by increasing funding for research, improving health care infrastructure to support accurate diagnosis and timely intervention, and enhancing support services at a national and regional level. The forthcoming European Parliament elections in June 2024 are the ideal moments to make that pledge. For individuals, families and health care systems, Alzheimer’s disease is a ticking time bomb unless we invest in our future health today.

The EU is not prepared for Alzheimer’s disease 

In Europe, approximately 7 million people are affected by Alzheimer’s disease, a number set to double to 14 million by 2050.1 On top of the physical and emotional distress this will cause, there are direct financial and social implications on families and communities, with Alzheimer’s costs expected to reach a staggering €250 billion by 20302 — bigger than the GDP of Portugal3 — placing an additional and substantial weight on global health care systems that are already struggling under cost and capacity burdens.4

Timely diagnosis stands as a cornerstone in determining the appropriate treatment for patients.

That’s why MEP Deirdre Clune is leading the call for a European Parliament hearing to discuss a focused EU strategy on dementia and Alzheimer’s disease. “Timely diagnosis stands as a cornerstone in determining the appropriate treatment for patients,” argues Clune. “Therefore, the EU must create a strategic framework which lays out clear recommendations for national governments and recognises the toll of dementia and Alzheimer’s disease on societies across Europe, encourage innovation and take on board best practices to develop effective and efficient approaches. Together, with a unified approach and firm commitment, the EU can pave the way for better Alzheimer’s care.”

In the next EU political mandate, policymakers must answer the call by developing a comprehensive EU Beating Dementia Plan that specifically addresses the unique challenges posed by Alzheimer’s disease and building on established coordinated action plans for other significant health burdens, such as the EU Beating Cancer Plan. The European Brain Council and EFPIA’s, RETHINKING Alzheimer’s disease White Paper is a useful resource, calling for policymakers to rethink Alzheimer’s and offering policy recommendations to make tangible changes to improve the lives of people living with the disease.

EU member countries must commit to investing in diagnostic infrastructure, technology and integrated care that can help to detect Alzheimer’s disease at an early stage and ensure timely intervention resulting in the preservation of memory and, thereof, independent living and normal social functioning.

Laying the foundations at national level 

While action is certainly needed at the EU level, huge opportunity lies at the national and regional levels. Each member country has the chance to apply well-funded national dementia plans that tailor their strategies and responses to address the distinct needs of their populations, making a real and meaningful impact on the people and health systems in their country.

Inspiration stems from Italy, which recently launched its Parliamentary Intergroup for Neuroscience and Alzheimer’s, dedicating its efforts to raising awareness, fostering discussions among national and regional institutions, promoting clinician and patient involvement, supporting novel research, implementing new diagnostic models, and strengthening patient access to care.

Italian MP Annarita Patriarca, co-host of the Parliamentary Intergroup, affirms: “Primary responsibility of a member state is to ensure to all citizens the greatest standards of diagnosis and access to treatment and care. Thus, it is necessary to put in place a strong collaboration between the public and private sector to strengthen investments in neurological diseases. Improving patients’ diagnostic and care pathways, especially in a disease area like AD with such a high unmet medical need and societal impact will be the core focus of the intergroup.”

Additionally, during the Alzheimer’s and Neuroscience Conference: a priority for the country in July, members of the Italian Parliament importantly put forward legislative and regulatory solutions to ensure an early and accurate diagnosis.

Leading the conversation on the international stage  

Amid the growing burden of Alzheimer’s disease globally, this is a moment for policymakers to hold each other accountable. Member countries are uniquely placed to do this within the EU but also across the wider health care ecosystem, calling on countries and leaders to honor prior commitments that prioritized investment in relieving major health burdens, including Alzheimer’s.

Encouragingly, the May G7 Hiroshima Leaders’ Communiqué specifically recognized and supported dementia as a freestanding issue, breaking away from the typical categorization with NCDs. Moreover, the G7 health ministers published a joint Communiqué spotlighting the priority to “enhance early detection, diagnosis and interventions, including developing care pathways and capability and capacity building of health and primary care providers by strengthening primary health care (PHC)”.

These promising steps mean that Alzheimer’s disease is beginning to gain the recognition it deserves but also acts as a line in the sand to ensure complacency doesn’t creep in. Collectively, EU countries must assume a leading voice within the international fora, ensuring that Alzheimer’s disease remains a global health care priority and receives the investment it warrants.

Time to commit to action in Alzheimer’s disease 

September marks World Alzheimer’s Month, and its theme Never Too Early, Never Too Late, reiterates the importance of early diagnosis. It presents a valuable foundation to initiate discussions on country- and regional-level strategies to drive and strengthen diagnostic infrastructure and services for the prevention, diagnosis, case management, monitoring and treatment of Alzheimer’s disease.

Unless we act now, a generation of people will be forgotten as they begin to lose their memories.

“Unless we act now, a generation of people will be forgotten as they begin to lose their memories,” shares Frédéric Destrebecq, executive director of The European Brain Council. “By recognizing the urgency of the situation and making concerted investments, we can forge a path toward a more compassionate, empowered future for individuals, families and communities impacted by Alzheimer’s, and remember all those who’ve been lost to this devastating disease.”

It is never too early, never too late, to be remembered for taking action against this debilitating disease.

References:

1 – Jones RW, Mackell J, Berthet K, Knox S. Assessing attitudes and behaviours surrounding Alzheimer’s disease in Europe: key findings of the Important Perspectives on Alzheimer’s Care and Treatment (IMPACT) survey. The journal of nutrition, health & aging. 2010 Aug;14:525-30.

2 – Cimler R, Maresova P, Kuhnova J, Kuca K. Predictions of Alzheimer’s disease treatment and care costs in European countries. PLoS One. 2019;14(1):e0210958. Published 2019 Jan 25. doi:10.1371/journal.pone.0210958

3 – Published by Statista Research Department, 20 J. GDP of European countries 2022. Statista. June 20, 2023. Accessed August 1, 2023. https://www.statista.com/statistics/685925/gdp-of-european-countries/.

4 – The Economist. Why health-care services are in chaos everywhere. Available at:  https://www.economist.com/finance-and-economics/2023/01/15/why-health-care-services-are-in-chaos-everywhere. Accessed: July 2023.



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September 8, 2023

Labs: the (overlooked) building block of Universal Health Coverage

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Hepatitis C (HCV) — a potentially life-threatening virus that infects 1.5 million new people around the world every year — is highly treatable if diagnosed early.[1]

Unfortunately,  access to quality screening is far from universal. Countries like Egypt — one of the countries with the highest prevalence of HCV in the world — demonstrate the impact screening can have. In 2015, HCV was prevalent in an estimated 7 percent of the country’s population and accounted for 7.6 percent of the country’s mortality, presenting a significant health care and societal burden.[2]

But since then, Egypt has turned a corner. In 2018, the Egyptian Ministry of Health and Population launched a massive nationwide HCV screening and treatment campaign as part of its 2014-2018 HCV action plan.[3] The campaign’s results were inspiring: by July 2020, Egypt had screened more than 60 million people[3] and treated 4 million residents.[2] Today, Egypt is set to be the world’s first country to eliminate HCV within its borders.[2]

The results of Egypt’s HCV screening program speak to diagnostics’ power in contributing to improved health outcomes around the world. Among the essential components of any health system is the capacity for prevention, which includes timely screening and detection. But a preventive approach based on timely diagnosis won’t work without the right infrastructure in place.

Strong laboratories as a cornerstone of building better health care

Matt Sause, CEO Roche Diagnostics | via Roche

highlights the critical role well-functioning laboratory services play in health systems with good reason.[4] Around the world, clinicians increasingly rely on  laboratory tests for diagnostic and treatment decisions. These tests help them make more informed decisions that result in better care and potentially improved outcomes for patients.

The challenges facing labs today — and tomorrow

Two key challenges facing laboratory systems today are underfunding and insufficient resources. Despite their central importance, laboratories struggle to garner the political and financial support they need to be as effective as possible. For example, it’s estimated that while lab results drive approximately 70 percent of clinical decision making, laboratories make up only 5 percent of hospital costs.[5]

After all, it’s the health care systems with strong, resilient labs that will be best placed to manage future pandemics and ever-growing health threats like heart disease and dementia.

What’s needed is a political commitment to provide everyone with access to accurate and timely diagnosis that paves the way to effective treatment and health. And putting this commitment into practice can only be achieved and sustained through coordinated multistakeholder efforts and public—private partnerships. This is not just a worthwhile investment for patients, but also the wider health care system in the long run. After all, it’s the health care systems with strong, resilient labs that will be best placed to manage future pandemics and ever-growing health threats like heart disease and dementia.

Another challenge is the health care workforce. Effective use of diagnostics requires qualified people to drive it, with expertise in pathology and laboratory medicine. Yet the world currently faces a laboratory staffing shortage. For diagnostics in particular, baccalaureate degree programs in laboratory science have previously been on the ‘endangered list’ of allied health professions.[6] In the end, inadequately trained staff, frequent turnover and scheduling problems all make quality lab results more difficult to guarantee.

This UHC ambition is only possible when backed by a network of strong laboratories that help ensure individuals can access high-quality diagnostics services without financial burden in all health care systems.

concluded that 81 percent of these populations have little or no access to diagnostics.[7]

The path to Universal Health Coverage

Put simply, innovative diagnostics are only meaningful if they reach people where and when they’re needed. Advancing this equity is at the heart of the WHO’s vision for Universal Health Coverage (UHC) by 2030. The goal? To guarantee all people have access to high-quality services for their health and the health of their families and communities, without facing financial hardship.

This UHC ambition is only possible when backed by a network of strong laboratories that help ensure individuals can access high-quality diagnostics services without financial burden in all health care systems. To do this, UHC should explicitly include diagnostics services. Financially, it’s savings from screening, early diagnosis and targeted treatment that make UHC feasible. Health care systems will have to undergo a systemic shift from focusing on treatment to focusing on prevention. And that’s just not possible when clinicians don’t have access to fast, accurate and cost-efficient lab results to inform their clinical decision-making. Policies and regulations that safeguard UHC goals of access and health equity are essential to make progress toward UHC.[8] The Saving Access to Laboratory Services Act (SALSA), in the United States, is an example of how national policies can help to ensure sustainable laboratory networks and contribute to equitable access to essential healthcare.

Stronger labs can not only help health care systems make savings in the routine management of population health; investing in them also helps to reduce costs and prepare in advance for any future public health crises.

This year has already seen encouraging progress toward achieving UHC through enhanced diagnostics capacity. The adoption of the resolution on strengthening diagnostics capacity at the World Health Assembly in May was an important signal of growing international political support for diagnostics. It was also a call to action. The next step for this month’s United Nations General Assembly and Sustainable Development Goals (SDG) Summit is channeling political support for diagnostics into the development of an action-oriented declaration.

To put us closer to UHC, this declaration should commit to ensuring that national health plans include access to timely detection and prevention. That starts with supporting laboratory systems and establishing National Essential Diagnostics Lists that identify the most critical diagnostic tests to help diagnose patients quickly and accurately so that they can receive needed treatment. At Roche, we’re advocating that governments, industry, civil society and other policy stakeholders will come together around concrete plans and shared resources that strengthen diagnostics and the lab infrastructure that makes them effective. In line with our commitment to increase patient access to important diagnostic solutions by 2030, we plan to do our part.

[1] Hepatitis C. World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c (Accessed 22.08.2023)

[2] Egypt’s Ambitious Strategy to Eliminate Hepatitis C Virus: A Case Study. Hassanin, A. et al. Available at:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087425/ (Accessed 22.08.2023)

[3] Hepatitis C in Egypt – Past, Present, and Future. Roche Diagnostics. Available at: https://diagnostics.roche.com/global/en/article-listing/egypt-s-road-to-eliminating-hepatitis-c-virus-infection—a-stor.html (Accessed 22.08.2023)

[4] Monitoring the Building Blocks of Health Systems. World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/258734/9789241564052-eng.pdf (Accessed 14.07.2023)

[5] The Cost-effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing. Bogavac-Stanojevic N. & Jelic-Ivanovic Z. J Med Biochem. Volume 36, Issue 3, 238 – 242. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287218/

[6] Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century: Workshop Summary. National Academy of Sciences. Available at: https://www.ncbi.nlm.nih.gov/books/NBK215247/ (Accessed 14.07.2023)

[7] Essential diagnostics: mind the gap. The Lancet Global Health. Available at: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00467-8/fulltext (Accessed 14.07.2023)

[8] Private Sector Commitments To Universal Health Coverage. UHC Private Sector Constituency 2023 Statement. https://www.uhc2030.org/fileadmin/uploads/UHC2030_Private_Sector_Commitments_Statement_April2023.pdf (Accessed 29.08.2023)



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April 20, 2023

Putting health back in health care

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Advances in medical science and technology are rapidly changing and as we saw with the pandemic, diagnostic tests play a pivotal role in health care decision making. They inform treatment decisions, save costs and, most importantly, deliver better outcomes for patients. Unfortunately, these life-changing innovations are all too often not available to many of the people who need them most. Currently, 47 percent of the global population and 81 percent of people in low and lower-middle income countries have little or no access to life-saving diagnostics.

If you’re following the policy trend at large — or even if you’re not — this is where we inevitably turn to discussions of the role of Universal Health Coverage (UHC) in the pursuit of better access to screening and diagnosis. Population health is not only in the best interest of individual countries, but as evidenced by a global pandemic, it is important to global health as well. UHC — ensuring people can access the health care they need, when they need it, without financial hardship — is foundational to improving world health care.

Currently, 47 percent of the global population and 81 percent of people in low and lower-middle income countries have little or no access to life-saving diagnostics.

So, where do we start? With better access to diagnostics.

After the world faced a global pandemic and pulled together, we all learned vital lessons which must not be forgotten. First and foremost, we saw that by working together and sharing information early, we could develop diagnostics and vaccines faster. This learning must extend beyond times of crisis.

We also saw that health systems with well-developed diagnostics infrastructure were more effective at containing and controlling the pandemic. And they were better able to continue providing essential diagnostic tests and treatment monitoring for patients with other diseases such as cancer.

Normally, it would take years to bring a new test to market. Here — through focus and collaboration — we managed to do so in months.

As the world responded to urgent calls for better access to COVID-19 tests, hopes were also expressed that this would spark innovation leading to widespread testing, vaccines and treatments, which ultimately would reduce the spread of the pandemic.

After the World Health Organization (WHO) declared COVID-19 as a public health concern, the urgency galvanized companies to work at full speed. The first Polymerase Chain Reaction (PCR) tests for SARS-CoV-2 were available for limited laboratory use within eight days. Only 64 days later PCR tests were authorized for use and available for scaled-up testing in major health centers.[1]

Normally, it would take years to bring a new test to market. Here — through focus and collaboration — we managed to do so in months.

As reported by the Lancet Commission, investing in diagnostic capabilities has been shown to lead to fewer misdiagnoses, better use of resources, and better patient care.

Driven by necessity, countries invested in diagnostics capabilities to fight the virus and, as reported by The Lancet, real change was seen at a pace that would previously have seemed impossible.

Why stop there? 

Ann Costello, Global Head of Roche Diagnostics Solutions | via Roche

The recommended WHO Resolution on strengthening diagnostics capacity represents an important step toward recognizing access to diagnostics as a policy priority as well as establishing concrete policy measures, to ensure equitable and timely access. It would pave the way for a considerable shift in strengthening our health care systems, driving progress toward global health equity and global health security.

As reported by the Lancet Commission[2], investing in diagnostic capabilities has been shown to lead to fewer misdiagnoses, better use of resources, and better patient care.

Early diagnosis is the cornerstone of sustainable, efficient and resilient health care systems. This in turn would reduce late-stage health care expenditures, including long-term costs of chronic disease management and disability, and better manage costs for patients, payors and governments.

Increasing access to diagnostics is crucial to controlling and potentially even eradicating certain diseases like cervical cancer, HIV, tuberculosis, viral hepatitis and malaria.

Laboratories are an essential component of a sustainable, efficient and resilient health system. But only if there’s enough of them and trained staff to run them.

The crux of the matter is that staff shortages in both high-income countries and low- and middle-income countries continue to create a barrier to diagnostic services.

How short-staffed are we? Well, to put a number on it, an estimated shortage in diagnostic workforce capacity saw a need for an additional 480,000-576,000 staff to support diagnostic testing.[2] And who loses when we don’t have enough skilled laboratory professionals? Patients.

Investment in diagnostics such as improving laboratory infrastructure and workforce development must also be supported by smart local regulatory approaches. This will ensure that patients, regardless of where they live, have timely access to innovation and safe, effective diagnostics.

Health care could enter a new golden age, shifting our focus from primarily treating disease to preserving health through prevention and by helping people live longer, more healthy lives.

This can be through adherence to international best practices, such as those created by International Medical Device Regulators Forum and implementation of regulatory reliance models — where one regulatory body (or the WHO) relies on the decisions, such as marketing authorizations, inspections and product changes, already made by trusted authorities and recognized institutions.

Governments should prioritize expansion of professionals with expertise in pathology and laboratory medicine[3] and introduce laboratory personnel as a key component of workforce initiatives to address the needs of currently over-burdened health care systems.

A new golden age for health care?

Roche is building partnerships to increase access to diagnostic solutions in low- and middle-income countries and to strengthen targeted laboratory systems through workforce training classes. In May 2022, Roche entered a partnership with the Global Fund to support low- and middle-income countries in strengthening critical diagnostics infrastructure. The aim is building local capacity to tackle infrastructure challenges to improve diagnostic results and manage health care waste. This is in line with Roche’s ambition to double patient access to innovative, high-medical-value diagnostics for people around the world.

Health care could enter a new golden age, shifting our focus from primarily treating disease to preserving health through prevention and by helping people live longer, more healthy lives.

To achieve the golden age we need to learn from the past. All public and private stakeholders have a duty to work together to ensure diagnostics continue to improve health outcomes around the world by bringing this important resolution to life.

Where a person lives should no longer be the key determining factor in their health. We have a tremendous opportunity here, let’s take it.

[1] Accelerating diagnostic tests to prevent a future pandemic. Bill Rodriguez. Cepi. Available at: https://100days.cepi.net/100-days-mission-diagnostic-test-future-pandemic/ (Accessed 04.04.2023)

[2] The Lancet Commission on diagnostics: transforming access to diagnostics. Fleming, Kenneth A et al.The Lancet, Volume 398, Issue 10315, 1997 – 2050. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(21)00673-5.pdf

[3] https://www.ihe.net/ihe_domains/ihe_pathology_and_laboratory_medicine/ (Accessed: 04.04.2023)



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February 6, 2023

Heads roll in Ukraine graft purge, but defense chief Reznikov rejects rumors he’s out

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KYIV — Heads are rolling in President Volodymyr Zelenskyy’s expanding purge against corruption in Ukraine, but Defense Minister Oleksii Reznikov is denying rumors that he’s destined for the exit — a move that would be viewed as a considerable setback for Kyiv in the middle of its war with Russia.

Two weeks ago, Ukraine was shaken by two major corruption scandals centered on government procurement of military catering services and electrical generators. Rather than sweeping the suspect deals under the carpet, Zelenskyy launched a major crackdown, in a bid to show allies in the U.S. and EU that Ukraine is making a clean break from the past.

Tetiana Shevchuk, a lawyer with the Anti-Corruption Action Center, a watchdog, said Zelenskyy needed to draw a line in the sand: “Because even when the war is going on, people saw that officials are conducting ‘business as usual’. They saw that corrupt schemes have not disappeared, and it made people really angry. Therefore, the president had to show he is on the side of fighting against corruption.”

Since the initial revelations, the graft investigations have snowballed, with enforcers uncovering further possible profiteering in the defense ministry. Two former deputy defense ministers have been placed in pre-trial detention.

Given the focus on his ministry in the scandal, speculation by journalists and politicians has swirled that Reznikov — one of the best-known faces of Ukraine’s war against the Russian invaders — is set to be fired or at least transferred to another ministry.

But losing such a top name would be a big blow. At a press conference on Sunday, Reznikov dismissed the claims about his imminent departure as rumors and said that only Zelenskyy was in a position to remove him. Although Reznikov admits the anti-corruption department at his ministry failed and needs reform, he said he was still focused on ensuring that Ukraine’s soldiers were properly equipped.

“Our key priority now is the stable supply of Ukrainian soldiers with all they need,” Reznikov said during the press conference.

Despite his insistence that any decision on his removal could only come from Zelenskyy, Reznikov did still caution that he was ready to depart — and that no officials would serve in their posts forever.

The speculation about Reznikov’s fate picked up on Sunday when David Arakhamia, head of Zelenskyy’s affiliated Servant of the People party faction in the parliament, published a statement saying Reznikov would soon be transferred to the position of minister for strategic industries to strengthen military-industrial cooperation. Major General Kyrylo Budanov, current head of the Military Intelligence Directorate, would head the Ministry of Defense, Arakhamia said.

However, on Monday, Arakhamia seemed to row back somewhat, and claimed no reshuffle in the defense ministry was planned for this week. Mariana Bezuhla, deputy head of the national security and defense committee in the Ukrainian parliament, also said that the parliament had decided to postpone any staff decisions in the defense ministry as they consider the broader risks for national defense ahead of another meeting of defense officials at the U.S. Ramstein air base in Germany and before an expected upcoming Russian offensive.

Zelenskyy steps in

The defense ministry is not the only department to be swept up in the investigations. Over the first days of February, the Security Service of Ukraine, State Investigation Bureau, and Economic Security Bureau conducted dozens of searches at the customs service, the tax service and in local administrations. Officials of several different levels were dismissed en masse for sabotaging their service during war and hurting the state.

“Unfortunately, in some areas, the only way to guarantee legitimacy is by changing leaders along with the implementation of institutional changes,” Zelenskyy said in a video address on February 1. “I see from the reaction in society that people support the actions of law enforcement officers. So, the movement towards justice can be felt. And justice will be ensured.”

Yuriy Nikolov, founder of the Nashi Groshi (Our Money) investigative website, who broke the story about the defense ministry’s alleged profiteering on food and catering services for soldiers in January, said the dismissals and continued searches were first steps in the right direction.

“Now let’s wait for the court sentences. It all looked like a well-coordinated show,” Nikolov told POLITICO.  “At the same time, it is good that the government prefers this kind of demonstrative fight against corruption, instead of covering up corrupt officials.”

Still, even though Reznikov declared zero tolerance for corruption and admitted that defense procurement during war needs reform, he has still refused to publish army price contract data on food and non-secret equipment, Nikolov said.

During his press conference, Reznikov insisted he could not reveal sensitive military information during a period of martial law as it could be used by the enemy. “We have to maintain the balance of public control and keep certain procurement procedures secret,” he said.

Two deputies down

Alleged corruption in secret procurement deals has, however, already cost him two of his deputies.

Deputy Defense Minister Vyacheslav Shapovalov, who oversaw logistical support for the army, tendered his resignation in January following a scandal involving the purchase of military rations at inflated prices. In his resignation letter, Shapovalov asked to be dismissed in order “not to pose a threat to the stable supply of the Armed Forces of Ukraine as a result of a campaign of accusations related to the purchase of food services.”

Another of Reznikov’s former deputies, Bohdan Khmelnytsky, who managed defense procurement in the ministry until December, was also arrested over accusations he lobbied for a purchase of 3,000 poor-quality bulletproof vests for the army worth more than 100 million hryvnias (€2.5 million), the Security Service of Ukraine reported.  If found guilty he faces up to eight years in prison. The director of the company that supplied the bulletproof vests under the illicit contract has been identified as a suspect by the authorities and now faces up to 12 years in prison if found guilty.

Both ex-officials can be released on bail.

Another unnamed defense ministry official, a non-staff adviser to the deputy defense minister of Ukraine, was also identified as a suspect in relation to the alleged embezzlement of 1.7 billion hryvnias (€43 million) from the defense budget, the General Prosecutors Office of Ukraine reported.  

When asked about corruption cases against former staffers, Reznikov stressed people had to be considered innocent until proven guilty.

Reputational risk

At the press conference on Sunday, Reznikov claimed that during his time in the defense ministry, he managed to reorganize it, introduced competition into food supplies and filled empty stocks.

However, the anti-corruption department of the ministry completely failed, he admitted. He argued the situation in the department was so unsatisfactory that the National Agency for the Prevention of Corruption gave him an order to conduct an official audit of employees. And it showed the department had to be reorganized.

“At a closed meeting with the watchdogs and investigative journalists I offered them to delegate people to the reloaded anti-corruption department. We also agreed to create a public anti-corruption council within the defense ministry,” Reznikov said.

Nikolov was one of the watchdogs attending the closed meeting. He said the minister did not bring any invoices or receipts for food products for the army, or any corrected contract prices to the meeting. Moreover, the minister called the demand to reveal the price of an egg or a potato “an idiocy” and said prices should not be published at all, Nikolov said in a statement. Overpriced eggs were one of the features of the inflated catering contracts that received particular public attention.

Reznikov instead suggested creating an advisory body with the public. He would also hold meetings, and working groups, and promised to provide invoices upon request, the journalist added.

“So far, it looks like the head of state, Zelenskyy, has lost patience with the antics of his staff, but some of his staff do not want to leave their comfort zone and are trying to leave some corruption options for themselves for the future,” Nikolov said.

Reznikov was not personally accused of any wrongdoing by law enforcement agencies.

But the minister acknowledged that there was reputational damage in relation to his team and communications. “This is a loss of reputation today, it must be recognized and learned from,” he said. At the same time, he believed he had nothing to be ashamed of: “My conscience is absolutely clear,” he said.



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