The field of healthcare is currently experiencing a revolution, driven by cutting-edge health technologies that promise to enhance diagnostics, improve patient care, and offer advanced treatments for a multitude of diseases. Whether it’s the usage of artificial intelligence for drug discovery or the rapidly advancing approach of personalized medicine, technology can significantly improve global healthcare.
However, the unfortunate reality is that most of these advances are not designed with our most vulnerable communities in mind. In an ideal society, low-income countries would have the same equitable access to healthcare innovations as wealthy countries at a fair price. Sadly, this is not the society we find ourselves in.
The most recent example of this disparity can be seen with the US Food and Drug Administration approval of Casgevy and Lyfgenia, ground-breaking gene therapies for sickle cell disease. This marks the first US-authorized use of CRISPR technology, short for clustered regularly interspaced short palindromic repeats technology, which uses enzymes to edit small parts of the human genome. Although this offers new hope to many affected Americans, providing alternatives to bone marrow transplants and potentially curing the disease, several experts have raised concerns about low-income countries being side-lined. CRISPR technology, like other advanced treatments, is very expensive, estimated to cost between one to three million dollars. This makes it inaccessible not only to Americans who may not be able to afford these treatments, but also to vulnerable populations in low-income countries—thereby worsening existing health disparities rooted in structural inequities.
This raises significant challenges, given that sickle cell disease is disproportionately prevalent in low-income regions compared to wealthier nations. Estimates suggest that around two per cent of newborns in sub-Saharan areas are affected by sickle cell disease, highlighting the urgent need for accessible treatments in these communities.
CRISPR is not the only instance of healthcare innovations being inequitable. It was also evident in handling the Covid-19 vaccine. Despite rapid development and distribution efforts, significant disparities persisted in vaccination rates between wealthy and low-income nations, with leaders of wealthy countries spending substantial amounts to secure supplies well beyond their needs. By the end of 2022, only 25 per cent of people in low-income countries had received at least one vaccine dose, starkly contrasting with the 72 per cent in wealthier countries.
This issue unfortunately also hits home for the Indigenous community. Indigenous women in Canada often face obstacles in accessing even basic medical care due to geographic isolation and systemic discrimination, including racial segregation. For example, a study conducted by the Canadian Community Health Survey revealed that 18.6 per cent more pregnant non-Indigenous women have a regular healthcare provider compared to pregnant Indigenous women. This deficiency in both access and awareness, racial bias in medical treatment and research, and unequal distribution of health resources are the manifestations of structural racism.
This leaves us with the question: how can we bridge this gap?
The World Health Organization (WHO), renowned for its assertive leadership amid the Covid-19 pandemic and its awareness of health disparities, could be called upon to widen its capacity for “moral” leadership. By turning its attention to the up-and-coming landscape of innovative health technologies, the WHO has the potential to significantly influence their impact on global health equity.
Many experts advocate for ongoing research to lower costs and improve access to healthcare innovations. For example, recent research aims to create affordable genome editing cures for sickle cell and HIV that perform the procedure directly in the body, potentially establishing a new standard for future treatments.
There is an immediate need for open discussions on the regulation, pricing, and intellectual property rights of these innovations. If left to the market, companies can charge premiums, exacerbating health inequities.
Bridging this divide requires a collaborative effort from researchers, governments, funders, and stakeholders to understand the potential impact of these innovations on global health equity and ensure access for vulnerable populations.
Developing transformative healthcare technologies is only the beginning. The true challenge is effectively unlocking their full potential by ensuring these innovations are accessible. Only then can we ensure that the benefits of health innovations lead to more equitable health outcomes across the globe, regardless of a raging seven-figure price tag.