S3-1 Ricciardi DoH Vatican

22/01/2024
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Walter Ricciardi
Reflections on research and the future from a Public Health perspective
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Agenda
• A change of epoch in a world in turmoil
• The role of science in addressing formidable challenges
• Value based and Mission oriented approach to innovation and research
• 3 examples
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we are not living in “an epoch of changes, but a change of epoch”
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after 11,000 years we have entered a new geological age!!!!!
from Olocene to Anthropocene
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+ 0,2°
– 0,2°
+ 1,2°
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2 billions people live in war zones
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A different world
1348 2020
50% mortality 1% mortality
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X X XX
?
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Anthropocene
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3 examples
Vaccines
Cancer
Neonatology
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Vaccines save lives
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Vaccines are the most cost-effective health
care interventions there are.
A dollar spent on a childhood vaccination not
only helps save a life, but greatly reduces
spending on future healthcare.
Ezekiel Emanuel, NIH
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Vaccines are not perceived as a value technology
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Vaccines are not perceived as a value technology
Politicians
Managers
Professionals
Patients
Citizens
Industry
Media
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because
Politicians: want to be elected, loved and stay in power
Managers: want to keep a proper budget
Professionals: want to do a good job
Patients: want to go back to health
Citizens: want to pay less taxes and enjoy life
Industry: want to return on investment and make profit
Media: want to increase their share and clicks
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The only way to reconcile
is a Value Based Approach
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VBHC: Operationalisation of & Guiding Principles
for Solidarity in Healthcare
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https://ec.europa.eu/health/expert_panel/sites/expertpanel/files/024_valuebasedhealthcare_en.pdf
Chair: Lasse Lehtonen
Rapporteur: Claudia
Wild
Walter Ricciardi
Pedro Pita Barros
Werner Brouwer
Jan DeMaeseneer
Dionne Kringos
Martin McKee
Liube Murauskiene
Sabina Nuti
Luigi Siciliani
Experts: Muir Gray,
Bjørn Hofmann, Nicola
Bedlington
1. ACCESS AND EQUITY (SOCIAL JUSTICE,
FAIRNESS)
3. EFFICIENCY AND PRODUCTIVITY
(OPTIMIZATION AND DISTRIBUTION OF
RESOURCES)
2. QUALITY AND PERFORMANCE (RESPONSIVE,
APPROPRIATE & SAFE CARE)
HEALTH IS CONSIDERED TO BE AN INTRINSIC
VALUE: A PRECONDITION FOR PURSUING A
“GOOD LIFE”, FOR OBTAINING OTHER (VITAL)
GOALS WHAT PEOPLE WISH TO PURSUE IN LIFE.
SINCE UNIVERSAL HEALTHCARE INTENDS TO
PROVIDE HEALTH TO THE POPULATION (PATIENT
POPULATIONS AS MUCH AS THE WHOLE
POPULATION) THE “EQUITABLE” ACHIEVEMENT
OF HEALTH FOR ALL IS THE AIM AS
PRECONDITION FOR SOCIAL COHESIVE
SOCIETIES.
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DEFINING VALUE IN “VALUE-BASED HEALTHCARE”:
RECOMMENDATIONS & PROPOSALS FOR ACTION
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« Mission » concept
2018
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The Mission-oriented
research and innovation approach
« Missions provide a solution, an
opportunity, and an approach to
address the numerous challenges that
people face in their daily lives ».
Professor Mariana Mazzucato
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« Mission » concept
Commissioner Moedas and Professor Mazzucato
2019
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Goals of Missions
• to give direction to European research and
innovation in solving society’s pressing
challenges and produce tangible results
• to involve citizens and stakeholders more closely
in setting research priorities, but not only, which
will lead to equal access for everyone in Europe
to the best of European innovation & research,
resources, and global know-how
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Reports of the 5 Missions
Sept 2020
https://op.europa.eu/en/web/eu-law-and-publications/publication-detail/-
/publication/d0235612-b68a-11ea-bb7a-01aa75ed71a1
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https://ec.europa.eu/info/publications/implementation-plans-eu-missions_en
Launch of the 5 Missions
Implementation Plans
29 September 2021
Green light for the 5 Missions
September 2021
€1.9 billion until 2023.
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13 patient/citizen centered
recommendations for bold actions
5 intervention areas to reach
The Cancer Mission target
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13 Bold recommendations for bold actions
• « With ERNs »
• « Rare Cancers »
• « Model of ERNs »
• « Link with ERNs »
• « Cross border »
• « Network «
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Summary cancer portfolio Horizon 2020 (1)
EU contribution across programmes
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Summary cancer portfolio Horizon 2020 (5)
EU contribution regions Connections between beneficiaries
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Work of the Mission Board
Advise on the Implementation of Mission Actions May 2021
In synergy with the Europe’s Beating Cancer Plan
Prevention
Early
detection
Diagnosis &
treatment
Quality of life for
patients and
survivors
DG Santé
DG RTD
M Gabriel
S Kyriakides
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Can we try to do the same for vaccinations?
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Morens and Fauci, Cell 2020
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The Mission
Board on
Vaccination in
Europe
(MBVE)
MBVE goal: to identify,
promote & support the
implementation of
ambitious targets to
strengthen Europe’s
immunisation systems,
with a particular focus on
decision-making on
vaccination policies and
programmes.
Multi-disciplinary academic experts from
11 EU Member States (+ the UK), health
care & public health professionals, civil
society, patient representatives, and
industry.
MBVE Consensus Paper
Multi-disciplinary collaboration
Containing recommendations for action at
European & national level – to be finalised
by end of 2023
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Eva Höltl, Austrian Society for Vaccinology
Members of the Mission Board:
National experts
Austria
Greet Hendrickx, University of Antwerp
Pierre Van Damme, University of Antwerp
Belgium
Heidrun Thaiss, German Society for Social Paediatrics
and Adolescent Medicine
Germany
Zsófia Mézner, National Institute of Paediatrics Heim
Pal, Budapest
Hungary
Chiara de Waure, University of Perugia, Associate
Professor at the Department of Medicine and Surgery
Italy
Vytenis Andriukaitis, European Institute for Health
and Sustainable Development
Lithuania
Maarten Postma, University Medical Centre
Groningen, Chair of Global Health
The Netherlands
Marcin Czech, Institute of Mother & Child, Head of
Department of Pharmacoeconomics
Poland
João Paulo Magalhães, Portuguese National
Association of Public Health Doctors
Portugal
Miloš Jeseňák, Associate Professor of Pediatrics,
Comenius University, Bratislava
Slovakia
José Antonio Navarro Alonso, Former Head of
Immunisation Programme, Region of Murcia Department
of Health
Spain
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Active Citizenship Network | Mariano Votta
Members of the Mission Board: EU stakeholders
EU-level non-institutional stakeholders
Coalition for Life Course Immunisation | Daphne Holt
European Cancer Organisation | Silvia Romeo
European Public Health Alliance
European Public Health Association | Chiara De Waure
Federation of European Academies of Medicine
Professor George Griffin and Elisa Corritore
European Regional & Local Health Authorities | Michele
Calabrò
European Patients Forum, Anca Toma | Executive Director
Heidi Larson | The Vaccine Confidence Project
Other academic experts
Emilie Karafillakis | The Vaccine Confidence Project
Peter Piot | London School of Hygiene and Tropical
Medicine
Università Cattolica del Sacro Cuore, Rome
Annalisa Calabro, Chiara Cadeddu and Floriana
D’Ambrosio
Scientific Secretariat
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Mission temple for vaccination
in Europe
EQUITY
Data and
evidence for
decision-
making
Beliefs,
perceptions,
vaccine
confidence
Citizens’
access to
vaccines
Convergence
&
harmonisation
RESEARCH AND UNDERSTANDING
we did in less than a year what we did in the Mission Board in two years
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Implementation Phase
2024-26
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MBVE 3-year implementation
phase
I. MBVE Flagship programmes
Led by Members of the Mission Board, underpinned by KPIs
Each flagship to seek its own funding (public/private)
Year 1
2 flagships to be initiated
Year 2
2 flagships to be initiated
Year 3
2 flagships to be initiated
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The Lancet Child and Adolescent Health Commission on the Future of Neonatology
Daniele De Luca (PhD),1,2 Neena Modi 3, Peter Davis,4,5 Satoshi Kusuda, Saskia De Wildt, Martin Keszler,
Allyah Abbas-Hanif, Sandra Juul, Mark Turner, Jane Pillow, Nikki Robertson, Manuel Sanchez-Luna, David
Tingay, Alexandra Benachi, Flavia Bustreo, Gianluca Ianiro, Mark Hanson, Jan Deprest, Paolo De Coppi,
Agnes van den Hoogen, William Tarnow-Mordi, Anna Zanin, Ju-Lee Oei,^ Huayan Zhang, Victor Javier
Lara-Diaz, Lloyd Tooke, Heide Flori, Walter Ricciardi and Steven Abman *
1. Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University (Paris, France)
2. Division of Paediatrics and Neonatal Critical Care, “A.Beclere” Medical centre, APHP-Paris Saclay
University (Paris, France)
3. Section of Neonatal Medicine, School of Public Health, Chelsea and Westminster Hospital campus,
Imperial College London, London, UK
4. Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Victoria, Australia.
5. Department of Neonatal Services, The Royal Women’s Hospital, Melbourne, Victoria, Australia.
* Pediatric Heart Lung Center, Department of Pediatrcs, University of Colorado Anschutz School of
Medicine (Aurora CO, USA)
^School of Paediatrics, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
^Department of Newborn Care, the Royal Hospital for Women, Randwick, NSW, Australia
^Department of Addiction Medicine, Murrumbidgee Local Health District, NSW, Australia
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Figure 5. Recommendations from the Lancet CAH Commission for the future of neonatology.
Industries
Regulators
Parents
Government
and public
institutions
General public
Neonatologists
IRB/ethical boards
Outcome
Healthy baby Allied healthcare
professionals
Former patients
Other specialists
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The future is
not a
destination like
Rome or the
Garda Lake
waiting for our
arrival
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it is something like a bridge that we
have to imagine plan and build
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Thanks for your attention
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