Lord Coe: holistic solutions to health

"We are slowly and surely building physical activity out of the everyday," warned Lord Sebastian Coe, speaking exclusively to pharmaphorum at OPEN Health's inaugural 'Health Innovation: Big Ideas' event in London recently.

In addition to his role as chairman of the British Olympic Association, Lord Coe is an ambassador for 'Designed to Move'. This initiative aims to tackle the growing epidemic of physical inactivity and its impact on every facet of life by promoting the myriad of benefits that activity provides.

Lord Coe says the issue of physical inactivity had to be considered as part of a much broader picture. "The challenge isn't just seen through the optics of health. It's about the built environment; it's about the way we design cities; about making sure architects are studying some of these issues as part of their degree curriculum." He cited the fact that people entering public buildings are greeted with banks of escalators, and that it can take 20 minutes to find the stairs - just one example of how the decline of physical activity is leading to increasing levels of obesity and related diseases.

"The challenge of health is to use physical activity in sensible ways," he said.

"The top ten killers in the world, in the top 50 income countries, are inextricably linked to physical inactivity."

"Prescribing physical activity as a route out of ill health is really important ... We live in a world where we focus on technological solutions, and in healthcare that tends to be the right medicine at the right price with the right accessibility to it. But the top ten killers in the world, in the top 50 income countries, are inextricably linked to physical inactivity.

"The average kid in western Europe becomes 50 per cent physically less active between the ages of nine and 15," he explained, a statistic that would only result in increased pressure on the NHS over time, when it was already facing an annual £10 billion burden from preventable disease.

"These are big, unsustainable figures," he stated. "$6.2 trillion a year is the cost of preventable disease in the world.

"We're 21 per cent less active than we were in 1961 and this will probably rise to 35 per cent by 2030. Half the population of the US and China, and a third of UK and Brazil, will be physically inactive by 2030. It is unsustainable," Lord Coe cautioned.

Big data

He stressed that it was important for people to feel involved in their own health care decisions, which had not happened in the past: "The language around health and healthcare has been quite off-putting for most people," he explained. "In the '80s and a large part of the '90s we talked about 'patient episodes', whatever that meant." Such language had made patients feel alienated and had not helped with recent attempts to collect big data from health records in the UK.

Lord Coe felt there was merit in collecting big data to help develop personalised medicines, but that it had to be done in a way that protected patients' privacy and confidentiality. "Until recently, we've been dealing with very specific data and quite narrow and quite deep ... Big data doesn't give you the reason for a particular pathology, but it will give you a steer as to the likelihood of that disease or pathology taking place.

"We have got to learn to deal with large, messy amounts of data rather than small, specific amounts that won't always give you the clue to the potential for a problem."

Similarly, Kingsley Manning, chair of the Health and Social Care Information Centre (HSCIC), which is leading the UK's efforts to collect, analyse and present national health and social care data, echoed Lord Coe's views when he spoke to pharmaphorum at the event.

He highlighted the need for a balance between maintaining patient privacy and making best use of personalised data. He acknowledged that members of the public were suspicious about how information would be used, saying, "We have to recognise that the concerns expressed by a number of groups are legitimate."

"What people respond to is the specific; 'this is good for you, it is good for your family, it's good for the wider community'"

Regarding the recently postponed launch of the care.data initiative he said that because of the decline in trust, it was vital to be as transparent as possible, and said a "very direct conversation" was needed with patients and citizens, so that they understood the risks and benefits of sharing data. This hadn't been fully explained in the past, he said. "People respond to specific messages: 'this is good for you, it is good for your family, it's good for the wider community'," he said. "We have operated on a very simple assumption, historically, about implicit consent ... But in a situation where records will be generated by patients themselves, who hold their own records, the whole situation of confidentiality will become much more sophisticated," he concluded.

One thing both speakers agreed on was that the concept of wellness was more complex than in the past. The broader context had to considered when trying to empower people to take responsibility for their own health, in terms of providing opportunities for people to keep themselves active, as well as providing clear guidance on the pros and cons of opening up health records for analysis.

As health systems look increasingly to prevention as a means to limit the costs of managing chronic conditions, it is no longer simply about funding drugs. Pharma must decide how it can play its part more holistically in this environment.

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Health innovation: When big ideas meet big

About the Author:

Paul Tunnah is CEO & Founder of pharmaphorum media, which facilitates productive engagement for pharma, bringing healthcare together to drive medical innovation. It combines industry-leading content and social media engagement services with the globally recognised news, information and insight portal pharmaphorum.com, working with pharmaceutical companies, service providers and broader healthcare organisations to help communicate their thought leadership and connect them with relevant stakeholders.

For queries he can be reached through the site contact form or on Twitter @pharmaphorum

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