Science alone will not provide global health. We urgently need new approaches to put chronic diseases effectively on the agenda in the public debate and among key decision-makers across sectors. This is a huge task that will require partnerships, innovation and long-term commitment.

A consensus-building process - Scenarios of alternative futures

The debate kicked off in December 2003 at the two-day conference Oxford Vision 2020, a collaboration initiated by Novo Nordisk, the University of Oxford and the World Health Organization (WHO). The event brought together more than 70 leading health thinkers, activists and decision-makers with the goal of increasing the collective impact to bring a halt to the pandemic growth predicted for diabetes and other chronic diseases.

Professor John Bell opened the Oxford Vision 2020 conference, urging for changed priorities to address the huge economic and human costs of chronic diseases.

Oxford Vision 2020 is a three-year process of consensus building and developing recommendations for a new and comprehensive global approach to preventing and controlling chronic diseases, including diabetes. The initiative will therefore assist the WHO in the development of its new strategy to combat chronic diseases.

At the first conference, held at Magdalen College in Oxford, UK, participants defined the issues and discussed which levers for change need to be pushed in order to advance the complex agenda. Novo Nordisk’s CEO, Lars Rebien Sørensen, explained how the company is exploring the ramifications of the immense healthcare challenges of the coming decades and the possible pressures on the traditional pharmaceutical business model.

A series of similar strategic meetings will be arranged and we will continue the work between meetings to create a joint blueprint for action in accordance with the WHO strategy. The aim is that this entire vision process will enable us to step into a new era in dealing with diabetes and chronic diseases.

Through this focus on diabetes we may pave a way of thinking about creative solutions to chronic disease management that will have implications not only for people with diabetes but also cardiovascular diseases, obesity, hypertension and certain cancers – all of which share lifestyle risks with type 2 diabetes.

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At Novo Nordisk, we are focusing our thinking around two contrasting scenarios about how society and healthcare will evolve. Since we cannot confidently predict the future, scenarios are useful frameworks that provide a structure for asking “what if?” and helping determine how best to navigate successfully in different possible environments.

The first scenario, progress, assumes the continuation of scientific breakthroughs and new medicines but does not necessarily provide for the equitable distribution of the benefits of those innovations.

The second scenario is about what we have chosen to call utopian change. This scenario recognises that while science and technology have worked miracles, they have not adequately addressed determinants of health and illness such as inequality, political instability and poverty. Resolving these global dilemmas and their many associated ills will require a fundamental transformation in the way we think about them and the way we use science and technology. At the very least, they call for new approaches and new ideas.

The two scenarios represent two fundamental views: one where the present way of doing business in healthcare remains intact and the other where empowered consumers take action to form coalitions strong enough to deal with the huge healthcare and social challenges across sectors and geography. Yet both are about moving away from ‘sick care’ and taking the more progressive view on ‘health care’. We would like to see the best of both scenarios materialise. Breakthrough medications would be highly beneficial to all, and the visionary nature of the second scenario is well in line with the aspirations of our company to defeat diabetes. Working with our partners in the Oxford Vision 2020 initiative, we will use the scenarios to help chart a path to a more equitable and healthy future.