Many of the ideas, concepts, and approaches to achieving health equity we discussed in these pages last year remain as urgent as ever. At Takeda, we continue to believe that it’s time to rethink health equity—and we’ve made progress. We remain committed to helping create equitable health care for all. Our health equity roadmap is centered on a core question Takeda has asked for more than 240 years, and one we use as the human yardstick of progress: What more can we do for our patients? We believe that’s a question we’ll continue to not only ask, but respond to, for the next 240-plus years.
The Center for Health Equity and Patient Affairs is one part of our health equity roadmap. Sitting at the intersection of research and access, it’s intentionally structured as a Center of Excellence to provide essential services, programs, and frameworks that help Takeda build sustainable, physical, and intellectual infrastructures intended to address health disparities and inequities as a business strategy. While we may not have all the answers, asking questions fosters new ways of thinking and novel solutions that put us on the right path toward advancing health equity.
As we strive toward a more inclusive health ecosystem, it’s important to look at the key learnings we’ve identified and modify our core principles appropriately. We must remember to evolve and apply our findings to future work so that companies and the industry benefit as well.
Terms and definitions matter
It’s clear that there’s often a conflation of terms being used interchangeably: health equity (HE); diversity, equity and inclusion (DE&I); equality; corporate social responsibility (CSR); environmental, social and governance (ESG); and diversity in clinical trials—among others. But these concepts don’t mean exactly the same thing: health equity, for example, targets systemic factors that lead to inequity and calls for different strategies. We have to identify how each of these approaches plays a part in advancing health equity. If we just use them as synonyms, we miss an opportunity to develop the most appropriate mix of strategies to the multifactorial problem of health inequity.
Addressing health inequities is not a fad
The social determinants of health (SDOH)—the root causes of health inequities—are intertwined. Your education, economic stability, neighborhood, and social and cultural environment impact your understanding and opportunity to engage in healthy behaviors (Fig. 1). These factors can also limit access to appropriate resources to live your healthiest life. They make up our personal ecosystems and are often barriers to receiving quality care. This isn’t a surprise, but a reminder of how crucial it is to address health inequities—for us and future generations.
Although these issues run deep, this hasn’t paralyzed us at Takeda from continuing the journey to tackle health inequities. It has become apparent that it will take all of us working together to advance health equity. In fact, these challenges inspired us to do even more.
Health equity is a moral imperative and business strategy
While many agree there’s a pressing social need for addressing health inequities, the business case is equally as robust. For Takeda, advancing health equity will allow us to deliver our innovative medicines and therapies to more people and communities that need them. Driving health equity forward continues to be critical to our mission of providing ‘better health and a brighter future’ for all and making that a reality. That’s why Takeda was among the first of 39 companies to sign the Global Health Equity Network Zero Health Gaps Pledge at the World Economic Forum Annual 2023 Meeting in Davos. We agreed to ten key action commitments to embed health equity in our business strategy, operations, and investments. Our pledge at Davos reflects a commitment our company had upheld long before then, one grounded in our understanding that advancing health equity begins within the walls of our company and how we operate as a business.
Fundamental to making health equity a business priority is centering the voice of the patient and ensuring their diverse needs are incorporated into our business. For us, that means believing everyone deserves access to the care and medicines they need. This begins at the discovery phase and continues throughout commercialization and lifecycle management. What good are our medicines if patients can’t access them? We aim to understand the diverse needs of patients and the communities in which they were born, grow, live, and work. This perspective equips us to create more inclusive practices and innovative medicines that better reflect what and how patients want and need to engage with health care. Our patient-centric approach encourages every group across our global organization to envision how addressing health disparities and inequities can help our employees, the patients they serve, and the company.
The importance of active listening
Regardless of the industry that you’re in, achieving health equity calls for actively asking, listening, learning and then taking action, with an ear to the community and through ground-up strategic approaches. What resources do our local partners need to create more equitable communities and how can we provide access to our products for all patients regardless of where they’re born, work, live, grow, or age? What about those who live in remote areas or lack health insurance? What do patients and communities believe is the best way to tackle health disparities? What’s the next thing to do, then the next? What do our patients have to say about the plan? How do we make it sustainable? How are we measuring impact? These are some of the questions we use to guide our work and our partnerships because we know listening, learning, and co-creating can help provide positive impact to communities and to Takeda.
Asking ourselves “why” to help improve health outcomes for all
Over the years, many companies have learned that listening closely and building trust with patients are critical ingredients of good care management and delivery. That’s a key goal for us. We aim to treat the whole patient, using a customized approach that they can understand and adhere to, and that can deliver care close to where they live or work as they move along their health journey. We know that not every patient is the same clinically—not every patient responds to the medicines, therapies, or information the same way. Listening and learning will help us better understand not only what inequities are and where they exist, but why. Ask our team; they’ll tell you our favorite question is ‘why’. If we can understand the ‘why’ from the perspective of the patient, community, and their ecosystems, we’ll be better equipped to provide people with the personalized care they need.
It’s important to use data to understand not just what’s happening to our patients, but ‘why’ so we can truly measure how their health has improved. Gathering the data and infusing these considerations into the way our industry works also helps enable us to deliver better access to health for patients around the globe. We need to begin looking at data beyond the numbers and activities. Once we do, we’ll see it’s about the impact—the true measurement of whether something is working or not.
At Takeda, we’re designing metrics that measure impact and value at the community level—impact and value that matter to the patients and people we serve. These metrics are designed to uncover gaps in care and assess barriers to care. This approach creates a sustainable framework—from drug discovery through delivery—that helps shape our future work, collaboration, and efforts.
Needs first, then co-create
“We always start with the community identifying the need, no matter how basic or big. We don’t say, ‘We’re going to give you this.’ That’s a very colonialistic perspective, right? We always listen, learn, and co-create—that’s the order we start in. We then look for a way to ensure we are incorporating the learnings into our work, creating a path to make it sustainable, and educating, inspiring, and empowering others. All of our partnerships have started that way.”
Charlotte Owens, MD
Moving the needle with global partners
Health inequities are too vast and too multifactorial for any single entity to solve alone. That’s why Takeda continues to believe in partnerships that bring together the private and public sectors, as well as non-governmental organizations, with shared interests. They are instrumental to advancing health equity. We need multifactorial approaches to the multifactorial problem of health inequity. Our partnerships bring together a diverse mix of resources and civil and governmental expertise to create reciprocal social impact—impact that makes the world better and allows everyone involved to benefit at the same time.
We seek partners that will assist in providing tangible and sustainable impact at three levels: for the communities and patients we serve; our company; and for future generations to come. It’s our goal that all our partnerships educate, inspire, and empower all to be agents of change in their communities, regardless of their environments.
In November 2022, Takeda partnered with Discovery Education on a three-year science, technology, engineering, and mathematics (STEM) education initiative, Better Health in Action: From Classroom to Community. Discovery Education is the worldwide edtech leader. The program is designed to empower young people to understand the principles of health equity and to identify health inequities in their communities through interactive, research-based learning experiences. It provides a suite of free, comprehensive digital resources for educators, students, and families with children in grades 6 to 8 (ages 11 to 14) and teaches STEM skills. It also introduces them to career opportunities and role models in life sciences. This first-of-its-kind program with Discovery Education is available to Discovery Education’s audience of 4.5 million educators and 45 million students in more than 100 countries. The Better Health in Action program also expands global access by making our family guide and materials available in multiple languages.
We’re proud to be partners with Springer Nature and are continuing to roll out several initiatives including the global health equity Nature Café, an eye-opening docuseries of extraordinary people doing extraordinary work to combat inequities, and the Innovations In publication series. The newly launched Inclusive Health Research awards are designed to celebrate and support individuals and institutions that are driving more inclusive approaches to health research, and, in doing so, are promoting a future of greater health equity globally. These awards spotlight innovation and best practices in inclusive health research that have been influenced by engagement with affected communities and their expert representatives. The awards also aim to build a library of shareable case studies of new ideas and best practices that demonstrate the progress being made to advance global health equity.
Takeda has partnered with Surgo Health, a technology company headquartered in Washington, D. C., to establish a multi-country social and cultural vulnerability index embedded into Surgo’s Socio-Behavioral Intelligence Platform to provide insights that our global teams can leverage to identify vulnerabilities, and the underlying reasons for them. This will help us better customize our approaches because we gain a deeper understanding of the patient and their community.
Keep asking questions
In our efforts to do better and achieve our health equity goals, here are some of the questions we are asking across all stages of our work, from developing new drugs and vaccines to getting them to the people who need them: How are we engaging, empowering and elevating patients from all communities to guide our research and development? How are we responding to patients’ needs in our efforts to increase diversity across our clinical trials? How are we communicating the findings of clinical trials with patients in meaningful and understandable ways? While we may not have all the answers, surfacing the right questions invites solutions.
In 2022, Takeda launched its De Novo Initiative, which focuses on helping people to better understand their health. By partnering with our Diversity in Clinical Trials Team, we aim to train and establish new clinical trial sites in underserved areas and establish new investigators in those communities. We are training, developing, and enrolling a network of up to 30 sites new to Takeda, or new to clinical studies, with clinicians who care for and treat patients from underrepresented groups and/or underserved communities. This initiative provides opportunities to include clinical trials in community practices and to normalize the conversation of clinical trials, as well as provide information about disease prevention and better knowledge of conditions and their current treatments. We’re optimistic that this new effort will increase participation by creating better awareness and opportunities for all, especially underrepresented groups, and, in turn, improve diversity in our trials.
We’re constantly partnering internally to embed health equity into our global business—into the way we think and work, and in our decision-making process. Through our patient access work, we’re committed to broadening sustainable access to potentially life-changing therapies for patients throughout the lifecycle, from development to commercialization. Our most innovative medicines and therapies are not achieving their potential impact if the people who need them can’t access them. We believe by embedding health equity into our patient access efforts, we’re helping drive meaningful change to move closer to equitable care for all.
All of this work brings us back to the 240-year-old question: What more can we do for patients? The possibilities expand every day. What helps our patients helps us as a company. We hope our learnings and progress inspire others across all sectors. The world is calling us all to action.
AUTHORS
Charlotte Owens, MD, Vice President and Head of the Center for Health Equity and Patient Affairs, Takeda
Wolfram Nothaft, MD, Executive Vice President and Chief Medical Officer, Takeda
ADDRESS
Takeda, 500 Kendall Street, Cambridge, Massachusetts, 02142, United States
