Panel Highlights FOH Summit 2024: Equitable Access to Healthcare

How do we make sure that everyone — no matter where they live or what they earn — can access quality healthcare?

At the final session of the day, this question took center stage. Moderated by Ryan Noach, former CEO of Discovery Health, the panel brought together four leaders on the frontlines of tackling health inequities:

Dr. Priya Agrawal, spearheading global health equity at MSD/Merck
Maria Makhabane., Chief Growth Officer, Discovery Health
Dale Fisher, CEO, Silverchain Group, Australia
Dr. Henrique Neves, General Director of Sociedade Beneficente Israelita Brasileira Albert Einstein, Brazil

Together, they shared how real change happens when leadership, partnerships, and smart design turn well-meaning goals into measurable progress.

Inequality: A Challenge We Cannot Ignore

Ryan Noach opened the sessions with this statement:

“In South Africa, we have the highest Gini coefficient in the world — that shows up starkly in our healthcare system. Good intentions aren’t enough. We need action, accountability, and partnerships that deliver.”

He pointed to a recent FOH study published in Health Affairs, which laid out four practical steps for any organization serious about closing the equity gap. He emphasized that health equity must be elevated to a leadership priority and connected directly to KPIs and pay. Organizations must develop diverse, trained workforces and design care that truly centers on patients’ needs. Progress must be measured, tracked, and reported clearly so that communities can see the change. And above all, partnerships must be forged, especially with the communities being served.

From Slogan to Strategy

Dr. Priya Agrawal brought that strategy to life by showing how MSD is reshaping its entire approach:

“Health equity can’t be a side dish, it has to be the main dish. It’s part of our company scorecard, tied to every employee’s compensation. That shifts behavior and investment.”

She explained how MSD is rethinking research and delivery to ensure that vaccines and treatments reach underserved populations, not just wealthier markets. “Eighty-five percent of the world’s population lives in low- and middle-income countries. If we don’t design products and supply chains for them, we’re failing our mission.”

Affordability as a Path to Equity

Maria Makabane emphasized that expanding access must begin with affordability. Just 15% of South Africans currently have private health insurance, she explained, so Discovery Health is determined to reach one million previously uninsured people, an ambitious goal that requires rethinking what health coverage can look like. Discovery focuses on the most valuable care areas, such as primary care, screening, and wellness, to detect issues early and improve quality of life. At the same time, they are redesigning how care is delivered, using technology, AI, and better workflows so healthcare providers can spend their time where they have the biggest impact. “Seventy-five percent of our payments are now capitation, not fee-for-service — that aligns everyone’s incentives to keep people healthier,” she said.

Bringing Care Home

Dale Fisher, CEO of Australia’s Silverchain Group, reminded everyone that true access means meeting people where they are.

“We started as a children’s charity 130 years ago. Today we deliver home care to tens of thousands of Australians, many in marginalized communities.”

Fisher described how Silverchain is addressing critical gaps by expanding palliative care at home to give people the dignity of spending their final days where they wish. “Most people want to die at home, with dignity. We make that possible.” The organization is also creating culturally safe models that allow Indigenous Australians to receive end-of-life care “on country,” staying connected to their land and traditions. Another priority is tackling the mental health crisis among older Australians. “Sixty-five percent of older Australians have anxiety or depression symptoms, yet it’s invisible. We’re partnering with an Israeli company to pilot new models that can meet this silent need.” Fisher emphasized that Silverchain’s success is possible because their models make sense economically, attracting strong government partnerships and sustainable funding.

A Blueprint for Public–Private Partnerships

In Brazil, Dr. Henrique Neves described how Einstein Healthcare has transformed its role, moving from an exclusive hospital for São Paulo’s wealthiest residents to becoming a trusted operator of public hospitals serving the city’s most vulnerable populations.

“We now run more hospitals for the public system than the private. We take full responsibility — staff, supplies, operations, quality.”

The secret, he said, is clear contracting, agreed-upon quality metrics, and accountability on both sides. “Agree on what’s delivered, what it will cost, how it will be measured — and then pay on time. That’s the deal. And it works. Costs go down, quality goes up, queues disappear.”

Vaccines: The Real Equity Test

When asked how to avoid the “vaccine apartheid” experienced during COVID-19, Dr. Agrawal was clear: manufacturing alone won’t fix the problem. “Vaccines don’t save lives — vaccinations do. The most influential voice isn’t a global celebrity; it’s a trusted local healthcare worker. But they need support and training to reach people effectively.” She stressed that companies must design vaccines with practical realities in mind — simple to deliver, stable without expensive cold chains, and tailored to local needs — or the promise of access will remain out of reach.

Redesigning for Real Impact

Wrapping up, Maria Makabane reminded the audience that equity is about doing better with what we have. “Expanding access doesn’t mean lowering standards — it means rethinking how we deliver care, so cost isn’t the barrier that keeps people from a healthy life.”

The Takeaway

Throughout the session, one message resonated again and again: Health equity does not happen by accident. It requires leadership courage, smart design, clear measurement, community trust, and the commitment to challenge outdated systems.

As Ryan Noach concluded, “Equity is smart business and good policy. The real test is whether we’re willing to build systems that make it real for everyone.”

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