HEALTH - Maria Paola Chiesi / Gianfelice Rocca #sef2021 (ENG)

Thank you very much, Itachiro. We're going to start with the first round table that I participated in beforehand. I'm very pleased to see about 700 people connected, signifying the importance of this day together. I'd like to call on Maria Chiesi, who is Director of Shared Value and Sustainability of the Chiesi Group. Good morning, I can see you connected. Also John Felix, President of the Techint Group and the Humanitas Group. Good morning. Dr. Rocca, I can see you connected — I can see you with my glasses; when I take them off I can't see anymore, but this is part of visible sustainability. From this point of view, I'd like to understand with Dr. Chiesi the teachings — let's talk about the vaccine part, which is at the forefront of the news and a cause of concern — but apart from the vaccine biologic issue, the teachings you've taken from this horrible pandemic so far. The floor is yours. We cannot hear the audio. You have to activate your microphone. No, we can't hear you. Yes, now we can. Perfect.

I'll go back to you on the pharmaceutical agenda, which is a very pragmatic concept. I'd now like to give the floor to President Rocca. We've been talking about the acceleration of research in the pharmaceutical field — vaccines and related research. There have been doubts and misunderstandings, but it's undeniable there has been an acceleration never seen before in global pharmaceutical investment. My question is: do you think there has been an acceleration or investment in terms of sustainability? I realize the most important topic is population health safety, but I'd like to understand if you noticed an acceleration or increase in the speed of investment in sustainability from the healthcare point of view.

Certainly, COVID has changed something that may remain permanent. In the beginning, I was in Bergamo visiting hospitals and saw the tragedy that spread worldwide — it was the first country to experience such a bad event. There was an unprecedented exchange of information worldwide. We organized webinars on ICUs — we were the first — with dozens of thousands of participants all trying to find the best treatments. The great innovation was that all data on the genetics of the virus and gene sequencing were made available quickly worldwide. Technologies already existed — especially mRNA technologies — and were exploited because a paradigm shift in research took place. The relationship between government, the academic world, and regulators changed. Governments could start new corporations — think of the Oxford-AstraZeneca cooperation — enabling changes that would have taken years. This redesigned the relationship between risk and safety, which had driven up pharmaceutical costs due to the so-called 'litigation effect,' eliminating every possible mistake without considering the risk-benefit ratio. This requires dialogue with the population about both factors. The impact on healthcare systems was devastating. In Italy, we saw extraordinary human capital — orthopedic surgeons doing the work of infectious disease experts within weeks. The entire system adapted quickly, and the global supply chain readjusted impressively in months. Small companies came to the forefront. However, this exposed the inability to tackle structural healthcare system problems due to governance failures. Life expectancy for the 65+ population in the UK, US, Germany, and Italy has not increased in the last 10 years, whereas it had grown consistently before. This says a lot about the direction of research and care delivery. The next pandemics could be cybernetic — affecting data, telecommunication systems, and cybersecurity. We are totally unprepared. I welcome the attempt to establish governance authorities for these risks. Life sciences as a holistic system within social, economic, and philosophical sustainability is key. If citizens expect the state to guarantee health without any duty of prevention, we generate a society where health becomes impossible, triggering social and political frictions. Within the life sciences group of Confindustria that I chair, we are working on social sustainability, economic sustainability, and value creation.

Thank you, Mr. President. I'll go back to you later on another topic. You hinted that the acceleration is in terms of immediate response capability and global data sharing, but you also focused on the difficulty of making responses long-term and structural. One thing is the immediate response; another is embracing it long-term. As Mr. Monti mentioned, there's a need for a rebalancing mechanism — he referenced the Financial Stability Board for finance. We may think of a similar mechanism for health. It's too big a topic for individual states; what was lacking was international coordination on a global level — something we have for monetary policies, even if imperfect. I'd like to go back to you, Mrs. Chiesi, on the pharmaceutical agenda. What is it, and what would be the target for all the companies involved?

President Rocca, you were mentioned by your colleagues, so over to you to close this first round table. You've referred to points that worked well and other medium-to-long-term elements that need adjustment. It's easy to point to the vaccination campaign as the biggest challenge, but what is the biggest challenge in general, in your opinion?

The biggest challenge awaiting us is reconstruction — going back post-COVID and recognizing that the healthcare system and European welfare, where health is a key element, are still something to build. Europe, between China and the United States, needs governance mechanisms and strategic thinking, which is the responsibility of global, European, and Italian politics. Interest is focused on well-being more than any other field, but this requires combining economic, sustainability, and scientific competencies in a very innovative way. We produce 50% of the world's data — genetics, biogenetics, epigenetics, metabolism. Through AI, we can correlate this data and put it at the disposal of care and prevention for the first time in human history. Governing this sustainably, without a state-only reaction like COVID, is critical. In large hospitals, we need education and doctors who can manage new technologies while preserving the human dimension — empathy, more minutes with patients. The US is down to seven minutes. This must change. Doing this technological shift while maintaining human civilization — social and scientific — together is a great challenge. Italy can play an important role: strong in research and pharma production, with great human attention and research institutes combining education and application. Clinical science and innovation need real data from these institutions, which must also be delivered to people's homes through telemedicine. This is an extraordinary, beautiful challenge, but the governance issues are enormous. We are far from managing this level of complexity — it is one of the biggest challenges of complex systems governance connected to the quality of welfare. This is a European challenge, and our group is very committed, including within the G20. This requires a joint effort — private initiative, private investment, both private and public thinking. A state-centralist vision will produce two tiers of healthcare and countries aging in their capacity to face the future.