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Novo Nordisk’s Camilla Sylvest explains how the Danish pharmaceuticals company has been collaborating with cities since 2014 to combat the global rise in type 2 diabetes. The coalition of nine cities aims to prevent 100 million new cases by 2045 by working together to tackle obesity
Novo Nordisk’s ability to continue to deliver innovative products that benefit patients relies on strong, stable health systems. Yet today the diabetes challenge threatens those systems’ very economic sustainability. For us there’s a business risk in simply watching from the side lines. We know our contribution has to go beyond medicines and treatments, and it’s that realisation that spurred us to join others in launching a global fight against urban diabetes.
The Cities Changing Diabetes partnership, initiated by Novo Nordisk in 2014, now counts nine major cities across the world as collaborators, alongside 100 partners from the worlds of health, city management, urban planning, academia, community groups and foundations. We’re proud to have been recognised as good practice in reports by leading organisations such as UN Global Compact, WEF and the Access to Medicines Foundation. While this recognition has been encouraging and we are clear on our responsibility to play our part, the corporate case for action is also clear.
Last week in Houston our global coalition of partner cities set out an ambitious global goal to prevent more than 100 million new cases of diabetes by 2045. The coalition argued that achieving the goal will require ambitious action on the biggest modifiable risk factor for diabetes – obesity. Urban lifestyles are a major contributor to the growing prevalence of obesity, and thus diabetes.
To achieve the goal, we are calling for every city to ask: what will it take to bend the curve on diabetes in our city? By asking this question, city leaders can begin to play their part in changing the trajectory of the disease globally. But achieving the goal will only be possible if together we invest in building strong partnerships along the way.
As the world seeks to get to grips with challenges of the magnitude of the United Nations’ Global Goals, the partnership approach has never been so important. Companies have a new opportunity and imperative to play a role. With last week’s second global Cities Changing Diabetes Summit in Houston fresh in my mind – and new partner cities set to join the programme, including Hangzhou and Beijing – I wanted share some of the unexpected things our experience has taught us about how to drive partnerships like this.
1 Distinctive focus So many of the critical challenges on today’s global agenda cut across sectors, disciplines and borders. The alarming rise of diabetes is no exception and cities are the frontline; home to two-thirds of those with the disease. As the growth fast becomes unmanageable for health systems, shortening the lives of millions of urban citizens and constraining economic growth, seeing diabetes from an urban perspective has been an important focus for the partnership to rally round. As one of the partners in Rome, clinical epidemiologist Dr Antonio Nicolucci, put it: “I think that the true value is to have people understand how important this change of perspective is: going from disease understood as an individual problem to disease understood as the result of environmental, urban and general policies.”
2 Research as catalyst The way in which the social and cultural dynamics of urban lifestyles influence health is under-researched; and the challenge looks different from city to city. So robust evidence became a critical bedrock for any meaningful action. But research also acted as a call to partnership. We brought on board two expert partners at the global level, University College London and Steno Diabetes Center Copenhagen, with the commitment to researching what makes people vulnerable to diabetes in a city setting. That was the basis for building a network of partnerships with city and health leaders, and academics in cities around the world. At the summit we heard time and again how this research helped health leaders see the challenge differently.
3 Community with purpose Collaboration works when we feel ourselves to be a part of something bigger – in common cause. As our partner, Cai Chun from Shanghai Municipality of Health and Family Planning, put it, “Medical institutions came to us first, then disease prevention and control division got involved and, later, we have communities and community agencies joining us. We all put our heads together to control diabetes and there’s definitely more collaboration.” It also works at the global level: one of the biggest asks from partners at the summit was to formalise the collaboration between cities in the programme. This means Mexico City can learn from Xiamen, and Copenhagen from Johannesburg.
4 Core infrastructure Any partnership needs a small set of organisations to play an anchor role – bringing people together repeatedly in a way that builds ownership and can sustain momentum. Global events like last week’s are important milestones in that activity. But each city also has a core project group who are responsible and accountable for driving the partnership. Katrine Schønning, head of public health in Copenhagen, described the value of a strong and open core: ‘We’ve established some really good relationships in the working group, and we’ve also been disagreeing without anybody getting angry about it. … And because the relations in the working group have been good, it’s also been possible to throw some wild ideas on the table.’
5 Adjacent allies Because so many of today’s challenges are interlinked, partnerships can multiply impact by connecting with others who share the same agenda, but often come from a different perspective. That means pushing yourself to identify and forge links with those who can bring a fresh angle. For example, people managing cities are increasingly seeing the synergies between improving health and becoming resilient to climate change. Novo Nordisk is working with C40 to establish the policies in cities that benefit both the state of the environment and the health of citizens. Meanwhile, collaborations with the Robert Wood Johnson Foundation, Gehl, and the organisation Peers For Progress bring fresh perspectives and momentum to the programme.
6 Generous spirit Partnerships nearly always have blurred boundaries and often what is learnt by those involved can benefit a much wider set of organisations. At the summit, the Cities Changing Diabetes programme made publicly available the most innovative and effective approaches from pioneer cities around the world. The Urban Diabetes Toolbox arms leaders in any city to create their own action plan to tackle urban diabetes and obesity. It is acts of sharing that can create a much greater impact.
7 Activist mind-set As a private sector organisation driving public-private partnerships, your legitimacy will naturally – and rightly – be questioned. At Novo Nordisk, we’re clear that what matters to us is not just the business we do, but how we do business. That’s captured in what we call the Novo Nordisk Way, and also in our triple bottom line business model, through which we seek to create lasting social, as well as economic and environmental value. Our role in this partnership works because it isn’t about us; it’s about the cause: urban diabetes. And that’s perhaps most clear in the global goal we set out at this summit. We called for an ambitious action to bend the curve of diabetes, and through that prevent more than 110 million new cases of diabetes by 2045.
No partnership is easy, and nor is it an overnight process. It requires patience, commitment and stamina. For our part, we know that contributing to sustainable healthcare systems means staying committed in the long-term. We’ve learnt a lot since the beginning in 2014, and we’re growing in number so that the cities involved have over 100 million citizens between them. If we’re to have the impact we want on urban citizens, and on patients, it’s partnerships that will get us there.
Camilla Sylvest is executive vice president of commercial strategy and corporate affairs at Novo Nordisk. She has just moved back to Denmark from China after two years heading up the region. She saw first-hand the innovative Cities Changing Diabetes partnership in action in the pioneer cities of Shanghai and Tianjin.