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The alarm has rightly been sounded on a silent killer. Faced with the staggering figure that 40 million people lose their lives each year to non-communicable diseases (NCDs), it is time to leave our comfort zones and consider how to best pool expertise to make sure that the right treatments are reaching the right patients, at the right time. Singling out the cost of treatment as the main barrier to access, as was the case again during the UN NCD hearing in July, does little to address the multiple barriers to access. Yes, we cannot fudge the affordability question and the price of insulin or cancer drugs does matter, but if we want to make progress we need a holistic approach. Why is it that in spite of companies’ tiered pricing policies and partnership efforts, access to these treatments still remains a challenge, in particular in low-income settings? The fact is that there are multiple factors that come into the equation, and most relate to weak health systems. For instance, in many countries, diabetes is still not seen as a priority for action. Funding is thus not properly allocated to train or equip healthcare workers to detect the symptoms or advise on the course of treatment. This opens the door to costlier, yet avoidable interventions down the road. People who are unaware they have the disease are at risk of suffering from heart attack, blindness, amputation, kidney failure. Additionally, secure and efficient distribution of medicines to treat NCDs, including insulin that requires cold chain specifications, is far from guaranteed in developing countries. Non-functioning supply chains can influence the availability of medicines as hefty mark-ups along the way are common, and the circulation of falsified medicines is substantial. As more tools and technologies emerge, it will be essential to put in place supply chains that are less fragmented, with fewer intermediaries, that will enable lower retail prices, better forecasting, higher availability, better monitoring of quality, and better adherence to standard treatment guidelines. According to the IMS Institute for Health Informatics, USD 269 billion per year could be saved if health systems worldwide tackled patient adherence to treatment. A proper monitoring and follow up with patients will lead to improved adherence to prescribed medicines, overall medication uses and prevention of adverse events, and achieve major therapeutic gains. In the absence of a robust primary care system, NCDs go unnoticed until complications arise, adequate treatment is not initiated, and treatment effect is not consistently monitored. While we mustn’t gloss over the affordability question, we just can’t afford not to address these health systems failures. One of the learnings of the multiple factors influencing access is that it does not suffice for our industry to be a mere transactional player in the health care system, i.e. a supplier of medicines. Discovering and developing new medicines and vaccines is our bread and butter, but we actually do much more than that: we foster innovation across the continuum of medical education, prevention, treatment and care. We share expertise and experience in strengthening supply chains, but also in training of health care workers, human resources management, treatment adherence, and health literacy. Additionally, by participating in multi-sectoral partnerships, we contribute to creating innovative finance models and build the bodies of evidence that will be crucial to meet the NCD targets. A case in point is our work with Access Accelerated, a first-of-its-kind collaboration led by more than 20 pharmaceutical companies who are all pooling their efforts together with IFPMA, the World Bank and the Union of International Cancer Control to focus on improving access to treatment and care for NCDs in low- and middle-income countries. Concretely, this translates to on-the-ground support to integrate NCD services into primary healthcare, like in Kenya. In March, a pilot programme was launched to help the Kenyan Ministry of Health meet their ambitious goal to achieve universal healthcare coverage by 2022 and to contribute to the global target to reduce NCD deaths by two-thirds by 2030 set in the Sustainable Development Goals. Critical to Access Accelerated is our ability to track progress and continuously adapt our approach. We have put independent measurement at our core by working with Boston University’s School of Public Health to develop a framework that rigorously measures and evaluates our programs. Our industry, whether it is about R&D or complying with regulatory requirements, strongly supports evidence-based approaches, and it strives to apply the same approach to investments in health partnerships. This will show us what’s working, what’s not and how we can adapt and scale-up our work to develop other pilot programs. We owe it to the beneficiary populations and to our partners on the ground. As NCDs are sweeping the entire globe, addressing health system failures is becoming ever more apparent, and it will be essential to tap into the private sector experience. Our industry brings extensive knowledge, expertise, and resources to develop innovative solutions. We can accelerate progress by pooling resources, leveraging tried and tested solutions, trying new, innovative pilot programs, and working with expert partners to support health systems with the management of life-long conditions. We’re committed for the long-haul to help ensure our life-changing therapies we work so hard to develop reach the remaining millions of people suffering from NCDs. About the author: Thomas Cueni is Director General of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA).

But it’s difficult to think about value when we have no buoy for understanding it outside our traditional lenses: for example, our time, our job, and what others tell us they are worth in cash. This, largely, is the world’s paradigm for value so far. But understanding what value really means changes everything—and will be at the center of the decentralized revolution in global coordination that will unfold over the next decade. So, where do we begin?

Let’s start with gold.

Gold is an inherent value. When backing a market, gold allows us to grow a balanced economy well into the trillions. But why does it allow for massive stable markets to form around it? It is gold's permanence that creates stability. We understand that gold will always have value, because it is inherent in all of us, not just in one part of the world, but everywhere, not just today, but tomorrow and for the long haul.

In the 1930s when the gold standard was removed, we learned that the U.S. dollar didn’t need gold to back its economy to flourish. We learned that it was just a symbol for U.S. citizens to decentralize their coordination around the United States economy.

It turns out, common agreement is a philosophy for building shared economy.



And so it seems inherent value is a marker for us to begin exploring what the future could look like—a future beyond gold and the existing realm of credit. And so what else has inherent value? Is education as valuable as gold? What about healthcare? What about a vote that can’t be tampered with? What about an ID that can’t be stolen or erased? What about access to nutrition or clean water? You will find value everywhere you look.



It turns out, we’ve already done the legwork necessary to uncover the most elemental inherent values: The Sustainable Development Goals are commitments grown out of the drive to bring to life basic tenets of the Universal Declaration of Human Rights—the closest possible social contract we have to a global, common agreement.

We’ve already agreed, as a global community, to ensure inclusive and equitable access to quality education. We’ve already agreed to empower all women and girls, to ensure pure and clean water access for all, to promote health at all stages of life, and to end hunger.

We’ve already agreed.

Our agreements are grounded in deep value centers that are globally shared, but undervalued and unfulfilled. The reason for this is our inability to quantify intangible value. All of these rich, inherent values are still nebulous and fragmented in implementation—largely existing as ideals and blueprints for deep, globally shared common agreement. That is, we all agree education, health, and equality have value, but we lack common units for understanding who and who is not contributing value—leaving us to fumble in our own, uncoordinated siloes as we chase the phantoms of impact. In essence, we lack common currencies for our common agreements.

Now we find ourselves at the nexus of the real paradigm of Blockchain, allowing us to fuse economics with inherent value by proving the participation of some great human effort, then quantifying the impact of that effort in unforgeable and decentralized ledgers. It allows us to build economic models for tomorrow, that create wholly new markets and economies for and around each of the richest of human endeavors.



In late 2017 at the height of the Bitcoin bubble, without individual coordination, planning, or the help of institutions, almost $1 trillion was infused into blockchain markets. This is remarkable, and the revolution has only just begun. When you realize that Blockchain is in a similar stage of development as the internet pre-AOL, you will see a glimpse of the global transformation to come.



Only twice in the information age have we had such a paradigm shift in global infrastructure reform—the computer and the internet. While the computer taught us how to store and process data, the Internet built off that ability and furthered the conversation by teaching us how to transfer that information. Blockchain takes another massive step forward—it builds off the internet, adding to the story of information storage and transfer—but, it teaches us a new, priceless and not yet understood skill: how to transfer value.



This third wave kicked off with a rough start—as happens with the birth of new technologies and their corresponding liberties. Blockchain has, thus far, been totally unregulated. Many, doubtless, have taken advantage. A young child, stretching their arms for the first couple times might knock over a cookie jar or two. Eventually, however, they learn to use their faculties—for evil or for good. As such, while it’s wise to be skeptical at this phase in blockchain’s evolution, it’s important not to be blind to its remarkable implications in a post-regulated world, so that we may wield its faculties like a surgeon’s scalpel—not for evil or snake-oil sales, but for the creation of more good, for the flourishing of commonwealth.

But what of the volatility in blockchain markets? People agree Bitcoin has value, but they don’t understand why they are in agreement, and so cryptomarkets fluctuate violently.  Stable blockchain economies will require new symbolic gold standards that clearly articulate why someone would agree to support each market, to anchor common agreement with stability. The more globally shared these new value standards, the better.

Is education more valuable than gold? What about healthcare or nutrition or clean water?


We set out in 2018 to prove a hypothesis—we believe that if you back a cryptocurrency economy with a globally agreed upon inherent value like education, you can solve for volatility and stabilize a mature long lasting cryptomarket that awards everyone who adds value to that market in a decentralized way without the friction of individual partnerships.

What if education was a new gold standard?

And what if this new Learning Economy had protocols to award everyone who is helping to steward the growth of global education?



Education is a mountain. Everyone takes a different path to the top. Blockchain allows us to measure all of those unique learning pathways, online and in classrooms, into immutable blockchain Learning Ledgers.

By quantifying the true value of education, a whole economy can be built around it to pay students to learn, educators to create substantive courses, and stewards to help the Learning Economy grow. It was designed to provide a decentralized way for everyone adding value to global education to coordinate around the commonwealth without the friction of individual partnerships. Imagine the same for healthcare, nutrition, and our environment?



Imagine a world where we can pay refugees to learn languages as they find themselves in foreign lands, a world where we can pay those laid off by the tide of automation to retrain themselves for the new economy, a world where we can pay the next generation to prepare themselves for the unsolved problems of tomorrow.



Imagine new commonwealth economies that alleviate the global burdens of poverty, disease, hunger, inequality, ignorance, toxic water, and joblessness. Commonwealths that orbit inherent values, upheld by immutable blockchain protocols that reward anyone in the ecosystem stewarding the economy—whether that means feeding the hungry, providing aid for the global poor, delivering mosquito nets in malaria-ridden areas, or developing transformative technologies that can provide a Harvard-class education to anyone in the world willing to learn.


These worlds are not out of reach—we are only now opening our eyes to the horizons of blockchain, decentralized coordination, and new gold standards. Even though coordination is the last of the seventeen sustainable development goals, when solved, its tide will lift for the rest—a much-needed rocket fuel for global prosperity.

“Let us raise a standard to which the wise and the honest can repair.”  —George Washington
The views presented in this article are the author’s own and do not necessarily represent the views of any other organization.