Healthcare Trends with Elsy Dumit

00:00:00: Climate change.

00:00:01: for us in public health is probably one of the biggest threats to public health.

00:00:04: These disease-carrying organisms are traveling farther out from their chosen geography.

00:00:09: What does a resilient healthcare system really mean?

00:00:12: Are we ready from a population perspective?

00:00:15: We were really focused on hygiene and sanitization and wearing masks and being very aware and empathetic.

00:00:21: And

00:00:22: then there's always some influencer that's pushing something.

00:00:25: Wellness,

00:00:25: longevity is going to depend on the same five things that public health tells you about.

00:00:36: Hello everyone and welcome to this very first episode of Beyond the Deck here at Rollenberger.

00:00:43: I'm your host, Dorival Bettencourt, and today... I have a really, really exciting conversation for you here with our first guest, my esteemed colleague and friend, Elsie Dumit.

00:00:56: Elsie is a principal in our health care and life science practice here in Rollenberger in the Middle East.

00:01:04: She has an extensive and impressive career.

00:01:07: in the healthcare space, works across the GCC with the leading institutions, with governments on helping them build resilient healthcare systems, but also works a lot across the pharma space, biotechnology.

00:01:19: She has a master's in public health and global health from the Johns Hopkins University, also degrees in biotech from Georgetown, and I can go on and on and on, but maybe the best way to learn a bit more about her and her work is to speak to her directly.

00:01:38: Elsie, welcome to the podcast.

00:01:41: Thank you.

00:01:42: Thank you.

00:01:43: It's a real pleasure to have you on this podcast.

00:01:46: I think this conversation really excites me for three reasons.

00:01:49: First of all, you're my friend.

00:01:52: Second, we work a lot together, so I'm very aware of the work and the impact of the work you do.

00:01:59: And lastly, as you know, I'm also a bit of a healthcare buff, not an expert IQ, but have a big interest in the topic.

00:02:07: So if we start by that, you know, there is a lot of information out there around healthcare.

00:02:14: Of course, this is a core topic for us as human beings, but it's often a little bit difficult to really make sense of what's going on, right?

00:02:22: You hear that there's some really promising areas of research, say in... in cancer research or in therapies.

00:02:30: But can you help us just kind of really cut through that noise and structure what you see as being the key healthcare trends right now happening globally?

00:02:41: Well, I think even before we talk about the trends, I think it's important to, like you said, cut the noise and differentiate between what's actually a real healthcare trend versus what's a fad.

00:02:52: If we're looking at healthcare from a macro perspective, some of the trends that we're seeing are being propelled by some of these local drivers.

00:03:01: So a big trend that we're still continuing to see both in lower income countries and higher income countries is the continued increase and also prevalence of non-communicable or chronic diseases.

00:03:14: Non-communicable diseases are diseases that are not infectious or not, you don't catch it.

00:03:20: Many of them are due to lifestyle.

00:03:22: So these have to do with your heart.

00:03:24: So cardiovascular disease.

00:03:26: They have to do with your weight, how much you move, things like obesity, which is definitely a disease, dyslipidemia, which is high triglycerides, hypertension, again.

00:03:38: With diabetes?

00:03:39: Diabetes is a big one.

00:03:40: So all of these, while they are independent diseases, they are what we also call comorbidities.

00:03:47: So they are diseases that Often come hand in hand with each other or one can lead you to be more more prone to catching something else.

00:03:56: So we're still seeing that both across high and low and of course medium income countries and I'll explain why I have this why I mentioned this differentiation and it's because Usually when a country goes through what we call the epidemiological transition is okay.

00:04:10: That's a big big

00:04:11: word.

00:04:12: That's a big word.

00:04:12: Yes, we love that in public health.

00:04:14: So just explain that.

00:04:15: What does that mean exactly?

00:04:17: So when a country goes through an epidemiological transition, it's really a bell curve.

00:04:22: And it's when a country, let's say, increases its socioeconomic status, it increases in affluence, which goes hand in hand with a change in lifestyle for the general population.

00:04:32: So you go from a population that is more used to manual labor to one that is used to a sedentary lifestyle.

00:04:40: So you're no longer, let's say, working the fields, you're working in front of a computer.

00:04:44: Okay.

00:04:44: And what does that do to your body?

00:04:46: Now, with this affluence, with these higher paying jobs, this, let's say, more sedentary, less mobile lifestyle, you have an increase, you have a change in disease.

00:04:55: So you go from the preventable communicable or infectious diseases, and now you're shifting toward these non communicable diseases.

00:05:03: Okay.

00:05:04: At the same time, because you are a more affluent in country, you have the country, the regulators, the providers are offering better care, better health care, and the population has better access to health care.

00:05:15: So that means that while you have these chronic conditions, you still have a big chunk of the population living longer than ever before, which means that you now have new diseases related to old age, such as cancer, dementia, et cetera.

00:05:28: And you have a different burden or strain on the health care system that Didn't didn't really exist before in generations past because the population would die off at an earlier stage.

00:05:39: Okay, so you you focused on the point in this transition on the point of the change in activity so to speak.

00:05:46: but I guess that also Change in diet probably has absolutely

00:05:50: yes The more affluent a country is and we've seen it especially with the advent of you know big globalization in the nineties.

00:05:56: You saw a lot of these let's say American brands and we've seen it here.

00:06:00: You know you go to the malls.

00:06:01: you have a lot of these chains which are fantastic.

00:06:04: We have access to anywhere or anything we want from any country here in the GCC.

00:06:09: but there there's there's kind of a health issue that comes with it because a lot of these chains are not really healthy food or they're they're junk food.

00:06:19: and then we can go into a conversation about the how the global food industry has turned healthy organic or kind of heart-rich food less accessible by turning up prices.

00:06:30: it's not really it's it's.

00:06:31: we can go into supply demand and economics.

00:06:33: but

00:06:34: Okay, great.

00:06:34: So if I bring that all together, that's so.

00:06:37: one major trend is this

00:06:39: non-communicable diseases as a result of this

00:06:41: transition.

00:06:42: What would be another major

00:06:44: trend?

00:06:44: I think another major trend that we're seeing And again, I differentiated between the global north, global south or higher and lower income countries, especially in higher income countries.

00:06:54: And in some lower income countries, we're seeing, of course, the digitalization of health care, which is a great macro trend.

00:07:01: You have the advent of AI, which means perhaps more efficient and more rapid diagnostics, more support for physicians.

00:07:09: So we have a lot of these physician and decision maker support tools within health care settings.

00:07:13: I think that's fantastic.

00:07:15: But it is kind of the other side of the coin means that another trend aligned with it that we're seeing is a potential larger divide.

00:07:23: Globally, whereas if the global north or the higher income countries have access to this digitalized healthcare provision, you still have a lot of lower income countries that are quite analog, don't have this digitalization, so they're not reaching the speed and efficiency of provision that you can see in some other countries.

00:07:41: I'm not saying that digital is the answer to everything.

00:07:44: Of course, we still, especially in public health, we believe about the power of always going back to basics, and I think that's very important, especially within healthcare, but Globally, this is a trend.

00:07:54: Digitalization, AI kind of augmented provision through technology and through digital means, that of course is impacting health in a positive way and health care provision, but can also potentially increase the divide.

00:08:11: Sounds great.

00:08:12: So that's, you would say these are global trends, right?

00:08:14: Happening pretty much across the impacting both the global north and south.

00:08:19: Now if we take that and we zoom now into our region here in the GCC, how do you see that playing out here in the region?

00:08:26: I mean, I think both are very... Kind of very prevalent very present trends in the region Especially when we look at non communicable diseases.

00:08:35: if you look at the top five burdens of disease across the GCC They're all related to non communicable diseases

00:08:41: Diabetes right chronic kidney disease

00:08:43: my heart disease chronic kidney disease diabetes type one and two type two especially because of lifestyle.

00:08:50: We have a lot of hypertension, obesity.

00:08:52: What's

00:08:53: the difference, sorry, like between overweight and obesity?

00:08:56: It's a difference between actually the actual number on the scale and the BMI.

00:08:59: So really the body mass index and the mass you're holding in your body compared to your biological age, your physical age and your heart health.

00:09:09: Okay.

00:09:09: So these two global trends are pretty much very prevalent

00:09:11: here.

00:09:11: Very prevalent here.

00:09:12: But we're also seeing And I think what we're going to start seeing is diseases related to climate change.

00:09:19: Again, climate change for us in public health is probably one of the biggest threats to public health.

00:09:24: We have climate change, we have antimicrobial resistance, and of course, you know, the spread of non-communicable diseases.

00:09:30: Now, with climate change, especially in regions with the topography that GCC has, very arid climates, desert regions, without consistent access to fresh water.

00:09:43: We can start seeing more and more.

00:09:45: let's say health issues related to heat, heat stress, heat stroke, heat exhaustion, especially with the with the workforces that are spending a lot of time outdoors.

00:09:55: And then of course, in the future, there's a potential risk of lack of access to fresh water, which of course powers everything.

00:10:01: I mean, you know, you're in manufacturing supply chain, we need fresh water, we need it.

00:10:05: if we need the electricity for cold chain, you know, it's just.

00:10:09: it's a trickle effect and a domino effect.

00:10:11: And I think climate change is going to be huge.

00:10:13: It's going to force a lot of let's say in Advent, sorry, we have a lot more environmental migrants.

00:10:19: So we're not, right now we know all about economic migration.

00:10:22: You and I are economic migrants into this region, right?

00:10:25: But we're going to start seeing a lot.

00:10:27: Never thought

00:10:27: of it that way, but yeah.

00:10:28: I mean, think about it, yeah.

00:10:29: And then we're going to start seeing, I think, a lot more environmental migration due to rising water levels, due to, you know, the loss of freshwater, et cetera, and that of course has its health issues along with it.

00:10:43: We also see it with the changing travel of vectors.

00:10:49: Let's say organisms that carry disease from one place to another from one organism to another like a mosquito like a mosquito like a bat like a rat like a pangolin if you want to go big.

00:11:02: and with the the advent of climate change and with rising global temperatures we're seeing For example, at the case of the mosquitoes, we're seeing that these vectors, these disease-carrying organisms are traveling farther out from their chosen geography.

00:11:18: So now they're no longer just in the equator.

00:11:20: They're going further south and further north.

00:11:22: Okay,

00:11:22: so just to see if I understood that.

00:11:24: So with the increase of temperatures, basically these organisms can now survive and be, let's say, comfortable.

00:11:31: in regions further and further from there, let's say when they're usually endemic.

00:11:34: Yes, correct.

00:11:36: So this sounds like there's some challenges on the horizon here for the region from a healthcare perspective.

00:11:42: But also opportunities.

00:11:43: But there's one more that we really need to talk about.

00:11:45: that's important.

00:11:47: It's really a big topic of conversation across all the countries we work in and it's the topic of health financing.

00:11:57: the traditional structures of health care financing in the GCC have dictated that really the government is your payer, is your provider, is your regulator.

00:12:06: So when you see ministries and departments of health at a national level or at an emirate level like in the UAE historically, they covered the costs of health care, which... you know, if we have that for granted, we can take it for granted, not great, but we're fortunate, but we can also take it for granted in the sense that we are not stewards of our own health because we know that no matter what happens, someone is going to pay for it, someone's going to take care of it.

00:12:31: So now we're realizing that as population is growing, there's population increase everywhere, there's life expectancy increase everywhere, the government shouldn't, or let's say the health regulators shouldn't play this role on their own.

00:12:44: And so there has to be a rethinking around who pays for healthcare, and that's where private health insurance is coming in, the advent of healthcare payers, but also... How do we quantify and validate and cost health care provision?

00:12:59: And this is where the topic of value-based care comes in.

00:13:02: So rather than having this traditional mentality of volume of no matter how many patients, let's say the more patients a physician sees, the more that they get paid, we're looking now at outcomes and values.

00:13:12: So regardless of whether a physician sees ten or five patients in a day, If the physician has better health outcomes from those five patients than the physician does from the other ten patients, this physician is compensated.

00:13:27: Compensated

00:13:28: and incentivized basically for the outcome as opposed to just throughput.

00:13:31: Yes, absolutely.

00:13:33: Great, I mean there's a lot to unpack on that as well and also we could then talk about the balance between public health care provision like you have here in the region, but also you have, for example, in northern Europe, in the Scandinavian countries, where you have very strong welfare systems.

00:13:49: Of course, the big difference is that there it is also heavily financed by fiscal income, i.e.

00:13:54: through taxes.

00:13:54: Taxes, funds.

00:13:55: Whereas

00:13:55: here, fiscal income but fiscal through the natural resources and other forms of taxation as opposed to personal income tax and corporate income tax.

00:14:05: And then the other extreme in the US, where the drive is for a very private driven.

00:14:11: But just to come back to the region, one thing that I wanted to get into a little bit was, you know, when I look at all these vision documents, right, vision twenty-thirty of various countries, Qatar, UAE, KSA, there's one word that keeps coming up, which is resilience, and particularly in the context of health care, resilience.

00:14:33: healthcare systems, resilient public healthcare system.

00:14:36: What does that mean, right?

00:14:37: Because it's one of those words that we use so much.

00:14:40: We need to be resilient.

00:14:41: The economy needs to be resilient to the point where we forget what it actually means, right?

00:14:44: So can I help us understand what does a resilient healthcare system really mean?

00:14:49: Of course.

00:14:50: So resilience in healthcare has multiple folds.

00:14:53: You have what we call health security.

00:14:56: Health security is protection of the population against unforeseen or uncontrolled spread of disease, but it also means health security for the population in the sense of protected supply chains.

00:15:09: So protected lists of essential medicines, protected access to health care in times of need.

00:15:17: So that's one aspect of resilience.

00:15:18: The other aspect of resilience that is also very relevant in the countries is having beyond just localizing supply chains for security and safety, it's also localizing manufacturing and supply chain for a diversified economy.

00:15:35: So as the GCC countries are trying to move away from an oil-dependent GDP, we're trying to look at other sources of GDP.

00:15:45: And one, a very good source, of course, is... healthcare, it's the provision of healthcare, it's pharmaceuticals and the manufacturing of these to of course generate more GDP, generate more income in the country, but also protect the supply chain and make sure that you know exactly what is being given to your population for healthcare and to save their lives.

00:16:07: Yeah, because for me, when I think about resilience, I think a lot about this point of your ability to respond to and then recover to a big shock or crisis.

00:16:16: Absolutely.

00:16:16: And then, of course, and once I say that, everyone immediately thinks remembers COVID, right?

00:16:21: And I know this is an area of your research and also of your academic background in terms of global health crises.

00:16:28: Just as a little side point, how prepared are we for the next pandemic.

00:16:35: I mean, hopefully, hopefully it doesn't happen.

00:16:37: But first of all, how likely is it that we'll have another major pandemic?

00:16:42: Very

00:16:42: likely.

00:16:42: It is very likely.

00:16:43: Okay, thanks for that news on Friday.

00:16:46: I'll take that into my weekend.

00:16:48: But okay, so if it's very likely it's going to happen, how prepared are we vis-a-vis how unprepared we were for COVID?

00:16:58: It's funny, you should ask.

00:16:59: I don't know if you know, but the reason why I am Living in the GCC where I stayed in the GCC after initially coming was because I was tasked to work on COVID response for for one of the countries where where you and I serve.

00:17:13: and Of course, this was given my background given the work I used to do at that PAHO the Pan American Health Organization So the regional office for the Americas for the WHO and really the focus of a lot of my studies.

00:17:23: It was it wasn't just emergency preparedness and response, but it was it was outbreak control preparedness and response.

00:17:32: And my then client, a decision maker within a health regulator asked me, how prepared is my geography for COVID?

00:17:40: This was in February of twenty twenty.

00:17:42: We had already heard of, you know, what was happening in in China, what was happening in Italy, the four cases that that Dubai had gotten the

00:17:51: early days.

00:17:51: Very

00:17:52: early days.

00:17:52: And I told my client very clearly.

00:17:56: you are going to get slammed unless A, B, and C happens.

00:18:00: Of course, A and B didn't happen, which means A and B were related to containment, so stopping the disease from coming into the country.

00:18:07: We knew it.

00:18:08: Because of the way the world works, unless you completely shudder yourself, you ground all flights, you destroy your country's economy, you weren't going to contain it.

00:18:17: So I said, option C is mitigation, stopping it from spreading uncontrollably and stopping it from going beyond your borders.

00:18:24: Okay.

00:18:24: And so that's how it started.

00:18:25: So now you asked me this again, how prepared are we?

00:18:28: It really depends.

00:18:29: I think COVID really highlighted and put in very stark relief the tears and the cracks in public health systems and in healthcare systems.

00:18:38: And I think we did learn from them.

00:18:39: And I do see the GCC countries have learned a lot.

00:18:42: And this is why we're talking about localizing supply chain and having a secured medicines list and having access to vaccines.

00:18:52: Are we ready from a population perspective?

00:18:56: I don't think so.

00:18:57: And this might come off as a little harsh or maybe even pessimistic, but I think It's easy to forget that just less than five years ago, we were really focused on hygiene and sanitization and wearing masks and being very, very aware and empathetic and caring for our neighbor, saying, if I'm a little bit sick, I won't come near you or I'll wear a mask.

00:19:19: My duty is to protect you, not just myself.

00:19:22: That's really gone quickly out the window.

00:19:23: So from a behavioral perspective, we've kind of gone a bit back to our old

00:19:26: ways.

00:19:28: Back to the comfort, I think part of it is... a defense mechanism dealing with a post-traumatic stress because it was a horrible time globally.

00:19:36: But I think a little bit of it is also a lashing out because a lot of people I think felt that some of their freedoms were restricted and also they saw collapses of entire economic and financial systems in their countries.

00:19:52: And I empathize with both sides.

00:19:53: Of course, me being on the scientific side and the infection control side, I will gladly give up my freedom of movement and gladly be forced to wear any sort of mask.

00:20:02: Because you understand

00:20:03: the implications.

00:20:03: Exactly, exactly.

00:20:05: But it's easy to forget.

00:20:07: So I think governments, certain governments, especially in the GCC, have learned certain, have learned the lessons and this is why you see a lot of CDC, you know, CDC equivalent entities come up.

00:20:17: You have a GCC

00:20:19: Council for

00:20:20: Disease Prevention and Control.

00:20:22: So Saudi had its own Saudi CDC, which then turned into the public health authority, an even bigger entity tasked with the protection and the let's say propagation of public health of the population.

00:20:33: We see similar things all across, especially in Qatar and the UAE.

00:20:38: So the countries and the governments are ready to protect their population and be ready for what's to come.

00:20:43: But then you have that social behavioral aspect, as you rightly said, that we can't control.

00:20:49: Now, when you were talking about resilience, you mentioned a few times localization.

00:20:55: And you mentioned localization of supply chains.

00:20:56: And maybe you saw my eyes light up a little bit.

00:20:59: Because this is an area that's very close to my heart.

00:21:02: It's my core area of work.

00:21:05: And you and I work together on this topic, particularly in the context of localization of pharmaceutical manufacturing.

00:21:11: There have been some I think some great advances right in both in manufacturing, but also in in localizing research and development of a pharmaceuticals.

00:21:21: tell me a little bit about.

00:21:24: We know what have been the successes and then we can get into a few other points.

00:21:28: But just first of all what's what's actually happening?

00:21:30: right because there are a lot of big announcements But I want to understand what's for the for the listeners.

00:21:36: What's really happening on the ground in terms of pharmaceutical manufacturing, the Gulf.

00:21:40: So when we talk about pharmaceutical manufacturing, of course, to our listeners, this is a very, very broad topic, an extremely, extremely broad value chain, as you and I have infinitesimally, I think, defined by now.

00:21:55: And we look at different aspects.

00:21:56: And so it could be anything as simple as, you know what's as another country, send me your, your medicine, your actual chemicals, let's say, or your API's advanced pharmaceutical ingredients.

00:22:08: I will develop the secondary packaging for them, i.e.

00:22:11: the vials, they go in the boxes, the syringes, or it could be something as detailed and as precise as, you know what, I will do a clinical trial to test the safety, the efficacy, and then the dosage, phases one, two, and three, and spread of this drug within my population.

00:22:29: to understand the effects on my population.

00:22:31: So it's really everything from the research to the actual development, going to the manufacturing plants, even before that sourcing the raw materials from the earth or taking them from organisms.

00:22:42: That's the difference between chemical and biological pharma.

00:22:45: And then turning it into a medicine, a drug, a therapy, a vaccine.

00:22:50: So what we're seeing here in the GCC, first of all, is a very commendable ambition.

00:22:56: to localize, of course, decreased dependency on external sources and external supply chains, but also really protecting the population.

00:23:05: So we are seeing a lot of, now a shift from that secondary packaging that I mentioned.

00:23:10: Yes,

00:23:10: which would be kind of a little bit, probably a lower end of the value chain,

00:23:13: so to speak.

00:23:14: Yeah, toward the end, lower margin if we're talking about it from an economic, sorry, from a financial perspective.

00:23:22: two more of, you know, what I want to have ownership over the scientific aspect of this, over the development, so I know exactly.

00:23:29: The IP.

00:23:30: The IP.

00:23:30: And even when there is an IP, we still have this concept of fill and finish, where you might not own the intellectual property to this chemical synthesis.

00:23:41: or the purification of the API to then turn it into a synthesized drug.

00:23:46: But you still have ownership of what this, let's say, this mixture then turns into and how you want to administer it.

00:23:53: And this is where we talk about the production of different dosage forms of medication.

00:23:58: have oral, you have liquid, transdermal, injectable, etc.

00:24:04: But so essentially, to sum that up, there are some promising, let's say, developments.

00:24:09: There's of course a very big ambition, but that ambition is actually translating into some concrete actions.

00:24:15: Concrete

00:24:16: actions, but it is and I think we're all being very realistic about the fact that it is and will continue to be a bit of a slow burn because we are building from the ground up.

00:24:28: The countries are shifting from becoming completely import dependent to becoming on their way to self-sufficiency within certain areas of pharmaceutical manufacturing.

00:24:41: But there are still some challenges to face around capacity and capability and so there is a talent.

00:24:49: pool of course being developed and being trained right now in the GCC but it's not as wide or as large as it should be to kind of hit the ground running.

00:24:58: so it's more of a brown space.

00:24:59: you know we're not going into this area where we're super mega experts here in the GCC and that's why they.

00:25:06: we're seeing also a lot of partnerships joint ventures acquisitions of external companies or international companies the incentives of them coming to set up shop here in the region specifically in Abu Dhabi and KSA.

00:25:20: We're seeing a lot of kind of regional headquarters popping up and then looking at the eventual tech transfer so that we stop this dependency on international supply chains, international sources, international countries and we're learning instead from them.

00:25:35: So we're seeing a lot of let's say local experts or local workforce being sent abroad six months due training in this pharmaceutical plant with this big pharma company with this, let's say R&D source, RDI, research development and innovation RDI source and coming back and then leading.

00:25:54: So it's really, it's not a right now plan, it's a right now and much longer.

00:25:58: Long term ambition.

00:26:00: All right, now Elsie, you know, nowadays we're bombarded with information on the internet, on the social media platforms, bio hacks, the latest supplement that's going to change your life, and then there's always some influencer that's pushing something, right?

00:26:18: So first of all, I wanted to understand a little bit about this whole wellness space, how you see that, because I know that this is a big thing already in the UAE, and it's an emerging also area, particularly in KSA.

00:26:31: What's happening in this space of wellness, longevity, integrative medicine?

00:26:36: Can you tell us just a little bit about that?

00:26:37: Sure, but let's take a step back and define longevity.

00:26:40: What is longevity?

00:26:42: Longevity isn't just about living longer.

00:26:45: It's about sure, living longer.

00:26:47: but also healthy.

00:26:49: So that those extra years of life, you're living them in quality.

00:26:52: Exactly.

00:26:52: Okay,

00:26:53: great.

00:26:53: Got it.

00:26:53: Yes.

00:26:54: There's this obsession with living longer and living forever that I, I mean, I personally don't understand, but I do understand wanting to have whatever years I have in my life be of quality.

00:27:05: What's the point in living twenty extra years if you're going to be bedridden?

00:27:09: So that's how we're defining longevity.

00:27:11: Now there is an aspect of the government and of course the health regulators wanting their populations to be healthier just for population well-being and quality of life to also reduce burden on the healthcare sector.

00:27:25: But then there's also this kind of commodification.

00:27:28: of wellness that we're seeing a lot and this is when you mentioned biohacking and I kind of I rolled my eyes.

00:27:32: it's this this?

00:27:35: I don't know if some of it of course is of course warranted.

00:27:38: it's great I agree.

00:27:39: I love that we have so much more information to become more health literate and understand our health and our health status.

00:27:46: but I do think that sometimes people are taken advantage of because they're offered this artificial easy way out.

00:27:53: Yes,

00:27:54: and as a scientist, you probably drive you crazy.

00:27:56: There's

00:27:57: no research to back this up.

00:27:58: Where

00:27:58: is the scientific method?

00:28:00: Where is the hypothesis and the proving?

00:28:03: But at the end of the day, if you look at it, and I mentioned going back to the basics before as a big tenant of public health, wellness, longevity is going to depend on the same five things that public health tells you about.

00:28:14: It's what you eat.

00:28:16: It's how much you move and how you move, how much you sleep, who you're surround yourself with, and then how you pray, meditate, be spiritual things.

00:28:26: Maybe your spiritual side of things.

00:28:27: That stress and that spiritual side.

00:28:29: So really, if you have these five things, this is holistic health.

00:28:34: That's

00:28:34: definitely a nugget for us to keep in mind, right?

00:28:37: These five pieces.

00:28:38: Absolutely.

00:28:39: Eat well.

00:28:40: I'm not saying be restrict yourself and be miserable because then that adds stress, but just be conscious of what you eat how much you eat.

00:28:49: Move sleep well sleep enough surround yourself with the right people, surround yourself with people who empower you, challenge you, good vibes, and then just have a way to center yourself, to calm your mind and your thoughts, be that through spirituality, meditation, prayer, whatever you want that to be.

00:29:05: Okay,

00:29:06: and of all these tips you're giving the listeners, which one of these?

00:29:11: Do you actually practice and it's like let's say your number one go to to keep yourself balanced and balanced in this.

00:29:16: you know this crazy consulting life that we have of travel of intense work.

00:29:21: It's a bit of everything.

00:29:22: It has to be a bit of a really

00:29:24: taken I can holistic.

00:29:26: I am the worst at sleep with our travel.

00:29:30: food sometimes is difficult.

00:29:31: You know if I'm working late on the client.

00:29:33: I don't.

00:29:33: I don't want to eat you know like grilled chicken and broccoli.

00:29:37: I want a pizza.

00:29:38: Something comforting.

00:29:39: Exactly.

00:29:40: Exactly.

00:29:40: I think these but it's a mixture of everything but these two I would say are the hardest.

00:29:44: Okay.

00:29:45: The hardest.

00:29:46: And you know throughout this conversation I noticed you know you speak with so much passion about these topics and I think we could be here for entire whole day talking about it.

00:29:55: So I have to ask you know how did you how did you get into this space right?

00:29:59: Is this something that you were?

00:30:00: were you the kid with the science kids playing around in the house you know with the little test tubes and stuff and you knew you wanted to work in health as a child?

00:30:09: I knew I wanted to do something.

00:30:11: I was the kid with the science kids, science kids mostly because my parents were typical Arab parents who, you know, you're a doctor, you're an engineer

00:30:19: or you're a lawyer.

00:30:21: So I had that but I was on my Barbies.

00:30:23: Okay, I love Barbies and I love you know riding my bike.

00:30:26: So I had that that let's say girly side and the scientific side Growing up.

00:30:31: I always thought I was gonna be a doctor or a physician.

00:30:33: I would go into medicine.

00:30:34: That was the plan.

00:30:35: and then I remember very vividly in tenth grade My cousin who with whom I'm very close and was very close to had a horrific car accident and I went to see him in the hospital.

00:30:45: And then it just hit me like I I'm crying and I can't do this.

00:30:48: I cannot.

00:30:49: I still think you would have made a great doctor.

00:30:50: Thank you.

00:30:51: Thank you for that.

00:30:52: I know, I can't cry in front of patients.

00:30:54: You know, I felt that I just, I can't just be, have that disconnect, lose a bit of that humanity.

00:30:59: Not that physicians aren't, don't have that humanity, but I just couldn't.

00:31:03: So then I got to university and I remember at Georgetown, it was sophomore year that you declared your major, but I declared first semester freshman year because I had this very eye-opening conversation with a friend from one of my classes.

00:31:16: She was a, an upperclassman and she told me about this amazing course she was taking.

00:31:22: And she was writing a paper about how many miles a day women in a Sub-Saharan African country had to walk just to get water for their families and come back.

00:31:31: And the impact on their physical and mental health and that of their children.

00:31:35: And I said, oh my God, this is so cool.

00:31:38: I want to do this.

00:31:38: I want to not just do research on this, but I want to make sure that women who have to walk seven miles a day just to get water don't have to do that anymore.

00:31:48: And so then that opened up the the area of public health.

00:31:52: Of course, my major was science, tech and international affairs.

00:31:55: Concentration was biotech and global health because back then I knew, you know, health to reach global scale needs technology.

00:32:03: And this is this was it.

00:32:04: And then it was internships and jobs.

00:32:06: And I was always a way

00:32:08: to be very close to this passion without necessarily following, let's say, the clinical

00:32:12: roots.

00:32:13: Yes.

00:32:13: Great.

00:32:13: So.

00:32:14: You know, just to close the session, you know, this is beyond the deck.

00:32:18: So let me ask, you know, if we put the PowerPoints aside, analysis, you know, the analytical side of what we do, the research, the structured thinking, if we leave that all aside, you know, as a core value, like in your heart, what really drives the work that you do?

00:32:39: I think it's three things.

00:32:41: For me it's a strive for excellence.

00:32:43: even as a kid.

00:32:44: I was a perfectionist and I wanted to get the best grades and top marks.

00:32:49: So to drive for excellence and I think anyone who works with me will tell you that I do push for excellence in my teams.

00:32:54: I

00:32:54: can attest to that.

00:32:54: Thank you, but of course within reality within a realistic empathetic lens.

00:32:59: the second thing is What drives me is kindness.

00:33:03: I think if my work doesn't emanate kindness to the beneficiaries of my work, to the people who work with me, then I don't want to do it.

00:33:12: And then the third one very importantly is impact.

00:33:14: And I know that there's this misconception that consultants just turn out papers and here charge you and I'm out.

00:33:19: But I do want my work to always have an impact on society, on population health, on health equity.

00:33:27: And I think for the most part, most of my projects have.

00:33:30: till now, and I think that's also very rewarding, but it's also what keeps me driven within this job.

00:33:36: It's not an easy job, but if I can prove the naysayers wrong and give myself a reason to, yes, okay, the fatigue is there, but you're doing something good, then that keeps me going.

00:33:48: That's beautiful.

00:33:49: Thank you.

00:33:49: Elsie, thank you so much for this great conversation.

00:33:55: And that brings us to the end of our first episode of Beyond the Deck with Roland Berger.

00:34:01: and I hope you enjoyed the discussion and it can contribute a little bit to you also having more balanced and healthy lives.

00:34:08: So thank you for joining.

00:34:09: If you enjoyed, subscribe and looking forward to seeing you soon in Beyond the Deck.