Who Should Draw the Blueprint for Better Health?

For all the progress made in health, the opportunity to achieve better health outcomes remains unequal. Innovation matters when it reaches the people who need it, and that does not happen automatically. Our challenge, and collective responsibility, is to address what stands between innovation and better health outcomes.

Communities are not “out there” waiting to be reached. They are already connected through relationships, routines, and places of trust. The challenge may be less about reaching people and more about understanding what stands between them and better health. Barriers can emerge across the journey to care, from trusted information and screening to transportation, affordability, and navigating what comes next.

Better health starts by listening to community leaders and building solutions with them.

Making health more accessible, therefore, requires seeing those gaps, understanding the barriers, and building bridges with the people experiencing them.

A recent visit to Meharry Medical College and Nashville General Hospital brought this to life. Many of the physicians are Meharry graduates who have chosen to dedicate their careers to serving the local community, bringing a deep understanding of the people and places they serve. Their commitment extends beyond medical care to what patients need to manage their health once they leave the hospital, from a “food pharmacy” to connections with local resources. It’s a recognition that health is shaped by much more than what happens in the exam room.

That raises two important questions: Who is not getting care? And who needs to come together to change that?

Answering those questions requires more than data. It requires listening.
 

Building from the Community Out

Too often, the blueprint is already drawn before communities are invited into the room. A better approach is to ask communities to help define the problem, identify barriers, shape solutions, and determine what meaningful progress should look like.

At Novartis, our early work through the Inclusive Health Accelerators, community-led partnerships that identify local barriers and codesign solutions, is putting that principle into practice. Our early learning reinforces a simple idea: better health starts by listening to community leaders and building solutions with those who understand the barriers best.

This is more than inclusion. Community leaders bring knowledge that institutions, quantitative data, and technology alone lack. They know where trust exists, why people disengage, what has been tried before, and which barriers may be invisible to outsiders.

The principle is universal, but the solution should not be.

A trusted pathway may begin in a barbershop, place of worship, school, local clinic, food bank, or with a community health worker. The goal is not to copy and paste the same intervention everywhere. It is to apply the same discipline: Understand who is being missed and why, listen, build with local partners, measure what matters, adapt, and sustain.

This also changes what it means to scale. Scale should not simply mean doing more of the same in more places. Sustainable progress means listening to each community, working with trusted local leaders, and building shared accountability, sustained investment, and stronger connections to health systems. It also means helping communities build lasting capabilities, including the skills, leadership, and resources needed to sustain progress beyond any one program or funding cycle. This all takes time.

No organization can do this alone. Communities, health-care professionals, health systems, governments, researchers, civil society, foundations, and industry each hold part of the solution. Data can help identify where people are being missed. Communities can help explain why. Local partners can help build pathways people will use and trust.

If better health is the destination, communities cannot simply be the last stop for solutions designed elsewhere.

They should help draw the blueprint.