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EF: Considering you are an epidemiologist by profession, what would be your advice on navigating a pandemic?

RT: It is very important for any world organisation or country to keep in mind we can always have a health condition that could modify our daily dynamics. Population diseases linked with cyanotic diseases are always at risk of expressing themselves as we have seen with SARS Covid-2. To be prepared is fundamental; we have already learnt lessons in the past from influenza, from SARS in 2003 as well as other diseases and to certain extent we have generated preparedness within that context. Preparedness requires information systems, for example surveillance systems and preferably online information that can be analysed to generate informed decisions. The second component linked to preparedness is to know what supplies are needed and human resources movements, their reactions and interactions. Preparedness has many frameworks and a number of international organisations have generated a referential framework which includes a set of experts because every decision has an impact beyond health. With coronavirus it has been the interaction of health and economy, health and the social benefit of a strong economy. It is very relevant to react based on evidence and information, science must be linked to the concept of preparedness related to systemic prices. Finally we must have the capacity to think out of the box, taking advantage of the opportunities and work with partners as solutions can come from different places. Summarising, we must be prepared, use evidence generated by science and evolve and develop partnerships to solve the problem.

EF: Could you elaborate on the collaborations you are working on now and what are your expectations?

RT: The academic and health research institutions are fundamental building blocks of health research and we collaborate with both national and international organisations in this area. The Mexican national health institutes are magnificent, very capable and with excellent surgeons and technicians supporting the ongoing research process. We have seen a lot of information during this health crisis related to ongoing research generating what we call “info- demics” which is an excess of information coming out very fast without the usual filtering process or an analysis of the value of the information -quite natural given the present context. We also partner with institutions and industries from the mechanical and bio-engineering areas, ventilator developers, with institutions that do diagnosis, platforms and clinical laboratories investing risk into finding a sustainable solution, in this case vaccines. Some organisations are looking for the combination of antivirals that could generate the immune system to react, so there are many solution-finding features happening. The government must be involved in any process as they are the ones that take the decisions whereas we are in contact with these organisations and institutions to take the risks and leverage or channel any possible solution for the advantage of the country.

EF: How do you balance tactic and strategic decision-making between communicable and non-communicable diseases? How do you allocate resources to both areas with the present urgent need to address Covid-19?  

RT: Coronavirus has shown us there is an interaction between infectious and chronic diseases, individuals become more vulnerable if they already have a preexisting disease (obesity, hypertension, etc.) and generating risk for the patient. We have been working a lot on digital health applied to detection, management and control of chronic diseases all through digital health platforms. These platforms are a huge benefit and they need to be at the center of the health systems as they provide the necessary information to make informed decisions at the patient’s level allowing for a personalised risk assessment, addressing each individual with personalised solutions. A mix of chronic diseases, infectious diseases, social conditions and digital health provides the capacity of strong data or business intelligence. We can even include new knowledge like genomics, proteomics and metabolomics, add this information in a unique and intercommunicated process which will allow for better decisions and generate solutions. We are totally focused on using digital health platforms because it allows us to find a solution that will cover the entire spectrum from general planning management to a personalised intervention. We are in the era of personalised public health interventions which is a reflection on the power of information. This is a new concept to manage health, risk, prices, etc., all on a digital platform.

EF: Invested in digital health as you are, what would be your advice to other leaders willing to get into digital healthcare but don’t understand how it works? What are the success metrics for this sort of endeavour?

RT: The crisis has actually provided a very interesting opportunity for any industry or business to look into the health of their employees, monitor them, know what they are doing and even intervene to maintain their health conditions. The pandemic has generated the issue of health conditions in the working environment not only physically but emotionally as well (mental health) and it’s a way of knowing more about our workforce to allow for a better quality interaction generating benefit. I think it is better to partner than to start something from scratch, to learn from others and from their experience. As a result of a learning process and working in alliance we are doing amazing things digitally speaking. Partnerships are an excellent way of creating excellence and taking advantage of joint knowledge.

EF: Could you highlight any digital project you are particularly proud of?

RT: Early detection and diagnosis for chronic diseases to detect individuals that don’t even know they suffer diabetes or hypertension. Chronic diseases are one of our strongest areas and now we are linking that to Covid-19. We are pushing ventures that offer possibilities to those infected with SARS Covid-2, our digital platform MIDO (Medición Integrada para la Detección Oportuna) is population based, done all over the country to generate the capacity to empower companies, we have an electronic vaccine system which is a very strong vaccine system to maintain vaccine coverage per individual (per adolescent, per child, etc.). For the new vaccine we need a similar information system which is very sophisticated but at the same time easy and down to earth. Thirdly we have a development we have generated for monitoring our population employee base but we are also doing this for other companies to monitor the health to have a daily record on the individual health of each employee. We also include them into our chronic disease genomic with all the pertinent information and the capacity to add continued medical education.

EF: How do you think we can keep momentum in the allocation of health resources in Latin America?

RT: It is a moment to learn more about health investments and that they must not be neglected; managerial experience and technical experience investment is very relevant and through them we can maintain momentum.

EF: What would you like your 2020 tenure to be remembered for?

RT: I think humility is important, I have always considered that public health is all about team work; in public health we speak in plural because the importance of making good decisions lies in listening and taking advice. Individualism and personal success is gratifying and stimulating but any contribution made is the result of a collective effort.  

EF: Do you have any dream project moving forward?

RT: Together with my team generate the capacity to leverage and enhance the health systems in the region, to achieve change for the benefit of health systems while impacting people’s health.

August 2020