When it comes to healthcare, it's no secret that patients with fewer resources often have worse medical outcomes than their wealthy peers. But speakers at International Vatican Conference for health urged lawmakers and health professionals to start with the poor.

Dr. Paul Farmer, cofounder and chief strategist at Partners in Health said that some countries are already starting to build with the poorest citizens in mind.

"The language [Rwanda] used was right out of development economics. And they said, 'We're going to focus on the bottom quintile.' That means the poorest fifth, and we're going to focus on the rural over the urban, and the widow, and the child, and the genocide survivor. And so, this language was different and well suited. Chelsea has been there quite a bit as well, and worked with the Rwandan authorities as have I for many years. But the effect was the same."

The COVID-19 pandemic displayed health inequities worldwide. In fact, a recently published JAMA study found data to suggest that income inequalities within U.S. counties were associated with a heightened number of coronavirus cases and deaths.

"And I think that's a lesson that we need right now. I know we'll get into the question of vaccine hesitancy, which is a very complex issue, and not a simple one. But when you're visibly serving, certainly as a clinician, when you're visibly serving those in greatest need, they may be the sickest, they may be the poorest, but somehow they're the most vulnerable. That generates trust."

How to serve everyone

Today big data is a hot topic. The technology promises more insights on who needs care and into understanding population health.

"It's very important that you base your decision on data, on solid evidence. And with this you can help to target the precise part of the population that needs more. With this, you can target the prioritization of resources," Dr. Walter Ricciardi, president of the World Federation of Public Health Associations, said during the panel.

"With this, you can take the decision that does not harm a substantial part of the population, privileging the one that is needing most so essentially. But for this, we haven't enough data, and moreover we haven't enough expertise."

But Ricciardi noted that big data often means having millions of data points, and in an evolving situation like the coronavirus pandemic, those aren't always readily available.

"Now, essentially it's very difficult, because when we speak about big data we speak about millions and millions of data," he said. "And this is not very easy to do. And in Europe it is also particularly difficult because of the attitude of member states to protect, which of course is very important, the privacy of people. So, you have to find a new balance."

The vaccine rollout 

Today some countries are moving from only treating COVID-19 cases to vaccinating folks against the virus. However, vaccination rollout around the world is not equal.

"Albeit, while here in the United States we continue to vaccinate on average about three million people a day, our experience at home is diverging rather rapidly from so much of what the world is continuing to endure," Chelsea Clinton, vice chair of the Clinton Foundation, said during the panel.

"And that, not only do we have a responsibility, I think, a moral urgency to try to help alleviate suffering around the world, it also very much is in our own economic security and public health self-interest."

Vaccine access is just one issue public health officials are facing at the moment. Vaccine misinformation is also spreading around the Internet, Clinton said.

"So, just need to be clear, this is me just speaking as Chelsea, and not with the Clinton Foundation or with the Clinton Health Access Initiative, is that I personally very strongly believe there has to be more intensive and intentional and coordinated global regulation of the content on social media platforms.

"We know that the most popular video across all of Latin America for the last few weeks that now has tens of millions of views is just an anti-vaccine, anti-science screed that YouTube has just refused to take down.

"We know that often anti-vaccine content that is created in the United States, unfortunately, flourishes across the world through the pathways of WhatsApp, Facebook, Instagram, and we know that ... because I have tried appealing to the leadership of these companies to do the right thing, has just not worked. And so, we need regulation."

It is important to note that Facebook and Google have pledged to curb the spread of misinformation about the virus and vaccine. The Silicon Valley giants have also set up vaccine finders to help users connect to information and registration for the shots.

So, what is next for the future of health? The speakers unanimously agreed that moving away from a fee-for-service and towards universal coverage would be key to combating inequities. While no speaker had a specific way that should roll out in the future, the needs of the patient should come first.

"Whenever you have a universal health coverage, of course, your services must be organized on a population health basis," Ricciardi said. "So, essentially, looking at the needs and demands on the population and meeting these needs and demands, rather than offering services that are inappropriate, expensive, and maybe making money for the providers."