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EDITORIAL
Head of Editorial: Jack Salter jack.salter@outpb.com
Deputy Head of Editorial: Lucy Pilgrim lucy.pilgrim@outpb.com
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MORE THAN MEETS THE EYE
Welcome to our ninth edition of Healthcare Outlook.
This issue’s eye-catching cover star, Johnson & Johnson, is committed to delivering the eye health needs of patients around the world.
Fuelled by innovation at the intersection of biology and technology, the company collaborates, innovates, and works seamlessly together to care for patients at every stage of their eye health journey.
Johnson & Johnson’s vast portfolio of vision solutions includes ACUVUE®, the number one selling contact lens brand in the world, and iLASIK, the refractive surgery solution used in over 25 million patients worldwide.
“It’s not every day you get to be part of a company that produces over five billion medical devices a year. The scale is phenomenal, and it’s incredibly exciting to be involved in a supply chain that operates at such high volumes,” says Ryan Reinhardt, Vice President, Supply Chain, Johnson & Johnson, Vision.
We also cast our eyes over Varex Imaging (Varex), a leading innovator, developer, and manufacturer of X-ray imaging component solutions.
During the past year, the X-ray imaging sector across North America has witnessed some notable changes in cold cathode technology, which Varex has recently transitioned to using.
This means the company is able to streamline and improve its X-ray imaging process, paving the way for major transformations in healthcare and diagnostics.
“We’re on the leading edge of getting customers to understand the technology; it’s going well, and we’re very optimistic,” shares Mark Jonaitis, Senior Vice President and General Manager of X-ray Sources.
Elsewhere, we take a close look at the London Fire Brigade, one of the world’s oldest and largest fire and rescue services.
A key part of the history and DNA of the UK capital, the Brigade aims to make London the safest global city with a world-class emergency service.
“If you look at today’s reality, especially in a global city like London where risk continues to evolve at an unprecedented pace, it is a significant challenge for any emergency service to keep up with,” acknowledges Jonathan Smith, Deputy Commissioner for Operational Preparedness and Response.
Last but not least, keep your eyes peeled for the extensive healthcare services offered by Mount Meru Regional Referral Hospital in Tanzania.
We hope that you enjoy your read.
Jack Salter Head of
Editorial, Outlook Publishing
EUROPE & MIDDLE EAST AFRICA
CHIMPS’ FOREST FIRST AID FILMED
CHIMPANZEES IN UGANDA are utilising plants from their forest habitat to treat open wounds and other ailments, as caught on film by University of Oxford scientists working alongside a local team in the Budongo Forest.
New research reveals that the rarely witnessed events are prevalent, with records dating back 30 years. Chimpanzees perform self-care and medical care on each other by applying chewed-up bark to injured areas or using their mouths to attempt to heal swollen or cut body parts.
PREPARING THE NEXT GENERATION OF NURSES
A NEW TRAINING academy for nurses has been established in Kent, UK to prepare the next generation of healthcare professionals. It features advanced simulation suites that provide valuable real-life insights and expertise.
Canterbury Christ Church University and the Kent and Medway NHS and Social Care Partnership Trust (KMPT) have partnered to create the Health and Wellbeing Academy. This centre will emphasise simulation-based learning, collaborative curriculum development, and research, allowing for practical clinical training.
Additionally, the academy will enhance collaboration between educational institutions and frontline NHS staff, ultimately improving health outcomes across the region.
ASIA PACIFIC
BRAIN STRAIN CANNOT BE SUSTAINED
A NEW STUDY suggests that long working hours may not only be harmful to people’s health but could also alter their brain structure.
Recent research has identified significant changes in the brains of individuals who are overworking, which involves both physical and emotional
According to studies, they had been previously observed freeing other chimpanzees from traps set by humans and using leaves to wipe after bowel movements, adding to the growing evidence of primates utilising natural resources to heal and stay healthy in the wild.
strain as well as insufficient rest.
The study was conducted by two scientists from Chung-Ang University and Yonsei University in South Korea, who monitored 110 healthcare workers divided into two groups –those who were overworked and those who were not.
In South Korea, where the legal limit for work hours is 52 hours per week, overworking has become a significant public health concern.
PIONEERING PEEPER PROCEDURE NORTH
IN A GROUNDBREAKING surgery, doctors used a transorbital approach when threading an endoscope through a woman’s eye socket to excise a cancerous tumour that had wrapped around her spine and spinal cord, invading the vertebrae in her neck.
The 19-year-old was diagnosed with a chordoma, an extremely
rare form of bone cancer, when she started experiencing double vision at just 18 years old.
Neurosurgeons at the University of Maryland Medical Center had practised the procedure on cadavers many times before the operation. They were able to remove the tumour without disturbing the eyeball by creating a surgical corridor.
The patient is now in recovery after the latest scans came back clear, and the doctors remain optimistic about her prognosis.
MYRIAD BENEFITS OF MIRACLE MEDICINE
EXPERTS SUGGEST WEIGHT loss drugs may significantly enhance longevity by reducing the risk of illnesses associated with ageing, such as heart, liver, and kidney disease, as well as cancer, marking what is being referred to as the ‘golden age’ of medicine.
The UK government is pushing to make the injections and pills, which currently only treat obesity, more readily available, with many new treatments set to enter the healthcare market.
GLP-1 medications were initially developed to treat type 2 diabetes. However, there is now mounting evidence that suggests they have wide-ranging effects that cannot be explained solely by weight loss. Experts believe their ability to calm inflammation in the body is also key.
NORTH AMERICA
LIVE LONGER DESPITE LIVER DAMAGE
GSK HAS ANNOUNCED its decision to acquire an experimental drug for liver disease from Boston Pharmaceuticals, with a total investment of up to USD$2 billion.
The drug, efimosfermin, is expected to launch in 2029 as a monthly subcutaneous injection for the treatment of steatotic liver disease (SLD). Additionally, it is currently undergoing clinical development for the treatment of metabolic dysfunction-associated steatohepatitis (MASH), an advanced stage of liver disease characterised by inflammation and damage due to fat accumulation.
GSK also plans to explore the drug’s potential for treating alcohol-related liver disease (ALD). SLD affects approximately five percent of the global population, whilst ALD impacts around 26 million patients worldwide.
AFRICA
ADVOCATING FOR ACTIVITY
IN THE SEYCHELLES, FIFA’s Be Active campaign is raising awareness of the importance of physical activity. The country hosted Africa’s first FIFA Beach Soccer World Cup earlier this month as part of the Special Olympics.
The collaboration involving the Local Organising Committee (LOC), World Health Organisation (WHO), and FIFA aimed to promote health and unity through sports initiatives.
A clinic held between games at the tournament brought 20 players together to participate in soccer training sessions and encouraged the audience to be active for at least 60 minutes a day.
FIFA and WHO are long-term partners, working together to bring the Be Active campaign to events around the world.
Pharmaceutical Supply Chain Resilience
Pascal Degen, Vice President of Global Supply Chain Management at Bachem, explains the challenges faced by the pharmaceutical supply chain in uncertain economic and geopolitical circumstances
Writer: Pascal Degen, Vice President of Global Supply Chain Management, Bachem
In an interconnected economy, industries operating on an international scale are increasingly vulnerable to supply chain disruption. Global events can have a profound impact on all industries, with the pharmaceutical sector particularly at risk due to its extensive and international supply chain.
From chemicals to active pharmaceutical ingredient (API) manufacturing, formulation, packaging, and drug delivery, there is potential for disruption at any stage along the supply chain – such as personnel, materials, service, and equipment shortages.
In recent years, several geopolitical,
economic, and environmental global events have placed significant strain on the supply chain. From the blockage of the Suez Canal to the conflict in Ukraine and the trade war between China and the US, the pharmaceutical industry has been severely impacted.
The COVID-19 pandemic, in particular, reinforced how such events can bring the pharmaceutical supply chain under strain, with the need for a robust and flexible supply chain contingency plan against an unpredictable geopolitical climate becoming prevalent.
During the pandemic, the pharmaceutical industry faced
disruptions at manufacturing sites caused by various events, such as explosions, unplanned revisions, and natural disasters.
These incidents were additional strains during an already challenging time, exacerbated by political instability in Southeast Asia further destabilising the supply chain.
API MANUFACTURERS IN THE SUPPLY CHAIN
The pharmaceutical supply chain is extensive and involves many players, with ample opportunity for stumbling blocks along the way.
APIs – the primary components that give drugs their therapeutic effect
– play a vital part in the pharmaceutical supply chain, meaning disruptions to the production and supply of APIs can have severe ramifications for the availability of essential medications to those in need.
The demand for chemically synthesised peptides has surged recently, largely due to the expansion of peptide applications from niche to mainstream diseases.
In addition, clinical trials favouring chemical synthesis and the emergence of more convenient administration methods beyond injections, such as nasal or oral formulations, have also contributed.
This increased demand necessitates a larger supply of materials – a trend that has been on the rise in recent years.
Presently, there are more than 80 approved peptides and 18 approved oligonucleotides made possible due to a tried and tested robust supply chain.
FROM MATERIALS TO MEDICATION
At API manufacturing companies such as Bachem, a leading specialist in the production of peptides and oligonucleotide API alongside contract development and manufacturing, the supply chain begins at the API level, where upstream chemicals are sourced internationally.
These chemicals are essential in the synthesis required to initiate the manufacture of peptide and oligonucleotide APIs.
Next, the product is either distributed directly to the customer or to a formulation site, where ingredients from across the globe are combined to produce the final medication or finished dose product.
The product is then packaged using globally sourced materials such as aluminium and plastics. This process takes place as near as possible to the market or is consolidated, depending on the organisation’s structure.
MAINTAINING CONSISTENCY AMIDST UNCERTAINTY
To plan against threats in the global pharmaceutical supply chain, companies have implemented various strategies to guarantee a robust supply chain, ultimately ensuring medications reach the users that need them. Key steps include:
1. Maintaining strategic stock levels.
2. Validating transportation routes.
3. Dealing with secondary and tertiary suppliers for key starting materials.
Crucially, an effective supply chain requires resilience across every facet of the pharmaceutical supply chain, whether ecological, societal, organisational, or psychological. This demands adaptability in pressured situations, despite ambiguity or adversity, to turn weaknesses in a company’s supply chain into a strength. Resilience can be underpinned by four pillars:
1. Visibility – Understanding your position, anticipating future events, and strategising accordingly is crucial. Full visibility encompasses not just your processes, people, and technology, but also extends to your suppliers and their suppliers, as well as the origin of materials from service providers. This comprehensive visibility is vital for operational efficiency. As such, Bachem has implemented three main elements to ensure visibility is maintained:
a. Risk management – Allows identification and management of risks through an annual deep-dive risk analysis from a demand, supply, and manufacturing perspective.
b. Business continuity management – Prepares teams mentally and logistically for ‘what if’ scenarios, including safety stock levels, transportation route validation, and dealing with secondary and tertiary suppliers for key starting materials.
c. Stringent emergency management system – To respond effectively to incidents.
2. Flexibility – Crucial for swift and effective responses to disruption. Not being limited to organisational agility, flexibility also includes the adaptability and intuition of employees. Personnel must be versatile in adopting new methods, recognising issues, and integrating problem-solving skills into their daily routines.
Flexibility in thought processes and technology is equally important to maintain resilience in a dynamic environment, which must be initiated from a topdown perspective. Flexibility can often be achieved through a lean management philosophy, which can be implemented across the organisation.
3. Collaboration – Provides a framework for an organisational structure whilst extending beyond internal operations to encompass external partnerships. However, it must begin within the company fostering a shared language and understanding to facilitate cooperation.
Leadership plays a pivotal role in establishing a structure that promotes a cooperative approach. This common understanding of language, work content, and market objectives is the cornerstone of global alignment, enabling people and organisations to evolve together.
4. Control – Maintaining oversight of processes and personnel is essential for predicting and managing potential outcomes. These components collectively enhance the ability to manage risks and capitalise on disruptive elements. With agility, a disruptive factor can be transformed into an opportunity.
Many companies put processes and key performance indicators (KPIs) in place to measure their status in order to provide alerts when a system is becoming unstable. Global enterprise resource planning (ERP) systems can facilitate this control across internal and international networks.
Effective control procedures will also involve weekly and monthly measurements to maintain accurate data, helping to continuously improve performance and maintain timely visibility and control over the supply chain, allowing companies to take appropriate measures.
DELIVERING ON COMMITMENTS TO CUSTOMER AND PATIENT
In summary, it’s essential to underscore the importance of supply chain resilience in today’s interconnected world.
Understanding your business and its risks, fostering transparency, and integrating supply chain risk management into your governance and leadership tools are all critical components of this.
Global events can pose significant challenges to the supply of APIs, and thus, the continuity of drug supply. Any disruption can have significant downstream effects, and it is the duty of pharmaceutical companies to ensure their supply chains are robust
enough to continue supply in the face of disruption.
Manufacturers must implement robust strategies to minimise these risks and secure the continuous production and supply of APIs.
This necessitates a specialist understanding of the nuance of the global pharmaceutical supply chain and the ability to adapt to an unstable global landscape.
By doing so, manufacturers can fulfil their commitment to ensuring drug supply and making sure patients’ medications are continually accessible.
ABOUT THE EXPERT
Based in Bubendorf, Switzerland, Pascal Degen is the Vice President of Global Supply Chain Management for Bachem. He holds a master’s degree in industrial engineering and pharmaceutical management from the Swiss Institute of Technology (ETH) in Zurich. Degen gained broad operations management experience in various industries and functions for almost 20 years before joining Bachem in April 2019.
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HEALTHCARE AS AS ITS COMMUNITIES UNIQUE
A new healthcare company dedicated to improving the health outcomes of American Indians and Alaska Natives, Indigenous Pact is committed to building health equity in one generation. We speak to Kurt Brenkus, CEO and co-Founder of Indigenous Pact, and Emma Godfrey, Managing Director of global design consultancy Elmwood New York, to learn more
Writer: Lauren Kania
American Indian and Alaska Native populations have the lowest life expectancy in the US.
Indian Nation adults are nearly three times as likely as non-Hispanic white adults to be diagnosed with and die from diabetes, while women are twice as likely to die of pregnancyrelated causes.
These outcomes are compounded by a history of endemic barriers affecting the provision of quality healthcare, including economic
adversity, rural isolation, cultural differences, and a chronic shortage of medical personnel.
Underfunding is another critical issue. In fact, federal prisoners receive two to three times as much healthcare funding compared to the Indian Health Service – the government agency in charge of providing health services for American Indians and Alaska Natives.
This undeniable crisis in health equity can only be overcome by a
strong, united platform advocating for Native American healthcare.
That is precisely what Indigenous Pact was created to provide.
“Leveraging an approach that blends tradition with innovation and ensuring Native-led solutions drive lasting impact, Indigenous Pact works alongside our Tribal partners to co-create a future where every Native person has access to the quality care they deserve – no matter where they are,” introduces Kurt Brenkus, CEO and co-Founder.
The organization is a Nativeled, woman-owned, certified B Corporation dedicated to achieving health equity for American Indians and Alaska Natives in one generation.
Founded in 2017 by Brenkus and his wife Aimee – Chairwoman of the Board and descendant of the Oneida Nation of Wisconsin – Indigenous Pact works in partnership with Tribal
Nations to develop and deliver sustainable, revenue-generating healthcare solutions that strengthen sovereignty and improve health outcomes for Native communities.
Operating remotely across the US, the organization serves Tribes in diverse regions and tailors solutions to each community’s needs while offering a comprehensive line of care delivery and strategic services.
Indigenous Pact team members bring decades of experience working and living in Indian Country, and with many being Tribal members themselves, they deeply understand the communities they serve through shared experience.
“True healthcare transformation can only happen when we unite, share knowledge, and work as one,” states Brenkus.
“SPEAKING WITH TRIBAL LEADERS AND ALLOWING THEM TO SHAPE OUR CREATIVE THINKING THIS WAY WAS CRUCIAL FOR MAKING THIS BRANDING PROJECT A SUCCESS. WE HAD TO CULTURALLY IMMERSE OURSELVES IN THE COMMUNITY WHILE EMBODYING A SPIRIT OF EMPATHY-LED IMAGINATION”
– EMMA GODFREY, MANAGING DIRECTOR, ELMWOOD NEW YORK
BUILDING HEALTHIER FUTURES TOGETHER
To Indigenous Pact, health equity means ensuring every Tribal citizen has access to quality healthcare regardless of location, funding limitations, or systemic barriers. This is only possible by strengthening Tribal sovereignty and ensuring Native Nations have the resources, infrastructure, and autonomy to lead their own healthcare solutions.
The organization focuses on long-term sustainability, helping Tribes build healthcare systems that generate revenue, expand services, and improve health outcomes.
“By prioritizing self-determination and helping Tribes create long-term, financially sustainable healthcare solutions, we are building a stronger, more resilient healthcare system that will serve Native people for generations to come,” asserts Brenkus.
By ensuring future generations will inherit a stronger, more robust medical system, Indigenous Pact is working to achieve its mission of creating health equity in one generation.
The organization believes this crisis can only be overcome with a strong, united platform of Native American healthcare advocacy.
“Health equity cannot be achieved in isolation,” states Brenkus.
“A unified front allows us to amplify Native voices, secure critical funding, and share best practices that benefit all Tribal communities.”
For too long, Native healthcare has been underfunded and fragmented. The federal trust responsibility has not translated into adequate healthcare access, leaving many Tribes to struggle alone.
Ultimately, when Native populations stand together, they
hold the power to drive systemic change – whether by influencing policy, improving funding models, or advocating for culturally competent care.
Indigenous Pact is committed to building this collective movement by working directly with Tribes to strengthen their healthcare systems and ensure they receive the resources, policies, and protections needed to thrive.
TRADITIONAL KNOWLEDGE AND COLLECTIVE WISDOM
Indigenous Pact’s Community Care service connects Tribes to a network of proactive healthcare providers and delivers advanced specialty care.
“Community Care is designed to help Tribes build sustainable, culturally relevant systems that improve healthcare access, coordination, and long-term outcomes,” details Brenkus.
Emma Godfrey, MD, Elmwood New York
The service expands access to healthcare through virtual and in-person services, ensuring Tribal members receive seamless, wholeperson support. It also strengthens care coordination so patients can move easily between services – including primary, specialty, behavioral, and traditional medicine –without barriers alongside integrating traditional healing with modern medicine to maintain holistic care that is culturally relevant.
Indigenous Pact helps Tribes strengthen local healthcare infrastructure by training teams and creating systems that are financially
and operationally sustainable.
“Community Care helps Tribes take control of their health systems, reduce disparities, and ensure every Native person has access to the care they deserve,” expands Brenkus.
This service represents a transformational shift away from fragmented, crisis-based treatment toward a sustainable, proactive model of care.
With Native healthcare’s history of being underfunded, overburdened, and difficult to navigate, particularly in rural areas, Community Care directly addresses these challenges and helps Tribes build locally-driven,
revenue-generating medical systems designed to last.
“This model revolutionizes Tribal healthcare by expanding access through virtual and in-person care, tailored to each Tribe’s unique needs and empowering them with the tools and expertise to manage and sustain their own systems,” details Brenkus.
EMBRACING TRANSFORMATION
Recently, Indigenous Pact paired with Elmwood New York (Elmwood) – a global design consultancy powering brands for a brave new world – to create a brand identity for its new healthcare model as part of a wider
organizational rebrand.
Elmwood is renowned for its design and branding work in the healthcare sector, making it the ideal partner to help take the visual identity of Indigenous Pact to the next level.
“We were looking for a partner who could help us create a brand that would authentically reach and engage with the diverse communities of American Indians and Alaska Natives,” specifies Brenkus.
“Crucially, the visual identity needed to support our ambition of transforming the health of Indigenous Peoples and building health equity in one generation.”
The organization worked with Elmwood to create a new logo, refresh its color palette, provide new design patterns, and develop a seamless design system across its digital and physical touchpoints.
“Through Indigenous Pact, Aimee and Kurt set out to leverage the collective strength of Tribal Nations to bring about change. This mantra became one of the key guiding principles for our design,” informs Emma Godfrey, Managing Director of Elmwood.
“However, we had to balance this unifying approach with the equally important need to capture the diversity and individual sovereignty of Tribal Nations.”
From the company’s extensive interviews with Indigenous leaders, it learned the extent to which the cultural codes and symbols of each Tribe are distinct.
Tribal Nations have been fighting for individual sovereignty for hundreds of years, making it crucial that the identity created for Indigenous Pact could authentically represent and speak to each community.
“Speaking with Tribal leaders and allowing them to shape our creative thinking in this way was crucial for making this branding project a success. We had to culturally immerse ourselves in the community while embodying a spirit of empathy-led imagination,” details Godfrey.
INDIGENOUS PACT’S KEY PRIORITIES FOR 2025
In the coming year, Indigenous Pact is focused on scaling impact, strengthening Tribal healthcare sovereignty, and ensuring long-term stability.
Its key priorities include:
• SCALING COMMUNITY CARE – Expanding locally driven, culturally rooted healthcare solutions to more Tribal Nations, ensuring greater access to primary, specialty behavioral, and traditional medicine.
• INCREASING REVENUE FOR TRIBES – Helping Tribes navigate Medicaid, the Affordable Care Act (ACA), and Healthcare Information System (HIS) reimbursements to create sustainable healthcare funding models.
• ADVANCING POLICY ADVOCACY – Working at federal and state level to secure funding, influence policy, and protect Tribal healthcare rights.
• ENHANCING WORKFORCE DEVELOPMENT – Investing in Tribal healthcare training and staffing solutions to help build a strong, local workforce.
• EXPANDING PARTNERSHIPS – Strengthening collaborations with Tribal leaders, healthcare organizations, and policymakers to accelerate innovation and create scalable solutions.
“This year, driven by our mission to achieve health equity for American Indians and Alaska Natives in one generation, Indigenous Pact is doubling down on our commitment to ensure more Native communities gain access to sustainable, high-quality healthcare,” Brenkus outlines.
To visualize the diverse Tribal Nations coming together under the mantle of healthcare equity, designers Meg Beckum and Elyanna Blaser leveraged the Indigenous art form of quilt work, specifically looking at the motif of the native star quilt.
A strong cultural tradition across all Tribes, the native star quilt symbolizes
honor and generosity. As a storytelling device, quilt work was a perfect representation of diverse Indigenous communities coming together as one.
Elmwood also designed a logo for the organization’s Community Care services, made up of a red circle placed in the center of a star.
“You can think of this red circle
as the individual surrounded by an expanding circle of support, whether that’s family, doctors, or fellow Tribe members. Everything flows from the single person in the middle to a wider community founded on values of proactive care and support,” Godfrey proudly concludes.
INDIGENOUS PACT’S CORE VALUES
• BRAVERY
• EMPATHY
• WISDOM
• TRANSFORMATION
DESERVING OF A MEDAL
Comprising a distance of more than 26 miles and with over 56,000 participants in 2025, the London Marathon is undeniably a major sporting and logistical feat. Behind the scenes, countless healthcare charities and organisations are on hand to help runners reach the finish line
Writer: Lily Sawyer
This year’s running of the London Marathon, which continues to be one of the UK’s largest annual sporting events, took place on 27th April in partnership with official charity partner Pancreatic Cancer UK.
Annually, organisers select a Charity of the Year to publicly support which is actively undertaking an innovative project that will create a lasting impact on its beneficiaries.
Pancreatic Cancer UK, for example, is working on a ground-breaking new test that will enable earlier disease detection, to which donations from this year’s event will contribute.
The Charity of the Year also receives several other benefits including increased funding opportunities, guaranteed race entries, and exclusive use of the sought-after title.
Marie Curie UK has already been selected as the official London Marathon Charity of the Year for 2026 as it seeks to fund improved
end-of-life care for people living with terminal illness.
Partnering with national healthcare charities is a longstanding tradition for the event, which offers a significant number of race places to various healthcare organisations, allowing individuals to raise money by way of sponsorship and donations.
Furthermore, a new Charity Bond Scheme, launched in 2024 and set to take effect in 2026, seeks to enable potentially underrepresented UK charities to secure more affordable London Marathon race places in the form of bonds for a term of up to four years, supporting greater inclusion for smaller charities.
THE SILENT CAREGIVER
One of the many healthcare charities that participates in the London Marathon each year is St John Ambulance (St John).
FUELLING FOR THE LONDON MARATHON
Alongside a comprehensive training plan, it is strongly advised that marathon runners adhere to dietary and nutrition advice to fuel themselves accordingly in preparation for the big day. This includes:
• A week before the race – Reducing training load whilst beginning a carbohydrate-rich diet, also known as ‘carb loading’. This should include between five and seven grams (g) of carbohydrates per kilogramme of bodyweight.
• The day before the race – Pre-race nutrition should consist of meals high in carbohydrates and low in fibre and fat, such as pasta, potatoes, noodles, or rice with chicken, fish, or tofu, and a side salad. It is advised to consume the largest meal at lunchtime and a smaller meal in the evening.
• The morning of the race –Consuming simple carbohydrates, such as white bread, three to four hours before the race.
• During the race – As with prerace nutrition, carbohydrates are the body’s preferred source of fuel during the race. As such, consuming 30-60g of carbohydrates per hour for the first three hours of the marathon is recommended, increasing to 60-90g per hour after that. This can be in the form of energy drinks, gels, and bars.
• After the race – Eating a snack within 30 minutes of finishing the marathon, followed by a carbohydrate and proteinrich meal, replenishes energy. Continually sipping small amounts of water is also advised to remain hydrated.
In addition to the 220 marathon places the charity offers runners, its overall contribution goes much deeper.
Providing first aid, ambulance, and medical support services on site at the marathon since the event’s inception, St John’s involvement is often unsung but crucial.
Run entirely by volunteers, the St John team operates from within medical tents stationed at every mile of the marathon, with runners triaged between tents by a St John ambulance where necessary.
Positioned all the way along the
last mile of the marathon and beyond the finish line is the ‘Finish Team’, part of the official London Marathon Medical team, which includes around 60 physiotherapists, St John doctors, specialist accident and emergency (A&E) nurses, as well as a consultant on standby.
To enable the team to effectively provide the necessary medical assistance, each marathon runner is fitted with a bib, on the back of which compulsory medical information must be provided, such as emergency contact details, medical conditions, and blood type.
Runners cross over Tower Bridge during the 2025 London Marathon
Sabastian Sawe of Kenya raises his arms as he crosses the finish line on The Mall to win the men’s elite race during the 2025 London Marathon
The London Marathon’s Medical Director, Professor Sanjay Sharma, also offers medical advice on the official website each year which runners can access ahead of the race, answering FAQs and providing insight into the fitness levels required to compete.
TO TRAIN OR NOT TO TRAIN?
In addition to paying heed to medical advice, it’s vitally important for London Marathon participants to train correctly and fuel their bodies.
As such, the event’s organisers release mandated training plans each year, differentiated for beginner, improver, advanced, and wheelchair participants.
Alongside a weekly running schedule that builds incrementally towards the race date, the plans also include advice for participants on staying hydrated, nutrition strategies, and how to hit their fundraising targets.
Furthermore, climate conditions must be carefully considered, especially if runners aren’t used to long distances in elevated temperatures.
This year’s marathon was unseasonably warm, with temperatures of up to 23 degrees Celsius, which led to organisers issuing additional advice closer to the time of the event on how to stay safe in the heat.
Wearing loose mesh clothing, for example, was recommended to prevent overheating, whilst runners were advised to begin the race slowly and frequently visit the additional water stations that had been drafted in.
Having already received over one million applications, next year’s London Marathon is set to be bigger and better than ever, both in terms of spectators and participants.
With this in mind, the message from the event’s organisers, and medical staff in particular, was particularly prevalent – stay safe out there!
THE HEALING POWER
Symbiotic interactions between people and animals go as far back as human history itself. What once started as a working relationship with animals relied upon for survival purposes – such as hunting, herding, transportation, and protection – has now evolved into an emotional connection that rivals traditional familial bonds.
As early as 460 BCE, Greek
therapeutic due to the animal’s ‘healing rhythms’.
There is no denying that humananimal relationships are crucial to modern society, and despite being used to alleviate medical conditions
From relying on animals for daily tasks to connecting with them for emotional well-being, the advantages of incorporating animals into medicine and therapy are unparalleled and only continue to grow with further research.
In modern medicine, AAT is an umbrella term and refers to a variety of services and treatments that involve interactions with animals.
skills, developing social or behavioural skills, and increasing motivation towards activities like exercise or socialising.
These animals – who range in shape, size, fur colour, and number of legs – are seen in many different settings such as care homes, educational organisations, hospitals, correctional facilities, and patients’ homes.
One company, Pets as Therapy, has partnered with prisons across the UK to provide the opportunity to interact with dogs. These therapeutic sessions have been observed to reduce stress levels, decrease volatility, allow inmates to explore different ways of expressing and processing their emotions, and find a sense of connection with the outside world.
Such interactions also reduce the risk of self-harm and suicide whilst providing a calming influence, supporting engagement, increasing coping skills, creating a safe and non-judgmental space, and boosting confidence.
In some institutions, there are dog training programmes (DTPs) available, which allow inmates with model behaviour to train them for service purposes – such as guide or therapy dogs – or teach basic commands to shelter dogs to increase their likelihood of being adopted.
A study conducted to analyse the impact of DPTs found that these programmes led to a reduction in crime rates within prisons alongside an increase in positive mental health aspects such as self-esteem, well-
Studies have also shown that participating in these programmes can greatly improve relationships between the inmates themselves, along with inmates and staff, in addition to providing professional skills that can be utilised outside of correctional facilities.
Finally, contact with animals is beneficial as physical touch in prison culture is traditionally viewed as
either violent or sexualised. Therefore, interaction with animals can help many access therapeutic aspects, lower stress, and provide a safe outlet for emotions.
PROVIDING HOPE TO VETERANS
Another way AAT makes a significant impact is by assisting veterans who have returned from service.
THERAPY ANIMALS IN ACTION
BOA CONSTRICTOR – In 2009, a man trained his boa constrictor, named Redrock, to give him a ‘hug’ when he felt a seizure coming on, warning him in advance.
CAMEL – Kazzy the Camel visits young children and the elderly in the US, gently putting her head on their laps and giving them kisses as a way to cheer them up.
– Los Angeles-based organisation Fuzzy Friends Rescue and Shelter offers therapy ferrets for schools, nursing homes, and hospitals. The ferrets make for ideal therapy animals as they are small, litter-trained, social, and attentive.
MINIATURE PIG – A miniature pig in the state of Florida was used to provide support to a child with Down’s Syndrome, as his father was allergic to more traditional service animals such as cats and dogs.
– Forest Gump, a therapy llama in Canberra, Australia, frequents nursing homes to provide socialisation due to his docile nature.
– Capuchin monkeys have been trained to assist people living with spinal cord injuries and mobility impairments, reaching for things otherwise inaccessible and providing companionship.
– Therapy elephants aid the development of children with special educational needs in Thailand, who ride the elephants in addition to washing, scrubbing, and playing ball games with them. The activities are designed to instil confidence whilst highlighting the importance of
The therapy helps to empower veterans with complex mental health difficulties, specifically those with post-traumatic stress disorder (PTSD), anxiety, or depression. The transition to civilian life can be difficult regardless of the circumstances, and physical limitations and mental health conditions can compound the process. According to the US Department of Veterans Affairs, approximately one-third of veterans experience physical or mental disorders.
Interacting with animals, traditionally dogs, has emerged as a valuable tool to support in managing these challenges and overall well-being.
Offering unwavering support and a renewed sense of purpose, working with therapy dogs has been shown to improve the cardiovascular system, elevate mood, decrease cortisol levels, and increase confidence in social settings.
The animals can also assist in restoring a sense of autonomy and are able to detect signs of distress, intervening appropriately. Additionally, the bond formed between veteran and animal can often surpass companionship and become a source of healing and emotional support.
In 2021, North Carolina Senator Thom Tillis and Connecticut Senator Richard Blumenthal led the Service Dogs Assisting Veterans (SAVES) Act into legislation, establishing a programme to award grants to nonprofits that provide and place service animals with veterans.
This recognition of animals’ importance in modern society and their many therapeutic benefits is a testament to their crucial and growing role in medicine.
This role will only continue to expand as more research is conducted to discover new applications for therapy animals and ways to integrate them into traditional treatment methods.
AAT makes a significant impact is by assisting veterans who have returned from service
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VISION CARE FOR EVERY STAGE OF LIFE
Committed to delivering the eye health needs of patients around the world, Johnson & Johnson has vision solutions for patients at every stage in their lives. Ryan Reinhardt, Vice President, Supply Chain, Johnson & Johnson, Vision tells us more about how the company collaborates, innovates, and works seamlessly together to care for patients at every stage in their eye health journey
Writer: Lily Sawyer | Project Manager: Michael Sommerfield
Fueled by innovation at the intersection of biology and technology, Johnson & Johnson (J&J) prioritizes delivering on the eye health needs of its patients around the world.
“We understand that eye health evolves over a lifetime, from contacts to cataracts,” introduces Ryan Reinhardt, Vice President, Supply Chain, Johnson & Johnson, Vision.
As such, J&J has built a unified, global organization that collaborates, innovates, and works seamlessly together to care for patients at every stage of their eye health journey.
Providing vision solutions for patients throughout their lives, the company’s portfolio is vast.
Its ACUVUE® contact lens portfolio is the most trusted by eye doctors
globally (1) and is the number one selling contact lens brand in the world (2)
Meanwhile, J&J’s refractive surgery solution, iLASIK, has been used in over 25 million patients worldwide, delivering exeptional visual quality with a patient satisfaction rate exceeding 96 percent.
Having started his career journey in engineering in Buffalo, New York, Reinhardt’s own journey into healthcare is an interesting one. His strong foundation in the industry sparked a hunger to pursue an MBA to broaden his skillset – sponsored by his company at the time.
This led to him moving abroad to lead aftermarket, spare parts, and distribution operations, which turned out to be a transformative move both
professionally and personally.
“I took this as an opportunity to not just deliver on the work I was undertaking but also enrich my life; I wanted to immerse myself in the culture and committed to learning the local language. What began as a three-year assignment evolved into a decade-long journey,” he smiles.
EVOLUTION AND GROWTH
During Reinhardt’s time working abroad, he held several leadership roles, expanding his scope beyond his initial work overseeing aftermarket, spare parts, and distribution operations.
“I led a factory before transitioning to a healthcare company, where I took on new challenges,” he shares.
While working with at the
HEALTHCARE OUTLOOK:
WAS IT AN INTENTIONAL MOVE WHEN YOU TOOK ON THE ROLE AT J&J TO LEAD THE VISION SUPPLY CHAIN BUSINESS?
Ryan Reinhardt, Vice President, Supply Chain, Johnson & Johnson, Vision: “I’ve always seen J&J as one of the great American companies, with a unique position in both the pharmaceutical and medical technology sectors.
“This dual presence across such critical industries is what sets J&J apart and makes it an exciting place to work. The opportunity to step into a leadership role within one of their MedTech businesses, where I could truly make a meaningful impact, was incredibly appealing.
“I saw this as a chance to not only contribute to a company with a rich legacy but also to shape my career trajectory within an organization that offers immense growth potential.
“The combination of J&J’s strong reputation, its broad reach in healthcare, and the opportunity to lead in the MedTech space were key factors that motivated me to make this move.”
healthcare company, Reinhardt became responsible for larger sites. As such, this period of his career became defined by leading and managing factories and supply chains, providing an opportunity to glean insights into the intricacies of a global logistics operations.
After 10 years working abroad, Reinhardt had the opportunity to return to the US, assuming a new role in Seattle.
“Here, I led the end-to-end supply chain for the ultrasound business. My responsibilities continued to evolve,
and from that point on, I focused on overseeing end-to-end supply chains for different business sectors,” he explains.
Two years ago, Reinhardt assumed his role at J&J, where he now leads end-to-end supply chain operations for vision.
While his technical roots in engineering have always played an important role, Reinhardt’s focus has shifted over the years toward business leadership – particularly in the realm of managing complex supply chain functions.
“IT’S NOT EVERY DAY YOU GET TO BE PART OF A COMPANY THAT PRODUCES BILLIONS OF CONTACT LENSES A YEAR. THE SCALE IS PHENOMENAL, AND IT’S INCREDIBLY EXCITING TO BE INVOLVED IN A SUPPLY CHAIN THAT OPERATES AT SUCH HIGH VOLUMES”
– RYAN REINHARDT, VICE PRESIDENT, SUPPLY CHAIN, JOHNSON & JOHNSON, VISION
J&J’S STEPS TOWARD SUSTAINABILITY
As the company continues to advance its sustainability efforts, J&J is tackling climate change by reducing its carbon footprint and increasing the use of renewable energy across facilities.
It is also reducing waste, optimizing packaging, helping customers and patients recycle more, and protecting natural resources by finding alternative solutions to protect the environment.
J&J’s manufacturing plant in Jacksonville, Florida was awarded Leadership in Energy and Environmental Design (LEED) status, recognizing its sustainable design.
Meanwhile, the company’s intraocular lens manufacturing sites recycle wherever possible, including its product boxes, cardboard cartons, and swabs, with its Dutch manufacturing facility receiving Zero Waste to Landfill certification.
“This evolution reflects my growth from an engineer to a business leader overseeing global supply chain operations,” he prides.
DELVING DEEPER
Having always been drawn to processes, science, and math, engineering seemed the perfect way for Reinhardt to channel his passions.
“It helped me to develop strong problem-solving skills and allowed me to work in a field that matched my analytical mindset,” he observes.
However, after gaining more experience in the workforce, Reinhardt’s interests began to shift. He realized he had a growing passion for business leadership – specifically gaining an understanding of how a business operates at a larger level.
“I wanted to focus on driving outcomes that benefited the business, employees, shareholders, and ultimately its customers or patients.”
This small shift in focus led him to explore new avenues where he could merge his technical background with leadership and strategy.
Thus, Reinhardt’s decision to move into the healthcare supply chain was deliberate and thoughtful.
“Before joining the healthcare industry, I worked in the capital equipment manufacturing sector, where we sold products to healthcare companies,” he informs.
Reinhardt found this intersection of business and healthcare intriguing, and with several friends already working in the healthcare industry, the opportunity to make a noticeable difference in patients’ lives piqued his interest even further.
Today, Reinhardt also wants to be part of an industry that has a direct, positive impact on the world.
Whether improving the health of children, adults, or anyone along the healthcare continuum, the ability to make meaningful contributions to people’s well-being is a daily motivator.
Our engineers drive innovation in eye health by turning patient insights into advanced products. Help us pave the way:
“KNOWING THAT THE DECISIONS I MAKE IN MY ROLE CAN HAVE SUCH AN IMPORTANT IMPACT MAKES IT INCREDIBLY FULFILLING, AND THAT’S WHAT ULTIMATELY DREW ME TO THIS PATH IN HEALTHCARE”
– RYAN REINHARDT, VICE PRESIDENT, SUPPLY CHAIN,
JOHNSON
& JOHNSON, VISION
“Knowing that the decisions I make in my role can have such an important impact makes it incredibly fulfilling, and that’s what ultimately drew me to this path in healthcare,” Reinhardt states.
KEY LEARNINGS FROM ACROSS THE GLOBE
Working in various roles across different regions throughout his career has provided Reinhardt with invaluable personal and professional insight.
“Each step along the way has broadened my understanding of the role that manufacturing and supply chain play within a business,” he tells us.
In the early stages of his career, Reinhardt’s focus was very much on optimizing individual factories or distribution centers, ensuring operations were running smoothly and driving the right outcomes at a micro-level.
As his career progressed, he began to see how all these roles fit into the larger picture.
Transitioning from leading a factory to overseeing end-to-end supply chains allowed him to view how these functions tied into broader business objectives.
“My thinking evolved and moved up the value chain as I assumed more responsibility and began to
IMPORTANT INFORMATION FOR CONTACT LENS WEARERS
ACUVUE® Contact Lenses are available by prescription only for vision correction. An eye care professional will determine whether contact lenses are right for you.
Although rare, serious eye problems can develop while wearing contact lenses. To help avoid these problems, follow the wear and replacement schedule and the lens care instructions provided by your eye doctor.
Do not wear contact lenses if you have an eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. If one of these conditions occurs, remove the lens and contact your eye doctor immediately.
For more information on proper wear, care and safety, talk to your eye care professional and ask for a Patient Instruction Guide, call 1-800-843-2020, or visit www.acuvue.com
understand the deeper connections between the supply chain and overall business success,” he recalls.
One of the most important things Reinhardt learned from living and working abroad was the value of understanding and connecting with local culture.
“I spent a lot of time immersing myself by learning the language, forming friendships with local people, and understanding what motivated them,” he passions.
This led to a deep belief that relationship building is key to achieving desired outcomes and that these connections often transcend geographic boundaries.
Being open, curious, humble, and willing to learn from different cultures was essential to Reinhardt navigating his time working and living in different regions and leading teams successfully across continents.
When he returned to the US, he was able to apply this broader worldview, approaching problems and devising strategies in new ways.
“This cross-cultural exposure expanded my horizons, allowing me to think more creatively and strategically when facing challenges,” he informs.
Ultimately, it was these experiences that shaped the way Reinhardt approaches leadership and problemsolving today.
STANDING OUT FROM THE COMPETITION
With its approach to bridging the gap between two very different industries – fast-moving consumer goods (FMCGs) and medical devices – working in vision presented an opportunity to tackle a unique set supply chain operations.
“It’s not every day you get to be part of a company that produces over five billion medical devices a year. The scale is phenomenal, and it’s incredibly exciting to be involved in a supply chain that operates at such
high volumes,” he excites.
J&J’s process starts with getting products off the production line, directly into its warehouses, and then swiftly to customers around the world.
On the other end of the spectrum, the equipment side of the business involves a much more assemblydriven process and is focused on electromechanical assembly.
This is the typical medical device approach when dealing with lowvolume, high-complexity products sold to the likes of surgeons and hospitals.
Two distinct models – one focused on high-volume FMCGs and the other on more specialized medical devices – demand very different supply chain solutions.
“We have these models existing alongside each other within Johnson & Johnson Vision. Being able to manage and optimize both in one supply chain is truly special,” he says.
J&J also has a high level of automation on site which, in Reinhardt’s opinion, is world-class.
AN ADVANTAGEOUS MODEL
With significant advantages afforded by J&J’s end-to-end supply chain network model, especially in terms of alignment with the organization, there’s no ambiguity when it comes to its end goal.
“We all know what we’re working toward, and this clarity enables us to develop strategies that drive business outcomes rather than just functional ones,” Reinhardt confirms.
Everyone at J&J works together to achieve these goals, and this unified approach allows for quicker, more effective decision-making.
Because the whole company is aligned in terms of its understanding of business objectives, it can make decisions more closely linked to customer needs.
“Ultimately, this leads to better outcomes for the eye care professionals we work with, as well
as the patients who rely on our products,” he outlines.
One of the key benefits of J&J’s model is that it helps executives understand and respond to customers better.
“We can link our decision-making directly to customer needs, which strengthens our ability to deliver the right products at the right time.”
However, with such a contained business model, Reinhardt notes how important it is to be mindful of what’s happening outside the immediate vicinity.
“We have to make sure we’re not overlooking best practices or innovations happening in other parts of J&J,” he explains.
To mitigate this, it focuses on creating centers of excellence through which J&J teams can collaborate with other parts of the company to share insights and learn from each other.
“This approach allows us to bring best practices from across the organization into our supply chain processes, ensuring we’re always striving for continuous improvement while still maintaining full ownership of our mission to deliver the best possible outcomes for customers, patients, and the business,” Reinhardt confidently concludes.
We return to Varex Imaging, whose Senior Vice President and General Manager of X-ray Sources, Mark Jonaitis, elaborates on the company’s ongoing innovations in the cold cathode X-ray market and geographic expansion into India
Writer:
Lucy Pilgrim | Project Manager: Poppi Burke
During the past year, the X-ray imaging sector across North America has witnessed some notable changes in cold cathode technology.
Namely, the gradual industry acceptance of liquid metal bearing (LMB) X-ray tubes, particularly in computed tomography (CT) and cardiac diameter (CD) modalities, indicates a shift from conventional ball-bearing X-ray tubes utilized in recent decades.
This move continues to strengthen big healthcare corporations, including GE HealthCare, Philips, and Siemens, who have migrated to the fabrication of LMB X-ray tubes.
In recognition of this evolution, Varex Imaging (Varex) has adopted the technology for its continuing exploration of cold cathode X-rays over the past year, catering to the needs of its customers and industry transformation.
“Varex is developing its own LMB X-ray tubes to have a full offering of what customers want or need,” opens
Mark Jonaitis, Senior Vice President and General Manager of X-ray Sources.
CUTTING-EDGE COLD CATHODE TECHNOLOGY
Varex’s recent transition to the use of cold cathode technology means it is able to streamline and improve its X-ray imaging process, paving the way for major transformations in healthcare and diagnostics.
“WE’RE ON THE LEADING EDGE OF GETTING CUSTOMERS TO UNDERSTAND THE TECHNOLOGY; IT’S GOING WELL, AND WE’RE VERY OPTIMISTIC”
– MARK JONAITIS, SENIOR VICE PRESIDENT AND GENERAL MANAGER OF X-RAY SOURCES, VAREX IMAGING
The technology involves putting multiple field emitters in a single tube, thus extracting more electrons.
Cold cathode technology therefore offers many advantages as it allows multiple emitters to be fired in sequence and in close proximity because they don’t generate any heat when creating an X-ray, meaning that accurate images can be created quicker and more efficiently.
Since we last spoke to the company 12 months ago, it has continued the live testing and verification of cold cathode technology to ensure its compatibility and reliability once it enters the commercial stream.
A number of globally-recognized corporations have already progressed in making cold cathode technology commercially viable across a multitude of industries.
X-RAY TRAINING FACILITY
Alongside building a new site, Varex has taken the initiative to establish a training cell facility for X-ray imaging, thus reducing long lead times for cells to be used in microscopy techniques.
This is particularly beneficial for the company’s greenfield factories, significantly reducing the time it takes to prepare cells.
Varex presets the cells to be functional and operational in its brownfield facility, allowing the company to easily uproot and place them in the greenfield facility when ready, streamlining the entire X-ray manufacturing process.
For instance, Sino-US joint venture NuRay Technology has incorporated it into baggage scanning devices for security inspection, alongside other medical and dental diagnostic applications.
Elsewhere, Australia-based Micro-X has used cold cathode technology to create lightweight mobile X-ray units, which offer much greater flexibility.
Many of Varex’s customers, meanwhile, are increasingly adopting cold cathode technology and showing an interest in the company’s demonstrator unit.
This lets them explore and learn about the technology’s advantages and gives them the opportunity to decide on specialized focal spots, such as the target angle and pitch, to fit their specific requirements.
“VAREX IS DEVELOPING ITS OWN LMB X-RAY TUBES TO HAVE A FULL OFFERING OF WHAT CUSTOMERS WANT OR NEED”
– MARK JONAITIS, SENIOR VICE PRESIDENT AND GENERAL MANAGER OF X-RAY SOURCES, VAREX IMAGING
“We’re on the leading edge of getting customers to understand the technology; it’s going well, and we’re very optimistic,” Jonaitis shares.
IMPRESSIVE GEOGRAPHICAL EXPANSION
Varex’s geographical expansion continues to be its biggest endeavor as it hopes to capitalize on the significant population growth in India, where it is establishing a brownfield facility with a specialized service center.
“You can’t hide from the fact that the most populous country in the world is going to need a lot of different services, including healthcare,” Jonaitis affirms.
The service center will be part of an extensive worldwide network, which means the company can send inserts
A GREEN STANDPOINT
Varex is strongly committed to environmental, social, and governance (ESG) practices, with sustainability remaining a particularly important focus, as it firmly believes in recycling materials from both an ecofriendly and financial standpoint.
The company therefore utilizes a vast range of rare earth metals as part of its operations, including tungsten, and prides itself on being able to use reclaimed metals rather than labmanufactured ones.
“If it’s good for the planet, then it’s good for us!” Jonaitis states.
and load them in the country where they are being used, while any repair products can be easily distributed, thus streamlining the manufacturing and application process.
Varex’s facility in India complements the company’s factory in Wuxi, China, built over 70 years ago, which loads inserts sent from Salt Lake City in the US.
Unlike its Chinese facility, the company has committed to creating a more comprehensive operation in India by establishing an end-to-end LMB X-ray tube manufacturing facility.
“It’s going to be a factory for raw materials all the way to inserts and loaded units – we’ve never done that level of venture before.
“As the world becomes more of a competitive landscape, you can’t afford to pay the middleman for
things you can or should do yourself,” Jonaitis reflects.
DEDICATION TO LOCALIZATION
The brownfield facility in India will not only enable greater vertical integration but also service localization, which is crucial to Varex’s success in a changing economic environment.
Historically, the company’s dedication to localization stems from its Wuxi facility, which was developed following anticipated population growth in China and major international investments in Chinese medical equipment.
With this in mind, much of the local population was employed in the factory as Varex wanted to be part of the area’s growth.
However, given its worldwide presence has grown considerably in recent decades, the company strives to reduce its dependency on imports
from China and instead utilize regional suppliers.
“We feel we can’t depend on China like we did in the past when we did a huge sourcing push and developed our factory there.
“I don’t believe that was misplaced because it was a great move for the localization of services and allowed us to serve Chinese customers. However, with the current tariff environment, it doesn’t make sense to use Chinese suppliers in places like the US,” Jonaitis discusses.
With this in mind, Varex is developing a more regional supplier network to cater to its global presence and ensure a fair cost structure while maintaining high-quality products.
Localizing the supply chain is no mean feat as it involves establishing many new partnerships.
“The reason you have established suppliers is because they make it easier to work with them and
they listen to and incorporate your feedback,” he concludes.
As such, creating a brand-new supply chain for the latest facility will take substantial effort, but Varex is prepared to tackle this head-on and achieve significant growth.
This commitment aligns with the company’s mission to remain up-todate in the X-ray imaging sector while also meeting the needs of its customers across the globe.
Tel: +1 801 972 5000 www.vareximaging.com
As one of the largest fire and rescue services globally, the London Fire Brigade is a key part of the history and DNA of the UK capital. We speak to Jonathan Smith, Deputy Commissioner for Operational Preparedness and Response, to learn more about the Brigade’s efforts towards a safe and prepared future
Writer: Lauren Kania
Project Manager: Cameron Lawrence
SERVE AND PROTECT TRUSTED TO LONDON
With the aim to make London the safest global city with a world-class emergency service, the London Fire Brigade (LFB) is proud to be one of the world’s oldest and largest fire and rescue services.
Protecting a region as large and diverse as Greater London, which encompasses 1,587 square kilometres (sqkm), is no simple task, necessitating only the most advanced and proactive team of firefighters, control staff, and professionals to ensure the safety of so many people and properties.
“Within the Greater London region, you have anywhere between nine and 10 million residents,” notes Jonathan Smith, Deputy Commissioner for Operational Preparedness and
HEALTHCARE OUTLOOK: GIVEN YOUR ROLE AS THE FIRE AND RESCUE SERVICE, HOW IMPORTANT ARE YOUR PARTNERS AND SUPPLIERS AND THE
RELATIONSHIPS YOU MAINTAIN WITH THEM?
Jonathan Smith, Deputy Commissioner for Operational Preparedness and Response: “We can’t deliver on our plans without operating with key partners and suppliers. The LFB spends approximately £100 million annually on third-party goods and services.
“The organisations we work with are critical to how we deliver our service. We may be the ones on the frontline, but we’re only able to do that because of the relationships we have.
“We’re under no illusions that we don’t operate in isolation. We operate with key partners to deliver our
Response.
“For context, Scotland has a population of five million, so the urban density we deal with is arguably the most challenging in the entire UK.”
The Brigade boasts 102 land-based fire stations, a riverboat station with two state-of-the-art boats that deploy into the River Thames, over 140 pumping appliances, and approximately 5,000 firefighters, officers, and control staff, making it –by any metric – a globally significant fire and rescue service.
To support this vast area, the organisational structure of LFB is divided into three sections of staff – operational (firefighters), control (999 call handlers), and professional departments such as legal, procurement, and IT.
services, which include the different functions that sit within the Greater London Authority (GLA), such as the Metropolitan Police Service, Transport for London, and sister emergency services like the London Ambulance Service, who are all critical as we move forwards.
“There’s no one agency or organisation that can resolve the challenges we face all on their own.”
Jonathan, now in his 26th year in the fire and rescue service, began his career in Norwich, UK, after graduating from university and seeking a long-term career path that would provide fulfilment and the ability to make a difference.
“I fell into the service almost by accident. Someone suggested I look into fire and rescue, and once I did, I found that it immediately appealed to me and would challenge me both physically and mentally whilst allowing me to help the public in a meaningful way,” he insights.
After serving in Norwich for eight
years, he moved back to the Southeast (Hertfordshire) before moving to the LFB in 2019, where his career has focused on control and mobilising, operational resilience, and oversight of the Brigade’s 103 fire stations.
“Since 2022, I’ve been in my current position as Deputy Commissioner for Operational Preparedness and Response, overseeing all of our blue light functions within the LFB along with operational training.”
WORLD-CLASS FIRE AND RESCUE SERVICES
Having served in the industry for over
two decades, Jonathan has witnessed it change considerably over the course of his career, with it now being more complicated and nuanced than ever before.
“When I joined, the role was challenging but straightforward. We knew what we were there to do,” he details.
“If you look at today’s reality, especially in a global city like London where risk continues to evolve at an unprecedented pace, it is a significant challenge for any emergency service to keep up with.”
Specifically, in 2022, firefighters found themselves facing conditions
never seen before, such as operating in temperatures of up to 40 degrees Celsius as they tackled the most significant wildfires London had ever seen. This highlighted the Brigade’s need to ensure its training, technology, policy, procedures, and equipment were keeping pace with the challenges presented by climate change.
Of equal importance to a modernday fire and rescue service is its culture.
The LFB conducted a culture review, which told a story about the organisation and workforce, highlighting a need for reform.
“Not everyone was able to come to work and be their best selves, and we’ve been working incredibly hard over the past few years to address those challenges.
“Everyone is committed to changing for the better because you can’t evolve and develop as an organisation if you don’t continue to improve the culture,” expands Jonathan.
This cultural shift is evident through the Brigade’s six values of service, integrity, teamwork, equity, courage, and learning. These were very much driven by colleagues within the LFB and have been integrated into the strategies, plans, and ambitions the Brigade has moving forwards. It was really important that the values were not seen as simply a set of words but were helping to drive transformational change throughout every aspect of the Brigade.
These values and goals point to the Brigade’s overarching mission to
“IT’S A HUGE PRIVILEGE
AND RESPONSIBILITY TO BE PART OF THE MOST DIVERSE AND GLOBAL CITY IN THE UK. WE AT THE LFB ARE PROUD TO BE A PART OF LONDON’S HISTORY AND DNA”
–
JONATHAN SMITH, DEPUTY COMMISSIONER FOR OPERATIONAL PREPAREDNESS AND RESPONSE, LONDON FIRE BRIGADE
ensure that when Londoners dial 999, they are connected to a world-class, 21st-century fire and rescue service.
It’s not just about emergency response either – it’s about protecting and preventing incidents from happening in the first place and working collaboratively alongside local communities to face challenges with confidence and teamwork.
“We are focusing on using the latest technology and investing in operational training, kit, and equipment to keep firefighters
upskilled to deal with wildfires, highrise fires, acts of terrorism, and fire hazards in new technologies such as lithium-ion batteries and e-bikes,” details Jonathan.
FIREFIGHTING IN THE 21ST CENTURY
To tackle the modern-day challenges the LFB faces daily, it has invested in modern firefighting – one of its biggest endeavours to date and a direct response to the learnings from the Grenfell Tower fire.
THE LFB’S VALUES
SERVICE – “We put the public first by remembering who we are as an organisation and that we are here to serve and protect London.”
INTEGRITY – “You can’t operate in the public sector and deliver services to people in their greatest need if you aren’t transparent and honest and accept where you get things wrong.”
TEAMWORK – “The team ethic was one of the things that attracted me to the service. Being part of that team is what makes being in fire and rescue the job that it is, but it also expands to working with others.”
EQUITY – “We’re an organisation that employs human beings, and we all come with our own strengths and weaknesses, so we need to ensure people feel comfortable to be themselves at work because they’ll deliver a better service.”
COURAGE – “There are two types of courage – physical and moral – to challenging unacceptable behaviour and putting your head above the parapet to stand up for what’s right.”
LEARNING – “With the world moving at such a fast pace, we are constantly evolving and learning as an organisation.”
The tragic structural fire that occurred in 2017 was the deadliest in the UK since the Second World War and prompted an overhaul of operational response arrangements and how the LFB and other emergency services delivered firefighting and control room operations.
“We did a huge amount of work and delivered our Control Improvement Plan, which was a five-year investment into the control room to capture specific areas around high-rise firefighting, fire survival guidance, mass evacuation, and incident command,” details Jonathan.
Additionally, the Brigade implemented License to Operate to further support operational staff in remaining competent and safe across all areas of operations, especially incident command and emergency driving.
These changes and investments in operational training were put into place to ensure the LFB is able to deliver services in the best and most professional manner possible.
“We know the Grenfell Tower fire showed systemic issues within the LFB that we needed to address. We’ve been doing that ever since and have delivered against all the Phase 1 recommendations levelled specifically at the LFB.
“Our improvement has been recognised, which we are very proud
of. However, we are not complacent and know that we must continue to improve as a fire and rescue service.”
The continuous improvement of the Brigade is why it is investing in modern firefighting with a focus on tactical ventilation, fire behaviour training, and dealing with emerging technologies.
“Everything is going into this strategy to ensure the LFB is prepared for all of the challenges of the 21st century,” states Jonathan.
CREATING A SAFER, MORE PREPARED LONDON
As the LFB looks at the future of London in relation to climate change, it is prioritising sustainability initiatives and efforts.
“We are putting our shoulder to the wheel regarding this issue and are a part of the Mayor of London’s commitment to net zero and improving air quality,” insights Jonathan.
“As one of the anchor institutions within the GLA, we have a key role to play here.”
In 2023, the Sustainable Development Strategy was published and includes initiatives such as decarbonising fire stations, electrifying the fleet, and reducing the total amount of carbon dioxide (CO2) produced.
One innovative development the LFB has implemented is the use of hydrotreated vegetable oil to replace diesel in the Brigade’s fleet in an effort to reduce CO2 emissions from pumping appliances.
Pivotal lessons were learned from
events like the COVID-19 pandemic, where the LFB served as a key component to the city’s resilience against the virus, helping to establish vaccine centres and working with health services to assist Londoners.
Such unprecedented events force the Brigade to ensure it is able to respond to emerging challenges using forward-thinking skills and predict where the next big challenge will come from in order to be ready on the frontline.
“This focus, along with the cultural
changes we are introducing, are two sides of the same coin. You can’t do one without the other, and it is crucial that we enact these for a better, safer future across the Greater London region,” concludes Jonathan.
Tel: 0208 555 1200
info@london-fire.gov.uk
www.london-fire.gov.uk
A LEGACY OF CARE
Mount Meru Regional Referral Hospital is committed to continuous improvement and adheres to the best possible practices in healthcare. We speak to Hospital Director, Alex Ernest, about how the facility focuses on providing a comfortable and safe environment to meet the needs of its patients
Writer: Ed Budds | Project Manager: Harry Thurlow
At present, Africa is facing a rapidly escalating demand for quality healthcare due to ongoing population growth and the high prevalence of both communicable and non-communicable diseases.
Consequently, many African nations are now prioritising improvements in healthcare access, affordability, and quality.
This governmental focus, coupled with the urgent need to combat disease, has transformed the continent’s ever-expanding
healthcare sector into a vital investment area.
As such, the African healthcare industry is experiencing significant advancements, with numerous countries fostering supportive environments for medical professionals.
Whilst a litany of challenges remains, positive trends in disease control are evident, suggesting substantial future growth and impact in the crucial areas of disease prevention and management.
Playing an influential role in a pivotal time for the continent’s healthcare industry, and under the strong leadership of Tanzanian President, Dr Samia Suluhu Hassan, facilities such as Mount Meru Regional Referral Hospital (Mount Meru) continue to go from strength to strength.
Dr Samia’s vision and unwavering commitment have ensured highquality healthcare services through the allocation of significant funds to improve infrastructure, equipment, and drug availability.
“Her leadership has overseen a major transformation in healthcare provision nationwide, and Mount Meru is just one of the many beneficiaries,” shares Hospital Director, Alex Ernest.
A HISTORY OF HEALTH
Mount Meru’s history dates back to 1915, when it was first opened as a treatment centre for World War I casualties.
The ground-breaking facility was originally divided into two sections, with the opposing halves later
merging to form one hospital which was officially opened in 1926.
Adhering to the guiding principles of the Good Samaritan parable, it has consistently provided healthcare services ever since, persisting through the atrocities of World War II and emerging into independent ownership.
Subsequently, as a state-owned regional referral hospital, it serves a catchment population exceeding two million across seven districts of the Arusha region of Tanzania.
With a dedicated team of over 650 staff, Mount Meru offers extensive
healthcare services to both local and international communities, encompassing numerous specialties.
“Our services range from outpatient to inpatient care, with a particular focus on emergency and critical care, orthopaedic trauma and surgeries, as well as diagnostic imaging and laboratory services,” Ernest informs.
“We are lucky to have an extensive range of specialists and superspecialists who enable us to provide high-quality healthcare in a calm and comforting environment,” he continues.
HEALTHCARE OUTLOOK: HOW DID YOU FIRST BECOME INTERESTED IN THE HEALTHCARE INDUSTRY?
Alex Ernest, Hospital Director: “My mother’s nursing career inspired a deep interest in healthcare, which led me to pursue a place at medical school and then eventually postgraduate studies in obstetrics and gynaecology.
“From 2009 to 2020, I served as a senior lecturer at the University of Dodoma’s College of Health Sciences, where I gained valuable teaching and leadership experience in the medical field.
“In the autumn of 2020, I accepted a position at Mount Meru, appointed by the Ministry of Health. I’m extremely passionate about building a strong, inclusive healthcare system that serves both our local and global communities.”
Strategically located in a city rich with tourist attractions and home to a plethora of regional and international organisations, the hospital is ideally positioned to serve global communities in need of medical attention.
FIRST-CLASS SERVICE
Equipped with state-of-the-art medical technologies, Mount Meru features a well-equipped VIP lounge and wards staffed by skilled professionals providing first-class medical attention and procedures. It additionally boasts advanced ambulance services, enabling the hospital to offer both inpatient and outpatient care.
“We also provide outreach services to local communities far from the hospital, including
community medical education, mentorship, and direct medical care. Our well-equipped van allows us to reach even the most remote areas, ensuring equitable medical care throughout the region,” Ernest outlines.
“Moreover, our hospital addresses the needs of the geriatric population by providing clinic services, palliative care, physiotherapy, mental health clinics, and psychological support.”
Undoubtedly, Mount Meru’s competitive advantage lies in the exceptional customer service provided by its dedicated, skilled healthcare professionals, who utilise robust treatment approaches supported by advanced, internationally accredited laboratory tests and comprehensive imaging services.
“WE ARE LUCKY TO HAVE AN EXTENSIVE RANGE OF SPECIALISTS AND SUPERSPECIALISTS WHO ENABLE US TO PROVIDE HIGH-QUALITY HEALTHCARE IN A CALM AND COMFORTING ENVIRONMENT”
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ALEX ERNEST, HOSPITAL DIRECTOR, MOUNT MERU REGIONAL REFERRAL HOSPITAL
MOUNT MERU MISSION, VISION, AND CORE VALUES
“As a public hospital, we offer affordable services and generous exemption policies compliant with Ministry of Health guidelines, and our serene environment contributes to a positive patient experience,” he prides.
Across the entire spectrum of its operations, Mount Meru cultivates a secure and supportive work culture that promotes career advancement and development.
To achieve this, the hospital provides continuous weekly medical education and on-the-job training for employees, complemented by long-term mentorship and positive reinforcement through monthly awards and certificates presented to its top performers.
“Our incentive programmes, including departmental vacation trips and annual events, are designed to foster intrinsic motivation amongst our people,” he tells us.
MISSION – To offer specialised, quality, and affordable health services to the national and international community.
VISION – To be the leading facility in the provision of affordable and quality specialised healthcare and teaching services.
CORE VALUES
• Pursuit of excellence – Mount Meru strives to achieve the highest standards in health service provision and actively looks for opportunities to improve.
• Loyalty to government – The hospital continues to loyally serve the Tanzanian government and complies with lawful instructions given by its leaders.
• Diligence to duty – Staff devote themselves wholly to their work.
• Integrity and impartiality – Employees don’t engage in political or religious activities or allow personal political views to influence their duties.
• Courtesy to all – Mount Meru’s staff treat clients with courtesy, regard themselves as public servants, and are particularly considerate when dealing with vulnerable members of the public or disadvantaged groups.
• Professionalism – Mount Meru provides services to the highest professional standards.
The community is offered health education on the primary prevention of non-communicable diseases as part of Mount Meru’s social responsibility activities.
ADVANCING TREATMENT AND PROCEDURES
With a new continuum of care on the horizon for Africa, Mount Meru is aiming to concentrate its efforts on mitigating the alarming rise of noncommunicable diseases.
“A comprehensive approach is necessary to address current trends, prioritising initial prevention. Although our primary function is treatment, community awareness programmes, screenings, and
health education will also help to substantially reduce the disease burden,” Ernest reveals.
“We will continue to strengthen our outreach initiatives and allocate resources strategically towards preventive measures,” he affirms.
On the other hand, Mount Meru plans to transition from performing open surgeries to minimally invasive procedures within the next few years.
The hospital has completed construction of a new building that will serve as a dedicated theatre for these specific surgeries and is currently being fitted with the necessary equipment.
“We also aim to provide comprehensive cancer treatment services to optimise patient outcomes. Construction of our chemotherapy clinic is underway, and staff are currently undergoing training, as we plan to launch this service by the end of May 2025.”
Meanwhile, Mount Meru is prioritising the enhancement of its operational research capabilities in order to optimise treatment efficacy in the face of increasing drug resistance.
Ernest hopes this will be achieved through collaborative efforts with domestic and international research institutions.
“We invite collaboration with international institutions interested in joint research endeavours and are confident that this approach will yield superior results,” he concludes.
