Community engagement has become essential in bridging the gap between medical innovation and real-world access, according to Peter Wickersham, Vice President and General Manager of Gilead Sciences, UK & Ireland. He argues that scientific advances mean little if they cannot reach patients through trusted, practical channels. The disconnect between clinical possibilities and accessibility is not a technical issue but a failure to listen to how people actually receive care.
Closing the Gap Through Collaboration
In England, the hepatitis C elimination initiative exemplifies this shift. Wickersham explains that achieving the national goal required fundamentally changing how stakeholders collaborated. Instead of waiting for patients to seek care, the program brought services directly to them by partnering with drug treatment centers, prisons, and community organizations from the outset. This approach co-created care pathways that met people where they are, addressing barriers that previously prevented engagement.
The result was a collaborative model enabling testing and treatment in trusted community and prison settings. Over 17,500 individuals have been treated through partnerships with at least 79 drug treatment centers, positioning England to meet the global hepatitis C elimination target by 2030. Wickersham emphasizes that community-led approaches are not supplementary but central to achieving public health outcomes.
Visible Inequities in Underrepresented Communities
Wickersham identifies systemic invisibility as a key inequity affecting marginalized groups. Women comprise one in three people living with HIV in the UK yet are diagnosed later than men. Similarly, black women face higher rates of triple-negative breast cancer due to delayed diagnoses. These disparities reflect a broader failure to account for diverse patient needs, exacerbating health inequalities.
These patterns, according to Wickersham, reveal gaps in how healthcare systems design services. Late-stage diagnoses in underrepresented communities suggest care pathways often overlook the lived realities of accessing treatment, prioritizing clinical profiles over practical barriers.
Success Stories Built With Communities
By integrating NHS providers, charities, and peers with lived experience, the program removed traditional care barriers. Testing and treatment now occur in settings that align with how vulnerable populations access services, improving engagement and outcomes.
Another example is Martha’s Rule, born from a family’s advocacy after their daughter’s condition worsened. Now implemented across all acute hospitals in England and expanded to maternity services, it has already triggered hundreds of potential life-saving interventions. Wickersham notes that progress consistently emerges when those closest to a problem help shape solutions.
Barriers to Embedding Community Insight
The primary obstacle, Wickersham says, is timing. Community input is often solicited too late—after decisions are already made—to meaningfully influence them. While the NHS’s 10-Year Health Plan highlights patient voices and neighborhood-level care, it lacks detailed mechanisms for empowering communities beyond basic feedback channels.
Practical Steps Forward
Wickersham outlines three actionable steps for the health ecosystem. First, policymakers must involve under-resourced communities during initial strategy development and clarify how their input shapes outcomes. Second, health systems should treat community organizations as long-term partners, not consultation checkboxes. Third, care pathways must adapt to how people live, rather than requiring patients to conform to rigid service structures.
Measuring Progress Through Community Metrics
The hepatitis C model demonstrates that community-centered design drives measurable results. Over 17,500 individuals received treatment through partnerships with at least 79 drug treatment centers. This collaborative approach positioned England to meet the global elimination target by 2030.
