The problem with healthcare

Global health is undergoing dramatic transformation. Increasingly, health systems are struggling to cope with the demand on services as populations grow and health and wellbeing expectations rise:

Global populations are growing

United Nations projections in 2022 suggest that the global population could grow to around 8.5 billion in 2030, 9.7 billion in 2050 and 10.4 billion in 2100.

Healthcare inequalities are endemic

There is still disparity between healthcare provided both within and between geographies that must be addressed. This is evident when comparing the expenditure on health per capita between regions. According to World Bank  figures, the high income countries on average spent over 6,100 USD on health per capita in 2020. That is 140 times more than across those classified by the UN as “least developed countries”, where average healthcare spending was 44 USD.

Aging populations

Finally, there is an increasing trend of aging populations. According to the UN Decade of Healthy Ageing (2021-2030) report, in 2020, the number of people aged 60 years and older outnumbered children younger than 5 years and between 2015 and 2050, the proportion of the world’s population over 60 years will nearly double from 12% to 22%. The pace of population ageing is much faster than in the past.
The UK Government Office for Budgetary Responsibility note in their latest report [https://obr.uk/docs/dlm_uploads/Health-FSAP.pdf] that:
“Demographic pressures translate into higher pressure on health spending via two main channels. First, health spending increases with the size of the population, as meeting the needs of a larger population is more expensive. Second, health spending increases with the proportion of older people in the population, because per capita spending tends to be higher for the old than the young. Demographic pressures will only increase health spending as a share of GDP if they increase health spending by more than GDP, which is more likely for population ageing than across-the-board increases in population.”

All of these factors point to a dramatic increase in demands being placed on health services and resources and the UN warns that, while by 2050, 80% of older people will be living in low- and middle-income countries, all countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift.

Sustainability is a crucial aspect of health

Many examples point to the relationship between sustainability, environment and climate change and the impact on the health of global populations. A 2020 paper warns that “The challenges for health care continue to grow and in the 21st century healthcare policymakers and providers will need to respond to the developing impact of global warming and the environmental impact of healthcare service delivery.”

Healthcare largely improves lives but it can also contribute to environmental and social issues such as consuming scarce resources, generating unnecessary waste, contributing to poor social standards in supply chains, or releasing hazardous substances, amongst many others. With an increasing need for health services and higher demands on resources, a transformative change is needed to redesign health systems to be more sustainable.

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