Seventy years ago this month, the World Health Organization was created. This milestone offers an opportunity to assess the WHO’s progress toward fulfilling its mandate to promote “health for all.”
Amazing advances have been made during the past seven decades, like the increase in average global life expectancy at birth from 48 years to 72. Even greater advances are on the horizon. But will this dazzling health future be shared equitably across communities? Or will only the wealthiest 1 percent of the global population reap benefits that are inaccessible to the 99 percent?
A report we recently coauthored identified seven tension points that will have an outsized influence in answering those two questions. Policymakers at the WHO, in the United States, and elsewhere around the world will need to address these to make more progress in approaching health for all during the next 70 years.
Demographic shifts. Demographics and generational divides are defining the global health landscape. In the United States, tensions between healthy but not wealthy millennials (those born between 1980 and 1997) and wealthy but less-healthy baby boomers (those born between 1946 and 1964) are mounting over key health policies such as establishing a single-payer system. Countries faced with rapid aging, like Japan, are seeking solutions for spiraling health costs and a shortfall in caregivers, while countries in the Middle East and Africa are trying to improve health care access and quality for disproportionately large youth populations. As the world population approaches 8 billion by 2023, health service and delivery models must be fundamentally reworked to meet these shifting demands and achieve equitable care.
Innovation. A health-tech revolution is now fully underway. Wearable devices can now connect doctors and patients in real time. These allow for remote monitoring of individuals and their personal health data, providing reminders for when medications need to be taken and alerting medical authorities in case of a health emergency. Robots will aid in everything from complex surgical procedures to providing support for the sick and the elderly. The digitization of health information and medical records combined with artificial intelligence may soon generate better outcomes and reduce costs. But while many of these advances will improve efficiency, the initial costs of adoption may be high, rendering them accessible only to the 1 percent. Governments and health providers will have to coordinate with patients, vendors, and one another as they invest strategically to bring the benefits of these technologies to the 99 percent as well.
Science. Breakthroughs in bioscience present extraordinary possibilities for the future of health, but serious questions exist about equitable access — let alone ethical progress. Take CRISPR-Cas9, the inexpensive “cut and paste” tool for DNA that can delete, repair, or replace genes. It can be used to alter the human genetic code and cure diseases. It also raises the possibility of creating designer babies with desirable genetic traits — at least for the 1 percent. This use of CRISPR could exacerbate divisions within and between societies with long-term, heritable consequences. Aligning global standards on emerging life-science technologies like CRISPR will be necessary to strike the delicate balance of ensuring appropriate access that maximizes health benefits for all.
Consumerization. Patients increasingly view health as they do other consumer goods and services, leveraging a full suite of tools to make informed decisions. This “consumerization” of health care is empowering patients in markets around the world. In many developed markets, online reviews of providers and treatment courses are now commonplace. Policymakers will need to ensure that all patients have the ability to make choices about their health care providers, which should drive improved health standards and outcomes around the world.
Prevention. There is an urgent need to shift from a reactive to a proactive approach to health. Chronic, noncommunicable conditions such as heart disease, cancer, and diabetes account for 70 percent of all deaths around the globe — and the rate is rising. Yet these outcomes can be largely averted with diet, exercise, and other behavioral changes, improving health outcomes and reducing health care spending. Promoting preventive approaches represents a big opportunity to improve health outcomes on a global stage. Routine preventive screenings and awareness of effective diet and exercise are becoming quite common among the 1 percent. Public health officials need to actively spread such knowledge and practices to the rest of the socioeconomic spectrum to ensure equitable health gains.
Patient data. The growth of electronic medical records and connected medical devices is greatly beneficial to patients and providers alike. Yet this fast-growing ocean of data is an increasingly attractive target for cybercriminals. WannaCry, one of the largest global cyberattacks to date, directly affected the U.K. National Health Service, preventing hospitals from admitting new patients and compromising personally identifiable information. As other developed and emerging markets create their own electronic medical record systems, ensuring cyber security is essential.
Cost of care. The rising cost of health care is a global challenge. At the current pace, health expenditures will surpass 11 percent of global economic output by 2025. In the United States, the problem is acute. Spending will top 20 percent of the country’s gross domestic product by 2020, and elements of Medicare face insolvency later in the decade, posing challenges for both government finances and access to care. There is no one-size-fits-all solution to the challenge of rising costs across the array of health care systems around the globe. But the WHO and its member nations can do more to exchange best practices in maximizing access while reducing costs. This will be essential to ensure access to quality care for the 99 percent.
As the WHO marks seven decades of working to improve health for all, it is essential to examine how these seven tension points will shape health access and outcomes over the next decade and beyond. The global 1 percent will clearly benefit from advances in our understanding and treatment of disease and our ability to prevent it. But translating the promise of these innovations to broadly shared outcomes for the remaining 99 percent will require concerted attention from government, business, and public health leaders everywhere.
Per Kristian Hong is a partner in A.T. Kearney’s health practice. Erik R. Peterson is a partner with A.T. Kearney and managing director of the firm’s Global Business Policy Council.