In the fast-paced and dynamic field of global health, it can be difficult to find placid moments to reflect on the events of the past, the challenges of the present, and the hopes for the future. Last month, Dr. Michael Merson, Director of the Duke Global Health Institute, addressed members of the global health community and presented an opportunity for this reflection during his lecture titled The Future of Health.
Over the last 50 years, the landscape of global health has transformed considerably with the dawn of the HIV-AIDS pandemic, urbanization, the eradication of smallpox, and the legalization of birth control, to name a few. The worldwide life expectancy has increased from 57 in 1966 to 63 in 2015. Scientists have personalized the field of medicine with the development of genetic testing and DNA sequencing and researchers can even generate new skin with stem cell technology to treat burn victims.
Fifty years ago, we would not have been able to predict what global health would look like today. And today, we are no closer to knowing what the face of health will be in the next 50 years. But with that said, there are a handful of medical milestones, demographic shifts, and advances in healthcare that we can anticipate.
In his lecture, Dr. Merson shared his top 6 predictions for the future of global health: the rise of chronic and non-communicable diseases (NCDs), continued growth of infectious diseases, climate change influencing health, refugee migration, health technology, and increased longevity.
According to Merson, research estimates that NCDs will be the predominant cause of death worldwide. In one analysis, it is predicted that NCDs will be responsible for 74% of all deaths globally by 2030, compared to the 66% burden in 2015. Currently, the biggest risk factors for NCDs are smoking and unhealthy eating. Some studies estimate that by 2050, 10 million people will die annually from tobacco with three-quarters of this population living in low and middle income countries. By 2030, researchers also predict that more than half of the world’s adult population will be overweight or obese. Merson urged that while these are some of the most challenging policies to address, they must be brought to the forefront.
Emerging and re-emerging infectious diseases will also play a role in the future of global health. From Zika virus in Miami Beach to cholera in Haiti, Merson stressed to the crowd that “these are not going away.” As more stakeholders realize the deep-rooted connections between human, animal, and environmental health, it will be more important now than ever to use an integrative approach, especially with the ongoing pressures from climate change.
This past July 2016 was recorded as the hottest on record. With extreme heat and fluctuating water supplies, Merson predicted that we will see more mosquitoes and their related diseases moving into regions we have never witnessed before. As the climates rise, vectors will move north to follow the heat and health systems must be ready to address increases in disease incidence.
In the midst of combating these health issues, health professionals must also prepare for significant movements of refugee populations. “The refugee crisis right now has gotten worse every year…the health implications and health consequences of this are very serious,” Merson continued. Today, there have been 21 million refugees and 44 million people forcibly displaced globally. In Syria alone, there have been 12 million displaced people – about half of the country’s population. With refugee movement comes malnutrition, lack of psychosocial support, and no disease surveillance. Merson advocated that global health community must invest time and efforts into developing care delivery models that will address these concerns.
Merson’s last two predictions for the future of health go hand-in-hand. With health technologies developing more rapidly each day, life expectancies have been on the rise. Physicians are consulting patients through mobile phones, drones are delivering medicine across countries, and polio has been used to treat cancer patients. Patients are receiving greater access to and quality of healthcare through technology and researchers are predicting that some of today’s 11-year-olds may live to 120 years. As health technologies continue to advance, populations will continue to age.
Although it may be challenging or daunting to reflect on some of these predictions, it is with a lens of excitement and opportunity that we can look forward into the future of health. Now, more than ever, is the time for the development of and investment in healthcare innovations.