The 2021 PMAC theme – “Making Global Megatrends Work for Global Health in the 21st Century”, aims to take a long view, while also providing an overview, of four complex forces and the interplay between them, that are already reshaping our global health landscape; the relevance of changing geopolitics on global health, implications of key shifts in world population trends, the opportunity gains - and threats – of exponential technological change, and that most urgent of ticking clocks the imminent and evolving threats to global health and wellbeing posed by climate change.
It is not an exhaustive list. But these four trends are among those that have already generated seismic changes in recent years – in breadth and speed -- with implications for global health. Recognizing how the landscape might further evolve in decades to come, highlighting key challenges and likely consequences, will enable the global health community to explore how, where and with which partners to prepare alternatives for a global health vision that is ready for the future.
Climate change is described as the largest global health threat in the 21st century, endangering the last half-century's progress on health in the world. Air pollution prematurely kills approximately 7 million people a year. It is especially dangerous for children. According to the WHO, exposure to toxic air kills some 600,000 children under the age of 15 each year. What are critical elements of adaptation and mitigation that will impact global health and ecosystems?
Population ageing is projected to have a profound effect on societies, underscoring the fiscal and political pressures that health care, old-age pension and social protection systems of many countries are likely to face. By 2050, 80% of all older people will live in low- and middle-income countries. The share of the world’s population residing in urban areas is projected to increase to nearly 70% by 2050 -- much of it in Africa and Asia. In the context of migration, unplanned and unsustainable patterns of urban development, how can a better and shared understanding be developed across the life cycle for how people’s health and well-being are shaped in all settings, as we witness emerging health hazards, evolving disease burdens and the proportion of NCD-related deaths rising?
The disruptive nature of technology and the speed of technological change are seen as both game changer and spoiler. Even though investment in healthcare technology has doubled since 2015, the benefits remain – for now – unevenly distributed. The ubiquity of future connectivity and the ‘internet of medical things’ is starting to allow us to combine big data and artificial intelligence to track and predict outbreaks for greater preparedness, mitigating the future risk of pandemics. However, issues of privacy, mental health, cyberbullying along with fundamental concerns around how fake news and internet trolls distort how individuals view their world, their governments, their electoral processes, their communities and themselves—all raise significant challenges for civil society and public discourse, including on health issues. What are some of the strategic and policy drivers for global health related to these rapid changes in technology?
Global health is inextricably linked with geopolitics in many dimensions. The global challenges facing humanity are transnational in nature and transinstitutional in solution. No single government or international organization or other form of institution acting alone can solve the problems described. The critical role of using global foresight to inform global-scale decision-making systems is vital for global governance to keep up with global interdependence. For instance, access to medical products including medicines, vaccines, and medical devices are affected by patent protection, Free Trade Agreements, where benefits of technology and RandD in advanced high-income countries aren’t necessarily distributed for universal benefit. Countries with high economic and political power often play disproportionately critical roles in shaping the global health agenda, not always in the interests of all. This challenge requires the reform of global governance for health, and increased global health capacity in low- and middle-income countries so as to equitably participate in the global health architecture to shape global health directions.
PMAC 2021 aims to convene global thought leaders -- futurists, academics, policymakers and experts -- to take a long view and engage in constructive discussion on these megatrends, to identify solutions on how we can best cope with these common challenges.