How to summarize the key issues facing global healthcare? There are multiple vectors that interact simultaneously. And while there may be general agreement about the direction of those vectors, expert opinions about their magnitude and speed of change vary, both at global and regional levels.
As a first vector, let’s begin with the size of the global population. Although the growth rate is decelerating, total population continues to increase. Estimated in 2022 by the UN at 7.9 billion, estimates suggest figures of 8.6 billion in 2030, 9.8 billion in 2050, to reach a peak of approximately 11.2 billion somewhere around 2080.
A second vector is the health of the population and causes of death. Thanks to the progress made since 1800 in combating communicable diseases, nutrition and infant mortality, life expectancy has increased. It continues to do so – and this has two impacts. Firstly, the proportion of people aged over 65 will increase (from 9% in 2019 to about 16% in 2050). Secondly, the major causes of death are increasingly non-communicable diseases.
A third vector of global health is the evolution of the healthcare profession and its institutions. The global average of 1.3 physicians per 1.000 population in 1960, has increased to 1.76 in 2017. In reality those skills are unevenly spread, says the World Health Organisation (WHO). Across world regions, the density of health workers can vary by a factor of 10, and there is great variability in the skill mix. The WHO estimates a global shortfall of 4.3 million doctors and nurses, equivalent to 15% of the total number of heathcare professionals worldwide.
Increasing demand for healthcare services, plus insufficient skilled resources puts health institutions under constant stress. On top of that comes the ever-evolving nature of global healthcare priorities. Overcoming one healthcare challenge simply throws up a new one, which requires a completely different response.