Rapid Exploration: The Future of Health Between New Threats And New Opportunities

This rapid exploration is part of the Foresight towards the 2nd Strategic Plan project.

Individual and public health are probably THE most important issues for citizens and governments. In spite of major advances in curing of major diseases over the past century and a half, and a growing recognition of the importance of preventative measures, there are constantly new frontiers emerging in health-related S&T. In a nutshell, the most important threats to individual and public health are:

• Emergence of new thus far unknown communicable diseases (most recently COVID 19), possibly given rise to global pandemics;

• The declining effectivity of existing antibiotics, and growing difficulties in discovering new ones or finding other ways of strengthening antimicrobial resistance;

• Growing incidence of non-communicable diseases (dementia, mental illness, obesity, diabetes, cardio-vascular diseases and the like), often resulting from unhealthy environmental conditions (e.g. air pollution), malnutrition and lack of physical exercise.

These growing health threats are counteracted by new biomedical insights and technological means to help maintain and restore health:

• Insights into how our individual internal and external health “ecosystems” and microbioms influence our state of health;

• Understanding of the mechanisms and pre-dispositions of various diseases, which opens up new opportunities for identifying new vaccines and more personalised possibilities of medication treatment;

• New possibilities of repairing or even replacing organs and influencing the process of cellular division, which open up further possibilities of human enhancement (see Deep Dive on Transhumanism).

• Latest developments in better exploiting inter-connected health data for personalised treatmetns and prevention.

About this topic

A major challenge consists of preparing public health systems to better handle health risks and make novel medical possibilities widely available at affordable costs to the individual and to society. To be future-proof, health systems need to change in many regards, but opinions are split about the right way forward. They are supposed to absorb innovative approaches for cure and prevention, set incentices right, while at the same time keeping the costs for fair and sustainable health as low as possible. The recent COVID 19 pandemic has also shown that optimising health system capacities may well be cost-efficient under normal circumstances, but it endangers the ability to respond in a resilient manner to high-pressure situations like the one we have been experiencing during the past two COVID years. At the same time, the health systems in most European countries are confronted with shortages of health professional, from medical doctors to care professions.

Drivers of change

The interaction between new threats and new promises is influenced by a range of other factors.

• Closer interaction with thus far untouched natural ecosystems, where humans can get in contact with novel life-threatening diseases, represents a real challenge for public and individual health. The fast spread of dangerous communicable diseases is accelerated by global individual mobility.

• The prevalence of unhealthy lifestyles represents an issue of major concern, in particular the widespread adoption of “Western” and meat-rich diets. Although there are counter-movements, not least for climate-related reasons, the climate footprint of food supply continues to grow.

• Environmental degradation and air pollution represent important factors negatively influencing individual health, and well beyond respiratory damages.

• Climate change can at least reinforce health-threatening incidences, and lead to the spread of diseases and of their carriers to areas where they have not been detected before.

• Micro and nano-devices can be used for prostetics and implants as well as for carrying drugs to designated places in the body.

• Digitalisation opens up new opportunities for addressing a range of health challenges: from pacemakers to brain interfaces, and from online medical advice to big data analytics for diagnosis and personalised health services.

• The promise of pharmacogenomics for personalised health services continues to be held up by industry. It projects a huge potential once genetic information is decoded and understood.

• Costs of public health systems have been growing, and while digitalisation may well help reduce costs, it is also a factor driving a shift towards a two- or three-tier health system.

Futures

What if healthy life styles were rewarded, and unhealthy ones penalised?

• What if the most advanced preventative measures and treatments were available to the most well-off citizens?

• What if digital implants were hacked and manipulated?

• What if environmental degradation and air pollution continued to rise in major urban agglomerations?

• What if the costs of the opportunities inherent to new health technologies exceeded 25% of GDP?

• What if major pandemics arise much more frequently than in the past, demanding high flexibility from the health system and its employees?