GTFS: Global Trends and Future Scenarios Index

Global megatrend update: Changing disease burdens and risks of pandemics

Authors’ abstract

The world is currently experiencing a major shift in health problems related to economic development and changing lifestyles. Since 2000, the global burden of disease from communicable diseases (such as HIV, tuberculosis, and measles) has been outweighed by non-communicable diseases (such as cardiovascular diseases, cancers, chronic respiratory diseases, diabetes). Non-communicable diseases are also the most important cause of death in the world and are typically associated with developed-world lifestyles. But although communicable diseases are globally in decline, they still pose a significant health burden, especially in the developing world. A third factor in changing health conditions is the persistent threat of pandemics.

Many developing countries will find this shift challenging, as they will have to deal with a multiple burden of persistent communicable diseases and the risk of pandemics, combined with the increasing burden of on-communicable diseases.

In addition, significant health disparities still exist between and within countries, in particular between urban and rural areas. Consequently, some vulnerable population groups (e.g. children, poor people) are still at greater risk of poor health, although life expectancy and general health have been continually improving around the world.

A broad range of economic and social trends will influence the future of global public health. While some global environment-related drivers (e.g. access to drinking water) are getting better, others — such as urban air pollution and lack of access to basic sanitation — continue to pose a serious risk to human health. In addition, the incremental effects of climate change are contributing to the global burden of disease (as for example the risk of spreading vector-borne diseases). Another driver is related to accelerating technological innovations which are bringing many health benefits but also unknown health risks. Additionally, the pharmaceutical industry is slowing-down its development of new drugs for the treatment of ‘non-profitable’ diseases (mostly communicable diseases in developing countries) and diseases resistant to traditional antibiotics.

Actions on the global and national levels can greatly reduce the risks posed by these trends. Increased investment in health and infrastructure, improved education, and better governance are key factors in realising sustained improvements in human health.

The Millennium Ecosystem Assessment underlined that human health depends on healthy ecosystems, and so there are synergies between efforts to address health issues and those to protect the environment, both in Europe and worldwide.