Global Mega Trends Part 3: Changing Disease Burdens & Risks of Pandemics

The changes being outlined in this series of Global Mega Trends will inevitably have significant impacts on human health. The types of diseases and their prevalence will change according to many of the other trends described including: changing populations, urbanisation, mobility and climate change.

One of the most significant drivers for these changes is environmental health risks. Indeed, a quarter of all diseases and deaths globally can be attributed to environmental causes. Examples include: particulate matter, ozone, indoor air pollution, unsafe water and sanitation, contamination from waste, exposure to chemicals and noise.

Of all of these, urban air pollution is set to become the main environmental cause of mortality worldwide by 2050. This has resulted in a number of air quality regulations imposed by bodies such as the European Union. In the UK, failure to meet these standards has even resulted in the government being taken to court by Client Earth.

Impacts resulting from climate change will also like lead to increased disease, particularly vector-borne diseases such as malaria and dengue. The vectors or “carriers” of these diseases (mosquitoes) will be able to travel to new habitats as temperatures and other climate conditions change to extend their ranges.

Unsurprisingly, economics also plays a significant role. On the positive, future economic growth is likely to provide more finance for healthcare – great. On the other hand, this growth will undoubtedly continue the increase in global trade and travel spreading communicable diseases and pandemics. The World Health Organisation (WHO) has also highlighted the increasing affect that changing lifestyles are having on health. Since 2000, non-communicable diseases (NCDs) such as obesity and diabetes have been responsible for more deaths than communicable (infectious) diseases globally.

WHO identified four main lifestyle problems causing this trend of premature deaths:

  1. Tobacco consumption (6 million)
  2. Insufficient Physical Exercise (3.2 million)
  3. Unhealthy Diets (1.7 million)
  4. Harmful Use of Alcohol (data not available)

The two most common causes of premature deaths as a result are cardiovascular disease and cancer. With over 10% of the world’s population obese, clearly this is a substantial trend for policymakers to grapple with.

Increasing urbanisation is also driving significant changes. By 2050 the proportion of the world population living in urban areas is projected to reach two-thirds up from half in 2010. The majority of this will occur in Asia and Africa (see GMT 2: Towards a More Urban World).

Whilst there is potential for health care opportunities to be better in urban areas, large cities also concentrate environmental health risks, including air and noise pollution, and allow infectious diseases to spread quickly. Many cities are also growing more rapidly than the rate at which governments can provide proper sanitation and other essential infrastructure (see: Slumdog Millionaire: A Lesson on Sustainability?), which may result in increased exposure to water-borne diseases.

Demographic change is also influencing the type and spread of disease. The global population is ageing, having reached an average life expectancy of 71 in 2012 and projected to reach 75 by 2050. This is leading to more age-related diseases such as dementia and a vulnerability to air and other pollutants. Migration both from rural to urban, and between countries is also resulting in increased risk of diseases being spread across large areas.

Combined with this increased travel, the risk of serious pandemics due to growing antibiotic resistance further strengthens WHOs view that the world is unprepared for the next pandemic.

Summary:

If current demographic, urbanisation and health trends continue then developing countries will have to deal with an increased burden of communicable, NCDs and pandemics, particularly in slums of large urban areas.

As well as the human costs of these trends there will also be a significant loss of productivity resulting from these diseases that could negatively affect both developed and developing nations by diverting money, attention and resources away from adapting to the effects of technological, climate and other changes described in the series.

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