Megatrend

A Megatrend is a long-term driving force that is observable now and will continue to have a global impact in years to come

We are living longer and healthier lives, but global health concerns are growing. Science and better living standards have reduced infectious diseases, but unhealthy lifestyles, pollution and other anthropogenic causes are turning into health burdens. Obesity is becoming a global health issue while the challenge of malnutrition remains. Our understanding of health is increasingly multidimensional and connected to lifestyles (stress, diets) and the environment (pollution), as well as genetics and the microbiome.

In developed countries in particular, non-communicable diseases (NCDs) such as cancer are major morbidity and mortality causes. Antimicrobial resistance is one of our top health threats, mental health challenges are rising and the recent COVID-19 pandemic provided a stark reminder - after the SARS and MERS outbreaks which could be contained - that new ‘zoonoses’ (i.e. infections that jump to humans from another animal) are an ever-present risk to global health. Scientists warn that new (zoonotic) diseases could emerge, (or re-emerge) from the impact humans are having on the environment.

At the same time, the convergence of technologies, personalised medicine and e-health approaches, all bring opportunities. The better use of data and technology is transforming health outcomes for patients and citizens and enhancing our ability to detect threats. Digitalisation and large population datasets, new knowledge (in the life sciences, physiology, neurobiology, medicines, medical devices and diagnostics) are all contributing to better care. A focus on disease prevention, rather than cure, holds promise for a healthier future. Despite the fact that life expectancy has been increasing, it is not all ‘healthy years’, and this is adding pressure on to long-term care systems. In addition, the demand for skilled health care professionals is growing. Health inequalities and the increasing number of the ageing population in the EU present ‘shifting health challenges’.

This Megatrend is part of the Megatrends Hub

Timeline

The driving forces of the Megatrend change over time. This timeline indicates more established and newer trends that are influencing the future direction of the Megatrend

Trends

They indicate a direction of change in values and needs which is driven by forces and manifests itself in various ways within certain groups in society already. 

Keep calm and carry on, but also ‘be prepared’

There are systems in place that monitor ongoing threats and systems that provide support and emergency funds in response to crises. ‘Preparedness plans’ aim to protect the health, safety and resilience of communities and critical infrastructures. The World Health Organisation stated in 2018 that the biggest future health risk was the emergence of an unknown “Disease X”. In 2019, Disease X became COVID-19 and it exposed the ‘under-preparedness’ and vulnerabilities in the system. Preparedness is an ongoing activity that comes at a cost, but COVID-19 has showed that the cost of preparation is lower than the cost of not preparing.

Live Forever (Ageing, NCDs and COVID-19)

We are living longer and healthier lives, but they are not all healthy years. Non-communicable diseases (NCDs) are the leading cause of death globally and cases are rising. Currently, about two thirds of all deaths in the European region are due to diabetes, cardiovascular disease, cancer, chronic respiratory diseases, and mental health conditions and the prevalence is set to increase with an ageing population. People with NCDs have a higher risk of severe COVID-19 disease and COVID-19 intensifies NCDs. Evidence is growing that the so-called ‘long-COVID’ could turn into a chronic condition too. But there are counter signs appearing to the increasing ageing and NCD population with a push to ‘live forever’, new medicines and everlasting avatars.

Digitize me and my health 

Digitalisation is bringing changes to society, offering both opportunities and challenges for health. Digital technology can take advantage of Artificial Intelligence (AI) in the development of applications that support health. There are wearable technologies and remote monitoring devices, telemedicine (e-health) and communication tools, as well as AI-supported diagnostic devices that are providing better care. These will improve prevention, diagnosis, treatment, monitoring and the management of health-related matters. Online services (‘telemedicine’) can reach those who would not, or could not go to a clinic, for a physical or mental health consultation.

A healthy environment 

There is increasing realisation that health is a multifactorial outcome with strong causal links to the environment in which humans live. This idea is summarised under various concepts such as ‘one health’ or ‘planetary health’, with the latter emphasising the connection between human health and nature. A clean environment is essential for human health and well-being. Approximately 19 million premature deaths are estimated to occur annually because of the pollution of air, soil, water and food globally. Despite air quality improvements, many cities and regions still exceed the regulated limits. The climate crises, depletion of stratospheric ozone, loss of biodiversity and noise pollution, are all adversely affecting human health.

Mind yourself

Good mental health is a central part of overall health and well-being. Mental health challenges affect 84 million people across Europe. Living with mental ill-health often means having poor physical health, poor relationships and a lower quality of life. It can mean being less able to succeed at school and work and more likely to be unemployed. Mental health challenges lead to premature mortality. Eco-anxiety and war trauma are on the rise in Europe.
Depression and anxiety are leading causes of disability. Other mental disorders include bipolar disorder, schizophrenia/psychoses, dementia, and developmental disorders such as autism. 

It’s a miracle

Health is challenged by the emergence of diseases that are resistant to antibiotics and new infectious diseases that are spreading in our increasingly connected world. Breakthrough treatments are helping to counteract some of these, but more will be needed for the future. The COVID-19 pandemic built on and drove innovation in the area of vaccines. mRNA vaccine technology has been successful and is hugely promising for the future. We are finding new medicines, and repurposing older medicines (such as Remdesivir), that are being used successfully to fight coronaviruses. Revolutionary technologies such as the genetic scissors ‘Crispr’ and cell-based therapies are on the rise.

Previously Covered Trends

These are trends that were spotted in the past, and might have grown or faded away in time.

• Not your health, my health (Personalised Medicine)
• Policies to support innovation
• Priority for prevention & early detection
• Sustainable Development Goal 3

Future Snapshots

A future snapshot shows a plausible image of what might happen in the future in relation to this Megatrend. It is a creation built using knowledge and imagination. These snapshots presented here are excerpts of inspiring future-oriented reports written by other colleagues and organisations.

Technology Delivers (scenario 3)

“Governments are now more demanding and strategic about the way they invest in health technology. They are explicit about the health problems they want to address, and have actively engaged in shaping the innovative health tech market through new partnerships. Even before birth, a child’s genetic predispositions to illness are known. This presents a fundamental challenge to insurance-based health systems, which are complemented by national solidarity funds. Most people assume technology can cure whatever health problems they experience and are less interested in preventive measures. Patients are increasingly seen as ‘clients’.

The widespread use of health monitoring sensors, home robots and connectivity across a range of health and domestic devices has enabled people to manage their health at home. Citizens are either unaware or unconcerned that authorities and agencies use Big Data from diverse sources to intervene in every aspect of public life that could affect health and well-being. However, following high profile security breaches, public campaigns for the ‘right to disappear’ have emerged”.
 

Other sketched scenarios are: The future is local, Your health your responsibility

Health Futures Project Scenarios for health in 2037 The European Health Forum Gastein  (2017)

Human Organ Replacement (scenario 8)

“It is 2040. Artificial organs have become a widely used option in medical treatment. Many human organs exist in artificial versions, on chips or as organoids and can be reproduced and replaced at least once. Not all organs are replaceable yet - some are too complex. Organoids and in-silico models can be used to quickly develop treatments; other solutions are based on genetic engineering or require therapeutic cloning and breeding (i.e. Xenotransplantation). The bio-printing of organic tissues presents a third avenue for human tissue replacement. Suitability, durability and minimising side effects are key concerns for replacement of human tissues. Preventative transplants have been increasing. There is still scepticism despite that organs and other parts of the body are replaced in ordinary 'surgeries'. Human enhancement is still a divisive issue.

In some countries, private health insurers co-operate with the medical devices industry to develop new and better generations of artificial organs. These are used among well-off people, those who can afford to pay for the latest solutions. Costs are not borne by the health insurance in circumstances where artificial organs are aimed to improve lifestyle, or to prolong life in general. An age-limit of 90 years is set for this kind of surgery. For the early adopters life span has already increased dramatically and a life expectancy of 120 years is in sight."

Other sketched scenarios are: Defeating communicable diseases; Assisted living; Precision medicine 

Glimpses of the future from the BOHEMIA study. European Commission (2018)

Open Health: Transparency 2050

"The idea of sickness has almost totally disappeared in the Open Health scenario, as various vital sign measurements have indicated that health and sickness are almost impossible to separate from one another. Through access to personalized health data, citizens have been motivated to take better care of themselves, their families, and those close to them. Although increased health data access has improved people’s knowledge about their own capabilities and feelings, the dependence on technology has also grown. For example, recognizing harmful working habits in the 2050s is easy.

Consumption of alcohol has decreased, but there are still people who choose not to acknowledge the effects of certain lifestyle choices on their health. As awareness grows, people have come to realize that their social surroundings and circles can have harmful influences on health. Various indicators reveal how students’ health develops from the first grade to the last grade. According to this data, schools can receive additional bonuses from the central administration. The potential bonuses for taking students from poor to good health are larger than merely maintaining good health in well students. For example, during primary school many children who have grown up with unhealthy lifestyles find sport as a hobby and learn to eat a balanced diet. With an efficient primary school system, the inequalities of health are reduced across the board."

Other sketched scenarios are: Democracy of the fittest: Vision 2050’; The new Nordic model: Wellness 2050; Hero Doctors: Equality 2050 

Four scenarios for human-driven health and freedom of choice. Demos Helsinki Health 2050 (2016)

“Desolation health” Storyline 

“The European model declined and the European governance, shared values and the common market were destroyed following the economic crisis. To gain some legitimacy, national governments cooperate with different stakeholders for policies that are short-sighted and do not consider health implications. Economic stagnation has led many countries to gradually reduce the number of people that can avail public services, increase user charges for services and limit the number of public health providers. "Health shocks”, defined as unpredictable illnesses that diminish health status, increase and innovative medicines, focusing on quick-fix solutions, and treatments are hardly affordable for European states and citizens. The deterioration of living standards undermines the community values and leads to tensions among citizens and mistrust in policy making. Citizens suffer from the consequences of climate change as international containment agreements have been stalled for decades”.

Other sketched scenarios are: Healthy together; We will health you; The rich get healthier

The Four Fresher Scenarios Fresher - Horizon2020 (2021)

Further Reading

Want to explore more? Some interesting readings below:

• Health at a Glance: Europe2020 OECD and European Commission
• Non-communicable diseases European Commission
• State and outlook 2020: knowledge for transition to a sustainable Europe European Environment Agency
• Healthy environment, healthy lives: how the environment influences health and well-being in Europe European Environment Agency
• The 2021 Ageing Report: Economic and Budgetary Projections for the EU Member States (2019-2070) - European Commission 
• EU4Health 2021-2027; a vision for a healthier EU and European Health Union - European Commission
• Transforming the Future of Ageing - SAPEA

This Megatrends hub is a repository of foresight related information. It highlights long-term driving forces and its underlying shorter-term trends. This repository can help you understand the changing society in a broad and more systemic way. 

Disclaimer: this repository is by no means comprehensive and apart from established scientific knowledge contains also issues which are subject to scientific debate and where research is ongoing or only starting to give the reader some insights and ways to further explore the topics in more depth.