One expert’s prediction of the future of our health

The scary thing about what Dr Stefan Hajkowicz has to say about future healthcare megatrends is that what he is speaking about is neither new nor surprising; these are trends that are unfolding before our eyes right now.

Ageing populations, unhealthy diets, lack of physical activity, antimicrobial resistance – these issues have been on the healthcare radar for a while now, and are not unknown to the general public.

Yet, preventive measures are slow in coming, whether it be from governments, industry or individuals themselves.

“The thing that happens to us isn’t something out of the blue typically. The thing that happens is often quite boring, and it’s just been gradually building while we watched it occur without the ability to act,” he says.

“I think that’s what comes to me from a lot of the foresight work I do, where we’re looking at trends and data that are actually quite well-known out there.”

The Commonwealth Scientific and Industrial Research Organisa-tion (CSIRO) senior principal scientist on strategy and foresight adds that it is the translation from knowledge into action that is “the bit we don’t seem to get”.

Dr Hajkowicz notes that megatrends don’t usually happen out of the blue, and normally gradually build-up while we watch without acting. Photo: Filepic

Based in Brisbane, Australia, Dr Hajcowicz specialises in exploring future trends, risks and scenarios in order to help people, organisations and governments plan better and make wiser choices.

He is also the author of the book Global Megatrends: Seven Patterns of Change Shaping Our Future, which came out in May.

He was in Kuala Lumpur recently by invitation of the Australian High Commission for a speaking tour, and managed to squeeze in an interview with Fit for life just before leaving for the airport.

A different space

Explaining the term megatrend, Dr Hajcowicz says: “Megatrend is a concept we borrow from the United States academic John Nasbitt, who published a book of the same title in 1982.

“It is a gradual trajectory of change that pushes the world into a different space from where it is today. It is defined by multiple trends, which deal with more specific topics and issues that are more temporally- and spatially-bound, so they are within a smaller region and a smaller time period.

“And where these trends combine and coalesce to form a more significant trajectory of change is where we get the concept of megatrend.”

Megatrends tend to take place over a long period of time, typically over a span of five to 20 years.

“These are long-term shifts we’re talking about, so we’re not talking about stuff on the immediate time horizon,” he explains.

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Read more: Possible solutions to our future healthcare problems

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More importantly, Dr Hajkowicz believes that: “The reality of the systems we create today that lead to better quality of life in the future? We absolutely have to peak sort of five to 20 years in advance to be able to make better outcomes happen for the future.”

This means that we have to decide on and implement the changes we want to see in the next couple of decades, now, in order for them to make a difference.

Ageing and expenses

In its World Population Ageing 2015: Highlights report, the United Nations (UN) estimated that the number of people aged 60 and above will outnumber children aged nine and below in the world by 2030.

It also estimates that 14.4% of Malaysia’s population will be aged 60 and above by that time.

This is just a whisker away from the 15% used to classify an aged population, which we will definitely achieve by the year 2035.

“The globe as a whole has a more aged profile. The median age is moving up for people,” says Dr Hajcowicz.

He adds: “The rise in chronic illnesses, along with the ageing population, is what will push healthcare expenditure way up.

“Right across advanced economies, healthcare expenditure is rising more quickly than income growth in the economy generally, And we are having unsustainable growth in healthcare costs generally – we are creating healthcare costs we can’t afford.”

Sugar and fat

“A lot of this is diet and lifestyle-related as well,” he says, adding that dietary issues like the rapid increase in fast food and sugar consumption that have happened in the Western economies are currently being replicated in Asian countries.

There is a similarity in the current levels of sugar and fat consumption, and smoking in the mid-20th century, where it took a long time for governments and people to act, despite the availability of evidence that smoking was linked to cancer. Photo: Filepic

“I think, for sugar and fat consumption, there is something akin to cigarettes, in that it took a long while for us to wake up to what cigarettes were doing.”

Dr Hajcowicz gives the example of advertisements featuring a doctor recommending a particular cigarette brand in the 1950s, when there was already evidence linking smoking cigarettes and cancer from the 1900s.

“And even though it got stronger and more and more clear that there was a link, it took us a very long time before we started to take action.”

And this is not just affecting adults. “If you look at childhood obesity, it is continuing to rise at sharp rates right across the globe,” he says.

“Because I look at the data on type 2 diabetes and cardiovascular disease, I think we’ve got to do something. The consequences of doing nothing on this one, and saying it’s fine, are too great in terms of the loss of life, the debilitating illnesses people can get, and the costs on the healthcare system,” he says.

Lack of movement

Dr Hajcowicz adds: “Physical inactivity is a phenomenon we have picked up in our data sets too.

“The rates of physical inactivity are on the rise, people are more sedentary.”

Data from OECD (Organisation for Economic Co-operation and Development) countries, which mostly comprise European countries, shows that the amount of leisure screen time for individuals has gone up, while the amount of movement in generally is declining.

He also shares that an article on the pandemic of physical inactivity published in medical journal The Lancet, attributed millions of deaths to the lack of normal physical activity.

“There is quite a substantial body of research showing that those cities where people walk more, ride more, there’s more public transport and lower rates of car ownership, typically, are healthier cities,” he says.

“My personal belief is that the invention of the car is one of the dumbest things we did,” he adds, although he quickly admits to being a hypocrite as he owns a car too.

Lack of antibiotics

The other health megatrend on the horizon is antimicrobial resistance, where microorganisms harmful to humans are increasingly developing resistance to available antibiotics.

“It is a massive risk facing the human population, which is at the early stages. We need to manage the use of antibiotics. We cannot use antibiotics to the extent we do in the human population and livestock production.

“If we do, we will see increasing numbers of bacterial species that are resistant to all antibiotics, and that can kill us.

“This is happening already in the world, and there are strong forecasts and evidence to suggest that it will happen more,” says Dr Hajcowicz.

He observes that there has not been a new class of antibiotics introduced for at least three decades.

“The pharmaceutical sector is not incentivised to develop antibiotics. We’ve kind of wrung the cloth dry in terms of scientific techniques to make new antibiotics.

“We need a renewed effort into antibiotics.

“There’s much more money flowing into vitamins and nutraceuticals and lifestyle products, rather than antibiotics, which doesn’t actually make much sense – antibiotics are harder to tackle, but they have a better pay-off.”

He observes darkly: “It’s not going to be apparent to us why this matters until things all go mental, and then we’ll have an infectious disease outbreak that is unable to be managed.”

In fact, this megatrend was deemed serious enough to be addressed at the recent UN General Assembly in New York, United States – only the fourth time in the UN’s history that a health issue made it onto the meeting agenda.

This resulted in all UN member nations signing a declaration to combat the proliferation of drug-resistant bacteria during the assembly.

Source : Star2.com