BMJ in UK BMJ India BMJ Brazil BMJ in North America BMJ China

Sustainable Health: 2037

Scenario B

Scenario B | Sustainable Health: 2037

In this world governments are focused on collaborative efforts to solve some of the world’s biggest problems. They are entrusted to manage a programme of “softer globalisation” to provide society with the opportunity to adapt to technological advances and secure future economic sustainability. Governments have worked together to introduce regulated data collection about individuals, ensuring it is used transparently and ethically. High levels of international, industry and cross-industry collaboration are encouraged through government incentives.

By 2025 migrating populations have significantly increased owing to conflict and the expected large-scale impact of climate change. Together with global population ageing, this has exerted unprecedented pressure on public services. Civil society is also threatened by the large-scale replacement of professional workers by machines. Nations are coming together to address these big, global issues.

An international treaty enshrining the right to work is signed in 2027. A combination of regulation and taxation have encouraged a diverse and highly collaborative research ecosystem including technology corporations, academic research institutions, patient groups, venture philanthropists, charities, smaller biotech companies and crowd-funded labs. National governments sign up to a joint research framework prioritising areas that will make the biggest difference to global population health such as infections, dementia, and chronic disease prevention. Curiosity-driven research is also common, particularly in Africa where innovative local and international start-ups are attracted to the relatively low research costs.

In 2037 an open science culture prevails in which international, inter-industry and interdisciplinary collaborations prevail, and research data and software are freely available. Researchers progress their careers by producing high quality data sets in areas prioritised by governments, which are assessed in accordance with international outcome measures. Most researchers combine scientific qualifications with advanced engineering, programming or policy and communications expertise. A large proportion are employed by international health agencies.

Global surveillance and laboratory systems continually monitor data to detect outbreaks, analyse epidemiological trends and predict the spread of diseases. Patients donate their live data via implanted sensors to the International Health Service, which is managed using proven and trusted technology pioneered at England’s Digital National Health Service. Research institutions pay to access this data on behalf of researchers transparently and ethically.

Machine learning allows computers to analyse and interpret huge datasets in real time, rapidly reaching influencers of the world’s most costly diseases. Dementia incidence, for example is plummeting. DNA analysis to inform clinical management and research is possible at the point of care. Behaviour change tools using virtual, augmented and mixed reality technology are rapidly making lifestyles healthier, even in remote regions.

However, the replacement of human-to-human interaction by pervasive technology is exacerbating mental health problems associated with social isolation and loneliness. Ever increasing life expectancy raises a new ethical question: at what point do longer lifespans yield diminishing returns for society?

Insights from leading figures

“I think the key driver is to improve value for money because by working with others you can pool resources and address big problems that a single organization could not address in the same way. There’s maybe a trend for research to get bigger, there are bigger problems that need to be looked at from different angles.”

“Inter-industry collaboration stops the replication of data over and over in other companies also working in that space…”

“I could see the open data agenda is moving forward and expanding, and more things will be made publicly available at an earlier stage with the potential to have more discussions earlier on. … Consortia could get larger. Technology and machines get more and more expensive so they need to be shared between more researchers. So there’ll be more sharing of data and equipment”.

“In order to have any traction on research outcomes, you need to run those sorts of trials across borders, because that is the only way you get sufficient numbers of people who are phenotypically similar to be able to do that sort of research. So you’ve not only got the supply side becoming international, but the demand side of the people who use it, is also international”.

Weak signal: International initiatives

The UN’s 17 Sustainable Development Goals of the 2030 Agenda for Sustainable Development came into force in January 2016. The new Goals are unique in that they call for action by all countries, poor, rich and middle-income to promote prosperity while protecting the planet. They recognize that ending poverty must go hand-in-hand with strategies that build economic growth and addresses a range of social needs including education, health, social protection, and job opportunities, while tackling climate change and environmental protection.

Weak signal: Legislation for quotas of human workers?

A recent study by the International Bar Association claimed robotics could force governments to legislate for quotas of human workers. The UN has recently opened a new centre in the Netherlands to monitor artificial intelligence and predict possible threats, including the risk of mass unemployment. 

Scroll down to view our three other scenarios or go back to the Future of Global Research overview.