The scope of the issue deserves to be included in the discussions for the health plan, for this reason we explain the main points of the mentioned report.
Global public health is under increasing pressure and health systems around the world are at risk of becoming ineffective for their purpose.
The covid-19 pandemic has highlighted ever-present shortages and emerging threats to public health, including antimicrobial resistance (AMR), vaccine burden, and nutritional and infectious diseases driven by climate change. The post-pandemic landscape, with an increase in inflation, wars and poverty, presents a complex landscape for mental health due to an increase in stressors such as violence, poverty and isolation.
There is a certain danger that in times of global economic crisis, attention and resources will be diverted to other purposes, forgetting the context of health, which will push all the tired and obsolete health systems to the edge of the precipice.
Concomitantly with the post-pandemic, health systems must undergo silent health crises. Health outcomes during the COVID-19 pandemic have been weakened by the delayed effect. Early evidence shows that the post-covid situation is affecting people’s quality of life and employment status, contributing to absenteeism from work and early retirement, a tighter labor market and reduced economic productivity.
The resulting economic impact is estimated to be around $140-600 billion in the United States alone, if recent costs continue, lost quality of life, lost income and productivity, and increased health care spending.
But we must not forget that the pandemic has also diverted resources from other diseases, such as the detection of cancer and tuberculosis, and immunization campaigns have been put on hold. Polio vaccination rates have fallen to their lowest level in 14 years, possibly bringing the wild strain back to Africa in 2021.
Urbanization, use change, and natural disasters are increasing the emergence and re-emergence of diseases, including invasive fungal diseases, while global warming is increasing the number of measures to transmit existing diseases such as malaria and dengue.
Expanding sources of disease will combine with the constant burden of disease, increasing life expectancy, to strengthen the burden of the health system in an expanding and advancing economy.
In the last decades there has been a significant shift towards non-communicable diseases, linked to the growth and aging of the population, along with a delay in the coverage of health systems. The key implication is that loss of health benefits and disability increases rather than deaths.
Medical advances have made it possible for people with multiple comorbidities (such as diabetes, hypertension, heart disease, and depression), which remain complex and expensive to manage. People are living longer in poor health, and soon more sustainable changes in life expectancy are gaining strength beyond the force of the pandemic.
However, there is a sense of danger that is dying from pandemic work and the human tendency to focus on new, recent and more visible crises.
However, “silent” crises with cumulative impacts can quickly overtake a single, catastrophic event. The covid-19 pandemic has been linked to nearly 15 million deaths worldwide, and this figure is expected to rise three years after China’s strict COVID-19 restrictions. But by comparison, an estimated 4.95 million were associated with drug-resistant bacteria (RAM) in 2019 alone, and about 1.27 million of those were considered directly attributable to RAM. Air pollution was estimated to be responsible for another 9 million deaths in the same year, corresponding to one in six deaths worldwide. While there are limitations to data collection and analysis in all three cases, and the outcomes of COVID-19 could be far worse in the absence of swift action, the comparisons highlight the potential for silent crises to cause complex and fugitive damages.
As the burden of disease increases and innovation expands the scope that medicine can treat, the inexorable demand for healthcare faces long-term challenges.
The covid-19 pandemic is disrupting traditional prevention and treatment services, resulting in a backlog in hospital and community care that can be difficult to eliminate. More than 7 million people in the United Kingdom of Great Britain (more than a tenth of the population) were waiting for non-medical care in September 2022, while 10% of jobs were vacant while the NHS was trying to keep staff.
Health systems are likely to increase economic pressure, with economic taxes or reduced income, as well as higher costs of goods and labor, as inflation persists, economies grow more slowly or stagnate, and governments re-prioritize spending to address more salient security and social issues.
Even before the COVID-19 pandemic exacerbated staff shortages, the World Health Organization (WHO) predicted a global shortfall of 15 million health workers by 2030. Some health systems are experiencing a decline in productivity as skilled workers leave due to burnouts and concerns about staff. and patient safety. Skills and infrastructure gaps are further undermining capacity, as staff are overwhelmed by challenges for which they are not adequately equipped or supported, leading to further tightening of pay and grade levels.
Medical inflation is expected to continue to slow GDP growth in many countries, and financial pressures on working populations are expected to increase as rates rise. The United States already spends nearly 20% of its gross domestic product on health care, even before its largest cohort of the population (the “Baby Boomers”) has retired.
Governments, insurers, or employers may respond by limiting coverage and shifting a greater portion of costs onto individuals, reducing access to and affordability of health care. The two-tier health systems, prevention and treatment, already prevalent in many developed and advanced economies, can become even more entrenched, with private for-profits serving patients with greater ability and willingness to pay, while poorer people continue to live. the public provision was more and more corrupted.
The constant demand-supply mismatch gradually weakens the ability of the health system, even in the richest countries, to cope and adapt, and to begin to reduce the quality of care and access to care. Fragile health systems could be quickly overwhelmed by one or more catastrophic events. A large-scale cyberattack, war, extreme weather event, or new or emerging infectious disease could result in the collapse of health systems within one or more countries, resulting in a sudden increase in deaths from all causes. The gradual failure of health systems further undermines overall health, widening health disparities, slows economic activity, and undermines political and social stability as the net collapses.
It is imperative that we incorporate the hard-earned lessons of the last pandemic in preparing for the next iteration of health crises. Continuity of public health policies and interventions at the national and regional levels can overcome the conflict that a large part of the burden of chronic disease is, indeed, preventable. Achieving public benefits requires governments and societies to promote conditions that support well-being and encourage healthy lifestyles, such as good nutrition, clean air, safe housing and social cohesion.
Public health institutions, health providers, and funders can play a key role in improving interactions and coordination between the different parts of the health system to share information, increase capacity, and improve the overall health of the population. The long-term plan will help governments to better assess and manage health system risks, as well as align policies that directly or indirectly affect health (such as agricultural policies that regulate antibiotic use and increase the risk of RAM). Governments and societies will also need to increase their safety crisis preparedness strategies to resist emerging threats.
In parallel, national and global health institutions and systems must be strengthened against multiple challenges. Innovation in care delivery, staffing, and financing models are required for health systems to effectively address disease prevention, early detection, and multiple care costs for a time-fragile and chronically ill population. There is also the potential for healthcare to take advantage of technological advances and digital transformation that other sectors have embraced, such as increasing capacity with technology and combining virtual and in-person costs to reduce costs.
There are also opportunities to strengthen public health in all countries, especially in the areas of pandemic surveillance and preparedness, scientific cooperation, mitigation of global threats such as climate change and AMR. It is necessary to avoid the nationalism of health in the economic and security aspects, which is already working today. Ongoing collaboration and data in the health, pharmaceutical and life sciences fields support our efforts to continue to advance our understanding and capacity to effectively respond to emerging health risks.
*Specialist in occupational crises.
