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Dreaming the Future of Health for the Next 100 Years

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Dreaming the Future of Health for the Next 100 Years Dreaming the Future of Health for the Next 100 Years White paper from the Global Health Summit Beijing China, January 26-27 2013 “Without health, nothing is of any use, not money nor anything else” Democritus, 5th century B.C Acronyms Dreaming the Future of health in the next 100 years: White AI artificial intelligence AIDS acquired immune deficiency syndrome The word cloud shown above is paper from the Global Health Summit Beijing China, January CDC Centres for Disease Control generated from the text of all the 26‐27 2013 CEO chief executive officer plenary sessions of the Summit. The GE General Electric cloud gives greater prominence to Written by Dr Rene Loewenson Training and Research H1N1 influenza A virus subtype H1N1 words that appear more frequently. Support Centre ICN International Council of Nurses Generated by R Loewenson 2013 at Funded by the Rockefeller Foundation IP intellectual property http://www.wordle.net/ See page 26 for full delegate list JGSPH James Grant School of Public Health April 2013 JLI joint learning initiative MOOC massive online open courses NCD non communicable disease The views expressed in the report do not reflect those of the PHC primary health care Rockefeller Foundation and should not be attributed to any PUMC Peking Union Medical College individual delegate to the Global Summit except where a R&D research and development direct quotation is provided. Quotations from the Summit RF Rockefeller Foundation used with permission. Published quotes reference cited. SARS severe acute respiratory syndrome SE socio‐economic Photograph credits indicated under photos. UK United Kingdom Cover photo Venice Bienalle with permission © Luca De Biase UN United Nations 2013 UNDP United Nations Development Programme UNEP United Nations Environment Programme WEF World Economic Forum WHO World Health Organisation Contents Introduction: From the last 100 years to the next………….....…1 Organising the dreaming………………………………………………………2 What lies ahead? Trends shaping the future………………………..3 What are we more certain about………………………..…………………..3 What debates and uncertainties do we have…………………………..6 Waking up in 2050: Scenarios for the future of Health ………….……………………………9 Scenario 1: The scramble for resources .……..........................10 Opening a window to the future… Scenario 2: Health if we make it happen …………………………….….11 It is a warm Wednesday in January 2050 in Santiago. The newscaster Scenario 3: High control, winners and losers .….....................12 is reporting the latest performance figures for the city, and Ana Scenario 4: Healthy convergence, we’re in this together ………..13 frowns as she hears that wellbeing and air quality have both dropped a few points. In the centenary year of the landmark Doll and Hill study Taking action for a future of sustained health………………………15 on smoking and lung cancer this is not good for public relations! She makes a mental note to discuss this with the City Forum later in the Foundations for action: shaping values, thinking and learning….15 day. For now she has to prepare for a visiting delegation from Tokyo, Sites of action: technology, policies, public health…………………..18 Lagos and Los Angeles who have come to finalise the protocol Means of action: transforming state, society and enterprise…….21 connecting the electronic data and remote sensing systems for maintaining population health across their megacities. Ana has kept Leadership for healthy futures……………………………………………..23 in touch with them online in the peer to peer learning platform as they all connected years ago to the same cyber‐ engineer supporting their 3D vaccine printers. With Saito from Tokyo, Meng from Lagos References…………………………………………………………………………..25 and Raul from Los Angeles she had many long debates over the years on issues ranging from how to rebuild solidarity, to what the priorities Summit delegates and contributions…….……………………………..26 should be for planetary health. She can’t wait to see them again! Introduction: From the last 100 years to the next How will we enable the growth and In 2013, as part of its Centennial, the Rockefeller the opening of the Summit, big dreams are at development of healthy societies over the Foundation is holding a series of gatherings that bring the centre of significant change, such as 20th together the world’s leading thinkers, innovators, century improvements in sanitation, or 21st next 100 years? entrepreneurs, and political leaders to identify, century resolutions on universal coverage. understand, and solve problems in innovative new “Health is an eternal theme of humanity – and a ways. strong, healthy and sustainable society is our common pursuit. So let us dream, but then let us Towards this, in January 2013, the Foundation and return here to earth to do the work that is needed to Peking Union Medical College (PUMC) held in Beijing attain health and harmony at home”. Minister Chen China, a Global Health Summit: Dreaming the Future Zhu, Minister of Health, China, 2013 of Health for the Next 100 Years. The two hosts each brought a one hundred year track record in public This White paper is thus a provocation to dream health. and act! It presents the key trends, debates and ideas that were raised in and after the Summit. The Summit gathered 112 prominent leaders from Through this, it envisages the multiple potential government, international organizations, academia, futures that may emerge from these trends, the civil society and business and from numerous choices that determine them, and where we disciplines to discuss the question: “How will we could act, even now, to shape futures of enable the growth and development of healthy sustained health. Hookworm treatment dispensary, Tennessee, USA 1914 societies over the next 100 years?” RF Centennial site The White paper seeks to stimulate reflection, A 100 year horizon lies beyond the boundaries of our debate and submission from a range of actors Actions to address hookworm by the Foundation in the early knowledge and enters the realms of our imaginings. that play a role in sustained health. The paper 1900s connected improved living conditions, economic productivity and health. Learning from the co‐operation across “In 1913, trying to project forward to the year 2013, it was seeks to engage young people on a future of government, social agencies and communities needed to the dawn of the application of germ theory. It was the health that they will both shape and live in. The prevent hookworm, a 1915 Rockefeller Foundation report by W beginning of organized public health ….They would have ideas presented intend to enrich the activities Welch and W Rose proposed a new public health education to imagined that because they understood what bacteria and priorities of leaders and stakeholders who build the approaches and cadres needed to improve population were, that any day now, all infectious diseases were going work for social change, especially for vulnerable health. Foundation activities promoting public health since 1913 to be gone.. They could not have imagined …that five years people. They will also inform the Rockefeller now span 52 countries across 6 continents. later, 75 million people would die in the great influenza Foundation’s goals, grant‐making priorities, and pandemic of 1918. So the folly of imaginings is high”. networks. “…our approach has been innovative, our methods collaborative, Laurie Garrett, Council on Foreign Relations, USA, 2013 our focus on bettering the human experience. That is what will continue to guide us in the century to come”. David Rockefeller, However, as Foundation President Judith Rodin 前人树 栽,后人 乘凉 “One generation plants the January 2013 and Minister of Health Chen Zhu, China recalled in trees, another enjoys the shade” Chinese proverb Organising the dreaming The White paper does not make predictions Delegates made input on the trends, actions, other population health scientists (Martens and or a forecast of a certain future. It rather leadership and knowledge for a future of sustained Huynen 2003). projects different scenarios for the future. It health through a mix of plenary panels, presentations, group discussions, artist “We massively underestimate the magnitude of makes explicit the critical assumptions and representations and video interventions. A list of change that’s going to hit us in the future, and we overestimate the stability of our world” Richard uncertainties we have about the future of the ten ‘dominating’ trends seen to be affecting Horton. Lancet,2013 healthy societies, and the different plausible health in the next century was ‘crowd-sourced’ by futures they imply, as a basis for creative Rockefeller Foundation before the Summit as a Just as new thinking was needed in public health trigger for discussion. Delegates identified and a century ago, so 21st century global health calls thinking about how to shape the future. discussed further the trends that they felt to be for input from beyond public health institutions. most important. These included the demographic Many disciplines exert influence on health and The White paper draws on the delegate inputs at the revolution; new ways of learning and social and not all could be present at the Summit. There Summit, interviews conducted after and background economic convergence and science and technology. was limited voice of young people or civil materials (See References and Acknowledgements). Artists representations of the group discussions society, despite their unique lens and the role of were used to share the exchanges. The transcript ‘active citizenship’. Interviews and document of all discussions in both plenary and groups was review was thus carried out to obtain these Forecasting vs Scenario thinking reviewed to identify the most frequently raised views. trends, five for which there was greater certainty, and five that were more uncertain or debated. The complexity and uncertainty inherent in imagining is reflected in mixed, sometimes While these inputs provided rich experiences and contradictory perceptions, sometimes reflecting insights, there are also limitations. Scenario the tension of pessimism of intellect and projections generally don’t have time horizons optimism of will.
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