Following the publication of the Public Health Status and Foresight Report (PHSF) 2014 by RIVM, an article has been published in the Lancet about the health challenges 2040.
Does an ageing population and thriving Western lifestyle predict that the big three diseases of present; cancer, circulatory disease, and dementia, will be the most burdensome diseases of the future?
Partly. Cancer features four times in the top 10 causes of death in the UK, and dementia which costs and accounts for more disability adjusted life years than any other disease, is expected to double in prevalence every 20 years to 66 million by 2030 and 115 million by 2050. Both of these diseases are unlikely to take a 'back seat' with our ageing population.
However, "there are few public health issues of greater importance than AMR, both in the UK and across the world" (Department of Health). The development of novel antibiotics has slowed drastically, whilst antibiotic use is rising, causing the continual emergence of resistant microorganisms. High rates of resistance have been found in common bacteria, and scant reports of completely drug resistant TB, amongst other completely drug resistant microorganisms, may highlight the start to the end of the great antibiotic era.
AMR is not only restricted to bacteria, as all microbes have the potential to mutate and render our drugs ineffective. The incredible advances made to manage malaria and HIV could be reversed, with these diseases once again escalating out of control. In a world of inordinate AMR, sepsis would be a common terminal event, minor operations would be too high risk without prophylactic antibiotics, and cancer treatments that induce immunosuppression would be a much riskier proposition.
The Public Health Status and Foresight Report (PHSF) 2014 provides a broad overview of the most important trends in Dutch public health. In the coming years, life expectancy will continue to rise, with large differences between population groups. More people will live with a chronic disease and healthcare costs will increase. What does this mean for the future of public health? Which of these trends do we want to tackle first? People differ in what they think is most important. To make Europe healthier, we need to use these differences to develop a strong strategy.