The impact of population growth, wealth and urbanization
In the developing world, rapid economic growth and an emerging middle class have dramatically increased demand for health services, even while governments struggle to bring social services to remote and underserved populations, often for the first time. In India, for example, it is projected that the government will need to train some 800,000 new clinicians if they hope to match the proportion of doctors to population seen in many developed world countries like the UK.
Since 2009, the balance of the world's population now lives in urban areas, creating a series of new challenges for governments and the healthcare sector. In Africa, Asia and Latin America, urbanization has resulted in vast shantytowns and slums with little to no access to health services, freshwater or sanitation services. And as urban populations swell, so too does the incidence of illness such as hypertension, heart disease, obesity, diabetes and asthma.
Increasing affluence has also created a series of new challenges for the healthcare industry as the gap widens between the rich and the poor, resulting in a disparity in the availability and quality of care. And as more people move into the ranks of the middle class, the impact on the disease profile has been dramatic as changing diets result in increasing levels of obesity and diabetes.
Responding to growing needs for healthcare services requires investment in those services and in the infrastructure required to support it.
The nexus of water, energy, food, climate change and waste
The combination of rising energy costs, scarce resources and climate change are creating critical challenges for healthcare providers. For one, this nexus has an immediate and dramatic effect on the health of the world's population: water scarcity and climate change are increasing the incidence of drought and famine leading to significant malnourishment and disease in many regions of the world, while rapidly rising costs for food and energy are – in some cases – forcing families to make difficult choices between putting food on the table and paying the bills.
For the healthcare industry itself, these challenges raise the cost of delivering health services and put healthcare facilities at risk. Energy is a particularly difficult challenge: US hospitals spend roughly US$8.5 billion per year on energy costs and consume almost twice the energy per square foot of traditional office space. Brazil's hospitals are reported to account for 10.6 percent of the country's commercial energy use.
As a result, the cost of operating health systems will dramatically increase as energy, food and water start to consume larger proportions of healthcare budgets. These costs will continue to impact both private and public organizations operating in this sector. Pharmaceutical companies, who use a significant amount of water and energy in the development and manufacturing of treatments, will see input costs soar and will be forced to increase prices while health systems seek to reduce the financial burden of care.
Managing waste has also become a key concern for healthcare providers. At the institutional level, the cost of waste disposal will continue to rise and create new challenges for the environment. In Nigeria, for example, poor waste disposal and management has led to high levels of contamination in many of the country's rivers and basins, leading the Mercer Quality of Living Report to name Port Harcourt one of the 25 dirtiest cities in the world.