The Next Health Crisis is Already Here: Adapting to the realities of 21st-century aging

The OECD’s 23 February report Ready for the Next Crisis? Investing in Health System Resilience is as prescient as it is factual, adding to the long list of issues where the OECD performs critical analysis. It sets forth powerful ideas and shares valuable policy guidance with its member countries, which represent 63% of global GDP and 75% of world trade. While the report is prompted by the acute crisis of COVID-19, it is clear that like so much else the pandemic accelerated trends already well underway as a result of globally aging populations. As longevity increases and we live well into our eighties and nineties, the conditions and diseases of aging profoundly increase both in real terms and as a percentage of overall budgets and economies.

This is the next health crisis, and it’s already here. Health systems are now at a tipping point and require focused policy reform, given the pandemic has put health systems under extreme stress with long-lasting health impacts and enormous economic disruption. While we must consider the potential for acute global health crises—like another pandemic or antimicrobial resistance—health systems are, in fact, already contending with the “slow-burn” crisis of age-related health challenges: from Alzheimer’s, osteoporosis and fragility fractures; to diabetes and cardiovascular disease; and oncology and elder caregiving

OECD governments must redouble their support for intellectual property rights—patent protection for biomedical and technology innovation—and ensure value-based pricing for health innovation.

Indeed, planning for a pandemic-like shock is only the tip of the iceberg. Just consider the growing friction in the United Kingdom over its NHS; the political arguments exploding in the United States over the impending doom of its Medicare programme; or the more ingrained challenges in Japan related to its super-aging status. Systems across the OECD that were invented in the post-war era must now adapt to the realities of 21st-century aging.

We must act, focusing on three areas to ensure health system resilience not only for the “next crisis” but for the one already with us resulting from health needs for modern aging societies:

  1. Demand policies that support health innovation. As the Global Coalition on Aging’s newly-created Alliance for Health Innovation suggests, OECD governments must redouble their support for intellectual property rights—patent protection for biomedical and technology innovation—and ensure value-based pricing for health innovation. Basic reforms of the regulatory systems from the United States, Europe, United Kingdom and Japan can build upon the streamlined and patient-friendly approval processes created out of necessity during COVID-19. Solving for the crisis already here in cognitive decline—Alzheimer’s and other dementia that are on a trajectory to bankrupt us—will require the incentives to find innovative cures. A resilient health system must have biomedical and technological tools to solve for Alzheimer’s.
  2. Shift from the 20th century acute care model to a 21st century “predict and prevent” model. In the latter, we invest in prevention strategies and earlier detection and diagnosis. Just as childhood immunisation was one of the cornerstones of 20th-century longevity, we now need life-course immunisation that reaches into our later decades and across vaccine-preventable diseases. This will deliver important individual and health system benefits. Influenza vaccination, for example, reduces the risk of cardiovascular mortality by 56%, dementia by 36% (in certain cases) and stroke by 13%, resulting in both better health and lower systemic burden of care. Extend to shingles, pneumococcal pneumonia and regular and ongoing COVID-19 vaccinations to drive the greatest benefits.

Rather than the 20th century acute care model, we must implement proactive measures to promote healthy habits from nutrition to exercise, and including medication adherence.

There must also be a willingness to spend today on early detection and diagnosis for age-related conditions, from osteoporosis, which left unchecked leads to costly, life-threatening fragility fractures, to cardiovascular disease, cancer and diabetes. Super-aging Japan changed their reimbursement policies for Fracture Liaison Services to help avoid second fragility fractures, which are what causes pain, unhealthy aging, death and billions more in spending. There are proven economic benefits: according to a 2021 WHO report on healthy aging in the Western Pacific region, a 5% improvement in 2017 disability rates would result in 55 percentage points more GDP per person by the end of the century in Korea; 53 percentage points in Japan; and more than 40 percentage points in Vietnam, New Zealand and Australia.

  1. Build on the lessons from COVID-19 highlighted by the OECD campaign “Beyond Applause”. From elder caregiving to pragmatic but effective community health creativity, COVID-19 revealed that hospital- and traditional healthcare personnel-based health infrastructure is not up to the current crisis. Indeed, gaps and burdens on the health workforce poses one of the biggest threats to resilient health systems. Rather than the 20th century acute care model, we must implement proactive measures to promote healthy habits from nutrition to exercise, and including medication adherence (particularly an issue with older adults among whom polypharmacy is more common). New and innovative technologies can also drive earlier detection and diagnosis, positively impacting quality of life and cost for everything from bone health and heart valve disease to diabetes and oncology.

While the OECD’s Ready for the Next Crisis? Investing in Health System Resilience is geared toward such real challenges as “pandemic preparedness” there is a health system crisis already here—amplified and laid bare by COVID-19’s challenges. We must enact substantial change to strengthen health systems for the needs of aging 21st-century OECD societies.


Latest Developments

We keep our members and partners in touch with the most recent updates and opinions in the worldwide dialogue on population longevity and related issues.

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World Population Reaches 8bn As It Grows Older

The world’s population reached 8bn people on Tuesday and will hit 9bn in 15 years as it experiences an unprecedented surge in the number of older people, according to the latest UN data. The global fertility rate has more than halved since the 1950s to 2.3 births per woman. With mortality also falling, the number of people aged 65 and over is expected to rise from 783mn in 2022 to 1bn by 2030 and reach 1.4bn by 2043, the UN population data revealed.

Global Coalition on Aging (GCOA) Launches Cross-Sector Alliance Committed to Health Innovation at High-Level Forum on The Silver Economy

Today, the Global Coalition on Aging (GCOA), along with cross-sector stakeholders representing patient advocacy, policy, industry, and academic communities, announced the launch of the Alliance for Health Innovation at the High-Level Forum on the Silver Economy in New York. The Alliance is dedicated to establishing the importance of innovation in achieving healthy aging and health equity through investments, policy reforms, and strategic partnerships.

Japan Must Face Up to Growing Danger of Drug-resistant Germs

In the wake of more than 6.4 million COVID-19 deaths worldwide and unprecedented economic destruction, the global community has no excuse to be caught unprepared for the next pandemic. Yet right now, a devastating parallel plague is already underway and worsening. Some years, it is killing well over 1 million people, according to medical journal The Lancet.

A Bipartisan Bill Could Prevent The Next Pandemic

In Washington, Republicans and Democrats are typically at loggerheads when it comes to healthcare policy. Just consider the recent Inflation Reduction Act, which made extensive changes to Medicare and also extended Affordable Care Act subsidies. Every single congressional Democrat voted for the legislation, while every single member of the GOP voted against it. But occasionally, a bill is such an obviously good idea, and so desperately needed, that it commands significant bipartisan support. The PASTEUR Act, co-sponsored by 31 Democrats and 31 Republicans in the House and two members of each party in the Senate, is just such a bill.

Korea Must Act Now to Combat Growing AMR Threat

Public officials are overlooking one of the gravest long-term threats to the Korean people, the health system, and economy: antimicrobial resistance (AMR). Some pathogens ― bacteria, fungi, parasites, and viruses ― have evolved strains that resist the antimicrobial medications we currently have available to fight them. Health care professionals often must watch helplessly as patients succumb to infections that antibiotics could once have easily beaten. They know that new antimicrobials, including and especially antibiotics, could easily gain the victory ― but they have none at their disposal.

Policy Statement on the Impact of Price Negotiations on Innovation, Healthy Aging and Equity

As the CEO of the Global Coalition on Aging (GCOA) and a newly formed cross-sector Alliance for Health Innovation, we write to express our deep concern with the current legislation that allows for price “negotiations” in Medicare – a thinly veiled signal for America’s plunge into price controls that will have a devastating and adverse impact on biopharmaceutical innovation and our nations’ ability to support healthy aging.