As 2017 draws to a close, Aetna International’s Global President of Population Health, Dr Sneh Khemka, takes a look at the shape of the global healthcare market in 2018. His vision for 2018 embraces changes in disease patterns, antibiotic resistance, the ticking time bomb of undiagnosed disease, and the increased impact of healthcare technology.

Trends in global healthcare

1) Rapidly increasing global middle class. 
The world’s middle class is growing (in particular across the Middle East and Asia), creating more strenuous healthcare demands. This has resulted in new expectations from healthcare systems, demanding of digital, more convenient and sophisticated access. Due to this, challenges of how to deliver will continue to arise.

2) A change in global disease patterns. 
Partly due to the rapidly expanding middle class, there has been an increase in lifestyle related, as opposed to infection-related diseases. This is putting significant strain on local healthcare systems, as people are living longer and needing more expensive, long-term treatment.

3) Antibiotic and opioid crises.
Though world news is now attuned to the global antibiotic crisis, the opioid crisis is also sweeping developed countries as addiction to prescription medication is seeing an increase. Both are critical global crises, and urgently need to be addressed.

4) Undiagnosed diabetes.
High obesity rates have led to undiagnosed cases of diabetes around the world. In order to overcome this crisis, healthcare systems will need to acknowledge this worrying epidemic, currently manifesting as pre-diabetes and as metabolic syndrome, both of which most people are unaware they have.

5) Mental healthcare in developing economies.
In developed economies, there is distinct awareness of mental health issues and systems in place to cope with them. Yet, in developing economies, there is still a need for healthcare providers to work with governments to overcome social taboos and understand how mental health effects conditions, as well as economical productivity.

6) Global disparity of healthcare leading to unwarranted variation.
There is large divergence in the quality of healthcare provision and access around the world. 70% of people in the world have too little access to healthcare, whilst 5% of people have too much access. For example, America spends 19% of its GDP on healthcare, indicating the possibility that there are far too many and unnecessary services provided to people; while developing nations are often less than 3% of GDP – so how to address the inequalities?


1) Technology is on the frontline of patient care. 
It is essential to most healthcare systems around the world. However, although technology has advanced in healthcare, affordability has not. There are now increasingly expensive demands for enhanced solutions. This leads to ethical questions of how, and at what cost, we should extend life using technology - it is not easy to determine where technological intervention should end and where the human life cycle should kick in.

2) The data revolution is changing healthcare into a data-driven industry.
Healthcare has access to a wealth of data from wearable devices, to online analytics. Doctors can use this data to see what factors keep people healthy, rather than what makes them unhealthy. For example, aggregated data from online search engines are currently the best predictor of a viral epidemic. Data and technology also makes it easier for healthcare professionals to diagnose, treat and cure illnesses. This is evident in program such as IBM Watson, as it can search through 15 million journals to inform doctors about rare diseases and treatments.