Professor Devi Sridhar, University of Edinburgh, Scotland, United Kingdom

Alan Inglis Photography

Professor Devi Sridhar, University of Edinburgh, Scotland, United Kingdom


The high-level meeting “Health Systems for Prosperity and Solidarity: leaving no one behind” has a theme – include, invest, innovate. “Include” means improving coverage, access and financial protection for everyone, “invest” refers to making the case for investing in health systems, and, lastly, “innovate” is about harnessing innovations and systems to meet people’s needs.

In this context, what do you think are the biggest challenges for health systems over the next 20 or so years? And what are the greatest opportunities?

Professor Devi Sridhar, Professor of Global Public Health, University of Edinburgh, Scotland, United Kingdom

I think the biggest challenges for health systems are, firstly, getting enough money for primary health care and basic infrastructure. This means continuing the political fight for sufficient investment in health services around the world and pushing the needle towards accessible and high-quality universal health coverage.

Secondly, the combination of an ageing population, urbanization and powerful industries pushing unhealthy products around the world has led to rising chronic disease. Even relatively young people are suffering from chronic diseases such as cancer, diabetes, heart disease and high blood pressure. Preventing this burden is difficult for the health system broadly, given that the main drivers are smoking, alcohol misuse, sedentary lifestyle and overweight/obesity.

Thirdly, drug-resistant infections are a rising – and terrifying – threat, for which our usual drugs to treat people during surgeries or birth, or to treat those with tuberculosis and other infectious diseases, no longer work. How can health systems cope without enough antibiotics for certain populations, such as children suffering from pneumonia, combined with antibiotic overuse in other populations?

Despite all of this, I also see big opportunities in the years ahead. We are seeing leadership at the global level from the heads of the World Health Organization, the World Bank, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Bill & Melinda Gates Foundation, and the Wellcome Trust; they recognize that health systems are a crucial priority and must have regular and robust support.

We are seeing heads of government from across the world recognizing the importance of health systems in order to prevent pandemics, reduce drug-resistant infections, and provide lifesaving care to women and newborns during childbirth. Health systems have been linked to national economic productivity, security and human rights.

And finally, there is rising citizen engagement in health care, from the United Kingdom and the United States of America to India and Senegal, ensuring that health care is an important electoral issue and that politicians push beyond rhetoric to make real change on the ground.