Is the epidemiological transformation happening at an unprecedented rate in Asia?
The change is fast, but as you would expect. The increase in deaths relating to air pollution, for example, has been rapid, but if the equivalent data was available I don’t believe it would be different to when the Europeans began to industrialize. It is just that we have more of an idea of what people are dying from today. The main difference is that Asia is aging faster than Europe did and that is complexly intertwined with the rise of NCDs.
How many countries in Asia are close to realizing universal health coverage?
Objectively measuring countries is part of the challenge we face. I cannot say a particular country has reached a particular level of universal health coverage (UHC). Japan, Singapore and South Korea are clearly in great positions. All I can provide for the others is anecdotal evidence that, for example, Thailand is doing an outstanding job in ensuring sick people are not impoverished, or that Sri Lanka is making great advances with limited resources.
Private providers seem to play a far greater role in Asia than in developed countries.
Many countries acknowledge private providers are part of life when we talk about UHC. Governments are mobilizing a lot of revenue for healthcare funds but they focus on purchasing and regulation to cover all citizens, not on service provision. The insurance funds provide incentives to both the public and private sectors as this allows for far greater flexibility and faster responses than when governments operate health facilities on their own.
By 2050, Asia should be far richer and certainly far older than today. How do you imagine healthcare being delivered then?
I believe if Asia experiences the growth projected, there will be many billions more consumers driving the personalization and commoditization of medicine. The result will be a networked, technologically advanced care system, where a pinprick can reveal much about your health. This could be monitored remotely, so the elderly remain at home but are not a burden on families. Health workers would function as a response team whenever an emergency arises.
That is a strong vision.
It may sound far-fetched, but I am an optimist and it would get us away from the stepladder type of referral healthcare systems that now exist.