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Keynote Sessions
2. Non-Communicable Diseases (NCDs) including mental health are and will be a major
burden. Currently, 74% of all deaths (41 million) are linked to NCDs. Yet, health systems often
struggle to effectively manage NCDs, as (particularly in low- and middle-income countries)
they are primarily designed to manage acute, infectious diseases rather than chronic
conditions like NCDs. Necessary resources, including trained healthcare workers, will be
needed to effectively prevent, diagnose, and manage these diseases. NCDs often require
long-term, complex care strategies that involve multiple health services and providers. Health
systems may not be structured to provide this level of integrated care. Health systems may
also have issues to quickly adapt to the rapid, unplanned urbanization, the globalization of
unhealthy lifestyles, and the influence of commercial determinants of health, that are all
driving NCDs, and which require addressing risk factors that underpin NCDs. Health systems,
which tend to be more focused on treatment than on prevention, will need to be reshaped to
make prevention a core strategy. This all means that strong political determination will be
required to not only adapt the organization, but also the financing of health systems in order
to effectively address NCDs.

3. Ageing populations will shift demand and needs. As people live longer, the risk for them to
develop chronic diseases or disabilities increases, leading to a higher demand for healthcare
services, including long-term and complex care strategies. This will require additional
financial and human resources. More healthcare workers will be needed with training in
geriatric care and chronic disease management. Home-based care options, and
telemedicine services may play an ever more important role. At the same time, the basis to
fund care, including for the growing group of elderly, will shrink as the proportion of working
people versus older people will decrease. Both for financial reasons, as well as for (mental)
health reasons, systems will need to be built to make ageing more inclusive in society, more
active, and more healthy. Social services will have to be integrated with health services at the
community level.

4. Climate Change may put additional pressure on health systems. Climate change is
threatening the sustainability of health systems’ performance through increasing pressures
from rising heat, extreme weather events, droughts, shifts in duration and prevalence of
diseases, and the potential for increased novel diseases being introduced. Storms, floods,
and heatwaves can cause injury, illness, or death. Changes in temperature and rainfall can
alter the behavior of insects and other species, leading to changes in infectious diseases.
Climate change can contribute to food and water insecurity, leading to illnesses and
malnutrition. Health infrastructure may become damaged or in need of redesign. People’s
mental health and wellbeing can be affected. While everyone is exposed to climate-related
health threats, some people will be more vulnerable due to their exposure, sensitivity to
climate stressors, current state of health and wellbeing, or lack of sufficient resources to cope
or remove themselves from harm.

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