Health has gone through an unprecedented period, leading to seismic changes in how we value and approach wellbeing. David Humphreys, global practice lead for health policy, offers a perspective on the forces shaping the world of health in the new year.

As the year ahead marks the fourth with covid-19, many are more hopeful than ever that this terrible disease is mostly in the rearview mirror. More importantly, there is a sense in the health world that lessons from the pandemic are translating into action—acceleration in innovation, a new era in cross-sectoral collaboration and an integration of health into overall societal goals and efforts.

Yet the potential for immediate challenges is also apparent. Countries and systems will face increasing debt levels, delays in treating important health conditions and severely fatigued health resources—among other issues. Just as critical, translating stated priorities such as equity into meaningful practice remains dubious, especially when stakeholder actions are not always driven by evidence.

As I discussed this past November at the Future of Healthcare Week Asia 2022, there are clear forces shaping the world ahead in health, but with a path that has yet to be determined. Will health and wellbeing take a great leap forward, or will building pressures and a return to past norms force us to take a step backwards? Here are five key areas to track as we enter 2023:

• Preparing for future health risks? Covid-19 has rightly raised awareness and action around future preparedness for ‘Disease X’, building of health system resilience and new approaches to known challenges like HIV. But the combination of ever- evolving infectious disease threats and a backlog of unmet health needs is set to put enormous strain on already fatigued systems and populations. Outlook: muddled, but signs of positive movement

• New lens on investment in “health for health”? As discussed at the World Health Summit 2022, there are promising innovations in health financing and a growing set of actors–such as development banks and the investor community—pushing for a greater focus. But as the EIU has predicted in its most recent analysis, the environment for spending on health in 2023 is facing considerable headwinds. Outlook: difficult in the short term, compelling in the long run

• Path forward for sustainable, impactful innovation in health? In the past three years the world has seen the value of innovations in health, from vaccine development to significant strides with digital tools. This improved understanding and advances in medical science indicate an enticing future; however, approaches in value assessments and investment models continue to have difficulties in keeping pace. Outlook: promising,especially on the digital health front, but still lacking a sustainable future roadmap

• More expansive approach around individual health and life course? An important legacy from the ongoing pandemic has been a reassessment of what constitutes individual wellbeing and how health systems can best facilitate that goal. This trend is reinforced not just by population views, but also holistic policies on critical life course issues. Outlook: slightly optimistic, though likely struggles ahead 

• True integration of health with broader societal efforts and goals? As we have argued in the past, the interdependence of health and society has never been clearer. The consistent dialogue from stakeholders, including the recent Global Health Landscape Symposium 2022, demonstrates a reinvigorated commitment to known strategies like Health in All Policies and Social Determinants of Health. Outlook: Very hopeful, but requires a new mindset

When combined, these trends present a likely challenging 2023 as the world grapples with constrained finances and outstanding health-related burdens. At the same time, the year should also witness positive building forces that will help reshape society’s approach towards wellbeing in the long run. The major uncertainty therefore stems from how long the latter will take before driving significant change, and will depend on actors remaining focused on shared goals—not reverting to siloed behaviours.