Whilst many of us can describe trends that will shape the environment of our future, whether physical or economic, KPMG have gone so far as to itemise how nine out of ten “megaforces” will challenge healthcare.

Population trends show a wealthier middle class who live longer and so demand more of healthcare services to treat chronic diseases. To match the Western model of consultation, India would require 800,000 new clinicians, where in fact shortages are getting worse.

Novel service models in the UK (using telehealth and telecare) may suit better, as they demonstrated reductions of 20% in emergency admissions, 14% in elective admissions, and 45% in mortality rates.

The demand for freshwater is expected to exceed supply by 40% within 20 years, and the quantity used by healthcare facilities and pharmaceutical companies, who develop and manufacture medicines, will put significant pressure on availability, quality, and drive soaring costs.

We learn that the contribution to greenhouse gas emission by healthcare now tops 5% in the EU and is 8% in the US. The report goes on to describe projects that have significantly reduced energy consumption; retrofitting equipment and using simple energy saving measures saved the Royal Free Hospital in the UK EUR1.8 million per annum, and 100 hospitals in São Paulo reduced energy use by 25%, desirable in any economy.

The “megaforces” may be the stimulus to change the status quo in a world where 1.9 million premature deaths annually are attributed to simply breathing the smoke from cooking fires.


  1. KPMG International Cooperative. Care in a changing world: challenges and opportunities for sustainable healthcare. Zurich: KPMG International; 2012. Accessed 15 July 2013.