Global sustainable healthcare

Health systems worldwide must adapt to reflect the changing burden of disease, which has been characterized by a shift from communicable to non-communicable diseases. Sustainable health systems require investment in six building blocks, of which three - workforce, medicines and financing - are examined in this article. Sustainable financing involves collecting, pooling and redistributing resources. The preferred source of finance is general taxation, while pooling and redistribution should be equitable and involve the lowest possible transaction costs. Globally, there is a severe maldistribution of health workers, with the lowest number in places where the needs are greatest. Poor countries suffer from large-scale emigration, but even in rich countries there are often shortages in remote and rural areas. For many individuals, medicines are either unavailable or unaffordable. However, in all these cases, there is much that can be done to overcome the problems, if the political will exists.