Health transitions in a globalising world: towards more disease or sustained health?

In this paper, we argue that the concept of transitions is a useful way to address future changes in the health status of the world due to the processes of globalisation. To that end, we discuss the current forces affecting human health and the health transitions we have seen in the past. Next, we describe developments in the health status of populations according to three potential future ‘ages’: the age of emerging infectious diseases, the age of medical technology and the age of sustained health. Future health transitions are explored along the lines of four development paths (scenario groups), defined along two dimensions (global versus regional dynamics and emphasising economic objectives versus environmental and equity objectives). We conclude that managing the health transition effectively will require a micro- and macro-approach, taking into account the social, cultural and behavioural determinants of health.