Future-looking

This RPC wants to inform tomorrow’s health systems. Many countries in Asia and Africa are experiencing rapid changes that affect health-related needs. Issues such as ageing, urbanisation are putting new pressures on health systems and HIV is leading to a new pattern of need and use of health services.

There is a growing dissatisfaction with the health services established in the post-colonial or post-revolutionary period and Health is rapidly rising up the list of national priorities for governments in a number of countries. This has created a unique window of opportunity for health system change. The response will influence health systems for many years. The aim of the FHS RPC is to support efforts to make the best use of this opportunity. Our research is based on the following premises which will affect future health systems:

• Unregulated markets will not provide appropriate, cost-effective health services but the relative roles of markets, civil society organisations and the state in new kinds of health partnerships will vary between contexts.
  
• The increased availability of medical knowledge, trained and untrained health services providers and drugs has created new opportunities and challenges for individuals, communities and governments.
  
• Social changes associated with marketisation and globalisation are leading to new patterns of poverty and vulnerability which require new approaches to social protection and health finance.
  
• New technologies provide new opportunities for health system development with different impacts of different social groups.
  
• New ideas and innovations will increasingly emerge in societies that are experiencing rapid economic and social change and research has an important role to play in identifying and assessing the impact of these innovations.
  
• Effective policy adaptation to rapid change is neither “top-down” nor “bottom-up” but combines local innovations and macro-policies in a continuing process of institution building.