Trust or consequences

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Will innovations in health and medicine deliver? This is a question on the top of everyone’s mind as Covid-19 tests the resiliency of global medical supply chains. 

Over 100 experts recently participated in Trust CoLab, an innovative online exercise that developed a set of alternative scenarios about the future of medicine and health care. The exercise identified one potential development that quickly became quite salient: the prospect of global pandemic leading to drastic changes in health-care practices. This possibility is spelled out in “Scaling the Tried and True,” one of the four scenarios developed in the exercise.   

The MIT Center for Collective Intelligence and U.S. Pharmacopeia has now released a report, Trust or Consequences 2040: Will innovations in health and medicine deliver?, based on the Trust CoLab effort. The report is the product of a four-week process that elicited ideas from experts affiliated with leading organizations, including the Bill and Melinda Gates Foundation, the American Association of Pharmacy, and Harvard Medical School. Participants were asked to consider what developments might shape people’s health between now and 2040 and what impact these developments could have on the evolution of trust in medicine and health care.

The report details four potential future scenarios: 

 Scaling the tried and true: In response to a series of major health crises, key actors in health care cooperate across all sectors to build institutions with global scope, designed to deliver basic, proven cures to all. 

 Dangerous uncertainty: Problems with big data/AI and gene modification trigger devastating medical failures. Disparities in access continue. In response, the wealthy depend on the latest, science-based medicine, the middle class turns to trusted local caregivers, and the less-privileged rely on folk medicines and food-based cures. 

A world of difference: Rapid advances occur by pairing genetic information with big data and artificial intelligence, but inequality creates a “haves” versus “have-nots” dynamic. Those who cannot access the latest therapies mistrust the overall health care system. 

Solving tomorrow’s problems: Smart and deliberate innovation is distributed broadly. With diseases more predictable, the focus of health care shifts to prevention. Innovation leads to remarkable new discoveries and also curbs increases in health-care costs. 

As leaders around the world think about how to respond to the Covid-19 outbreak, considering potential fault lines that could increase risks in health care and medicine will become even more important. This prospect highlights the importance of experts coming together across disciplines, as they did in Trust Colab, to identify potential threats and opportunities to enhance the system’s resilience.

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