Title page 1

Contents 5

Acknowledgements 4

Foreword 7

Executive summary 8

1. Introduction to futures thinking and strategic foresight 11

1.1. Futures thinking and strategic foresight 11

1.2. The importance of futures thinking 11

1.3. Introducing the foresight brief series 12

1.4. The ITU approach to strategic foresight 13

1.5. Objectives of the 'Transforming health care for tomorrow' foresight brief 14

1.6. The case for health care 15

2. Sensing in a volatile, uncertain, complex, and ambiguous world 18

2.1. Exploring signals of change for a health care landscape 18

2.1.1. Evolving social landscape 18

2.1.2. Evolving technological landscape 20

2.1.3. Evolving economic landscape 21

2.1.4. Evolving environmental landscape 23

2.1.5. Evolving political landscape 24

2.1.6. Evolving legal landscape 26

2.1.7. Evolving ethical landscape 28

3. Analysing and refining key drivers of change 31

3.1. Drivers and critical forces influencing future evolution of health care 31

3.2. Drivers 32

3.3. Weak signals with disruptive potential 35

4. Visualizing possible future scenarios 38

4.1. Key drivers for exploring potential future scenarios 38

4.2. Exploring a range of scenarios 39

4.3. Envisioning scenarios through the interplay of key drivers 40

4.4. Wildcard events 47

5. Prioritizing the desired scenario 50

5.1. Four transformational scenarios 50

5.2. Visualizing transformational scenarios 51

5.3. Stress-testing the scenarios 59

5.4. Enablers of the desired scenario 60

6. Actioning the desired future 64

6.1. A roadmap to maturity 64

6.2. Actions to drive future-ready health care systems 66

7. Managing the ecosystem 69

7.1. Strength in stakeholder collaboration 69

7.2. Activating implementation mechanisms 71

Annex 74

Abbreviations 77

Glossary 78

References 80

Table 1. Drivers shaping the future of the health care landscape 32

Table 2. Drivers selected to explore the interplay shaping scenario development 39

Table 3. Stress-testing the shortlisted scenarios against the objectives of the foresight study 59

Table 4. Indicative measures of success 62

Table 5. Proposed roadmap to realize the desired vision 66

Table 6. Platforms and structured mechanisms for stakeholder collaboration 72

Figure 1. VUCA 12

Figure 2. Interlinked objectives intended to shape development of health care 15

Figure 3. Generational improvements in health outcomes, 1970-2025 16

Figure 4. Potential trajectories and outcomes 40

Figure 5. Navigating diffusion of technology benefits x mitigation of risks associated with technology 41

Figure 6. Navigating health financing x public sector capacity x climate adaptation 43

Figure 7. Navigating responses to the stressed other x trust in public institutions 44

Figure 8. Navigating public sector capacity x economic paradigms 46

Figure 9. Safe and shared 51

Figure 10. Adaptive stewardship 53

Figure 11. Civic mutual aid 55

Figure 12. Public-purpose mission era 57

Figure 13. Six pillars of an integrated framework for action 65

Figure 14. A well-connected ecosystem 70