Global demographic transitions—including aging populations and declining fertility rates, youth bulges, and complex migration patterns—pose significant challenges to health systems worldwide[1],2. These will result in structural changes with around 55 per cent of the world’s population living in towns and cities, projected to be 70 per cent by 2050[2]. However, changing demographics will impact health systems if we do not prepare; for example, countries with the most increase in non-communicable diseases, are least prepared to address in terms of their health systems[3]. Investing in health systems will be critical to tackle these challenges[4]. Key issues on demographic transitions relate to changing disease burden, healthcare infrastructure and access, aging population and long-term care, workforce and economic impact, maternal and child health, health policy and financing and technological advancements. In addition, there is a need to think of a life course approach to health and well-being and how health systems can be designed for this purpose[5]. Overall, there is therefore a need for a holistic approach to adapt health systems to respond to the shifts in demographics.

[1] PMAC 2026 overarching concept note: 1. PMAC2026 Concept Note as of 24 Jan (1).pdf

[2] Shifting Demographics | United Nations

[3] The Changing Demographics of Global Health

[4] Global health 2035: a world converging within a generation - The Lancet

[5] The life-course approach: from theory to practice: case stories from two small countries in Europe