Global health policy in the 21st century: Challenges and opportunities to arrest the global disability burden from musculoskeletal health conditions

Abstract

The profound burden of disease associated with musculoskeletal health conditions is well established. Despite the unequivocal disability burden and personal and societal consequences, relative to other non-communicable diseases (NCDs), system-level responses for musculoskeletal conditions that are commensurate with their burden have been lacking nationally and globally. Health policy priorities and responses in the 21st century have evolved significantly from the 20th century, with health systems now challenged by an increasing prevalence and impact of NCDs and an unprecedented rate of global population ageing. Further, health policy priorities are now strongly aligned to the 2030 Sustainable Development Goals. With this background, what are the challenges and opportunities available to influence global health policy to support high-value care for musculoskeletal health conditions and persistent pain? This paper explores these issues by considering the current global health policy landscape, the role of global health networks, and progress and opportunities since the 2000-2010 Bone and Joint Decade for health policy to support improved musculoskeletal health and high-value musculoskeletal health care.

Keywords: Global health; Health system; Musculoskeletal; Network; Non-communicable disease; Pain; Policy.

Fig. 1

Schematic of the factors that influence health policy, adapted from Shiffman and Smith [134].

Fig. 2

Graphic of the interdependency of the Sustainable Development Goals. Reproduced with permission from the International Science Council, Paris, France [68]. The graphic is based on an analysis of four SDGs and their interactions with other goals: SDG2: Zero Hunger; SDG3: Good Health and Well-being; SDG7: Affordable and Clean Energy; and SDG14: Life Below Water.

Fig. 3

The burden and impact of disease and what cannot be achieved with existing high-value care makes clear the priority research agenda. What is not being achieved in routine practice makes clear the avoidable burden that can be reduced with the better application of existing interventions with more priority and resources; i.e. macro-level reform. Figure adapted from Woolf [106] and reproduced with permission from The Journal of Rheumatology Publishing Company Ltd (permission licence 20–0054).