As we all live longer, the world needs a health system revolution to cope with ageing patients Onil Bhattacharyya, University of Toronto All over the world, people are living longer. A large part of this is due to improved treatment for illness; we can see this in the reduction in death rates from cardiovascular disease and the 32% reduction in mortality from chronic obstructive pulmonary disease worldwide in the past 20 years. There is no doubt that our prolonged life expectancy is a good thing, but improvements in treatment means that people are often living with many more chronic conditions, which can be very challenging to manage. As it stands, health systems all over the world are built around institutions, not people, and are not equipped to manage the complexity of patients with multiple diseases, who often live with mental health issues and the personal burden and social isolation that comes from being ill. Those living with multiple chronic conditions see their doctor often, are admitted to hospital more often, and receive support at home, but this is generally provided by different institutions that work separately from one another. This means the patients’ needs are often not met. This is already a major issue in high-income countries, but it’s made even worse in middle-income countries such as China and India, where the number of people with multiple chronic conditions is rising. The rates of diabetes, cardiovascular disease and osteoarthritis are increasing due to increased age, dietary changes, and sedentary lifestyles….