1. This Chapter provides information as to how future health systems and medicines supply organizations will have to adapt to demographic and disease burden changes, more specifically to the global increase in chronic noncommunicable diseases.

2. Increases in life expectancy, changes in fertility and disease risk factors will contribute to a change in pharmaceutical use and health-care delivery over the next 20 years.

3. The DALY burden of chronic disease already outweighs that for acute disease and will do so over the next 20 years. Low- and middle-income countries in the WHO African Region are the only group of countries in which mortality rates due to acute disease are expected to remain in excess of those for chronic disease.

4. The relative contribution to the global burden of disease of HIV/AIDS, of TB and malaria, is relatively low. However, the regional impact of these three infectious diseases is still huge, specifically in the WHO African Region.

5. Mortality for chronic conditions is expected to increase over time due to increases in mortality rates in the WHO Regions of the Americas, South-East Asia and the Western Pacific, as their populations age.

6. The implications for the delivery and use of pharmaceuticals are profound, as there will be a continuing increase in demand for chronic disease medicines, regularly provided and used for the lifetimes of individuals with these chronic diseases.