The Future of Healthcare in Europe

Tõnu Esko
Vice Director of Development and head of Estonian Biobank Innovation Center at Institute of Genomics, University of Tartu

Tõnu Esko, European Regional Board advisor for Movement Health 2030, helping to shape the Movement’s work in Estonia, shares his thoughts on the future of healthcare in Europe and Movement Health 2030’s transformative potential.

Society is finally waking up to the potential of genomics to bring about more preventive, holistic approaches to healthcare

Tõnu Esko
Vice Director of Development and head of Estonian Biobank Innovation Center at Institute of Genomics, University of Tartu

COVID-19 may have placed huge burdens on Europe’s healthcare systems, but another – related - crisis is just around the corner: that of rapidly aging populations.

Citizens over 65 years old will total 129.8 million by 2050, with a 56.1% rise in the number of people aged 75–84 years old (Eurostat, 2020). As their numbers increase, so will healthcare costs.

Although the elderly make up only around 15-20% of the current EU population, they are responsible for over half of healthcare expenditure (Kalseth, J., et al., 2020). As the pandemic has amply demonstrated, our current healthcare systems, solutions, and practices are not yet resilient enough to cope with this impending responsibility.

But there are plenty of opportunities for change. Firstly, society is finally waking up to the potential of genomics to bring about more preventive, holistic approaches to healthcare. At the Estonian Biobank and Institute of Genomics in University of Tartu, we have been trying to drum up enthusiasm about genomics for the past 20 years. Now, genomics is moving into the mainstream and being commercialised.

As the public engages with genomics more and more – with the likes of consumer DNA home tests, such as 23 and me – policymakers are beginning to recognise its potential to drive a paradigm change in public health management.

How? By shifting from treating patients to helping citizens live a long and healthy life via personalised healthcare.

couple walking

In Estonia, we are integrating genetics into health prevention programmes so that every citizen has their own genetic profile and knows their health risks. We use this baseline genetic information to separate people into different risk categories and offer them tailored lifestyle interventions to prevent them from falling ill.

Of course, genomics can only indicate how likely you are to develop health conditions; it does not signal that you will definitely fall ill. But it can certainly help people to live their lives in a more data-driven way and make healthcare more precise and personalised; if doctors know your genetic make-up, they can cater treatment to your unique body.

For citizens, this means a longer, healthier life; for healthcare systems, it could massively reduce preventable disease burden and, in turn, healthcare spending. This is a perfect example of how data-focused innovation can change how we practice and fund healthcare, resulting in better healthcare for all.

Secondly, while the pandemic has been a terrible experience, it has also opened our eyes to the potential of digital solutions and telemedicine to transform healthcare access and quality. Lockdowns have not exactly been enjoyable, but they have shown us that we can do a lot remotely – from staff meetings to doctor’s appointments. The pandemic has also sparked new collaborations between different stakeholders - policymakers, healthcare providers, and innovators – driving the integration of digital solutions into healthcare models and the development of more innovation-oriented health policy.

man on laptop

And this brings me to my last point: the enormous potential of cross-border collaboration to accelerate the adoption and scaling up of innovative healthcare solutions across the continent. Europe has a unique political model – its union – that enables us to more easily share resources and expertise. We must capitalise upon Europe’s cross-border scalability potential to make our healthcare systems more resilient. Movement Health 2030’s ability to bring together different regions and mindsets could be key here.

Why? Because for healthcare transformation, we need different stakeholders, especially policymakers, to collectively prioritise innovating healthcare. By coming together, we can drive forward the legal and policy changes needed to adopt disruptive innovations and improve digital and health literacy at scale.

Of course, we still need to ensure that every solution is adapted to the local context. But it is only through this collaborative scaling that we can build resilient and thriving European healthcare systems capable of coping with demographic change.


Kalseth, J., Halvorsen, T. Health and care service utilisation and cost over the life-span: a descriptive analysis of population data. BMC Health Serv Res 20, 435 (2020).