Published on 6 Jan 2026

The World In 2050

Professor Joseph Sung
Dean, Lee Kong Chian School of Medicine

I am reading a book, “The World in 2050: How to think about the future” by Hamish McRae. The author published a similar book some 30 years ago “The World in 2020”, in which he predicted a few things for the next 30 years (one generation). As it turns out, three features he predicted dominated the world in the last three decades: 1. Brexit; 2. Political rupture in the US; and 3. A Pandemic hit the world. As a veteran journalist and economist, he sees things predominantly from a political and economic perspective.

In The World in 2050, McRae talked about the shift of economic gravity from Europe and US to Asia. He depicted the problems of climate change and environmental disaster; the shifting ideas about how society should be organised (from democracy to the rise of a new middle class ruling the world); as well as the scenario where politics and religion shake the world. These are no surprises for many. However, he pointed out that the technology conundrum in 2050 is the most difficult piece of the future to predict. There is no crystal ball for this.

Image Credits: “Sci-fi city meets gnarled nature” by Ruth Hartnup, CC BY 2.0

Does technology bring good and improvement to daily living? Intuitively the answer must be Yes! But is it true? Are people happier with the internet and smart phones than before? Is health and wealth being distributed more evenly with less inequality being created? The honest answer would be… We Don’t Know!

The author argued that “every previous period of rapid technological change has seen increased living standards for the majority of people throughout the developed world since Industrial Revolution set the whole process in motion. There had, sadly, been groups of people who had their jobs displaced and lost out; there had been environmental and health costs of technological advance. But overall, in the advanced countries, living standards have risen steadily since 1800s… but (now) this is not what the figures show. Median earnings in the US have barely risen in real terms since 1970s. In Europe the picture is more varied, but certainly since 2007, it has at best been flat.”

In many countries, those at the top of the “food chain” are doing well, but for the middle and lower social classes, this is a disheartening time. Wealth disparity is rising, especially in high-tech countries such as the US and Europe. Robert J Gordon in his book “The Rise and Fall of American Growth” has pointed out that the next generation of Americans may be the first who has a lower standard of living compared to their parents. Modern technologies disproportionately reward the high-skilled, highly educated people. They become owners of data, intellectual property and capital. On the other hand, routine and low/middle-skill jobs are robotised, leading to stagnation for lower/middle-skilled workers. This is a “winner-takes-most” labour market. Furthermore, digital technology favours scalability and network effect. As a result, wealth is concentrated on a small number of people and their companies.

With the advent of digital health and precision medicine, we are all excited about better drugs and more powerful equipment. However, health technology also comes with high costs and demand for IT skills. If we don’t set the priority right, we might see that health technology benefits mostly the “can-afford” and “can-do” population leaving the under-privileged group deprived of the potential benefits of health technology.

The health industry is very different from the manufacturing industry. We can fully automate a factory, but we cannot robotise a hospital in its entirety. Service industry – the health sector in particular – must be crafted for individual needs at multiple levels. Therefore, we should not just invest in genomic profiling, big data analytics, wearable electronics etc, without thinking about whether these would benefit everyone at different socio-economic status and cultural background.

“Technology is inequality-amplifying by default, but policy can modify the situation,” McRae said. He pointed out that through investment in education and reskilling programmes, progressive taxation and improved access to technology, inequality can be mitigated. In clinics and hospitals, healthcare providers need to be aware of the problem of inequality of service and care. Value-based practice should be emphasised and humanity of care cannot be ignored.

While learning and applying technology to healthcare, we must certainly think about health equality.