Universal health coverage (UHC) is one of the core Millennium Development Goals adopted in the United Nations and the World Health Organization’s (WHO) strategic agenda. Surprisingly, even as we approach the year 2021, achieving UHC to a reasonable extent and protecting the most vulnerable segments of native populations remains a challenge even for the richest of nations (1). In recent years, traditional world health sector establishments have assumed that most of the market demand for drugs, medical technologies, and services took place in rich Western societies, including Japan (2). Most of the market supply in terms of innovation and technology production led by multinational businesses, such as Big Pharma companies, also took place in these nations (3, 4). Back in 2000, WHO estimates on national health systems worldwide ranked the top ten systems, seven of which were European and only three of which were Asian (Japan, Oman, and Singapore) (5). Due to urbanization on a mega scale, however, growth in living standards and affordability of medical care and medicines can be seen throughout rapidly developing regions (primarily the BRIC nations (Brazil, Russia, India, China) and Southern and Eastern Asia) (6). In November 2018, a public announcement by the Chancellor of Germany, the largest EU economy, emphasized that most of the essential innovation in this area is now taking place either in North America or Far East Asia, far surpassing the European Union. All of these changes reflect heavily on the market demand for drugs, medicinal devices, services, and long-term care worldwide (7).
Until the early 2000s, the global pharmaceutical market was still heavily dominated by the USA, representing approximately a 4% share of the global population and almost 50% consumption of brand-name medicines expressed in value-based turn over. Japan was ranked second in the same terms, preserving this position for a very long time. The contemporary pace of pharmaceutical innovation remains to be dominated by Western, Japanese, and Israeli-based multinationals (8). On the other hand, demand is exploding among emerging
economies and all major investors are aware that the lion’s share of growth opportunities as we approach 2050 will take place in these emerging economies, outside of mature high-income Organization for Economic Co-operation and Development (OECD) member nations (10). Emerging markets, such as the BRIC nations or EM7 (BRIC + Indonesia, Mexico, and Turkey), remain the core focus of foreign capital investment in long-term strategies and forecasts (9).
