Chronic kidney disease (CKD) affects approximately 850 million people globally, with CKD projected to become the fifth leading cause of years of life lost by 2040. The incidence and prevalence of end-stage kidney disease (ESKD) vary significantly across regions, with Asia experiencing some of the highest rates. Despite advancements in kidney replacement therapy (KRT), access remains inequitable, with low-income countries facing significant treatment gaps. In 2010, an estimated 2.284 million people died prematurely due to lack of KRT access, predominantly in Asia and Africa. By 2030, the global demand for KRT is projected to more than double, reaching 5.439 million patients, with Asia accounting for nearly half of this growth.  


The economic burden of dialysis is substantial, consuming 2–3% of healthcare budgets in high-income countries while serving less than 0.03% of the population. Cost disparities exist between hemodialysis (HD) and peritoneal dialysis (PD), with PD often being more cost-effective, particularly in high-income countries. For instance, Hong Kong's "PD First" policy has demonstrated the sustainability of home-based therapies, with 68% of dialysis patients on PD. However, in low-income countries, PD costs remain prohibitively high, exacerbating accessibility challenges.  Home based dialysis therapies are optimal modalities balancing the cost as well as the quality of life and outcome of the patients


Addressing the global burden of kidney disease requires multifaceted strategies, including policy interventions to promote cost-effective therapies, investments in healthcare infrastructure, and international collaboration to expand KRT access in underserved regions. Sustainable solutions must balance economic constraints, patient preferences, and clinical outcomes to ensure equitable care for the growing ESKD population.  Prevention of CKD and use of kidney transplantation are important means to help address the long term problem of this global epidemics

A sustainable future in medicine and health requires global collaboration. This is particularly so in the face of pressing global health challenges such as those impacted by climate changes, emerging infectious diseases, anti-microbial resistance, biotechnology development and health disparities. There is a need to accelerate health innovations and data sharing. For example, the World Health Organization COVAX programme has been instrumental in developing and distributing vaccines during the COVID-19 pandemic. Similar models can be applied to other infectious diseases and as a preparation for future pandemics. Such sharing of knowledge and technologies e.g. gene editing and synthetic biology may also lead to breakthroughs in the treatment of genetic disorders, cancers, and inflammatory and metabolic diseases. Besides, data sharing through platforms like the Global Health Data Exchange, Global Burden of Disease, Human Genome Project etc enable researchers and healthcare providers worldwide to foster evidence-based disease prediction and monitoring, drug development, and health policy and decision making. Equally important is capacity building e.g. training for healthcare workers, particularly for low and middle income countries. Finally, governments should also concentrate their efforts on green biotechnology such as the development of eco-friendly biomaterials and medical devices and sustainable drug production methods.

Achieving Universal Health Coverage (UHC) requires a resilient, responsive, and well-resourced healthcare system. While public healthcare services form the foundation of UHC, private hospitals can play a complementary role in expanding capacity, improving access, and driving innovation-particularly in systems facing resource constraints or rising demand for specialized care.
This presentation will explore how private hospitals, including investor-owned facilities, can help fill critical gaps in public systems without undermining the principles of equity and access. By leveraging their ability to scale services, invest in new technologies, and offer additional care options, private hospitals can support public sector goals while maintaining high standards of quality and patient-centered care. Through case studies from diverse healthcare systems, we will examine how well-designed partnerships and policies can harness private sector strengths in a way that aligns with UHC principles, ensuring that healthcare remains accessible, efficient, and sustainable for all.