Health service support in the future operating environment 2035.

The period to 2035 is likely to be characterised by instability between states and in relations between groups within states. It is predicted to include climate change, rapid population growth, resource scarcity, resurgence in ideology, and shifts in power from west to east. Many of these changes are likely to have an impact on the health of civil societies and those military personnel deployed by states to counter these challenges. This paper considers the potential impact of emerging global strategic trends on health service support (HSS) in the Future Operating Environment 2035. Global Strategic Trends-Out to 2040, The Future Character of Conflict and NATO Strategic Foresight Analysis Report 2013 provide the foundations of the paper. The study concludes that future impacts on HSS are neither completely predictable nor predetermined, and there is always a possibility of a strategic shock. Knowledge of vulnerability, however, allows an informed approach to the development and evaluation of adaptive strategies to lessen risks to health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.