Medicine and Health Care in the Anthropocene: Who Pays and Why?

The aim of this paper is to examine the nature of medicine and healthcare in the Anthropocene, in particular what exactly we mean by, and should aim to include in, the term ‘medicine’; how this is shaped by the characteristics of the Anthropocene; and what implications this has for ‘medicine’ as we move forward. It will consider how the provision of medicine may need to adapt to specific challenges such as the doubling of the average human lifespan since the Pleistocene, resulting in larger numbers of elderly, less economically active members of society against a socioeconomic context in which financial wealth is increasingly acknowledged as the main determinant of health across the lifecourse. As these less-contributory members need to be supported from within the existing resources and capital of their society, the paper will explore motivations for providing this support, both within populations and at an international level. The latter is particularly important as geopolitical tensions and conflict threaten to disrupt access to medicine and medical systems at a local level, leaving affected populations dependent on the international community for medical support. Lastly, by drawing on historical and archaeological evidence along with theories from evolutionary anthropology on the development of compassion, altruism and cooperation, it will make a case for considering cross-disciplinary approaches to human behaviour in the Anthropocene.