ABSTRACT:
Strategic foresight is essential in public health policy processes to address the inherent unpredictability of health threats, demographic shifts, and systemic interdependencies that linear planning cannot handle effectively. Traditional policy-making often extrapolates from historical data and current trends, leaving systems vulnerable to disruptions like pandemics, climate impacts, or technological upheavals that reshape disease patterns and care demands. Public health policies can benefit the use of foresight at key stages—agenda-setting, option appraisal, implementation, and evaluation—to build anticipatory capacity rather than reactive fixes. Horizon scanning identifies early signals of emerging risks, such as antimicrobial resistance or mental health crises, ensuring policies target root causes before they might further escalate. Stronger signals, such as ageing, climate change, technological progress and polarization are of even importance to depict scenarios as plausible, systematic and consistent pictures of the future. Foresight explicitly confronts cognitive uncertainties (gaps in evidence about future trends) and normative uncertainties (conflicting values on priorities like equity versus efficiency), fostering robust decisions that perform well across multiple scenarios. Scenario development and stakeholder participation then refine these into flexible strategies, aligning diverse actors and revealing blind spots in current approaches. By embedding foresight, public health policy processes shift from short-term firefighting to resilient, adaptive governance, optimizing resource allocation and cross-sector collaboration for sustained health gains amid global volatility. This need is particularly acute in contexts like the Netherlands, where ageing populations and environmental pressures demand proactive, evidence-informed foresight.