More specifically, Dr. Chan’s speech bluntly illustrates that although high-income countries are ultimately at fault for both the depressed economy and climate change, they will hit developing countries the hardest. Still, unmitigated capitalism and its impact on climate change will be the demise for everyone if we do not change our means of living and values right now. From Dr. Chan's speech:
The contagion of our mistakes shows no mercy and makes no exceptions on the basis of fair play. Even countries that managed their economies well, did not purchase toxic assets, and did not take excessive financial risks will suffer the consequences. Likewise, the countries that have contributed least to greenhouse gas emissions will be the first and hardest hit by climate change.
The financial crisis and climate change are not the only markers of bad policies and failed systems of governance. The gaps in health outcomes, seen within and between countries, are greater now than at any time in recent history. The difference in life expectancy between the richest and poorest countries now exceeds 40 years. Globally, annual government expenditure on health varies from as little as US$ 20 per person to well over US$ 6000.
Dr. Chan’s words on free trade, capitalist venture and their incompatibility with promoting equal health are especially compelling.
If businesses, like the pharmaceutical industry, are driven by the need to make a profit, how can we expect them to invest in R&D for diseases of the poor, who have no purchasing power?
In far too many cases, economic growth has been pursued, with single-minded purpose, as the be-all, end-all, cure-for-all. Economic growth, as many believed, would cure poverty and improve health. This did not happen.
In short, for us to somehow think capitalism run amok would promote health across the globe is ludicrous. Capitalism’s foundation is based on employers trying to get as much out of natural resources and employees as possible for the lowest costs, and then selling products at a premium. This formula is antithetical to promoting equality of any kind. And putting the global economic crisis in perspective, Dr. Chan makes the following statement: “In affluent countries, people are losing their jobs, their homes, and their savings, and this is tragic. In developing countries, people will lose their lives.”
Because our society values financial wealth as the key indicator of success, we fail to place adequate value on helping others. In the end, a globalized capitalist economy with virtually no regulation exacerbates health disparities and has even come back to haunt the power elite.
The policies governing the international systems that link us all so closely together need to look beyond financial gains, benefits for trade, and economic growth for its own sake. They need to be put to the true test.
What impact do they have on poverty, misery, ill health, and premature death? Do they contribute to greater fairness in the distribution of the benefits of socioeconomic progress? Or are they leaving this world more and more out of balance, especially in matters of health?
I would argue that equitable access to health care, and greater equity in health outcomes are fundamental to a well-functioning economy. I would further argue that equitable health outcomes should be the principal measure of how we, as a civilized society, are making progress.
This world will not become a fair place for health all by itself. Economic decisions within a country will not automatically protect the poor or guarantee universal access to basic health care.
Globalization will not self-regulate in ways that favour fair distribution of benefits. Corporations will not automatically look after social concerns as well as profits. International trade agreements will not, by themselves, guarantee food security, or job security, or health security, or access to affordable medicines.
All of these outcomes require deliberate policy decisions.
Turning to global climate change, Dr. Chan’s comments are equally poignant, though disturbingly so. As I’ve noted before, climate change will influence high- and low-income countries alike with increasing frequency and intensity in the coming years. Dr. Chan notes that major outbreaks, such as SARS will not only be more common, but will be handled with less efficiency and effectiveness if less resources are put into health systems due to the economic crisis.
Several consequences for health have been identified with a high degree of certainty. Malnutrition will increase, as will the number of deaths from diarrhoeal disease. More storms and floods will cause more deaths and injuries, and cholera outbreaks will occur with greater frequency.
Heat waves, particularly in large cities, will cause more deaths, largely among the elderly. Finally, climate change could alter the geographical distribution of disease vectors, including the insects that spread malaria and dengue.
All of these health problems are already huge, largely concentrated in the developing world, and difficult to control.
Although climate change is, by its nature, a global phenomenon, its consequences will not be evenly distributed. Scientists agree that developing countries will be the first and hardest hit.
According to the latest projections, Africa will be severely affected as early as 2020. A decade from now, crop yields in some parts of Africa are expected to drop by 50%. By 2020, water stress could affect as many as 250 million Africans.
Imagine the impact on food security and malnutrition. Imagine the impact on food aid. In many African countries, agriculture is the principal economic activity for 70% of the population. Among Africa’s poor, 90% depend on agriculture for their livelihoods. There is no surplus. There is no coping capacity. There is no cushion to absorb the shocks.
So what’s the bottom line? This statement sums it up quite nicely.
Up to now, the polar bear has been the poster child for climate change. We need to use every politically correct and scientifically sound trick in the book to convince the world that humanity really is the most important species endangered by climate change.
(Photo courtesy of the World Health Organization)