The planetary and the personal: (almost) 3 decades of work in health

AUMSS: Sowing the Seeds – Growing New Zealand’s future

doctors July 29, 2012

A/Prof Colin D ButlerNational Centre for Epidemiology

and Population Health

2

Main themes

public goods, norms, institutions

emerging diseases

gambling with the planet and global health

I have a dream

3

Public goods

Safety of a bridge (infrastructure)

Willingness to share information, common

language

Functioning banking/insurance/justice system

Public health (eg clean water, air, health services)

The sun

The planetary environment, ecosystem “services”

4

1. Nigeria 2.Tasmania 3. India

4. Earth 5. Future Health

6. Solutions

I have a dream

5

“As early as my first years at University I had begun to feel misgivings about the opinion that mankind is constantly developing in the direction of progress.

My impression was that the fire of its ideals was burning low without anyone noticing it or troubling about it.”

Albert Schweitzer (1875-1965)

6

7

1. Nigeria

8

Emerging diseases – a call for more

critical thought

9

335 Emerging Infectious

Disease “events”

Jones et al. Nature, (2008)

Lassa No reflection of disease burden,

existing or future

10

2. Tasmania

11

The Lancet, July 2012

12

3. India

Prevalence of stunting among children under 5 years old in India by state

Black et al, Lancet 2008

13

Picture UP

14

www.bodhi.net.au

16

17

Rohingya: forgotten people of Burma

18

A young unregistered refugee girl at Kutupalong camp uses a machete for splitting firewood to sell – her family’s only income.

(Richard Sollom, Physicians for Human Rights)

19

4. Earth

20

Sea Level: 1993-2011

Rainfall intensity : 1900-2011

Arctic sea ice: 1979-2012

Earth system observations

Land-ocean temperature: 1880-2011

uncertainty

“Weather Extremes Leave Parts of U.S. Grid Buckling”New York Times, July 25, 2012

“We’ve got the ‘storm of the century’ every year now,” Bill Gausman, senior vice president, Potomac Electric Power Company

road, rail, flights, nuclear power, electricity grids .. hospitals .. Health21

22

McDonalds & Coca Cola,– major sponsors of London Olympics! (& the next two, at

least..) and Cadbury’s for 2012

Raw data: FAO

oil

2nd price spike: oil price + climate change?

23

Two food price spikes .. Is the era of cheap food over?

Drought affected corn, Missouri, July 2012

"We're moving from a crisis to a horror story," said Purdue University agronomist Tony Vyn. "I see an increasing number of fields that will produce zero grain.“ (July 18, 2012)

24 24

Divided We StandWhy Inequality Keeps Rising© OECD 2011

NZ

Public goods erosion - corruption

• FIFA, Murdoch, Global financial crisis, “Banksters”, banking regulators, Goldmann Sachs, Swiss Banks, British Banks, Madoff, kleptocracy,

• Some environmental agreements

• Canberra hospital

• fake drugs, fake Yellow Fever immunization cards

• “medical industrial complex”

25

26

Giving birth by the light of a mobile phone –2012

5. Future Health

Civilisation: a system at risk?

energy, raw materials: emerging scarcity

economic system: archaic

inequality: civil stress, terrorism, fascism, war

27

28

rapid public health response*limited antimicrobial resistance, but increasing nutrition fair

public health breakdownnutrition worseliving conditions worseconflict increasing?

Could civilisation failure “breed” a

megapandemic?

* For diseases perceived as major threats to developed countries

29

“Demand will create a parachute”

29

6. Solutions

Suppression, science resistance

Cognitive, emotional overloadBarriers

Enablers

sustainability and public health

Public health precedents (infectious diseases, sanitation, health services, “health for all”)

Allies (civil society, some military – yes .. not a typo!)

energy, soil, new technologies

3030

I have a dream

31

MovementA large global civil society network of health activists supportive of Health for All - organised to combat the economic and political causes of deepening inequalities in health worldwide

 

The People’s Health Movement

A large global civil society network of health activists supportive of Health for All - organised to combat the economic and political

causes of deepening inequalities in health worldwide

33

34

Global Energy Assessment, 2012Switch rich country energy subsidies for fossil fuels

& nuclear to renewables and carbon capture

Solar (1975-20072007-10)

NUCLEAR

US$/kwH(2005

dollars)

35

UNEP: Global Environment Outlook IV, 2007

UN Human Rights Declaration meeting; Eleanor Roosevelt, 1947

36

What can one person do?

think, act, behave, purchase ethically

join with others

tithe your effort (10%)

a spiritual dimension is likely to help

37

reverence for lIfe

38

.. sunset, making our way through a herd of hippopotamuses, there flashed upon my mind,

unforeseen and unsought, the phrase .. The iron door had yielded: the path in the thicket had

become visible” Albert Schweitzer