IHP news #416
By The editorial team on April 28, 2017 Dear Colleagues,
Last weekend’s first round of the French presidential elections makes up the – not entirely surprising – backdrop of this week’s intro. In the second round, the French will get to choose between a French ‘Third Way’/’Yes we can!’ clone favoured by Goldman Sachs (and considered by Piketty as ‘the candidate of the Europe of yesterday’) on the one hand and somebody with a strong xenophobic & extreme right pedigree on the other hand. Not exactly an enticing choice, and it appears many French feel the same, even if most mainstream media (and the stock markets) already seemed jubilant about the (very likely) victory of Macron in the next round. Do the math yourself. About 20 % abstentions in the first round (with 11 candidates to choose from!), and out of the votes, more than 21 % for Le Pen, almost 20 % for radical-left wing candidate Mélenchon, 6.5 % for Hamon, .. This all points towards huge alienation versus “the system” and “the establishment” on both sides of the spectrum – sorry I have to use so called “populist” jargon, but there’s no other way to put this. So while I understand that some people in Brussels, Berlin and elsewhere are fairly happy with the outcome of the first round, I hope they also understand that European leaders only get one more chance to get it right in the coming years (instead of going for ever more ‘structural reforms’ that somehow always seem to end up in making the 0.01 % even richer, through the ‘magic of the markets’). If they blow it, the “EU as we know it” will be toast. Biased as I am, I don’t expect much from Macron and what I’d call “his kind of people”, but as I also don’t want the EU to implode altogether, I hope he (and his fellow leaders) can surprise European citizens in the years to come. They’ve certainly been warned enough over the past year.
Focusing then, more specifically, on global health, the French elections also provide an ominous warning. It’s clear that Mélenchon’s ugly truth,” If a system leads to a situation whereby the 8 richest people own as much as half the world’s population, the system is inherently wrong and evil “ is hard to argue with. Global health’s original sin – well, at least its sin of the past 20 years – is that Bill Gates isn’t just “the face” of global health for many citizens in the world, but also happens to occupy the number one spot on this list of extremely wealthy individuals. Put differently, in spite of the Gates foundation’s (mostly commendable) track record on global health in the past few decades, he still remains the very symbol of a perverse capitalist system – if you share Mélenchon’s analysis at least. Somehow, even now, many with power in the global health community have trouble to admit as much and thus refrain from asking fundamental questions about our economic system, which is why we’re all so fond of ‘inclusive globalization’ rhetoric, want to boost ‘resilience’ endlessly, love to focus on ‘leaving no one behind’ and the very poor while ignoring increasing inequality, innovate till we drop, are always on the lookout for PPPs and other “win-win-win” mechanisms, and wish these annual Oxfam reports would just go away. As long as the global health community (that is, first of all, the Tim’s, Jim’s & Seth’s of this world) don’t frame the fight ahead in these terms – it’s the economic system itself that needs to change fundamentally, a bit tweaking here and there won’t do it – we will not realize ‘health for all’, ‘health systems for all’, let alone ‘planetary health’ by 2030 or beyond. We better admit we’re in the “damage control business” then rather than using all this lofty rhetoric, fancy HPSR triangles & cubes, & new paradigms. Still, a new ‘triangle that moves the planet’ seems sorely needed. Anybody?
On the bright side, there’s no way people will continue to accept this gross inequity, having all the information they need now. Soon enough the (ever increasing) precariat and (increasingly squeezed) middle class will arrive at a similar conclusion: that they’re being screwed big time. How they react will then depend on how they’re wired, but chaos it will be, as Jim Kim seemed to understand at the Spring Meetings (although hinting more at future waves of migration). So yes, Macron et al, you certainly have your work cut out to make globalization work for everybody. The same goes, by the way, for the many globalization cheerleaders among our decision makers who, whenever it suits them better, like to proudly plant their bilateral aid flags instead. They’re emperors without much clothes. But let’s keep the latter issue for some other time.
On a merrier note, there was quite some big news for the HPSR community this week, with the launch of the first (and very interesting) World Report on HPSR in Stockholm, and the announcement of the theme for the 5th global HSR symposium in Liverpool, “Advancing health systems for all in the SDG era”. 40 years after Alma Ata, the topic seems well chosen, although these days you don’t really know how the world will look in a year from now. We might still be heading for a “Health Systems for None in a Dirty Bomb and Mad Men era” instead, with a bit of bad luck. The North-Korean crisis certainly looks worrying. Fortunately, at least some observers think China does have plenty of leverage over the North-Korean elite – “just make sure their girlfriends and mistresses can’t go to Beijing anymore to buy Dior bags and they’ll back down”. That’s a killer argument for Ivanka Trump, I’d say, so maybe she can convince dad not to do anything stupid? “In Ivanka we Trust” now, whether it’s in the battle against climate change, for female empowerment or to help avoid nuclear crises. Clearly, we’re in deep shit.
In this week’s IHP Featured article, Renzo Guinto explains why it’s important to build the social foundations of planetary health sooner rather than later.
Enjoy your reading.
The editorial team
(you find the pdf-version of the newsletter here: IHPn416 )
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