Global health security is again on everybody’s minds, with the latest Ebola outbreak in the DRC. As Laurie Garrett put it in Foreign Policy, the “new Ebola outbreak in the DRC Congo puts WHO and the global health system post-2014 reforms to the test”. It is thus quite likely that the DRC crisis (and the way WHO & others in the system respond to it) will feature prominently when the three WHO DG candidates make their final pitch (and unique selling proposition) in Geneva, before health ministers cast their vote.
No doubt, global health security is extremely important, and so are UHC (and many other vital global health goals in the SDG health era), but I’d argue that there’s another concern even more urgent. The current climate change acceleration (with among others, a melting Arctic, decades ahead of IPCC scenarios) which should make it clear to all concerned – self-proclaimed “global” and other – citizens that human civilization itself is at stake, this century (and beyond).
Against this dire backdrop, the next WHO DG thus has to be, first and foremost, a planetary health champion. And all the WHO DGs after him/her. Some friends and colleagues just consider “planetary health” as the latest fad, but as you might have guessed from the title of this piece, I disagree. The planetary health paradigm is the equivalent of Alma Ata in the 21st century.
So let me put it even more bluntly: the next WHO DG needs to have the guts to be a real “party pooper”, taking on the (now nearly hegemonic) ‘green growth’ paradigm of the global elite, or at least challenging the fact that it will suffice to avert catastrophic climate change. So please, don’t just interpret the new planetary health paradigm in a politically “palatable” way, Tedros/Nabarro/Nishtar, combining the (obvious) synergies with global health security (which are already on the G7/G20/…’s radar anyway) with an “easy” green growth discourse. Far more is needed, if you take planetary health in the 21st century and beyond seriously.
The reason is very simple, actually. It’s called “common sense”. If the “Precautionary Principle” is used in the EU for all sorts of regulations (for example, for what you get on your plate), we’d be incredibly dumb as a human species, not to start from this principle when trying to preserve our very habitat, the world. For the time being, though, we’re still – collectively – pretending we can have our cake and eat it too. Which is why we put all our eggs into the Paris Agreement & green growth basket, who give us a cosy feeling that at least we’re trying hard (that was before this disaster that dare not speak its name in the US got to power, of course).
To be clear, I’m all in favour of green growth, where possible, and the transition towards a low-carbon economy, deep decarbonization, etc…. better happen sooner than later. But it won’t be enough. The sense of urgency at the highest levels is still not what it should be (even if no doubt the Pentagon (and not just Ivanka) is also putting pressure on the US president now to stay in the Paris agreement). The destructive track record of global capitalism (and its key “partner in crime”, the global financial sector) also doesn’t bode well for all this to happen in the required time frame. Profound social transformation will also be needed, as well as a transformative change of the core principles & “values” permeating the global economic system. And it’s bloody urgent.
So let me frame in very simple terms what the next WHO DG needs to say, in my humble opinion: the American dream has to die. And the Chinese dream. Etc. It is just not possible, billions of people chasing their own version of the American dream in the coming decades, even with massive investments in clean energy. This is a war, no less, so like in every war, some rationing will be necessary, as well as massive global redistribution. Or perhaps, more accurately (and politically more palatably), the next DG has to say the following: a very different kind of American/Chinese/Nigerian/… dream is required, sooner rather than later.
Clearly, somebody in a global leadership position has to tell the world we can’t just have it all. The pope does so, yes. But the WHO Director-General is excellently placed too, given WHO’s focus on ‘the right to health’ (including for future generations I’d hope). There will be no right to health to claim whatsoever if we destroy our very habitat. If nobody tells this to people, over and over, then we can all just conveniently pretend we’re going strong in the fight against climate change. People like Michael “Optimism is a moral duty” Bloomberg, as much as I appreciate his efforts in this respect, (and other business-friendly climate “Pied Pipers of Hamelin”) will certainly not tell us otherwise.
The WHO DG doesn’t need to be a doomsayer. But he/she needs to say, eloquently and bluntly, what most people know now, or at least feel deep down, although many of us frantically try to suppress the thought while leading our daily lives. If we don’t change our ways, the bubble will explode, sooner or later. When that happens, it won’t be pretty.
The current US president won’t say it. Leaders in emerging economies won’t say it (as their citizens still dream of catching up with western lifestyles, understandably). Jim Kim doesn’t say it. So if not the WHO DG, who will say it?
This is the main war we need to fight in the coming decades, and we need a war-style effort as soon as possible, in each and every country. An organized approach to degrowth in countries that – at a collective level at least – already have more than enough, sustainable growth in countries that still need it very much to reach the basics of a human and dignified life; and redistribution, on a global scale, are some of the necessary ingredients of this war.
We can live better lives, yes, but only if we become more ‘human’ again- and share what we have with people who have less, live more slowly (instead of the frantic pace of living now, competing with everybody around the globe in a sort of 21st century version of a Hobbesian world, …), share work instead of pushing many (not sufficiently “efficient” people) out of the labour market, ….
The next WHO DG shouldn’t just get together at High-Level breakfasts with Angela Merkel, Bill Gates, Seth Berkley, Tim Evans and other Jim Kims to discuss global health policy. He/she needs to engage, structurally, with the ordinary citizens who already feel the impact of planetary ill-health in their daily lives. And he/she should certainly also invite the likes of Kate Raworth, Tim Jackson and other Christian Felbers to the tables in Geneva, as their ideas will be vital when trying to conceive a global economy that respects planetary boundaries and ensures a dignified life for all.
So no, I don’t think that “run-of-the-mill” campaign statements like “On climate and environmental change, I will support national health authorities to better understand and address the effects on health with a particular focus on countries such as small island nations most affected by these events” fit the planetary health bill. Many of these WHO DG candidates still seem to argue, mainly, for preparing health systems for climate change and other harmless sounding (needed but nowhere near sufficing) policies – making health systems “more resilient”, anyone? Maybe the three candidates don’t want to make the powers that be (that still have to vote them in ! ) anxious about their firebrand and revolutionary potential, so maybe it’s just tactics. But I certainly hope that after his/her election, that’ll change.
In sum: the next WHO DG has to mince no words on the planetary health challenge we face. We’re at war. Not just with the 0.01 %, but with ourselves as well.
And yes, let the philantrocapitalists and other “global health plutocrats“ do at the same time what they’re good at (I remember from my backpacking days that you always need to have a plan B 🙂 ): fund research into carbon capture and storage, all sorts of clean energy innovation (including mechanisms to cope with market failure). And let them also fund research into geoengineering, as I’m afraid we will need it.
But that’s not the role of the WHO Director-General. The next WHO DG must be a planetary health champion, and argue for profound social transformation and a different kind of dream for human beings. A dream that would make us all more human again. We need “real” planetary health leadership from the WHO DG. And we need it soon. The candidate who can deliver on this would get my vote.
(I’d give him/her 12 points, actually, if I could! Heck, I’d even start yodeling 🙂 )