IHP news #489
By Kristof Decoster on September 21, 2018
With the Liverpool HSR symposium, themed “Advancing health systems for all in the SDG era” now fast approaching, it’s safe to say we all already agree on at least one thing: our era is one of huge changes, some positive, others downright scary. Below just a few examples of the massive shifts we’re facing in the years and decades ahead.
Who would have thought, that less than 10 years after ‘Prosperity without Growth’ (Tim Jackson), some of the post-growth thinking is (already) making inroads in the European parliament and at least part of public opinion? True, we’re nowhere near a majority on this, and time is unfortunately not on our side, but soon, I hope (I’m a firm believer in self-fulfilling prophecies), a critical mass of people will believe, like Jackson, that “Children don’t keep growing, and neither does the planet & its ecosystems. Growth delivered great things but the dark side of it is taking over.” Star Wars fans will surely agree. Another quote from Jackson this week, catering less to Star Wars fans perhaps: “ Secular stagnation is emerging as the strongest reason for thinking about a post-growth economy… Rising inequality is a recipe for instability, not just in economic terms, but also in political terms.” We know a thing or two about that now in Europe (and the US). And yes, this cannot just remain a European (or even Northern) conversation, as economist Paul De Grauwe (not a post-growth fan) rightly pointed out that for the time being, “it appears the rest of the world wants to keep growing to reach a European consumption level”. And who could blame them? Still, even if (more) growth is indeed needed in many parts of the world, certainly in LICs, this should not remain an isolated European debate (with a touch of Latin American “buen vivir” here and there). In many ways, it’s just common sense on a finite planet. And perhaps one of the “Alma Ata 40 years later” conversations that should happen in Liverpool. On a darker note, if you thought Big Tobacco, Big Soda and Big Oil were already fearsome opponents, you can imagine what the ‘Big Growth’ armada of mainstream economists, growth fetishists and other (0.01 %) elites will throw in the way of any sort of transformative (and fairer) post-growth thinking & economy. (PS: I hate to say it, but there’s something about many men – call it the economic ‘male gaze’ – that favours growing of companies, organisations and countries, ever more. There’s a mini-Trump in many of us. (Don’t know about the universality of “mushrooms”, though : ))
Another encouraging trend then. In spite of the backlash in some corners, every week I also see evidence in the media that #MeToo is a very encouraging (and increasingly global) phenomenon & movement. I hope that women in many other sectors (like McDonalds staff this week) and women in countries all over the globe will feel encouraged to point out they’re indeed “not on the menu”. In the slipstream of these sexual harassment discussions, #MeToo also sometimes raises important questions on leadership (and leadership styles) in the 21st century. I sometimes have to think of that when walking back home in the evening. One of my neighbors has two little dogs. One of them is truly a ‘Mad Men’ dog – whenever he sees me, he starts running around in circles like a nutcase, rodeo-style, and barking like hell, obviously protecting “his” territory. He even jumps against the fence, so angry is he when he sees me coming (although I’ve never done anything else than just walking besides the fence). The other dog, slightly bigger, a “Tao dog”, observes all this frenzy from the little dog slightly amused, probably thinking, “why all this chest-thumping, my little friend. If you continue like this, you’ll soon catch an NCD or two”. The taller one obviously one doesn’t qualify as a ‘leader’, not even in dogland, but still, a tad more Tao would do the little one well (while I’m brushing up on my barking skills). There must be other ways to protect one’s fief.
Over to a more negative trend then. When it comes to the so called “SDG era”, worries are increasing that this “universal” agenda will be jeopardized by the trade war between the US and China, and other simmering conflicts between the two remaining super powers, with at least one side currently stuck in ‘zero sum’ thinking, and thus “Moving To Contain the Global Challenge By an Ascending China”. See for example how USAID more and more adopts a hard line on China’s development approach. The risk becomes very real that instead of a universal SDG (let alone planetary health) agenda, soon we’ll be thinking again in terms of influence spheres. But then again, in a way that shouldn’t surprise us too much. Roberto Bissio pointed out recently that “Development is conflict”. “…Peace and sustainable development should be mutually reinforcing, but at the same time we should not ignore that development implies deep changes in societies and those transformations will be resisted by those who benefit from the status quo.” You can’t really transplant this “within country” law to the looming battle between the US & China (and other powers), but yes, the SDG era will clearly also be one of conflict, not just of “win-wins…”
Some final worrying news from a psychologist, related to the rise of Trump & Brexit among others, in the Guardian this week: “when people feel threatened they seem to want ‘tighter’ social norms, with profound consequences for politics”. From that angle, in a world with ever more (perceived & real) threats, it seems rather important, as Kabir Sheikh pointed out a while ago, that global health finds a balance between “fear” and “care”. Hopefully, with emphasis on the latter. For this, it’ll need to team up with other progressive forces in the 21st century. If we fail, the “SDG era” will go down in history rather differently. More in particular, as “the beginning of the end for the human species”.
Enjoy your reading.
(you find the pdf of the full newsletter: IHPn489 )
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