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Cheerful despair

By Kristof Decoster
on December 5, 2017

This morning, I learnt from a somewhat similar-minded but slightly older colleague that the School of Life has ‘cheerful despair’ badges. They seem to sell well in our times. On a chilly December day like today, I tend to think we could use a few of these in global health as well.

Indeed, our world has become so unpredictable and looks so dangerous right now, that the ‘can do’ optimism which characterizes many people in global health seems more and more unwarranted – I was about to write ‘naïve’.  In messy times like ours, it’s perhaps no coincidence that many of us feel the need to “worship our religion”, proclaiming that against all odds, progress is possible in this world, better even, that ‘The time is now’ to move things forward! Next week, on December 12, that happens both for UHC (in Tokyo, among others), and on climate change (in Paris, where Macron and other leaders want to ‘reiterate their commitment’ in the fight against climate change). In both cases, however, it feels increasingly like nearly a ‘mission impossible’, as the world we’re facing currently seems to be going in a very different (read: dangerous) direction. And the billions that should go to some many global public goods seem to (1) either end up in billionnaires’ pockets & tax havens or (2) go to “security”, walls & defense budgets, no matter how many lofty op-eds Larry Summers & co write.

Whether it’s the “tribalism”    now prominent in American politics (and increasingly, in many other ‘developed’ countries, even if perhaps not yet to the same extent) and the fact that increasingly the ‘middle ground’ (for making more or less rational, strategic decisions on the future of countries) is disappearing, the fact that in spite of already huge inequality, many rich and powerful people and “disruptive” companies still seem prepared to rip up the social fabric of countries even further (the latest GOP tax reform is a case in point), or the unsavoury Trump-story that is taking more and more a (not entirely unexpected) Caligula-turn, with among others disaster waiting in the North-Korea crisis  (“the worry is that a mentally deranged president might lead the US into a nuclear war”, as somebody put it aptly in Foreign Policy earlier this week):  global health’s implicit or explicit embracing of cosmopolitanism, globalization, solidarity, and dare I say it, “partnership” increasingly feels like a bad joke in the current international (and many national) environment(s). The risk of downright infernal spirals in quite a few countries (including so called ‘developed’ ones) is increasing, if not already playing out, but big parts of the elites still don’t seem to get it. And so we continue to proclaim our belief in UHC or – in the words of the World Bank for example – a bright “low-carbon and competitive future”, while the world might be collapsing in front of our eyes. As anthropologist journalist Joris Luyendijk emphasizes, elites will always be needed, but too many people now don’t feel protected anymore by their elites. Instead, many feel betrayed by them. Some of the smartest ones among Davos men & women (like Bill Gates for that matter) begin to understand that  inequality has gone (way) too far, to the extent that it’s now – via different but mainly right-wing forms of populism – causing a scary “road to apparently nowhere” in many countries (the US & the UK are prime examples, of course – if you need to count on Tony Blair to reverse a Brexit, you’ve really reached rock bottom, I’d say : ) ). But it will take many more (and probably a new generation of political leaders, you can’t just count on “oldies” like Bernie Sanders & Jeremy Corbyn to avert political disaster), and better sooner rather than later, if we want to get anywhere near the SDG goals in 2030. Or more accurately perhaps, avoid global mayhem. It’s a race against time before political demons take over altogether.

By and large, though, the global health community still identifies too much with one ‘tribe’, without sufficiently acknowledging that without doing something substantial about the many who feel ‘left behind’ in their own countries, global health will lose the support it so badly needs, if it wants to make this a better world. The fact that quite a few people in global health now seem to put their hopes (once again) in people like Macron, Trudeau, Merkel and Xi Jinping, even Macri  (see the hope on a continued G20 global health agenda, now that Argentina will be hosting it), apparently more than ready to work with leaders they perceive as still ‘embracing globalization’, only underscores this point. This hugging of (some) world leaders and global health “champions” borders a global health version of “celebrity culture”, borrowing a leaf or two from Pankaj Mishra. Meanwhile, the current WHO DG is sending congratulatory tweets to (rather thuggish) leaders like Modi & Kagamé, if the latter embrace some progressive public health policies. Even Tedros is thus still not connecting the dots enough, even if we talk all the time about silos that have to be overcome in the SDG era and connections that need to be made.

So yes, let us worship our (very worthy) religions next week at the UHC & climate battle summits, while trying to hide the ‘cheerful despair’ feelings we might feel inside. But let us also try to draw the right lessons from the current precarious times: globally and nationally, the fight against (obscene) inequality is the main one.  And let’s pray that not some nuclear ‘black swan’ event messes up things further.

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