Disease | 2020 Vision for a Sustainable Society

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2020 VISION FOR A SUSTAINABLE SOCIETY

MELBOURNE SUSTAINABLE SOCIETY INSTITUTE


The Melbourne Sustainable Society Institute (MSSI) at the University of Melbourne, Australia, brings together researchers from different disciplines to help create a more sustainable society. It acts as an information portal for research at the University of Melbourne, and as a collaborative platform where researchers and communities can work together to affect positive change. This book can be freely accessed from MSSI’s website: www.sustainable.unimelb.edu.au.


Cite as: Pearson, C.J. (editor) (2012). 2020: Vision for a Sustainable Society. Melbourne Sustainable Society Institute, University of Melbourne Published by Melbourne Sustainable Society Institute in 2012 Ground Floor Alice Hoy Building (Blg 162) Monash Road The University of Melbourne, Parkville Victoria 3010, Australia Text and copyright © Melbourne Sustainable Society Institute All rights reserved. No part of this publication may be reproduced without prior permission of the publisher. A Cataloguing-in-Publication entry is available from the catalogue of the National Library of Australia at www.nla.gov.au 2020: Vision for a Sustainable Society, ISBN: 978-0-7340-4773-1 (pbk) Produced with Affirm Press www.affirmpress.com.au Cover and text design by Anne-Marie Reeves www.annemariereeves.com Illustrations on pages 228–231 by Michael Weldon www.michaelweldon.com Cover image © Brad Calkins | Dreamstime.com Proudly printed in Australia by BPA Print Group


Foreword

T

he last two centuries have seen extraordinary improvements in the quality of human lives. Most people on earth today enjoy access to the necessities of life that was once available only to the elites. Most people enjoy longevity, health, education, information and opportunities to experience the variety of life on earth that was denied even to the rulers of yesteryear. The proportion of humanity living in absolute poverty remains daunting, but continues to fall decade by decade. The early 21st century has delivered an acceleration of the growth in living standards in the most populous developing countries and an historic lift in the trend of economic growth in the regions that had lagged behind, notably in Africa. These beneficent developments are accompanied by another reality. The improvements are not sustainable unless we make qualitative changes in the content of economic growth. The continuation of the current relationship between growth in the material standard of living and pressures on the natural environment will undermine economic growth, political

stability and the foundations of human achievement. The good news is that humanity has already discovered and begun to apply the knowledge that can reconcile continued improvements in the standard of living with reduction of pressures on the natural environment. The bad news is that the changes that are necessary to make high and rising standards of living sustainable are hard to achieve within our current political cultures and systems. Hard, but not impossible. That is a central message from this book, drawn out in Craig Pearson’s concluding chapter. This book introduces the reader to the many dimesions of sustainability, through wellqualified authors. Climate change is only one mechanism through which current patterns of economic growth threaten the natural systems on which our prosperity depend. It is simply the most urgent of the existential threats. Climate change is a special challenge for Australians. We are the most vulnerable of the

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developed countries to climate change. And we are the developed country with the highest level of greenhouse gas emissions per person. There are roles for private ethical decisions as well as public policy choices in dealing with the climate change challenge. This book is released at the time of ‘Rio+20’, a conference in Brazil to review the relatively poor progress we have made towards sustainability in the past 20 years, and soon after the introduction of Australia’s first comprehensive policy response to the global challenge of climate change. Australia’s emissions trading scheme with an initially fixed price for emissions permits comes into effect on 1 July 2012. The new policy discourages activities that generate greenhouse gases by putting a price on emissions. The revenue raised by carbon pricing will be returned to households and businesses in ways that retain incentives to reduce emissions. Part of the revenue will be used to encourage production and use of goods and services that embody low emissions. The policy has been launched in controversy. Interests that stand to gain from the discrediting of the policy argue that it is unnecessary either because the case for global action to reduce greenhouse gas emissions and the associated climate change has not been proven, or that the new policy places a disproportionate burden on Australians. The health of our civilisation requires us to bring scientific knowledge to account in public policy. Everyone who shares the knowledge that is the common heritage of humanity has

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a responsibility to explain the realities to others wherever and whenever they can. The argument that the new policy places a disproportionate burden on Australians can be answered by seeking honestly to understand what others are doing. The critics of Australian policy argue that the world’s two largest national emitters of greenhouse gases, China and the United States, are doing little or nothing to reduce emissions, so that it is either pointless or unnecessary for us to do so. China has advanced a long way towards achieving its target of reducing emissions as a proportion of economic output by 40 to 45 per cent between 2005 and 2020. It has done this by forcing the closure of emissions-intensive plants and processes that have exceptionally high levels of emissions per unit of output, by imposing high emissions standards on new plants and processes, by charging emissionsintensive activities higher electricity prices, by subsidising the introduction of low-emissions activities, and by new and higher taxes on fossil fuels. China has introduced trials of an emissions trading system in five major cities and two provinces. This adds up to a cost on business and the community that exceeds any burden placed on Australians by the new policies – bearing in mind that the revenue from Australian carbon pricing is returned to households and businesses. The US Government has advised the international community of its domestic policy target to reduce 2005 emissions by 17 per cent by 2020. President Barack Obama said


to the Australian Parliament that all countries should take seriously the targets that they had reported to the international community, and made it clear that the United States did so. United States efforts to reduce emissions are diffuse but far-reaching. They now include controls on emissions from electricity generators, announced in March 2012, effectively excluding any new coal-based power generation after the end of this year unless it embodies carbon capture and storage. From the beginning of next year they will include an emissions trading system in the most populous and economically largest state, California. The United States is making reasonable progress towards reaching its emissions reduction goals, with some actions imposing high costs on domestic households and businesses. Australia has now taken steps through which we can do our fair share in the international effort, at reasonable cost. It would be much harder and more costly to do our fair share without the policies that are soon to take effect. What Australians do over the next few years will have a significant influence on humanity’s prospects for handing on the benefits of modern civilisation to future generations. This book will help Australians to understand their part in the global effort for sustainability. Ross Garnaut University of Melbourne 15 April 2012

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Contents Foreword by Ross Garnaut Table of Contents

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Author Biographies

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Drivers

1

1 Population Rebecca Kippen and Peter McDonald

2

2 Equity Helen Sykes

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3 Consumption Craig Pearson

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4 Greenhouse Gas Emissions and Climate Change David Karoly

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5 Energy Peter Seligman

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People

47

6

Ethics Craig Prebble

48

7

Culture Audrey Yue and Rimi Khan

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8

Awareness and Behaviour Angela Paladino

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9

Local Matters Matter Kate Auty

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10 Public Wisdom Tim van Gelder

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11 Mental Health Grant Blashki

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12 Disease Peter Doherty

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13 Corporate Sustainability Liza Maimone

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14 Governance John Brumby

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Natural Resources

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15 Ecosystem-Based Adaptation Rodney Keenan

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16 Water Hector Malano and Brian Davidson

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17 Food Sunday McKay and Rebecca Ford

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18 Zero Carbon Land-Use Chris Taylor and Adrian Whitehead

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Cities

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19 Changing Cities Peter Newman and Carolyn Ingvarson

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20 Affordable Living Thomas Kvan and Justyna Karakiewicz

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21 Built Environment Pru Sanderson

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22 Infrastructure Colin Duffield

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23 Transport Monique Conheady

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24 Adaptive Design Ray Green

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25 Handling Disasters Alan March

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Outcomes

221

26 Twenty Actions Craig Pearson

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Further Reading

234

Index

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12 Disease Peter Doherty

A

t present rates of consumption and waste that so rapidly deplete resources, we will need three earth-like planets to meet future requirements – even in the relatively short term. Poor people bear little responsibility for the rapid depletion of non-renewable resources and they do not use the massive amounts of energy that contribute so substantially to climate change, though grinding poverty is one driver of the continued clearance of those great ‘carbon sinks’, the tropical rainforests. And the poor majorities in developing nations, together with the disadvantaged in wealthy societies, suffer disproportionally from infectious diseases and inadequate access to basic human rights such as clean water and food. This inequity is an obstacle in our collective ability to transform into a sustainable society.

A Historical Perspective The long, slow growth rate in global population, discussed in chapter one, reflects the ‘trimming’ effect of both man-made catastrophes (wars, religion-inspired episodes of mass murder) and other factors that were outside human control. The chaos in Europe described by Barbara Tuchman in her book A Distant Mirror was a consequence of the disruption caused by

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bands of armed thugs who were unemployed after the end of the Crusades, together with other disasters including the massive mortality associated with the incursion of the bubonic plague. Likely originating from China to strike as ‘the black death’ (1348–50) in England, successive outbreaks of infection with the organism that was finally identified (in 1894) as Yersinia pestis killed one third to one half of the population of many European cities. Such outbreaks persisted for centuries. Then the increasing sophistication of navigation tools and sailing ships led to contact between previously isolated human populations that facilitated a continuing, two-way exchange of lethal infections. Syphilis (caused by Treponema pallidum), for example, likely traveled with Columbus and his men from the Americas to what was then considered to be the civilised world. In a time when superstition and ignorance still ruled (at least when it came to pathogens), major infectious disease events served to limit human numbers. While the mid-19th century saw our first clear understanding of the nature of infection and immunity, ruins like Melrose Abbey in the Scottish borders show that intelligent people had long understood something of the principles


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of sanitation. The Cistercian monks who built Melrose from the 12th century diverted fresh water from the nearby river Tweed in a ‘great drain’ that flushes through the Abbey complex. Fresh water for drinking and cooking came from the input flow, then the ‘drain’ served the need for both bathing and laundry and the exit flushed both human and tannery waste back into the river downstream. In London, the diarrheal disease cholera (caused by the bacterium Vibrio cholerae) was not linked to the water supply until 1853–54. That in turn established the basis of sanitary science, with the closure of contaminated wells and the progressive establishment of pumping stations and everything else that goes with providing clean, piped water for drinking and bathing. Then human death rates were further diminished by Lister’s development of antiseptic surgery, and by Semmelweis who insisted on thorough hand washing prior to performing obstetric procedures. Before Semmelweis, many women died of puerperal fever and sepsis (caused by a spectrum of invasive bacteria) subsequent to childbirth. These practical advances were underpinned intellectually by the science of Pasteur, who established (1860–64) the germ theory of infectious disease that led, through the 20th century, to the development of vaccines and antibiotics. Prior to the efforts of Pasteur, Koch, Yersin, Ehrlich, Salmon, Fleming, Florey, Theiler, Salk, Sabin and many other great scientists, even the wealthiest families suffered the loss of one or more children from

infection (TB, diphtheria, whooping cough, meningococcus, measles, etc). This experience is now uncommon for all who have the good fortune to live in the better-resourced societies. Through the sanitary revolution of the 19th century, the numbers of people on the planet only grew from 1 to 1.6 billion. At least in Europe, the negative effects of those increases were blunted by colonialist expansion into Africa and Asia, and the emigration of large numbers to fill-up the ‘empty’ landmasses of the Americas and Australia. Both ethically and socially we are still dealing with the disastrous, but perhaps inevitable, consequences of these events for Indigenous people, which (apart from taking their land) were made even more toxic by the transmission of unfamiliar infections (smallpox and measles) and prevailing attitudes based in spurious ideas of inherent racial superiority. To some extent, both the current shift of economic power from the West to Asia and the legal and illegal mass immigration from poor to rich countries can be considered to reflect a measure of payback. Then, despite the mass murder that occurred in World War I, World War II, various ‘small wars’ and African tribal conflicts (the Ibo in Nigeria, the Tutsi in Rwanda), the deliberate genocide practised by regimes led by psychopaths like Joseph Stalin, Adolf Hitler and Pol Pot, the more than 40 million deaths during the influenza pandemic of 1918–19, the starvation in the Sahel region of Africa, the continuing HIV/AIDS catastrophe, and the loss of life from various ‘natural’ disasters (earthquakes, tsunamis), human numbers

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increased four-fold through the course of the 20th century. The point I’m making here is that we can no longer rely on plagues, pestilences and other natural disasters to control human population size. We are, in fact, living in a much better ‘historical space’ where we essentially have many such threats under control. The recent Hollywood feature film Contagion illustrates what could happen if an incredibly infectious, novel pathogen suddenly crossed over from wildlife (fruit bats) to cause a human pandemic with a 30–40 per cent mortality rate. What the movie also suggested, though, is that the application of molecular science, together with the implementation of sound public health strategies, is capable of bringing such an incursion under control in the space of less than a year. My sense is that, given an element of artistic/dramatic license, the situation shown in Contagion is completely realistic, though there is no evidence that anything quite so awful is lurking out there. So far as we know, most of the truly dreadful infections (haemorrhagic fevers, like Ebola, Hendra, Tacaribe) are unlikely to make the switch to ready transmission (like influenza) via the respiratory route, the ultimate danger with any potentially pandemic pathogen. Could some crazy bioterrorist organisation initiate a global infectious disease catastrophe? Unlikely: unless we’re talking about a mad ‘greenie’ group that wants to depopulate the planet. By definition, pandemics go everywhere and ‘the chosen people’ will be just as vulnerable as everyone else. Then the pandemic itself would

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Poster for the film Contagion, a realistic scenario of a dangerous pathogen crossing from wildlife to humans and its subsequent rapid control.

be the story, displacing any discussion of the ‘just cause’ that motivated these self-righteous maniacs in the first place. Publicity is their oxygen. Still, security agencies should watch out for some ‘rogue state’ that might initiate an aggressive and unusual vaccination campaign. In summary, if we maintain our science and social structures, our numbers are not likely to be greatly reduced at some future time by a hideous and unpredicted infectious disease pandemic. Such events did trim human population sizes in the past, but the challenge for contemporary


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society is to limit our own reproduction in humane and ethically acceptable ways. Should we fail and continue on our present, increasingly unsustainable trajectory, other mechanisms will inevitable come into play. Perhaps what we have to fear most in that regard are the consequences of runaway climate change and the possibility of nuclear war that could follow the realisation that only a selected minority can survive. That is the global sustainability challenge.

Health and Wellbeing in the ‘Less Resourced’ World This is a massive topic, and I won’t attempt to cover all of the various parameters and ramifications, partly because I am ill-equipped to do so. What follows is an eclectic sample.

Food Other chapters deal with sustainable agriculture and food so I simply refer you to two recent books by Paarlberg and Falvey that seem to me to deal comprehensively and thoughtfully with this issue (see Further Reading at the end of this book). The consequences of many infectious diseases including malaria are much worse in those (especially children) who are suffering from macronutrient or micronutrient deficiencies. That profile of increased vulnerability to novel infections can also be true for people who are obese and/ or diabetic. Both conditions are related to inappropriate diets and poor eating habits, especially the overconsumption of sugar and other refined carbohydrates and the excessive use of alcohol. The recent, ‘mild’ 2009 H1N1

‘swine’ influenza pandemic was much more severe globally in Indigenous communities where such underlying disease problems are prominent. Sustainable production and equitable distribution of healthy foods need to be major international priorities that are, so far as possible, divorced from commercial imperatives and national politics based in perceived self-interest. Agriculture is one of the few areas where some of the ‘advanced’ countries seem determined to maintain subsidies that function effectively as tariff barriers, while (in some cases) also promoting practices that discourage the use of promising approaches (eg, the application of both commercial and public-sector developed GM technology) favored by many African food scientists. Then we are surprised when sophisticated fleets from the north ‘harvest’ the fish that have sustained poor people for generations and the dispossessed turn to piracy. The food question isn’t just about the supply of major nutrients and energy. When it comes to health, micronutrient deficiency is also a major issue in parts of the developing world. Some of this is related to the disease burden of, for example, roundworm infestation, a problem that also leads to macronutrient loss. The estimated dollar cost of worming children globally by treatment with inexpensive, generic drugs is in the range of $US250 million annually. The benefits of this relatively small expenditure would be massive. The list of prevalent micronutrient deficiencies includes iodine, iron, vitamin A, and folate, vitamin B9. Working in the

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public sector at the ETH in Zurich, Potrykus engineered ‘golden rice’ so that it contains 23 times the usual amount of the vitamin A precursor, beta carotene. The details were published in 2000, but this revolutionary product is still not in use. Funded by the Bill and Melinda Gates foundation, golden rice is being additionally modified to further provide greater levels of vitamin E, iron and zinc. Eating 150 grams or so a day would greatly alleviate the incidence of blindness and anemia in high rice-consuming countries. Hopefully this should, by 2013, have passed all the safety testing and regulatory hurdles and will be available for general consumption.

Water and Air Quality Many are aware of the disastrous long-term drought in the Sahel region of Africa. As we know from our own discussion about the Murray-Darling, implementing sound water policy can be very difficult, even in the wealthy democracies where at least some value is accorded to evidence. The issue of salt accumulation that we are trying to deal with here is, for example, of great concern when it comes to the Nile, the ‘life-blood’ of Egypt. Salt incursion into fresh water is also an increasing problem with ‘drained’ aquifers in India and in low-lying countries like Bangladesh, an effect that will be exacerbated by increased global temperatures and sea-level rise. Harking back to the ‘great drain’ at Melrose, it is also enormously important to provide people with fresh, clean drinking water. For poor rural communities, at least, the

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19th century solution of developing a safe, piped ‘distributive’ water supply may not be realistic. One approach is to drill wells and provide the necessary pumps, perhaps powered by solar panels. Apart from water-borne infections like cholera and typhoid, though, there is also the issue of depletion, partly as a consequence of agricultural practices resulting from the ‘green revolution’, and of arsenic accumulation. Arsenic is especially a problem in the Punjab region of India, and in Bangladesh. One way to get clean water is to use (osmotic) membrane filtration. Portable units are available, but the technology is relatively expensive and takes a lot of energy. Another approach is to use distillation, which removes both toxins and bacteria. Villagers can use a simple still heated by burning dried cow-dung, but there are also clean and inexpensive solar evaporators that provide clean drinking water. Cow dung is a commonly used cooking fuel in parts of India that, when burned in an enclosed living space, contributes enormously to the incidence of the debilitating condition COPD, chronic obstructive pulmonary disease. The problem is the amount of particulate matter that is released into poorly vented, enclosed spaces. A solution is to ferment the cow dung in an airtight circular pit, capture the resulting methane production, then pipe that to a gas stove. This ‘gobar gas’ is increasingly used for cooking and to power stationary engines in India, Pakistan and Nepal. Thinking ‘small scale and local’ rather than ‘distributive and networked’ can provide realistic and affordable solutions.


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Vaccines and Other Preventives People who live in agricultural communities where there are few, if any, social services, cannot be expected to think in terms of limiting family size if they are not assured that their children will survive. One of the 8 Millenium Development Goals (MDG4) is to reduce childhood mortality. As part of that, the aim has been to supply all the world’s children with the common vaccines of childhood. According to the World Health Organization (WHO), the increased use of measles vaccine between 2000 and 2010 has led to an 85 per cent drop in deaths from this disease. The size of the challenge to eliminate child mortality from disease, and opportunities

Other channels

Immunisation clinics

for disease prevention through vaccination, are shown in Figure 1: immunisation and antenatal clinics are widespread and reach most of the populations of Europe and the western Pacific whereas at this time they have little impact in Africa and southeast Asia. The difficulties posed by local wars and cultural perceptions for the Global Polio Eradication Initiative have been greater than expected: localised pockets of poliovirus remain in Africa and the Middle East (Figure 2). Nonetheless, with the financial help of organisations like Rotary, we will soon see the end of this disease. So far, only two pandemic viruses have been eradicated globally: smallpox (from 1979) and the cattle disease, rinderpest (2011). Rinderpest

Antenatal clinics

Mass Campaign

100%

ITNs delivered

80% 60% 40% 20% 0%

AFRA

MR

SEAR

EUR

EMRW

PR

World

Key: AFR: WHO African Region

EUR: WHO European Region

AMR: WHO Region of the America

EMR: WHO Eastern Mediterranean Region

SEAR: WHO South-East Asia Region

WPR: WHO Western Pacific Region

Figure 1. Channels used by National Malaria Control Programs to deliver disease control in various regions. Source: WHO. NMCP reports.

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Figure 2. Localised incidences of polio remain in Africa and the Middle East, although eradication is likely. Source: www.polioeradication.org/Dataandmonitoring.aspx. Data at HQ as of 6 March 2012.

and measles virus are closely related and are thought to have diverged from a common ancestor about 1200 years or so back. Though measles is incredibly infectious, we could also hope to eliminate it if everyone would vaccinate their children. The problem here is that the antivaccine sentiment in some advanced countries has led, for example, to infected children from wealthy nations reintroducing measles into poor communities that had effectively controlled the disease. That can cut both ways, of course, with a child returning from an overseas vacation recently causing a measles outbreak in a Canberra alternative school. Insect-borne diseases like malaria and dengue are major causes of childhood mortality in warm, tropical regions where there is poor mosquito control. A vaccine to prevent the

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catastrophic hemorrhagic form of dengue is currently being tested, while there is also some hope for an experimental, partially-protective (though expensive) malaria vaccine that operates to reduce mortality rather than infection rates. What works with malaria are DDT-impregnated bed nets. While spraying DDT (which is very cheap) onto water sources and the like is banned because of negative environmental effects, particularly on birds, it can be safely used within houses. Figure 3 shows how protection is improving in malaria-susceptible countries. Another mosquito-borne disease that kills children and adults in South America and West Africa is yellow fever. We have had an effective vaccine for more than 50 years but, because of cost (including the need for a ‘cold chain’), it is not widely used.


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Population at risk

15%

10%

Africa Americas Eastern Mediterranean South-East Asia Western Pacific

5%

0%

2002

2003

2004

2005

2006

2007

2008

2009

2010

Figure 3. Protection against malaria is increasing rapidly in some parts of the world where the population is at risk because of exposure to mosquitos. WHO. Source: NMCP reports.

The Empowerment of Women (Education and Electric Light) It has long been clear that the way to limit population growth is to educate girls and women and to give them much greater control over their own destinies. That does not mean, of course, that boys should in any sense be blocked from schooling, just that it is important to ensure equitable access. It is also essential to promote the availability of basic healthcare, an issue that is, again, as true for boys and men as it is for girls and women (Figure 1). Though perhaps not perfect, the Grameen Bank microfinance model has been shown to greatly improve the basic economic situation, and thus the lives, of many poor women and their families.

Using a central solar facility to charge batteries that can then be taken home at night to provide electric light may prove to be as powerful as any other mechanism for improving educational opportunities (and diminishing reproduction) at the village level. The Indian entrepreneur and humanitarian Bunker Roy has, for instance, promoted the ‘Solar Granny’ initiative. Reasoning that village grandmothers are sensible people who want to stay near their children and grandchildren, he has taken poor, uneducated women and trained them to install and maintain solar panels. His initiative provides a great example of how small, pragmatic steps that are sensitively developed from the perspectives of local, human realities can be of immense benefit for poor but close communities.

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The Global Polio Eradication Initiative

2010

2011

2012

2013

2014

By mid-2010

By end-2010

By end-2011

By end-2012

By end-2013

Cessation of all polio outbreaks with onset in 2009*

Cessation of all ‘re-established’ poliovirus transmission **

Cessation of all polio transmission in at least 2 of 4 endemic countries***

Cessation of all wild poliovirus transmission ****

Initial validation of 2012 milestones†

Polio cases by country The Global Polio Eradication Initiative strategic plan for 2010–12 has put in place targets towards interrupting wild poliovirus globally. All polio eradication activities are focused on achieving these global targets. Polio eradication targets 2010–13 * validated when > 6 months without a case genetically linked to a 2009 importation (ie by end-2010). ** validated when > 12 months without a case genetically linked to the re-established virus (by end-2011). *** validated when > 12 months without a case genetically linked to an indigenous virus (by end-2012). **** validated when ≥ 12 months without a case genetically linked to an indigenous virus (by end-2013). † Certification will require at least 3 years of zero polio cases in the presence of appropriate surveillance across an entire epidemiologic region.

Recompense for Sustaining Global Carbon ‘Sinks’ While we are accustomed to spending dollars to purchase tangible products, the idea that the wealthy nations should recompense the poor for sustaining what are essential natural resources has only come to prominence very recently. Apart from providing ‘development’ advice, expertise and financial assistance for promoting sustainable agriculture practices that limit the destruction of natural forests and

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jungle environments, the introduction of carbon taxes and carbon trading schemes supplies a mechanism for paying farmers to maintain the great carbon ‘sinks’ that scrub the atmosphere and limit the effects of greenhouse gases. This is one area where we can act immediately in ways that will, in the long run, improve the future prospects for all human beings. The poorer, tropical and subtropical nations have an invaluable ‘product’ that we all need and should not expect to access without cost.


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ACTIONS FOR 2020 A sustainable society must be a fairer world that promotes health and global wellbeing. Medical, agricultural and other professionals can provide expertise, but what is really needed are innovative economic models and courageous political leadership. Hopefully we can mobilise the necessary will before we are forced to act in ‘fire engine’ mode to counter some major, and perhaps irreversible, global disaster. Though agreed international regulatory frameworks and collective action clearly have important roles to play, any effective action can only work via mechanisms that also emphasise individual enterprise, insight and inventiveness. Perhaps what we need most is innovative investors and business entrepreneurs who function as global gamekeepers, not poachers, and focus as much on human as on financial capital. A dedication to greed makes people fundamentally callous and less than human. Giving back enhances lives, not least the life of the giver.

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Further Reading Disease Falvey, L. (2010). Small farmers secure food. Survival food security, the world’s kitchen and the critical role of small farmers. TSE Press, Thailand. Hall, A., Horton, S., de Silva, N. (2009). Plos Neglected Tropical Disease. 3 (3) e402. Paarlberg, R. (2010). Food politics: what everyone needs to know. Oxford University Press, New York. Tuchman, B. (1978). A distant mirror: the calamitous 14th century. Alfred A. Knopf, New York.


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