The planetary and the personal: (almost) 3 decades of work in health
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An invited talk to the Auckland University Medical Students Society, 2012
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The planetary and the personal: (almost) 3 decades of work in health
- 1. The planetary and the personal: (almost) 3 decades of work in health AUMSS: Sowing the Seeds – Growing New Zealand’s future doctors July 29, 2012 A/Prof Colin D Butler National Centre for Epidemiology and Population Health
- 2. 2 Main themes public goods, norms, institutions emerging diseases gambling with the planet and global health I have a dream
- 3. 3 Public goods Safety of a bridge (infrastructure) Willingness to share information, common language Functioning banking/insurance/justice system Public health (eg clean water, air, health services) The sun The planetary environment, ecosystem “services”
- 4. 4 1. Nigeria 2.Tasmania 3. India 4. Earth 5. Future Health 6. Solutions
- 5. I have a dream 5
- 6. “As early as my first years at University I had begun to feel misgivings about the opinion that mankind is constantly developing in the direction of progress. My impression was that the fire of its ideals was burning low without anyone noticing it or troubling about it.” Albert Schweitzer (1875-1965) 6
- 7. 7 1. Nigeria
- 8. 8 Emerging diseases – a call for more critical thought
- 9. 9 335 Emerging Infectious Disease “events” Jones et al. Nature, (2008) Lassa No reflection of disease burden, existing or future
- 10. 10 2. Tasmania
- 11. 11
- 12. The Lancet, July 2012 12 3. India
- 13. Prevalence of stunting among children under 5 years old in India by state Black et al, Lancet 2008 13
- 14. Picture UP 14
- 17. 17 Rohingya: forgotten people of Burma
- 18. 18 A young unregistered refugee girl at Kutupalong camp uses a machete for splitting firewood to sell – her family’s only income. (Richard Sollom, Physicians for Human Rights)
- 19. 19 4. Earth
- 20. 20 Sea Level: 1993-2011 Rainfall intensity : 1900-2011 Arctic sea ice: 1979-2012 Earth system observations Land-ocean temperature: 1880-2011 uncertainty
- 21. “Weather Extremes Leave Parts of U.S. Grid Buckling” New York Times, July 25, 2012 “We’ve got the ‘storm of the century’ every year now,” Bill Gausman, senior vice president, Potomac Electric Power Company road, rail, flights, nuclear power, electricity grids .. hospitals .. Health 21
- 22. 22 McDonalds & Coca Cola,– major sponsors of London Olympics! (& the next two, at least..) and Cadbury’s for 2012
- 23. Raw data: FAO oil 2nd price spike: oil price + climate change? 23 Two food price spikes .. Is the era of cheap food over? Drought affected corn, Missouri, July 2012 "We're moving from a crisis to a horror story," said Purdue University agronomist Tony Vyn. "I see an increasing number of fields that will produce zero grain.“ (July 18, 2012)
- 24. 24 24 Divided We Stand Why Inequality Keeps Rising © OECD 2011 NZ
- 25. Public goods erosion - corruption • FIFA, Murdoch, Global financial crisis, “Banksters”, banking regulators, Goldmann Sachs, Swiss Banks, British Banks, Madoff, kleptocracy, • Some environmental agreements • Canberra hospital • fake drugs, fake Yellow Fever immunization cards • “medical industrial complex” 25
- 26. 26 Giving birth by the light of a mobile phone –2012 5. Future Health
- 27. Civilisation: a system at risk? energy, raw materials: emerging scarcity economic system: archaic inequality: civil stress, terrorism, fascism, war 27
- 28. 28 rapid public health response* limited antimicrobial resistance, but increasing nutrition fair public health breakdown nutrition worse living conditions worse conflict increasing? Could civilisation failure “breed” a megapandemic? * For diseases perceived as major threats to developed countries
- 29. 29 “Demand will create a parachute” 29 6. Solutions
- 30. Suppression, science resistance Cognitive, emotional overload Barriers Enablers sustainability and public health Public health precedents (infectious diseases, sanitation, health services, “health for all”) Allies (civil society, some military – yes .. not a typo!) energy, soil, new technologies 3030
- 31. I have a dream 31
- 32. Movement A large global civil society network of health activists supportive of Health for All - organised to combat the economic and political causes of deepening inequalities in health worldwide The People’s Health Movement A large global civil society network of health activists supportive of Health for All - organised to combat the economic and political causes of deepening inequalities in health worldwide
- 33. 33
- 34. 34 Global Energy Assessment, 2012 Switch rich country energy subsidies for fossil fuels & nuclear to renewables and carbon capture Solar (1975-2007 2007-10) NUCLEAR US$/kwH (2005 dollars)
- 35. 35 UNEP: Global Environment Outlook IV, 2007
- 36. UN Human Rights Declaration meeting; Eleanor Roosevelt, 1947 36
- 37. What can one person do? think, act, behave, purchase ethically join with others tithe your effort (10%) a spiritual dimension is likely to help 37
- 38. reverence for lIfe 38 .. sunset, making our way through a herd of hippopotamuses, there flashed upon my mind, unforeseen and unsought, the phrase .. The iron door had yielded: the path in the thicket had become visible” Albert Schweitzer
Editor's Notes
- The planetary and the personal: (almost) 3 decades of work in health Associate Professor Colin D Butler National Centre for Epidemiology and Population Health Australian National University It is said that ancient practitioners of Chinese medicine compensated ill patients. It was the physician’s duty to keep them well. That story is probably imaginary, but the asymmetry of information and vulnerability between healer and patient (especially before the internet, but still the case for many low-income populations) creates a pathway for doctors (and drug companies) to enrich themselves. To counter such temptations it is vital for society to develop ethical frameworks that promote public goods. One such good is public health. Health is like air: easy to take for granted. Public health is often undervalued, especially in excessively hierarchical societies that believe in follies such as that health can be purchased, protected or restored by technology. Clinical medicine is vital, but less well recognised is the degree that health is determined by factors beyond an individual’s control, such as clean water, air, good nutrition and the distribution of opportunity. Today, many determinants of good global health are vanishing. These include of a familiar climate, many of our fellow species and ecosystems, and even inanimate resources such as oil, coal and phosphate. A minority of humans still prosper, but two centuries of global population health improvements are at risk. Future workers in public health need to participate with other concerned groups to lower these threats. This lecture will reflect on work since 1985 concerning these issues, with examples from Nigeria, Tasmania and India. It will also explore emerging global crises, including of food security, banking integrity and deepening inequality. I have given a lot of talks, but rarely as personal and flexible as this. I passionately believe in public health and have many reasons for this, and also quite a few stories. Of course though I value and recognise the place of clinical medicine, and see my role as trying to promote rather than force students to consider these issues. I have a particular interest in future health. As you may know, public health is often seen as the poor cousin among medical specialties, perhaps even more so among students, and it's encouraging to be asked to speak to you. Perhaps Prof Woodward has had a particularly beneficial influence upon Auckland students? It would be helpful to me to know the other speakers and topics, when you have the programme settled. Best wishes Colin -----Original Message-----From: conference speakers aumsa [mailto:conference.speakers@aumsa.org.nz] Sent: Saturday, 7 July 2012 9:56 AMTo: Colin ButlerSubject: Conference update Hi Colin The conference is getting close now and I am emailing to try to more formally dicuss what you will be presenting. You will be one of our keynote speakers and will have 45 minutes (ideally 35-40 minute presentation with 5-10mins of questions). Your audience will be around 230 medical students (roughly 70% pre-clinical) and you can make it as interactive or non-interactive as you wish. We would be happy for you to use any anecdotes, or stories of how you came to be in the position you are in today and why you chose public health. You could possibly discuss why you believes that public/global health is important to young medical students and what you believes it means to be a doctor in the 21st century from a public health perspective. You could also discuss some of our overseas work if you wish. You have probably done many presentations like this in the past, however if you have any questions regarding what you would like to present please let us know. A u c k l a n d U n i v e r s i t y M e d i c a l S t u d e n t s ’ A s s o c i a t i o n ( A U M S A ) T h e U n i v e r s i t y o f A u c k l a n d • F a c u l t y o f M e d i c a l a n d H e a l t h S c i e n c e s 8 5 P a r k R o a d G r a f t o n A u c k l a n d w w w . a u m s a . o r g . n z 10 April 2012 Dear Dr Colin Butler, From the 28th till the 29th of July this year Auckland University Medical Students’ Association (AUMSA) will be holding our inaugural medical education conference. AUMSA is a not-for-profit organisation run by medical students, representing all students studying at Auckland Medical School. At AUMSA, we are dedicated to helping medical students to grow into skilled doctors with a broader social conscience. The AUMSA Medical Education Conference titled “Sowing the Seeds – Growing New Zealand’s future doctors” is a two day conference that promises to be a weekend exhibition of inspiring speakers alongside practical sessions. The conference will showcase to medical students the opportunities that exist in medicine in New Zealand and inspire them to bring the successes of high achieving medical professionals from overseas back home to New Zealand. This will be the largest medical student conference in New Zealand as we are expecting over 300 attendees as well as external sponsorship. Because of your distinguished and interesting career, we would be honoured if you would consider attending in order to speak to the medical students participating, and help inform their perspectives on public health. We would suggest a 25 to 30 minute presentation providing an overview of your involvements this field followed by a 15-20 minutes of questions and answers. We would request your attendance for one session of 45min on either Saturday the 28th or Sunday the 29th of July. The exact time slot depends on your preference and also travelling arrangements. If you wish to also attend the opening ceremony on the morning of the 28th you would be most welcome. AUMSA will be able to cover your travel expenses and arrange travel plans for you. It would be great if you could indicate whether you are willing and able to attend. We appreciate that committing to something relatively far in the future may be difficult. A firm expression of interest would be acceptable also, as it allows us to continue our planning. Yours Sincerely, Suzy McKinney AUMSA Medical Education Conference Co-convener seminar - 12.45 to 2pm- you should speak for 30-40 minutes = "Environment, agriculture and infectious diseases of poverty. Challenges, concepts and disease control strategies for the 21st century."Colin Butler, PhD, MSc (epidemiology), BMed, BMedSci(Hons), DTM&H, DLSH&TMAssociate Professor, Australia National University College of Medicine, Biology and Environment Manson Lecture Theatre, 12.45 to 2pm, Friday 30 March 2012 There is growing recognition of the fundamental relationship between human-induced changes to the environment, agricultural activities and the risks of many types of infectious disease to humans, animals and plants. The advent of this interconnected configuration of influences presents enormous challenges for 21st century public health. This presentation will present highlights of a forthcoming WHO Technical Report which explores these issues and which calls for a more systems-based approach to scientific conceptualization and enquiry, and thus to research priorities and policy responses. I’d like to thank the organisers and sponsors My talk is called Environmental change: the need for health workers to think systemically in a shrinking world This is especially relevant to the “One Planet, One Future” part of the title of this meeting. In the background here we can see a smiling Japanese gentleman. He has just paid $770,000 for a single fish. That is $2600 a kg. We know, from what I call “brown economics”, that this is a very good thing, because this high price will doubtless stimulate the production of even more valuable tuna. (ironic) Single tuna fetches record price. Sydney Morning Herald http://wwwsmhcomau/executive-style/luxury/single-tuna-fetches-record-price-20120106-1pnlahtml#ixzz1lQBYoia9. 2012. "Environment, agriculture and infectious diseases of poverty. Challenges , concepts and disease control strategies for the 21st century."There is growing recognition of the fundamental relationship between human-induced changes to the environment, agricultural activities and the risks of many types of infectious disease to humans, animals and plants. The advent of this interconnected configuration of influences presents enormous challenges for 21st century public health. This presentation will present highlights of a forthcoming WHO Technical Report which explores these issues and which calls for a more systems-based approach to scientific conceptualization and enquiry, and thus to research priorities and policy responses.
- It is said that ancient practitioners of Chinese medicine compensated ill patients. It was the physician’s duty to keep them well. That story is probably imaginary, but the asymmetry of information and vulnerability between healer and patient (especially before the internet, but still the case for many low-income populations) creates a pathway for doctors (and drug companies) to enrich themselves. To counter such temptations it is vital for society to develop ethical frameworks that promote public goods. One such good is public health. Health is like air: easy to take for granted. Public health is often undervalued, especially in excessively hierarchical societies that believe in follies such as that health can be purchased, protected or restored by technology. Clinical medicine is vital, but less well recognised is the degree that health is determined by factors beyond an individual’s control, such as clean water, air, good nutrition and the distribution of opportunity. Today, many determinants of good global health are vanishing. These include of a familiar climate, many of our fellow species and ecosystems, and even inanimate resources such as oil, coal and phosphate. A minority of humans still prosper, but two centuries of global population health improvements are at risk. Future workers in public health need to participate with other concerned groups to lower these threats. This lecture will reflect on work since 1985 concerning these issues, with examples from Nigeria, Tasmania and India. It will also explore emerging global crises, including of food security, banking integrity and deepening inequality.
- It is said that ancient practitioners of Chinese medicine compensated ill patients. It was the physician’s duty to keep them well. That story is probably imaginary, but the asymmetry of information and vulnerability between healer and patient (especially before the internet, but still the case for many low-income populations) creates a pathway for doctors (and drug companies) to enrich themselves. To counter such temptations it is vital for society to develop ethical frameworks that promote public goods. One such good is public health. Health is like air: easy to take for granted. Public health is often undervalued, especially in excessively hierarchical societies that believe in follies such as that health can be purchased, protected or restored by technology. Clinical medicine is vital, but less well recognised is the degree that health is determined by factors beyond an individual’s control, such as clean water, air, good nutrition and the distribution of opportunity. Today, many determinants of good global health are vanishing. These include of a familiar climate, many of our fellow species and ecosystems, and even inanimate resources such as oil, coal and phosphate. A minority of humans still prosper, but two centuries of global population health improvements are at risk. Future workers in public health need to participate with other concerned groups to lower these threats. This lecture will reflect on work since 1985 concerning these issues, with examples from Nigeria, Tasmania and India. It will also explore emerging global crises, including of food security, banking integrity and deepening inequality.
- It is said that ancient practitioners of Chinese medicine compensated ill patients. It was the physician’s duty to keep them well. That story is probably imaginary, but the asymmetry of information and vulnerability between healer and patient (especially before the internet, but still the case for many low-income populations) creates a pathway for doctors (and drug companies) to enrich themselves. To counter such temptations it is vital for society to develop ethical frameworks that promote public goods. One such good is public health. Health is like air: easy to take for granted. Public health is often undervalued, especially in excessively hierarchical societies that believe in follies such as that health can be purchased, protected or restored by technology. Clinical medicine is vital, but less well recognised is the degree that health is determined by factors beyond an individual’s control, such as clean water, air, good nutrition and the distribution of opportunity. Today, many determinants of good global health are vanishing. These include of a familiar climate, many of our fellow species and ecosystems, and even inanimate resources such as oil, coal and phosphate. A minority of humans still prosper, but two centuries of global population health improvements are at risk. Future workers in public health need to participate with other concerned groups to lower these threats. This lecture will reflect on work since 1985 concerning these issues, with examples from Nigeria, Tasmania and India. It will also explore emerging global crises, including of food security, banking integrity and deepening inequality.
- (Filmer and Pritchett, 1999).
- It is said that ancient practitioners of Chinese medicine compensated ill patients. It was the physician’s duty to keep them well. That story is probably imaginary, but the asymmetry of information and vulnerability between healer and patient (especially before the internet, but still the case for many low-income populations) creates a pathway for doctors (and drug companies) to enrich themselves. To counter such temptations it is vital for society to develop ethical frameworks that promote public goods. One such good is public health. Health is like air: easy to take for granted. Public health is often undervalued, especially in excessively hierarchical societies that believe in follies such as that health can be purchased, protected or restored by technology. Clinical medicine is vital, but less well recognised is the degree that health is determined by factors beyond an individual’s control, such as clean water, air, good nutrition and the distribution of opportunity. Today, many determinants of good global health are vanishing. These include of a familiar climate, many of our fellow species and ecosystems, and even inanimate resources such as oil, coal and phosphate. A minority of humans still prosper, but two centuries of global population health improvements are at risk. Future workers in public health need to participate with other concerned groups to lower these threats. This lecture will reflect on work since 1985 concerning these issues, with examples from Nigeria, Tasmania and India. It will also explore emerging global crises, including of food security, banking integrity and deepening inequality.
- https://s3.amazonaws.com/PHR_Reports/stateless-and-starving.pdf
- It is said that ancient practitioners of Chinese medicine compensated ill patients. It was the physician’s duty to keep them well. That story is probably imaginary, but the asymmetry of information and vulnerability between healer and patient (especially before the internet, but still the case for many low-income populations) creates a pathway for doctors (and drug companies) to enrich themselves. To counter such temptations it is vital for society to develop ethical frameworks that promote public goods. One such good is public health. Health is like air: easy to take for granted. Public health is often undervalued, especially in excessively hierarchical societies that believe in follies such as that health can be purchased, protected or restored by technology. Clinical medicine is vital, but less well recognised is the degree that health is determined by factors beyond an individual’s control, such as clean water, air, good nutrition and the distribution of opportunity. Today, many determinants of good global health are vanishing. These include of a familiar climate, many of our fellow species and ecosystems, and even inanimate resources such as oil, coal and phosphate. A minority of humans still prosper, but two centuries of global population health improvements are at risk. Future workers in public health need to participate with other concerned groups to lower these threats. This lecture will reflect on work since 1985 concerning these issues, with examples from Nigeria, Tasmania and India. It will also explore emerging global crises, including of food security, banking integrity and deepening inequality.
- The green bars show uncertainty estimates. These are 4 earth system indicators. I could have chosen many more. Those of you who are or who have been clinicians know how important the bedside chart is, or perhaps the chart in the kennel or veterinary hospital. When I used to go on ward rounds it would often be the first thing I’d look at it. Here, we can see the temperature of the land and ocean is rising, there is growing evidence that rainfall is becoming more erratic, with both more intense rainfall and also more intense drought; with more variability, making it harder for farmers. This also has implications for human health, especially those living in low lying areas near rivers, in poor housing. The third indicator is sea level rise. The good thing about this is that the rate of rise is not noticeably increasing, at least over the last 20 years. However that is likely to change later this century. The final sign here is the extent of Arctic ice. The blue line is very recent data, from just a few weeks ago, and it show the coverage of Arctic ice since November. Basically it is tracking the dotted line which is the earlier record low, from 2006-07. The grey band is the average between 1979-2000.
- Restoring power in Bethesda. Md., after a wave of powerful storms on June 29. Read All Comments (132) » On a single day this month here, a US Airways regional jet became stuck in asphalt that had softened in 100-degree temperatures, and a subway train derailed after the heat stretched the track so far that it kinked — inserting a sharp angle into a stretch that was supposed to be straight. In East Texas, heat and drought have had a startling effect on the clay-rich soils under highways, which “just shrink like crazy,” leading to “horrendous cracking,” said Tom Scullion, senior research engineer with the Texas Transportation Institute at Texas A&M University. In Northeastern and Midwestern states, he said, unusually high heat is causing highway sections to expand beyond their design limits, press against each other and “pop up,” creating jarring and even hazardous speed bumps. Excessive warmth and dryness are threatening other parts of the grid as well. In the Chicago area, a twin-unit nuclear plant had to get special permission to keep operating this month because the pond it uses for cooling water rose to 102 degrees; its license to operate allows it to go only to 100. According to the Midwest Independent System Operator, the grid operator for the region, a different power plant had had to shut because the body of water from which it draws its cooling water had dropped so low that the intake pipe became high and dry; another had to cut back generation because cooling water was too warm. The frequency of extreme weather is up over the past few years, and people who deal with infrastructure expect that to continue. Leading climate models suggest that weather-sensitive parts of the infrastructure will be seeing many more extreme episodes, along with shifts in weather patterns and rising maximum (and minimum) temperatures. “We’ve got the ‘storm of the century’ every year now,” said Bill Gausman, a senior vice president and a 38-year veteran at the Potomac Electric Power Company, which took eight days to recover from the June 29 “derecho” storm that raced from the Midwest to the Eastern Seaboard and knocked out power for 4.3 million people in 10 states and the District of Columbia. In general, nobody in charge of anything made of steel and concrete can plan based on past trends, said Vicki Arroyo, who heads the Georgetown Climate Center at Georgetown University Law Center in Washington, a clearinghouse on climate-change adaptation strategies. Highways, Mr. Scullion noted, are designed for the local climate, taking into account things like temperature and rainfall. “When you get outside of those things, man, all bets are off.” As weather patterns shift, he said, “we could have some very dramatic failures of highway systems.” Adaptation efforts are taking place nationwide. Some are as huge as the multibillion-dollar effort to increase the height of levees and flood walls in New Orleans because of projections of rising sea levels and stronger storms to come; others as mundane as resizing drainage culverts in Vermont, where Hurricane Irene damaged about 2,000 culverts. “They just got blown out,” said Sue Minter, the Irene recovery officer for the state. In Washington, the subway system, which opened in 1976, has revised its operating procedures. Authorities will now watch the rail temperature and order trains to slow down if it gets too hot. When railroads install tracks in cold weather, they heat the metal to a “neutral” temperature so it reaches a moderate length, and will withstand the shrinkage and growth typical for that climate. But if the heat historically seen in the South becomes normal farther north, the rails will be too long for that weather, and will have an increased tendency to kink. So railroad officials say they will begin to undertake much more frequent inspection. Some utilities are re-examining long-held views on the economics of protecting against the weather. Pepco, the utility serving the area around Washington, has repeatedly studied the idea of burying more power lines, and the company and its regulators have always decided that the cost outweighed the benefit. But the company has had five storms in the last two and a half years for which recovery took at least five days, and after the derecho last month, the consensus has changed. Both the District of Columbia and Montgomery County, Md., have held hearings to discuss the option — though in the District alone, the cost would be $1.1 billion to $5.8 billion, depending on how many of the power lines were put underground. Even without storms, heat waves are changing the pattern of electricity use, raising peak demand higher than ever. That implies the need for new investment in generating stations, transmission lines and local distribution lines that will be used at full capacity for only a few hundred hours a year. “We build the system for the 10 percent of the time we need it,” said Mark Gabriel, a senior vice president of Black & Veatch, an engineering firm. And that 10 percent is “getting more extreme.” Even as the effects of weather extremes become more evident, precisely how to react is still largely an open question, said David Behar, the climate program director for the San Francisco Public Utilities Commission. “We’re living in an era of assessment, not yet in an area of adaptation,” he said. He says that violent storms and forest fires can be expected to affect water quality and water use: runoff from major storms and falling ash could temporarily shut down reservoirs. Deciding how to address such issues is the work of groups like the Water Utility Climate Alliance, of which he is a member. “In some ways, the science is still catching up with the need of water managers for high-quality projection,” he said. Some needs are already known. San Francisco will spend as much as $40 million to modify discharge pipes for treated wastewater to prevent bay water from flowing back into the system. Even when state and local officials know what they want to do, they say they do not always get the cooperation they would like from the federal government. Many agencies have officially expressed a commitment to plan for climate change, but sometimes the results on the ground can be frustrating, said Ms. Minter of Vermont. For instance, she said, Vermont officials want to replace the old culverts with bigger ones. “We think it’s an opportunity to build back in a more robust way,” she said. But the Federal Emergency Management Agency wants to reuse the old culverts that washed out, or replace them with similar ones, she said. Ms. Arroyo of Georgetown said the federal government must do more. “They are not acknowledging that the future will look different from the past,” she said, “and so we keep putting people and infrastructure in harm’s way.” Matthew L. Wald reported from Washington, and John Schwartz from New York.
- "We're moving from a crisis to a horror story," said Purdue University agronomist Tony Vyn. "I see an increasing number of fields that will produce zero grain."
- Divided We Stand Why Inequality Keeps Rising © OECD 2011 21 An Overview of Growing Income Inequalities in OECD Countries: Main Findings
- fake yellow fever immunization cards
- The cloth market in Lagos, Nigeria, where the area’s population has by some estimates nearly doubled over 15 years to 21 million, and living standards for many are falling. Children at a primary school in Ketu, Nigeria. In a quarter century, at the rate Nigeria is growing, 300 million people — a population about as big as that of the present-day United States — will live in a country the size of Arizona and New Mexico. Nigeria made contraceptives free last year, and government officials are promoting smaller families as a key to economic salvation, holding up the financial gains in nations like Thailand as inspiration. Children in classrooms separated by boards in Ketu, where three schools have classes in the same compound to save space. Last October, the United Nations announced the global population had passed 7 billion and would expand rapidly for decades. Giving birth by the light of the nurses’ cell phones at the Ketu Health Clinic. In sub-Saharan Africa, the rise in population far outstrips economic expansion. Of the approximately 20 countries where women average more than five children, almost all are in the region. At current growth rates, sub-Saharan Africa, which now accounts for 12 percent of the world’s population, will account for more than a third by 2100, by many projections. Credit: Benedicte Kurzen for The New York Times A vaccination clinic. Nigeria, already the world’s sixth most populous nation with 167 million people, is a crucial test case, since its success or failure at bringing down birthrates will have an outsize influence on the world’s population. Credit: Benedicte Kurzen for The New York Times Muriana Taiwo, 45, explained that it was “God’s will” for him to have 12 children by his three wives, calling each child a “blessing” because so many of his own siblings had died. Credit: Benedicte Kurzen for The New York Times A city scene in Lagos. As graduates pour out of high schools and universities, Nigeria’s unemployment rate is nearly 50 percent for people in urban areas ages 15 to 24 — driving crime and discontent. Credit: Benedicte Kurzen for The New York Times A student prepared a database at the Population and Reproductive Health Program at the University of Obafemi Awolowo. In a deeply religious country where many oppose contraception, politicians and doctors broach the topic gingerly, and change is slow. Credit: Benedicte Kurzen for The New York Times Elsewhere in the developing world, fertility rates have fallen sharply and are now similar to those in the United States. That transformation was driven by a mix of educational and employment opportunities for women, access to contraception, urbanization and an evolving middle class. Credit: Benedicte Kurzen for The New York Times Students at a primary school. Nigeria, like many sub-Saharan African countries, has experienced a slight decline in birthrates, to about 5.5 per woman last year from 6.8 in 1975. But this level of fertility, combined with an extremely young population, still puts such countries on a steep and disastrous growth curve. Credit: Benedicte Kurzen for The New York Times
- In summary, we have a civilisation at risk. We have emerging scarcity of raw materials, not just oil and energy; but also phosphate – essential for fertiliser - and rare earths – essential for the New Industrial Revolution that optimists look forward to. We have an archaic economic system, better suited for a world much earlier on the curve, before the planet got so full. This system denies limits to growth, and we need urgently need the Green Economy .. but this has been pointed out by visionaries from John Stuart Mill to EF Schumacher for a long time, with little result, as yet. Finally, we have immense inequality, that breeds civil stress, terrorism, fascism and war ---- Jackson, T. 2009. Prosperity without growth? The transition to a sustainable economy. Sustainable Development Commission. Meadows, D. H., D. L. Meadows, J. Randers, W. W. B. III. 1972. The limits to growth. New York: Universe Books. Meadows, D. L., W. W. B. III, D. H. Meadows, R. F. Naill, J. Randers, E. K. O. Zahn. 1974. Dynamics of growth in a finite world. Massachusetts: Wright-Allen Press, Inc. Turner, G. M. 2011. Consumption and the environment: Impacts from a system perspective. In: Landscapes of urban consumption. Edited by P. W. Newton. Collingwood: CSIRO Publishing. 51-70.
- Before I am accused of complacency, I fear these dismal conditions could re-emerge. We know, especially in parts of Asia and Africa of many densely crowded human populations, already with malnourishment, especially in South Asia. I hope I am wrong, but I worry that our trajectory, with high birth rates, resilient poverty, resilient inequality, and worse crowding will interact with climate and other forms of adverse global environmental change and breed one or more megapandemics. But that will be far from our only problem.
- Conjuring a parachute At 7:30 pm on Wednesday 20 JuneWhere: At the CSIRO Discovery Centre (turn up the hill from the roundabout in Clunies Ross Street) Prophets of the impending collapse of civilisation are increasing in number and credibility, bolstered by accumulating evidence. Glib reassurances of hope, technological rescue and reminders of previous false prophets of doom no longer bring relief; new strategies are needed. These include eroding the social contract that permits actions that poison our collective future, analysis of denial, and exposure of oppression. We need to create “social vaccines”; new fables that can help thwart collapse. Principally, we need a vast social movement; with scores of overlapping approaches. These are just a few. Associate Professor Colin D Butler is an Australian Research Council Future Fellow. His topic concerns Australia’s social sustainability, in a global context of increasing resource scarcity. He is a medically trained epidemiologist, National Centre for Epidemiology and Population Health, Australian National University. In 2009 he was named one of “a hundred doctors for the planet”. -----Original Message----- From: Colin Butler Sent: Sunday, 5 February 2012 10:39 AM To: Jenny Wanless Subject: RE: Talk to NSF in June Jenny Perhaps I could talk on this general topic (communication, hostility, denial, partying - "shopping therapy" - eg Dubai tower, Qatar soccer, "small wins", a "social vaccine"). Below is a long abstract, (accepted) for a meeting on emergent risk to be held at Princeton in September. Below that is part of a recent grant application, of relevance. Attached is a recent editorial, also relevant, and a book review of McKibben's "Eaarth". Fundamentally, though, I think a grossly dysfunctional (even if understandable) human response to the proximity of a looming crisis makes the crisis inevitable; think of Europe pre WWII, the French Court pre revolution.. Important to keep some hope, though! Colin PS I welcome comments, including ones that are critical. *** Understanding cyclic vulnerability to reduce the risk of global collapse Colin D Butler Australian National University (Princeton emerging risk conference) Population vulnerability is cyclic, analogous to immunity. Following epidemics, surviving populations have sufficient antibodies to inhibit repeat infection until a sufficient number of immunologically vulnerability people accrue, due to waning immunity and the maturing of a new generation. Other forms of cyclic risk exist, driven by the waxing and waning of collective memory and behaviour and amplified by the rise and fall of social mechanisms. Three examples are global conflict, inequality and economic history. In the first, strong global social forces following World War II (WWII) led to a sufficiently vigorous social contract to inhibit very large-scale state violence, fortified by numerous institutions including the United Nations. Almost 70 years later, the social immunity generated by the two World Wars is still fairly powerful, though some of the institutions are weakening. The second example concerns inequality. Following the Depression and WWII sufficient social forces were liberated to reduce inequality of several forms; in the US memory of the gilded age faded, in the UK the National Health Service was born, and the global wave of decolonisation appeared unstoppable. However, gradually, many forms of inequality have reappeared, including in most formerly Communist nations. Economic history comprises the third example. Economic booms and busts have occurred since at least the Great Tulip frenzy (1634-37), and the cycle continues, not least because mainstream opinion in new generations asserts that the problem has been solved and a new generation of naive speculators and investors is seduced. Today, global civilisation itself is threatened. This risk may be emergent, as defined by this meeting, but is also ancient and recurrent. Numerous civilisations have collapsed in the past; what differs today is the global scale of this risk. This is plausible due not only to globalisation but also to the convergence of several forms of risk immuno-naïveté. This vulnerability has also been described as arising from the Cornucopian Enchantment, a period since roughly 1980, when most economists, decision makers and even the academy reached quasi-consensus that the problem of scarcity had been permanently solved. This hubris seemed rational to a new generation, trained and rewarded to think that economics and ingenuity would of themselves solve all major problems; such pride was fortified (for a time) by data regarding cheap food, cheap energy and declining global hunger. However, in the last decade, data have accumulated that show not just diminishing reserves (eg oil); but less contestable evidence such as rising prices (oil, food), rising unemployment and increased social resentment. Nevertheless, most policy makers remain wedded to the old-world thinking that has helped create these developing, interacting crises. What can be more important than to reduce the emergent risk of global civilisation collapse? Failure to lower this risk may lead to a dramatic change in global consciousness, following a period likely to make the Dark Ages seem desirable. Instead, it is vital to immunise a sufficient number of people who can then demand, develop and support the requisite radical new policies. These include acceptance that resources are limited, development of green economic systems that will price negative externalities, and revival of fairness of opportunity. **** part of the grant application: Project 5.3 Climate change and public health communication [Butler, Steffen] There is increasing evidence that both suppression ((C. D. Butler, 2000; Oreskes & Conway, 2010) and cognitive barriers (eg denial, bias to optimism) inhibit understanding of the risk of adverse global change, including to the climate (C. D. Butler, 2011; Diethelm & McKee, 2009; Ornstein & Ehrlich, 1989). These impede policy uptake. Improved understanding of collective social and cognitive factors that protect or endanger civilisation, and thus population health, is an urgent research need. For example, global abhorrence of further war followed World War II, leading to the birth of the United Nations and other peace-promoting institutions (C. D. Butler, 2000). Although weakening, their influence persists, as if the horror of the previous decades had produced a temporary global social vaccine. To prevent future global eco-social collapse, workers can devise social vaccines which balance dysfunctlonal arousal (Weick, 1984) (likely to trigger outcomes such as despair and indifference) and a placebo, which induces complacency. Methods: This project will review and synthesise the emerging literature in this field and also interview key informants (including CIs McMichael and Steffen) concerning perceived barriers which inhibit policy uptake. Outcomes will include conference presentations and an edited book. Benefits should include better uptake of difficult messages by populations and thus policy makers. -----Original Message----- From: Jenny Wanless [mailto:jennifer.wanless@gmail.com] Sent: Sun 05/02/2012 09:42 To: Colin Butler Subject: Re: Talk to NSF in June Indeed I remember that you spoke to us. And yes,we have made very little progress - or more probably gone backward since that time. More and more of the public are vociferously opposed to any idea that humans are inducing climate change or anything else harming the earth. It even seems that more deny evolution. It is very puzzling. At NSF we have a couple of groups who have been talking about this recently. Tony McMichael said he had had an overwhelmingly hostile reaction to an article he published recently. He said that scientists are realising that they are failing to communicate, and wondering where they have gone wrong. If you have any answers we would be delighted to hear them - but I am not hopeful. Our meetings are on the third Wednesday, so it would be 20th June, 7.30pm. Speakers have half an hour to an hour, but we do want some time for discussion, and we finish about 9pm. And I don't deserve any congratulations - Ian did it, not me. But I am pleased to have brought up a mathematician. Jenny On Sat, Feb 4, 2012 at 9:19 PM, Colin Butler <[email_address]>wrote: > ** > > Jenny > > Thanks .. and congratulations to you and your son.. > > I am planning to hear Nicole Foss on the 13th, and probably my topic > will be somewhat related; I will try to come up with a title and short > description after hearing her. Please do not hesitate to nag me if you > think I have overlooked advising you. > > Do you have a provisional date in June, and also a suggested time to speak? > > You may recall that I spoke to N&SF in early 1998 - we have more or > less continued with business as usual since that time; indeed you > might say since Limits to Growth appeared, 40 years ago. > > Best wishes > > > Colin > > > > > -----Original Message----- > From: Jenny Wanless > [mailto:jennifer.wanless@gmail.com<jennifer.wanless@gmail.com> > ] > Sent: Sat 04/02/2012 20:49 > To: Colin Butler > Subject: Re: Talk to NSF in April > > That would be great - it sounds very relevant. Please let me know in > another month or so whether that still suits you, and a title for yout > talk. > Tony told me it was the recent round, so I took his word for it. > Actually I am the proud mother of a Future Fellow - our younger son > Ian was awarded it in the recent round, but he is in Pure Maths - Combinatorics. > I'm very glad that you were awarded it in something to do with > sustainability - maybe the Government will take some notice of it. > JennyW > > On Sat, Feb 4, 2012 at 11:44 AM, Colin Butler <Colin.Butler@anu.edu.au > >wrote: > > > ** > > > > Jenny > > > > Yes, I do remember you - of course! > > > > The Future Fellowship was actually awarded in late 2010, not the > > most recent round. > > > > Its topic is "Health and sustainability: Australia in a global context." > > > > I have a pretty hectic time in the next three months, but perhaps a > > talk in June or so would be possible? > > > > Best wishes > > > > Colin > > > > > > > > -----Original Message----- > > From: Jenny Wanless > > [mailto:jennifer.wanless@gmail.com<jennifer.wanless@gmail.com> > <[email_address]> > > ] > > Sent: Sat 04/02/2012 11:31 > > To: Colin Butler > > Subject: Talk to NSF in April > > > > Dear Colin - remember me? I'm still secretary of the Nature and > > Society Forum. Last week I asked Tony Capon whether he would talk to > > NSF at our 18th April meeting. He suggested you instead. He told me > > that you > received > > a Future Fellowship in the recent ARC round of grants. > > Congratulations - that is very prestigious. What is your field? > > Anway, I am sure it is something that is relevant to our concerns It > > has been a long time since > we > > heard from you, so I do hope you will agree to talk to us some time > > even > if > > April does not suit you. > > Jenny Wanless > > > > > > Even before that World Health Day I heard a joke. Two people have fallen from a very tall building. One is an ecologist and the other is an economist. The ecologist is terrified, but the economist is supremely calm. Don’t worry, he says, “demand will create a parachute”. The person who told us that joke was vilified by many people; some of you will have heard of him. His name is Paul Ehrlich. If we go back to the vaccine analogy, it is very clear that Ehrlich alienated many people because his message was too painful. I personally think, on good days, that a parachute is possible. But we are not going to use that parachute unless we can see the ground, and unless we can anticipate the consequences of hitting it, and I think far too, many people, including policy makers, politicians and what we could call the consuming class of about 1 billion people are in denial. They cannot see the ground, though by now, perhaps a few hundred million can, and they are calling very hard for the ripcord to be pulled. -----
- Carbon sink – climate change – SOD; urbanisation – cultural services Highly indirect .. CONTESTED
- Figure SPM-12. | Cost trends of selected non-fossil energy technologies (US$2005/kW installed capacity) versus cumulative deployment (cumulative GW installed) Chapter 24 data have been updated with most recent cost trends (2010) available in the literature for PV Si Modules and US onshore wind turbines. Note that the summary illustrates comparative cost trends only and is not suitable for direct economic comparison of different energy technologies due to important differences between the economics of technology components (e.g. PV modules versus total systems installed), cost versus price data, and also differences in load factors across technologies (e.g., nuclear’s electricity output per kW installed is three to four times larger than that of PV or wind turbine systems). Source: Chapter 24 .
- A world made new: Gleandon
- In summary, we have a civilisation at risk. We have emerging scarcity of raw materials, not just oil and energy; but also phosphate – essential for fertiliser - and rare earths – essential for the New Industrial Revolution that optimists look forward to. We have an archaic economic system, better suited for a world much earlier on the curve, before the planet got so full. This system denies limits to growth, and we need urgently need the Green Economy .. but this has been pointed out by visionaries from John Stuart Mill to EF Schumacher for a long time, with little result, as yet. Finally, we have immense inequality, that breeds civil stress, terrorism, fascism and war ---- Jackson, T. 2009. Prosperity without growth? The transition to a sustainable economy. Sustainable Development Commission. Meadows, D. H., D. L. Meadows, J. Randers, W. W. B. III. 1972. The limits to growth. New York: Universe Books. Meadows, D. L., W. W. B. III, D. H. Meadows, R. F. Naill, J. Randers, E. K. O. Zahn. 1974. Dynamics of growth in a finite world. Massachusetts: Wright-Allen Press, Inc. Turner, G. M. 2011. Consumption and the environment: Impacts from a system perspective. In: Landscapes of urban consumption. Edited by P. W. Newton. Collingwood: CSIRO Publishing. 51-70.
- Late on the third day, at the very moment when, at sunset, we were making our way through a herd of hippopotamuses, there flashed upon my mind, unforeseen and unsought, the phrase, "Reverence for Life." The iron door had yielded: the path in the thicket had become visible”. Sept, 1915