Health Without Borders: Epidemics in the Era of Globalization PDF
Preview Health Without Borders: Epidemics in the Era of Globalization
Paolo Vineis C A N C E R OBE ETES S B I A TY DI Health WITHOUT Borders EPIDEMICS IN THE ERA OF GLOBALIZATION Health Without Borders “From morality to molecules, environment to equity, climate change to cancer, and politicstopathology,thisisawonderfultourofglobalhealth–consistentlypresented inaclear,readableformat.Really,animportantcontribution.” —ProfessorSirMichaelMarmot,Director,InstituteofHealthEquity, UniversityCollegeLondon,Authorof“TheHealthGap” “Paolo Vineis provides convincing evidence that ourfailingeconomic systems and the plunderingofourenvironmentalresourcesarethreatstohealththatcannotbecombatted byleadingahealthylife-styleorbytheeffortsofnationalgovernments.A‘mustread’for politicians, skeptics and those of us who are attempting to promote international collaborationinenvironmentalprotection,economicstrategiesandpublichealth. Thisbookhasastarkmessage—ifwecarryonasusual,theglobalgainsinhealthmay bereversed.Readhowwegotintothismessandhowwemaybeabletogetoutofitby means of international economic and environmental collaborations. Vineis’ book is a major contribution to global health thinking which should influence policy and practice.” —ProfessorShahEbrahim,LondonSchoolofHygiene&TropicalMedicine “Thisisanexcellentandtimelyintroductiontothemostimportanthealthissuesofour time.Globalhealthispresentedasa‘well-conceivedthriller’withmanyactorsandan uncertainending.Thisisanexcellentoverviewoftherapidglobalchangeswearefacing inourenvironment,theirconsequencesforhealth,andthepotentialsolutions.Should be essential reading for all those involved in global health, health research and health services,aswellasallthoseconcernedaboutthehealthoftheplanetanditsinhabitants.” —NeilPearce,HeadofDepartmentofMedicalStatisticsandProfessorofEpidemiology andBiostatistics,LondonSchoolofHygiene&TropicalMedicine “Thisbookisasalutaryandsoundlyarguedreminderthatthe‘commongood’isnot simply what remains after individuals and groups have appropriated the majority of societalresources: itisinfactthefoundationonwhichanysociety rests andwithout whichitcollapses. Strengthening this foundation is vital to successfully tackling the growing global environmental and economical challenges, which are unequally distributed between and within countries. The book emphasizes that for this purpose technical solutions based on political choices inspired by social solidarity are called for. They represent feasiblealternativestothedismalandhazardousprospectsthatthesurvivalofhuman- kindwilllieinchanginghumansintotrans-humansthroughbiotechnologicalmanip- ulation,orintheescapetoMarsoranexoplanetforaveryfewpeopleoutofbillions.” —RodolfoSaracci,SeniorVisitingScientist,InternationalAgencyfor ResearchonCancer,Lyon PaoloVineis Health Without Borders Epidemics in the Era of Globalization PaoloVineis ImperialCollege London,UnitedKingdom ISBN978-3-319-52445-0 ISBN978-3-319-52446-7 (eBook) DOI10.1007/978-3-319-52446-7 LibraryofCongressControlNumber:2017941007 ©SpringerInternationalPublishingAG2017 RevisedtranslationfromtheItalianlanguageedition:Salutesenzaconfini.Leepidemiedellaglobalizzazioneby PaoloVineis,©CodiceEdizioni2014.AllRightsReserved. Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartofthe material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storageand retrieval,electronic adaptation,computersoftware,orbysimilaror dissimilar methodologynow knownorhereafterdeveloped. Theuseofgeneraldescriptivenames,registerednames,trademarks,servicemarks,etc.inthispublicationdoes notimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfromtherelevantprotective lawsandregulationsandthereforefreeforgeneraluse. Thepublisher,theauthorsandtheeditorsaresafetoassumethattheadviceandinformationinthisbookare believedtobetrueandaccurateatthedateofpublication.Neitherthepublishernortheauthorsortheeditors giveawarranty,expressorimplied,withrespecttothematerialcontainedhereinorforanyerrorsoromissions thatmayhavebeenmade.Thepublisherremainsneutralwithregardtojurisdictionalclaimsinpublishedmaps andinstitutionalaffiliations. Printedonacid-freepaper ThisSpringerimprintispublishedbySpringerNature TheregisteredcompanyisSpringerInternationalPublishingAG Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland fi Europehaseveryrightandeverycapacitytobeabletoofferthe nestmodelofsocial welfare on earth: we must stop squandering our opportunities! Thomas Piketty New York Review of Books, February 25, 2016 ThisbookisdedicatedtoLudwikFleck,agreatphilosopherandscientist,andTony McMichael,agreatepidemiologistandamasterofintegrity,inthehopethatfuture generations will read their work. Preface Why This Book Like in a well-conceived thriller, many different trends in the world are now converging to create an almost unbearable suspense about what our future — holds although the plot remains blurred, it is clear that life has become increasingly unsustainable and uncertain for many. Climate changes, mass migrations,wars,theeconomiccrisis,pandemics,theepidemicsofobesityand diabetes and unprecedented environmental degradation can no longer be considered separate threats to be dealt with in isolation. Rather, these and other global threats to human health and well-being often share common causesandhaveimpactsthatareconvergingdangerouslytowardsanunknown future.Theconsequencesforhumanhealthhavenotbeenfullydescribedand remain poorly understood. The principal motivation behind this book is to attempt to draw some of these threads together into a more coherent picture, to understand what the evidence suggests about the emergence of multiple healththreatsfromglobalchangesandtheirinteractions.Theguidinghypoth- fi esisisthatwehaveallcontractedadoubledebt:oneis nancial(andiswell known) and one is environmental (and is underestimated, particularly in health circles, and more serious). A second theme that is explored through- — outthebookisthat,liketheeconomy,thestateofhealthofhumankind that — on average has always improved so far may become increasingly unstable with areas of decline, accompanied by an ongoing widening of the socio- economic divide particularly within nations. ix x Preface “ ” After an introductory chapter that explains what global health is and describestheintertwiningofthethreatsthattheplanetisfacing,thefollowing chaptersaredevotedtothemaintopicsthatcontributetoglobalhealth;thatis, the impact of globalisation on the onset and distribution of diseases. These chapters address, for example, food, climate, environmentalpollution andthe impactoftheeconomiccrisisonhealth.Aseparatechapterisdevotedtocancer because its many and varied forms epitomise the multidimensional aspects of the problem: the divergence between increasing incidence and decreasing mortality rates in rich but not in poor countries (where both trends are increasing); the role of improved diagnosis; differential access to therapies; the changing landscape of risk factors; and the political problems of cancer control. Another chapter addresses a fundamental recent discovery about the mechanisms of disease, which promises to be of great relevance for global “ ” health: epigenetics provides a new perspective on the ability of the environ- ment to modulate the expression (functioning) of genes. In an era of con- — stantly changing environmental landscapes like in the quality and — composition of food epigenetics may prove to be essential in mediating the health effects of environmental change. The last two chapters draw some conclusions on how policies could be directed towards creating potential fi solutions for the problems described, and how only rede ning the environ- “ ” ment and health as common goods requiring our concerted protection can be effective in sustaining quality of life in the medium to long term. It is obvioustomanythatwaitingforpotentialsolutionstoemergefromthelawsof themarketaloneisnotgoingtobeenoughtomeetthehealthchallengesofthe fi twenty- rst century. If the environment and health are not eventually con- ceived and appreciated as common goods of humanity, then the separate problems described in this book will not be resolved. London, UK Paolo Vineis September 2016 Acknowledgements I am particularly grateful to Shah Ebrahim and Elisabete Weiderpass for their verythoroughreadingofthemanuscriptandthemanysuggestionsandstimuli they gave me. I am also very grateful to Rodolfo Saracci, David Blane, Kris Murray, Cristina Savio, Enrico Casadei, Roberto DeVogli, Pietro Ortoleva, Pietro Terna, Nerina Dirindin, Luca Carra and Roberto Satolli for their attentive reading and precious advice. Part of this book is taken from the lectures on the course of Global Health that I have coordinated for the past seven years (together with Helen Ward, Graham Cooke and Mariam Sbaiti) for the students of Medicine at Imperial College of Science, Technology and Medicine, London. The following link gives access to part of the course contents: http://tinyurl.com/pnlagc7. IthankDemranAliandShahibaBegumfortheirworkonNauruattheBSc – in Global Health at Imperial College in the years 2009 2011. xi Contents 1 The Double Debt: Economic and Environmental 1 The Economic Crisis 1 The Environmental Debt 2 The Baumol Disease and the Funding of the State 4 fi Co-bene ts of Climate Change Mitigation 5 Final Remarks 7 2 An Overview of What Global Health Is 9 Economy and Health 10 Converging Trends: The Quest for a Minimal State, Misconceptions on Science, Fragmented Research 11 Political Crisis, Health Crisis 13 Health in a Global World 14 Three Exemplary Cases: Nauru, Greece and Bangladesh 15 Obesity in Nauru: A Story of Early Globalisation 15 Greece: The Health Effects of Economic Crisis 16 The Case of Bangladesh 18 3 Food 21 The Two Faces of Nutritional Problems 21 The Global Food Industry 23 xiii
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