“Civilisation is a hopeless race to discover remedies for the evils it produces.” Are these the words of Ban Ki-moon? Or President Barack Obama? No. They were written nearly 300 years ago by Jean-Jacques Rousseau when he perceived inequality to be the greatest threat facing society. Last week, over 300 000 people took to the streets of New York to proclaim a new threat—climate change. In 2000 cities across the world, a coordinated civil protest of astonishing proportions took place. Of course, climate change is only one predicament the world must urgently address. Bob Orr, Assistant Secretary-General for Policy Coordination and Strategic Planning at the UN, pointed out ruefully last week that the world is facing more crises today than at any time in the history of the UN. But climate change must rank, Gro Harlem Brundtland argued, as “the most significant global health risk of this century”. Brundtland, author of our modern ideas about sustainable development, used the world’s first Climate Summit at the UN General Assembly to call for a new coalition of interests between governments, private sector, and civil society to overcome the climate crisis. The scale of this challenge is beyond anything our species has confronted.
Yet, it would be a mistake to see climate change as an isolated threat. Just before the UN General Assembly began, the UN’s Population Division warned about future population trends. Contrary to its previous position, their scientists concluded that the world’s population was unlikely to stabilise by the end of this century. Instead, we should expect population to increase from 7·2 billion today to around 10·9 billion by 2100, and perhaps to as high as 12·3 billion. The UN calculates that the only way to reduce this population pressure is through unprecedented fertility declines. The greatest challenge will be in Africa, where population is projected to rise from around 1 billion people today to somewhere between 3·1 and 5·7 billion in 2100. The consequences are serious—environmental, economic, political, and social. And there will be health consequences too if we do not alter the trajectory we seem to be on. At the centre of those health threats is nutrition. We already know that the world’s comparatively modest population (by future standards) includes 165 million children who are stunted and condemned never to fulfil their full potential. The combination of stunting, wasting, fetal growth restriction, and appallingly low rates of breastfeeding causes over 3 million under-5 deaths annually. Paradoxically, the world’s population is also enduring a crisis of overnutrition—well over a third of people are overweight or obese and no country has been able to report success in controlling its obesity explosion. The origins of sustainable health lie in childhood, and especially in childhood nutrition. One of the most effective ways to defeat both climate change and inequality is to invest in better nutrition in early childhood. The future we can anticipate is one where continuing population increases, unabated climate change, and a pervasive crisis in human nutrition will damage the health of many more millions of people. Can a new era of sustainable development refocus global priorities to address these challenges? The truthful answer from last week is that we just don’t yet know.
The Lancet – Read full article here.