Down from the UN NCD Summit
The choice: Life, liberty and the pursuit
of happiness? Or money?
After the UN Summit on NCDs: Briefing notes
This is the first of a series of news features following the UN high-level meeting on non-communicable diseases held at UN headquarters, New York, last month. These will focus on the implications and outcomes of the meeting, and on preparations for the next formal stages in 2012 and 2014.
Access pdf of last month's WN editorial on the summit here
Access pdf of the WN commentary on the summit by Philip James here
Access pdf of the WN series of commentaries on the summit here
Access pdf of this month's WN editorial on the summit here
My way or the desert highway? Jeffrey Sachs (left) and (right) King Khesar of Bhutan, source of his insights into life, liberty and pursuit of happiness
1. Acknowledge that the global burden and threat of non-communicable diseases
constitutes one of the major challenges for development in the twenty-first century,
which undermines social and economic development throughout the world, and
threatens the achievement of internationally agreed development goals
UN High-Level Meeting on NCDs. Political Declaration, Clause 1
The news team reports: The ideology of the United Nations and the most powerful national governments is to think of public health and economic development as two sides of the same coin. The argument, developed in innumerable reports and position papers, has been that disease impedes development, and also that what the world needs is more and more economic development. As shown in the opening statement from the UN High Level Meeting on prevention and control of non-communicable diseases, in the box above, 'social' is beginning to be bracketed with economic development. But the emphasis still remains on economic development – meaning, the circulation of more and more money.
Perhaps the most influential active economist in China, Niu Wenyuan, does not agree. He proposes a whole new way to gauge wealth. A recent feature (1) explains that his formulation includes five elements. The first is: 'Economic quality, which considers the amount of resources and energy needed to generate each 10,000 yuan of GDP'. But the other four are usually now left out of account when a nation's wealth is assessed. These are: 'Social quality, which includes differences of incomes between rich and poor that might led to destructive riots; environmental quality, which assesses the amount of waste and carbon generated per 10,000 yuan of economic activity; quality of life, which figures in life expectancy and other human development indicators; and management quality, which measures the proportion of tax revenue used for public security, the durability of infrastructure and the proportion of public officials in the overall population'.
This view undermines the foundations of last month's UN high-level meeting on prevention and control of non-communicable diseases. First, the final documents for the meeting assumed that economic development is the only relevant type of development. Second, some of the partners now positioned to strengthen development, are transnational corporations whose policies and practices increase inequity, degrade the environment, destroy public institutions and public goods, and whose profits increase in line with serious chronic diseases.
Agreement between China and the US
Master of the universe Jeffrey Sachs thinks big. He has a special interest in Africa (see globe, left) and in education (see him geared up in Mali, right)
Well, a reader may think, that's a Chinese view. It is also a US view. Perhaps the most influential active US economist is Jeffrey Sachs (pictured above). He is now impressed by the philosophy of King Khesar of Bhutan (pictured at top right, being crowned in 2006). The guiding philosophy of the king and his father before him is 'Gross National Happiness'. In a widely published statement last month, here are some of the new views of Jeffrey Sachs.
He now says of the US: 'The relentless pursuit of higher income is leading to unprecedented inequality and anxiety, rather than to greater happiness and life satisfaction. Economic progress is important and can greatly improve the quality of life, but only if it is pursued in line with other goals. In this respect, the Himalayan Kingdom of Bhutan has been leading the way. Forty years ago, Bhutan's fourth king, young and newly installed, made a remarkable choice: Bhutan should pursue "gross national happiness" rather than gross national product. Since then, the country has been experimenting with an alternative, holistic approach to development that emphasises not only economic growth, but also culture, mental health, compassion, and community'.
What does this have to do with rich countries? He says: 'We should not denigrate the value of economic progress. When people are hungry, deprived of basic needs such as clean water, health care and education and without meaningful employment, they suffer. Economic development that alleviates poverty is a vital step in boosting happiness' But then: 'Relentless pursuit of GNP to the exclusion of other goals is also no path to happiness… Single-minded pursuit of GNP has led to great inequalities of wealth and power, fuelled the growth of a vast underclass, trapped millions of children in poverty, and caused serious environmental degradation… As a society, it is one thing to organise economic policies to keep living standards on the rise, but quite another to subordinate all of society's values to the pursuit of profit'.
Box 1
The conversion of Jeffrey Sachs
Jeffrey Sachs is a 'neoliberal' thinker and a leading advocate of the Washington Consensus, which provides the ideology for economic globalisation and thus the rise of transnational corporations. His main impact on the world in his role as a master of the universe, has been as advisor successively to the Bolivian, Polish and Russian governments, the latter during the Boris Yeltsin regime. As such, each time he masterminded the 'shock therapy' doctrine designed to stabilise inflation, which involves mass privatisation, the selling off of public assets, and elimination of public services such as minimum wages, secure employment, pensions, state schools, and primary health care. This advice was accepted and put into practice by the rulers of these countries (3).
In the Monthly Review (4), Nancy Holmstrom and Richard Smith say that in advising implementation of his shock therapy on the former Soviet Union, Sachs 'supposed the transition to capitalism would be a natural, virtually automatic economic process: start by abandoning state planning, free up prices, promote private competition with state-owned industry, and sell off state industry as fast as possible…' Dramatic decreases in industrial followed, personal incomes halved, and unemployment, alcoholism and suicide rocketed. Other commentators also point to the emergence of 'gangster politics' in Russia, together with grossly increased inequity and internal terrorism and war, particularly dangerous in a country with a massive stockpile of nuclear weapons.
Jeffrey Sachs says in his own defence that his 'prescription' of 'the strong medicine' of shock therapy always included the need to administer massive aid. The US and its allies were never willing to give aid, and it is generally assumed that US policy was to welcome the prostration of Russia. The new model of Jeffrey Sachs is therefore all the more remarkable. Like other champions of 'the new world order' and of 'the American Century', he seems now to realise that there is more to decent societies than the impeded flow of capital.
And what does this have to do with last month's UN high level meeting, which welcomes transnational manufacturers of ultra-processed products as partners in progress? Jeffrey Sachs explains. 'Global capitalism presents many direct threats to happiness. It is destroying the natural environment through climate change and other kinds of pollution, while a relentless stream of oil-industry propaganda keeps many people ignorant of this. It is weakening social trust and mental stability, with the prevalence of clinical depression apparently on the rise'.
Mad pursuit of corporate profits
He goes on explicitly and directly to attack the transnational manufacturers of ultra-processed products. 'The fast-food industry uses oils, fats, sugar, and other addictive ingredients to create unhealthy dependency on foods that contribute to obesity. One-third of all Americans are now obese. The rest of the world will eventually follow unless countries restrict dangerous corporate practices, including advertising unhealthy and addictive foods to young children. The problem is not just foods. Mass advertising is contributing to many other consumer addictions that imply large public-health costs, including excessive TV watching, gambling, drug use, cigarette smoking, and alcoholism… Most countries invest to measure GNP, but spend little to identify the sources of poor health (like fast foods and excessive TV watching), declining social trust, and environmental degradation. Once we understand these factors, we can act. The mad pursuit of corporate profits is threatening us all'.
Life, liberty, and the pursuit of happiness… This sounds familiar. Jeffrey Sachs is special advisor to UN secretary-general Ban Ki-moon on the UN Millennium Development Goals. Before the thinking of the UN and its public partners on the prevention and control of obesity and other chronic diseases gets set in concrete, he had better have a word with secretary-general Ban. Better yet, public health professionals will now do well to start thinking hard about the underlying assumptions and philosophy of last month's meeting in New York, and all that is liable to flow from it.
References
- Watts J. China's green economist stirring a shift away from GDP. The Guardian, 16 September 2011.
- Sachs J. America and the pursuit of happiness. Gulf Times, 1 September 2011.
- Klein N. The new doctor shock [Chapter 7]. The capitalist Id. [Chapter 12]. In: The Shock Doctrine. The Rise of Disaster Capitalism. New York: Picador, 2007.
- Holmstrom N, Smith R. The necessity of gangster capitalism. The Monthly Review 2000; 51, 9
