Ten years ago, Captain America and The Hangover Part II were kings of the summer movie box office, Occupy Wall Street protestors were flooding into Zuccotti Park in lower Manhattan, and UN Secretary-General Ban Ki-moon stood before the UN General Assembly, declaring that it was time to address the surge of cancers, diabetes, and other noncommunicable diseases (NCDs) globally. His words marked the opening to the first high-level meeting on NCDs, the first UN General Assembly special meeting devoted to a health issue other than HIV/AIDS.
Matthew Oliver writes: More than 1.1 million people die from hepatitis B and C every year. An estimated 296 million people worldwide are living with hepatitis B, but only 2% of those are receiving treatment. For hepatitis C, which is curable, only 21% of the 58 million people worldwide who are affected by the disease are diagnosed, and fewer than two-thirds of those are on treatment.
Ahmed Mushfiq Mobarak writes: In the United States, where COVID-19 vaccines are plentiful, the biggest remaining obstacle to protecting the population is vaccine hesitancy. Meanwhile, public health experts are raising the alarm that the highly contagious Delta variant is spreading through unvaccinated populations—and additional variants could arise as long as the disease is endemic. But according to a new study, once more vaccines are made available in the developing world, there will be plenty of people eager to receive them—a finding that underscores the importance of global vaccine equity in saving lives and preventing the evolution of new, more dangerous variants.
As a physician, I know firsthand the important role that primary health care plays in the health of individuals, families, and communities. When it works well, it is the foundation of a good life and a thriving national health care system. When it is weak, people suffer.
- A coronavirus may have swept across East Asia more than 20,000 years ago.
- New research has found evidence of genetic adaptation to the coronavirus family of viruses in 42 genes in modern populations among the region.
- Aside from SARS-CoV-2, which causes COVID-19, the coronavirus family also includes the related MERS and SARS viruses.
- By uncovering the genes impacted by historical viral outbreaks, researchers can gain greater insight into our evolutionary genetic ability to fight disease.
- Chronic disease driven by processed food provided the backdrop for COVID-19 to spiral out of control.
- Fundamental and structural changes are needed in the way we engineer foods, with metabolic health as the industry’s North Star.
- A scalable, replicable framework being championed by KDD is the “metabolic matrix”, a science-based template for designing foods that ensure metabolic health.
- Birthrates are falling globally.
- In many countries, COVID-19 has suppressed population growth by causing a decline in births, migration and life expectancy.
- Even before the pandemic, urbanization was driving population decline.
At the end of May, the Chinese Government announced that parents in China would now be permitted to have up to three children. This announcement came only five years after the stunning reversal of the 1980 one-child policy.
Something is clearly going on.
That something is that China has experienced a fertility collapse. According to the latest census released in May, China is losing roughly 400,000 people every year. China still claims its population is growing, but even if these projections are taken at face value, the population decline previously projected to start by midcentury may now begin as early as 2030. This means China could lose between 600 and 700 million people from its population by 2100.
That’s right: 600 and 700 million people, or about half of its total population today.
China’s population changes are not unique among the superpowers. According to the United States’ most recent census, the US birthrate has declined for six straight years and 19% since 2007 in total. Like China, the US birthrate is now well below replacement rate at 1.6. (China is now at 1.3.) For a country to naturally replace its population, its birthrate needs to be at least 2.1.
You can also add the world’s second-most populous country, India, to the list of low-fertility countries, with a birthrate at replacement rate (2.1). Also include Japan (1.3), Russia (1.6), Brazil (1.8), Bangladesh (1.7) and Indonesia (2.0).
There are still big countries with high birthrates, such as Pakistan (3.4) and Nigeria (5.1). But even these numbers are lower than they were in 1960 – when Pakistan was at 6.6 and Nigeria at 6.4 – and declining every year.
The role of COVID-19 in declining birthrates
The COVID-19 pandemic is serving as a modifier – but not in the way commentators and comedians suggested when lockdowns began.
Remember all the jokes about people being stuck at home leading to a baby boom? As the data rolls in, its clear that in many countries, the opposite has occurred. Most children these days are wanted or planned children, especially in the developed world. Deciding to have a baby is contingent on being optimistic about the future – and optimism is difficult to muster during a global pandemic. In fact, the Brookings Institute estimates that 300,000 babies were not born in the US as a result of economic insecurity related to the pandemic.
Could this be a short-term phenomenon ready for correction? Possibly. Some analysts are anticipating a mini baby boom once vaccines are widely available and restrictions are lifted. But even a mini baby boom is unlikely to fully compensate for the decline. Experience shows that when a couple defers having a child, for whatever reason, they typically don’t make it up later. The unborn baby remains unborn.
A decline in fertility is just one way the pandemic is suppressing population growth in many developed nations. The other: closed borders. In 2020, Australia recorded its first population decline since World War I, due to stricter COVID-related border controls. Canada granted permanent-resident status to 180,000 applicants in 2020, far short of the target of 381,000 – and most of the new permanent residents were already in the country on student or work visas.
A third, grim factor is also at work: the death toll of the disease itself. Researchers predict that life expectancy in the United States has declined by a full year as a result of COVID deaths. Racial minorities were particularly hard hit, with African American life expectancy suppressed by two years and Latino life expectancy by three years. Officially, the pandemic is responsible for more than 3 million deaths – but that figure could be far higher, since some countries may be under-reporting deaths. This is probable, for example, in India, where the pandemic is claiming 4,000 lives a day; many authorities believe the real count is far higher.
But it’s not only the pandemic…
As John Ibbitson and I wrote in Empty Planet: The Shock of Global Population Decline, the forces driving population decline have been in place since at least the turn of the century.
The biggest force is urbanization. The largest migration in human history has happened over the last century and it continues today as people move from the country to the city. In 1960, one-third of humanity lived in a city. Today, it’s almost 60%. Moving from the country to the city changes the economic rewards and penalties for having large families. Many children on the farm means lots of free hands to do the work. Many children in the city means lots of mouths to feed. That’s why we do the economically rational thing when we move to the city: we have fewer kids.
Moving to the city also changes the lives of women, exposing them to a different version of life than their mothers and grandmothers lived in the country. Urban women are much more likely to have an education and a career, as well as easier access to contraception. Lower birthrates are the inevitable result. That’s why first-time mothers today are older and have fewer children, and teenage pregnancies have dramatically declined. In most developed countries, the birthrate of women over 40 has surpassed the rate of women age 20 and younger.
We can expect that a great defining moment of the 21st century will occur in three decades or so when the global population starts to decline. COVID might have even pushed the start of this decline forward – but it certainly didn’t cause it.
Why population decline matters
Why should you care about population decline? Fewer people are good for the climate, but the economic consequences are severe. In the 1960s, there were six people of working age for every retired person. Today, the ratio is three-to-one. By 2035, it will be two-to-one.
Some say we must learn to curb our obsession with growth, to become less consumer-obsessed, to learn to manage with a smaller population. That sounds very attractive. But who will buy the stuff you sell? Who will pay for your healthcare and pension when you get old?
Because soon, humanity will be a lot smaller and older than it is today.
- As G7 leaders meet, the costs of not acting on public health, climate and biodiversity loss are now becoming far higher than the costs of acting.
- The business community stands ready to support this agenda and the UN Sustainable Development Goals provide an ideal framework to do so.
- This week’s G7 Summit provides an opportunity for reinvigorated leadership and high ambitions.
At the beginning of the coronavirus pandemic world leaders were united in their calls for a global response to humanity’s biggest crisis in living memory. But that ideal quickly vanished, as international cooperation gave way to multilateral sclerosis and national self-interest.
Fortunately, this week’s G7 Summit provides an opportunity for reinvigorated leadership and Prime Minister Boris Johnson appears determined to raise ambitions. This comes not a moment too soon, as the costs of not acting on public health, climate and biodiversity loss are now becoming far higher than the costs of acting.
Vaccinating the world
The most urgent priority is vaccinating the world, as no one is safe until everyone is safe. It’s alarming therefore that the global vaccination programme, COVAX, has so far supplied only around 80 million doses in developing countries against a target of 2 billion by the end of this year. Indeed, of the roughly 1.8 billion doses of COVID vaccines administered globally, 28% have been in G7 countries, while just 0.3% have been in low-income countries. And at the current rate of deployment, it will take over 50 years to vaccinate everyone.
This is the classic prisoner’s dilemma outcome, where not cooperating is worse for every nation. Poorer citizens suffer without immunization and allowing COVID to circulate in developing countries could lead to new variants that spread around the world. The risk is that we undo hard-won progress, where healthcare systems and economies once again become gridlocked.
It’s clear we will not cross the global vaccination finishing line without proper funding, which is why the world’s richest countries must step-up and pay at least two-thirds of the estimated $66 billion needed. This is a pittance compared to the staggering sums COVID is already costing developed economies, with the U.S. government alone facing a bill of at least $16 trillion. Reports the G7 will deliver 1 billion extra vaccine doses to poorer countries over the next year would literally be a shot in the arm for those most in need.
Committing to bold climate action will also be a key test for the G7. Many developing nations are already publicly sceptical about COP26 in Glasgow, which is extremely unhelpful mood music, since the stakes couldn’t be higher. Again, no one is safe until everyone is safe, as climate change does not discriminate between rich and poor. We also know that effective climate diplomacy relies on the world’s biggest carbon emitters moving first, which is why it is now time for them to lead by example.
The suspicion of emerging economies is well founded, as the pledge richer countries made to provide them with $100 billion of climate finance per year is way off track. The OECD estimates around only $62 billion of public finance was raised in 2018, while Oxfam calculates the number may be even lower. Canada and Italy have been notably parsimonious, but it’s clear that collectively the G7 – which is responsible for around 80% of climate finance – can be far more courageous in building solidarity for a successful COP26. The benefits would far outweigh costs, as we desperately need developing countries to embark on a journey of green – rather than brown – growth.
Nor can the G7 go on ignoring the root-cause of the crisis: rampant biodiversity loss, which has dramatically increased our susceptibility to pandemics and climate disasters.
With humans and wildlife now living in ever closer proximity, 70% of new infectious diseases come from animals. Once more, we need to get the numbers in perspective. Globally, COVID has cost $28 trillion in lost output, whereas the annual cost of preventing further pandemics over the next decade is estimated to be only $26 billion. It’s imperative therefore that governments do not delay in taking much bolder action to protect our natural capital.
Similarly, G7 leaders cannot ignore the undeniable link between our maniac demolition of the environment and our impending climate emergency. Our forests, peatlands, oceans, mangroves and freshwater systems are all vital carbon sinks. Yet their routine destruction continues unabated, even though climate change could cost the world economy $7.9 trillion by 2050. It’s voodoo economics writ large that demands an urgent political response.
I do not for one minute envy the daunting challenges facing G7 leaders when they gather at the Carbis Bay Hotel this week. But they should keep several considerations in mind.
The public overwhelming wants us to build back better from the pandemic. The business community stands ready to support this agenda for change and renewal with resources, technology and know-how. And, crucially, we already have an oven-ready plan to aid our recovery: the UN Sustainable Development Goals.
When Mr Johnson signs-off the Summit’s communiqué, I hope he remembers the words of his hero, Winston Churchill, who famously said “I never worry about action…only about inaction”. Global Britain and the world will be watching.