Health Without Borders

This book discusses globalization and its impact on human health. The population of the world grew from 1 billion in 1800 to 7 billion in 2012, and over the past 50 years the mean temperature has risen faster than ever before. Both factors continue to rise, as do health inequalities. The first personal computers were produced in the early 1970s, but now there are almost 5 billion mobile phones in the world. Our environment is changing rapidly, with tremendous consequences for our health. These changes produce complex and constantly varying interactions between the biosphere, economy, climate and human health, forcing us to approach future global health trends from a new perspective. Preventive actions to improve health, especially in low-income and rapidly developing countries, are essential if our future is going to be a sustainable one.After a period of undeniable improvement in the health of the world's population, this improvement is likely to slow down and we will experience- at least locally - crises of the same magnitude as have been observed in financial markets since 2009. There is instability in health systems, which will worsen if preventive and buffering mechanisms do not take on a central role. We cannot exclude the possibility that the allied forces of poverty, social inequalities, climate change, industrial food and lack of governance will lead to a deterioration in the health of large sectors of the population. In low-income countries, while many of the traditional causes of death (first and foremost infectious diseases) are still highly prevalent, other threats typical of affluent societies (obesity, diabetes, cancer, cardiovascular diseases) are increasing. Africa is not only affected by malaria, TB and HIV, but also by skyrocketing rates of cancer. The overall impact of global changes that affect climate, food and the environment may even leave their mark on our DNA in the form of epigenetic changes. The book argues that the current situation requires effective and coordinated multinational interventions guided by the principle of health as a common good, rather than "personalized medicine", and that we cannot avoid taking a "common good" perspective when dealing with health. The crux of the problem is that an entirely profit-driven system is increasingly showing its distortions in all fields. Even worse, a competition-driven economy cannot - by its very nature - address global challenges that require full international cooperation. A communal global leadership is called for.