Richard Horton, editor-in-chief of The Lancet medical journal, isn’t at all sure which direction the world is headed.
He relayed both optimistic and pessimistic perspectives last week, in a talk sponsored by Stanford Medicine’s Office of the Dean and the Rambam Health Care Campus in Israel.
On the optimistic side, Horton – who has a strong interest in global health and medicine’s contribution to our wider culture – said evidence shows that the world is getting healthier year by year. Big names in academics and business have predicted the end of preventable mortality within the next two decades. And in its national security strategy document from late last year, the U.S. federal government prioritizes encouraging other countries to invest in health care systems.
On the pessimistic side, the Doomsday Clock, a gauge by the Bulletin of the Atomic Scientists of how close people are to destroying the world with technology, was reset this year to tie its worst reading since its creation in 1947. What’s more, Horton said, an argument can be made that some of the world’s democracies are facing challenges and their responses threats, such as nuclear conflict, may be hindered.
He asked the audience to vote on which view they had. Most sided with optimism. Horton chose neither.
“We don’t know how these forces, positive and negative, are going to play out,” he explained. “It is our choices together that will decide which trajectory we take.”
Citing health as the foundation for modern society, Horton made the case for a view broader than the individual or the community: planetary health.
“Planetary health aims to bring the disciplines of environmental science, political science, economics, social science all to bear on thinking about the health of our societies,” he said. “It’s inclusive of public health, it’s inclusive of global health, but it does try to unify the disciplines that we need to bring together to address some of the most difficult predicaments of our time.”
From that framework, Horton offered several action items for the scholar community. He encouraged a renewed commitment to the concept of knowledge for social progress, and a concerted effort to use data to hold decision-makers accountable. He urged the audience to consider unusual collaborations – such as the new Commission on the Value of Life from The Lancet, the Vatican and the Mario Negri Institute. And he emphasized the importance of journals, at a time when their audience has expanded from scientists and clinicians to include the media and social media.
“We need to believe in tearing down the barriers that stop people accessing information, and generating that information, and disseminating it,” Horton said. “We need to be strong voices – in a sense, the moral conscious of our community.”
Photo by Rod Searcey