"We live in an age of miracles when a group of public health nerds, backed by world leaders and front-line health workers, can save lives by the million."
One group Nick left out is us, the citizens! For 2020, President Trump called for a 29% cut to the Global Fund to Fight AIDS, TB, and Malria and VOLUNTEERS got 157 Republicans and Democrats in the House to sign one letter to top appropriators rejecting the cut....36 signed the letter in the Senate. So far the House has approved a 16% increase instead and the Senate appropriations subcommittee has done the same. You can go to groups like the anti-poverty lobby https://results.org to get on this train.
It's not just "public health nerds, backed by world leaders and front-line health workers." That's great news and reason for hope!
What is Mr. Kristoff's opinion on China's Belt and Road Initiative?
1
We're losing with measles.
3
No world leader has championed the most important global initiative of all: controlling human population growth and human destruction of the natural world.
9
“ why is the most powerful country in the history of the world stymied?”
When ordinary folk choose to be complacent about equitable wellbeing and health, and others contribute, by personal complicity, in creating barriers to viable, achievable types, levels and qualities of health and wellbeing for ALL, mass personal unaccountability is the toxic and infectious process!
WATS. We Are the Stymiers!
1
Bill Clinton, post-presidency, via the Clinton HIV Aids Initiative, has done a tremendous amount of work and fundraising to help millions of people living with HIV/Aids to obtain affordable drugs which save lives. He teamed up with President George H.W. Bush to raise disaster relief money after the tsunami in South Asia; after Hurricane Katrina; after Hurricane Ike. The brilliant, visionary doctor Paul Farmer (Partners in Health) and philanthropists such as Bill and Melinda Gates, among others, use their thirst for knowledge and their vast resources to help combat disease, poverty and hunger. Michael Bloomberg uses his part of his wealth to fight for sane gun control. Post-presidency, Jimmy and Rosalynn Carter have made Habitat for Humanity a centerpiece of their social justice work, with demonstrable results. The Obamas are working with young leaders in our country and throughout the world to come up with solutions and fresh perspectives for a range of issues and problems. And each of us can be informed, involved and charitable, even in modest ways which can help one person at a time.
8
I had no idea that the UN had committed to universal health care by 2030.
I have wondered is there is any like plan for world wide refugees. If we keep dragging our feet on climate change we will be facing ever greater amounts of those forced from their homes. I hope where I live will remain above water until I kick off, but really we don't know.
4
Do the
"Global programs founded in the 2000s have saved tens of millions of lives"
make up for the
"Global programs by the US War Machine founded in the 2000s have killed, maimed, displaced and irreparably damaged tens of millions of lives" ?
Don't think so.
The focus should be on not creating the breeding ground for misery in the first place instead of trying to remedy it afterwards.
Spending a lot more efforts on population growth is preferable to measures aimed at alleviating problems arising from said population growth.
A fair worldwide taxation system and genuine worldwide efforts to root out corruption of the elites would go a long way.
For every illionaire millions go hungry.
The world's wealthiest billionaires made enough money in 2017 to end extreme poverty around the globe seven times over.
Above else, no more wars for geopolitical reasons and to fill the pockets of the very few in the military/industrial/surveillance/security/political complex.
6
Leaders are a reflection of the people who choose them. GW Bush was chosen in a time when Americans and Britons were still relatively prosperous and magnanimous. Today's Americans & Brits - not so much.
There was a recent NYT article that described the travails of people who had left frightful conditions at home, traveled a thousand miles or more, and were waiting at the US border, contemplating an illegal crossing. My thoughts were, OMG - what can be done to a) help alter the situations that forced them from their homes in the first place and b) create a safe and reasonable means of speeding up the process of entering the country as a refugee. Unfortunately, the bulk of the responses discussed additional measures to keep them out, and how we simply "couldn't afford" to allow them to enter, no matter what.
Too many people are suffering, in America and Great Britain, and elsewhere. Those living in difficult situations either are part of the problem (gangs, drug lords, despots) or they are fleeing the terror. And those of us living in "safe" countries are struggling ourselves, with medical debt, extremely low wages, and constant fear.
And that, I think, is the key word: fear. We need to renew the sense of courage and resolve that was part of our national psyche in the aftermath of the 9/11 attacks. And I pray it doesn't take a national tragedy to bring that about - though I fear exactly that.
16
This is the work that really matters. I've been in refugee camps in Rwanda, Uganda, Tanzania; and in rural locations in places like Bangaldesh and Myanmar, Haiti and Nicaragua. Focus, motivation, and planning- with a modest amount of money- can save millions of lives and change the trajectory of nations. Thank you, Nickolas Kristof, for helping us keep our eyes on waht truly matters! We get a chacne to vote every four years. The dying children of the world can't wait that long.
17
Sadly, out of 7.9 billion people on earth, 5 billion live under dictatorships in most of Africa, Asia, the middle east, Russia, Venezuela, etc. They don't care about the average person, and any truth teller will find themselves, arrested, assaulted, imprisoned, poisoned, tortured, and worse, which is dead. These countries are often under military rule, dictatorships, which seldom even allow aid workers in, and often they don't leave alive. The fact that the leader of this country, DT, is only interested in furthering his private organization, and the Kushner Holdings, as they need to be refinanced each year to keep them afloat. It is amazing that the few who have stayed or gone to help in the places that aren't free, have given their lives for mostly women, children, and disadvantaged people in the name of education, health, hunger, safety, etc.
1
I am an Emergency/Family Nurse Practitioner who had the opportunity in 2015 to spend several weeks with a special and generous Emergency Medicine physician from UCLA providing surgical care at a small women and childrens's hospital in Yei, South Sudan. We deliverd babies and performed up to 5 major operations a day including C-Sections, amputations, and several different kinds of abdominal surgeries. We treated a variety of tropical diseases, malaria and HIV. We were also able to care for a 3 y/o young boy who had been severely burned in a fire pit. With daily treatments, wound care and a bit of luck we were able successfully prevent serious infection and contractures which would have surely caused disabilities that would have made his survival sketchy at best. He was able to walk and play by the time we left. The missionaries that ran the hospital worked 24 hours a day, 7 days a week. The ongoing civil war finally forced them to abandon South Sudan. The training programs they started for medical technicians, nurses and midwives were forced to close.
We need a president who can see farther than the mirror and regain our place in the world community. Set the example once again.
51
We need a ''Marshall plan'' for the 21st century.
That is to say we need to prioritize climate change directives RIGHT NOW over ALL ELSE. WE need to be spending in the trillions and we need every nation (or close to it) on earth if we are even to have a chance at surviving. Full stop.
EVERYTHING else is secondary.
Universal coverage for health care, education, jobs do not matter if a BILLION people are going to become displaced over the next decade. Not only will all those people have nowhere to go, but the costs of trying to accommodate them elsewhere will be incalculable, as well as passing the point of no return for our survival.
I applaud ALL of your columns Sir (especially since you have been doing them for so long) but we need to be dealing with this ONE issue now. We all need to be writing column after column and we need to be posing question after question to our lawmakers and people in power.
All else will not matter if we do not.
48
@FunkyIrishman
Nothing substantial will help with climate change if human beings don't change their consciousness (attitude, perspective, whatever you want to call it).
You, I and everyone else know, without a shred of doubt, that this is impossible to do in any substantial manner.
Right?
Well, if you and I and everyone is correct, then we're doomed.
I for one, an incorrigible optimistic, believe this is not correct. Human beings can change.
They just have to want to change (you know, like the old joke about how many therapists it takes to change a light bulb).
Well, what are we waiting for?
Let's do it.
it's simple. Just shift away from our current identification with all the stuff we think we are, to that which sees, hears, knows and feels all of this.
14
@Don Salmon
If you're not sure what that last paragraph means, see Dan Siegel's latest book, "Aware."
He's done an outstanding job of communicating the essence of human wisdom and happiness - something which has been hidden in religious texts for millennia, and presented it in a purely scientific manner, consistent with the most up-to-date neurological research.
I've summarized it for my patients here: http://txrecommend.blogspot.com/2019/07/your-amazing-brain-and-wheel-of.html
Siegel has taught a simple exercise he calls "the wheel of awareness" - designed to shift attention from "what" we are aware of to the simple experience of "being aware" - to over 30,000 people of all ages and from many different backgrounds, in many countries around the world.
They learn, in other words, to shift their brain state through a shift to the center of their awareness.
Here are some of the ways people have described what they experienced from this simple exercise:
"I felt a deep sense of love, peace, kindness and connection that arose spontaneously and filled me with tears of gratitude."
"It was incredibly peaceful. It was so clear, so empty, yet so full."
"I felt as wide as the sky, as deep as the ocean."
"I felt connected to the world."
"I was at home in the universe."
Needless to say, this far transcends "mindfulness."
It is something which may have the power to bring together people around the world - after all, we all have essentially the same kind of brain.
12
@FunkyIrishman
Thank you, FunkyIrishman, our earth over ALL else NOW has to be the focus. But we should see the trillions of dollars as an investment, not as spending, because they WILL pay off, if not in "solving" the climate crisis, at least by letting us enjoy birds, bees, and bears a bit longer.
Make the world Greta again.
8
Thank you Mr. Kristof for this opinion of hope and success. As others here have noted, the other columns in today's paper are profoundly depressing in showing how "trumpified" the nation and world are becoming. It's "me first" all the time--not America first but me, me, me. Now even the wealthy want sympathy for how hard it is to live in their gilded dog-eat-dog world. But somehow you carry on, having seen things like preventable death up close, and bring us stories of success, nobility and hope. Thanks for this. I really needed it today.
11
Great article, great ideas, and so refreshing that it’s not about impeachment.
2
“If these countries can manage it, why is the most powerful country in the history of the world stymied?” This country is ruled by the rich who want to distinguish themselves from the poor. That's why.
6
How can Nicholas Kristol give so many examples of what's going wrong and needs to be fixed in the world and not mention the climate? As our president does his best to deny science and destroy any efforts to fight fossil fuels, the public turns away from a problem with a time limit we do know how to solve.
4
The leaders remember to notice some social needs whenever they needed people's votes.
Our present leaders are people of money, people who never even come close to ordinary Americans and their problems.
We have no statesmen/women who ever had to suffer. They are people with only one thing on their mind, how to make more money. They are really limited and immature characters.
In the past, many leaders had experienced war and knew the consequences, they were the generation who said: never again.
Our current leaders play with fire and never show regret for the total destruction of the ME, they are ready for even more. They threaten with nuclear retaliation if others don't do as told.
1
There is much to think about in this column.
When our former Presidents have gotten behind some of these issues, life improves quickly for millions of poor families. Think of the good done to fight poverty by Jimmy Carter, both the father and son Bush Presidents, and Bill Clinton.
It is great news that vaccines are pulling down rates of pediatric deaths. And yet, we have some once conquered diseases returning in the USA because of the numbers of parents now falling for conspiracy and pseudoscience hysteria.
Access to clean water remains one of the largest global health challenges. The Gates Foundation is tackling much of the cause by offering entirely new engineering for toilets that bring sanitation to ghetto encampments in the Third World.
But meanwhile, the water infrastructure problems of Flint, Michigan still are not solved. Masses still rely there on bottled water.
6
The likes of Trump are not remotely interested in helping. They just don't care. Whether Trump is being impeached or not has absolutely nothing to do with anything. Whether he was the subject of impeachment or not, he would be doing nothing of the sort you describe. It's not in him. He will quash it wherever he sees it, because it doesn't put money in his pockets or in his buddies'.
3
Life expectancy in the US is declining.
2
And that's almost the worst of this worst we're living through. It makes it impossible for us to think about anything, to focus on our goals, to come together and respond to problems.
2
If world leaders came together and finally decided to address the issue of overpopulation, now that would be a miracle.
5
I believe Speaker Pelosi has no intention of letting the impeachment process drag on for a year. That's why she intends to keep a tight focus on the Ukraine issue, rather than a Ken Starr-type 3-year fishing expedition.
1
"...George W. Bush, Tony Blair and others made a heroic effort to tackle AIDS and malaria and save children’s lives around the world."
The current US president puts children in cages, and millions of Americans apparently think that's not such a bad idea.
One is not hopeful.
4
We at mothers2mothers (Mentor Mother Kunene pictured in your article) are grateful for Bush's legacy of PEPFAR which continues to make sure we can provide health and hope to hundreds of thousands of mothers and their families throughout sub-Saharan Africa.
1
Nicholas, I was led here at 03:30 h Sunday October 6 by reading an Email from you that opened by telling my one great thing that Blair and Bush did that saved millions of lives.
I want to put that in perspective, aided by BBC World Radio that I listen to through every Swedish night since it is a news source that with extraordinary regularity is a major complement to the Times.
Last night BBC World reported on a 10 month long effort to see what is happening to I believe the one million Iraqi women who lost their husbands thanks to the Bush-Blair war and its aftermath, the rise of Daesh.Isis. Many of these women have daughters who become one frail means of support by being temporarily "married off" by Shia clerics employing the Shia practice of temporary marriage to sell the daughter for money.
Thus we have a paradox: How could two world figures show their humanity on the one hand by support of a health program and their inhumanity on the other hand by support of a war whose unintended consequences plague the Middle East forever and ever?
And given the health effects that plague South Vietnam and neighbors thanks to Agent Orange does the US come out in the end as a country whose leaders should be on trial in international courts for the harm they have done?
And is the worst yet to come with a US-Saudi-Israel war on Iran?
Only-NeverInSweden.blogspot.com
Citizen US SE
4
Many different strands to pull out here, and I'll start with one: "... If these countries can manage it, why is the most powerful country in the history of the world stymied?..."
I think because we're actually no longer that country. We used to be, but for all the reasons people detail in these comments daily, we have become quite dysfunctional. We just can't use our power, mostly because of political polarization, a lack of respect for compromise, a reducing of all policy debate to a power and control contest, and these days, a lot of self-dealing. It's almost like the old saying, "We couldn't fight our way out of a wet paper bag." It all sounds trite, but many Americans worship personal wealth and material acquisition above all, feeling that using public money for the public good is stupid, pathological, or signs of "a loser" (as Trump would say). And finally, many people are downright cruel and unsympathetic to suffering, as we see, sorry to say, in comments and behavior from Trump and those who cheer at his rallies.
My husband is a global health physician and researcher, and his colleagues are such wonderful, idealistic people. But that's what it takes to tackle these things - idealism, and a commitment to address human suffering. Can we get that back, as a people?
P.S. Mr. Kristof, thanks for the way you engage with commenters, so interesting and unlike anywhere else on the web (that's worth reading, I should add...).
4
@original
I am thankful that your husband and others are tackling global health issues.
2
"Even flawed presidents and prime ministers can act in noble ways"
No man and no woman is without flaw or fault. There is and never has been a leader anytime, anywhere without fault.
The problem is though that to achieve, a leader has to realize that.
This is similar to Socrates who in Plato's Apologia Sua Vita states that the first step to knowledge is admitting that one is ignorant.
Refusing to admit to or recognize one's flaws, at whatever station in life or leadership puts a damper on potential "noble ways".
5
Nicholas, you have focused on a fact which has been near and dear to my heart for years...that is universal health care not only nationally but also globally. There is a reason why we, the people of the richest nation in the world, are remiss in this quest, indeed negligent. It is about the root of all evils...greed. America has lost itself to the wealthy industrialist who sacrifices our health and that of the environment's, to the powerful politician who is in his back pocket, to the Dow Jones, to the ignorant who bites off his nose to spite his face. As a retired RN, I have seen too many times what the lack of treatment can do to an already ravaged body. The health of the world is the root of its continuance and sustenance. We can not watch and do nothing. Life is too precious.
3
Thank you for the vision and hope.
1
Those children are the best argument against belief in an imminent, interventionist God. Belief in a God that could save such children but chooses not to is an abomination. Theists - believers in such a God - need to be told: theism is evil, they are evil. Theism should be eradicated from the face of Earth. If the established religions can't survive this, then so be it. God cannot act within the Universe or God is not at all. The faithful need to respect the possible reality, not worship a satanic fantasy masquerading as true and godly.
@GRW Sorry: "evil" not "satanic", "good" not "godly". I was inspired to write a comment like this - initially - in response to Maureen Dowd's article, but decided against it then. Reading this article directly after, I couldn't resist doing so a second time, obviously.
Please note that I believe in the freedom of religion, and - of course - do not believe that believers, even theists, are inherently evil. I merely seek the freedom to communicate that their often received and accepted view that belief in an immanent God is good, is contestable, that in my view it's evil instead, and nothing more.
That religion has become, in the case of many of its adherents, not a vehicle for living a good life, but an influence producing evil in and by them - selfishness, chauvinism, prejudice and wilful ignorance - is, in my opinion, a self-evident and dispiriting fact. Perhaps it was always so, but it seems especially so today, to me. Thank you.
How on earth can you write an article about the need for world leaders to make miracles to better human health and welfare without including climate change, which will have far more drastic human health impacts than anything you do include in the article? Baffling.
1
What you overlook is the fact that attention to the basic welfare of all of humanity is the only way to solve the ongoing refugee crisis in the world. The causes of war and poverty can be ameliorated, and it should be understood that there is no way...absolutely no way...for a country to isolate itself from the long-term damage that they are doing to the human community. Ignoring these things may be penny wise, but it will prove to be pound foolish.
Good work, Nicholas, keep going.
Here's a brief outline for research a strategy, based on many years of experience as a Unicef Field Rep in Asia and Africa and later IDRC Ottawa.
The internet is very effective and will be a key factor in helping
low income people connect with technology that works.
A very wise farmer in Bihar India in 1967 in a conversation
about irrigation pumps defined the technology question:
"Will it work, will it last, can I repair it, can I afford it?"
Dr David Hopper, agriculture economist, founder of the the International Development Research Centre, did his Phd
research in village India. He was later World Bank Senior VP Asia.
In his view, rural folks were astute analysts of technology.
Here are some suggestions for the Bill and Melinda Gates
Foundation:
Fund a network of research projects in Asian and Africa that
will connect solar technology with small farmers and their families.
Priorities:
A reliable low cost solar powered water pump... a 300 watt solar panel with a pump that villagers can maintain, that costs the price of a bicycle.
A solar powered fridge for vaccines for rural health centres.
A low cost toilet that works. google Botswana ventilated
latrine world bank.
over to you
ancient Canadian in a Yucatan pueblo
for authentication google
marlon brando visits india village with unicef official itn 1967
waterloo pump idrc journey rudin plumtree
When you have Evangelicals in stadiums praying for Jesus to make them millionaires, while certain they're on the list of the elect to be Raptured because they are such good Christians, this is what you get. Evangelical Christianity needs to take a cold hard look at itself before any progress can be made. American Evangelicals have embraced the worst of both capitalism and Bible thumping sanctimony and fused them into a self-serving stew of hatred for anyone outside their tiny little righteous bubble. I doubt this self-examination will happen though, because no one falls into this trap without already being deprived of an ability for critical thought, so the friction between prior belief and actual experience never occurs.
I'm certain that, through evolution, in any society there is a core who never questions anything about what they were taught before the age of seven. In a traditional culture, this might have served a very useful purpose, maintaining proven survival practices honed over unchanging millennia against any potential challengers; in a rapidly evolving modern one however, it's just a suicidal curse. For an explanation, there's a lot more going on here genetically, than anyone cares to talk about right now...
3
This is a wonderful reminder. The malevolent forces at play in the White House are not the only winds that can blow. They were artificially inflated by hype and lies. If anyone can find a way to forge a positive effort toward world health in the midst of the chaos, they will offer an antidote of a different kind.
10
Nicholas, my final submission at 04:19 already Sunday in Sweden I work off specific points you make or have made while I also keep Christine McM's comment in mind.
You led me years ago to start giving to Edna Adan Hospital in Somaliland and to Dr. Hawa Abdi in Mogadishu important health providers trying to bring down infant and mortality in Somalia with among the worst statistics in the world. Thanks for that lead.
That takes us back to my America where, as you note, life expectancy has been declining for three years, to which I add is also a country where mothers to be in one or more ethnic groups have infant and maternal mortality records that make one wonder if they live in 3d world parts of America.
Perhaps the primary such group consists of women seen as black in America. If you read an essay by a researcher last name Villanova over at the Times 1691 series you will read what American researchers Dorothy Roberts(U Penn) and Nawal Nour (African Women's Clinic in Cambridge MA) also write about. American Medicine "excuses" the high mortality rates by in effect seeing these women as belonging to a "race" with built in shall we say race-based defects. Incredible!
So over to Sweden, one of the countries that gives 0.7% to other countries as you observe. Universal pre, peri, and post natal care in Sweden gives mothers seen as black in the US, not here, 1st world maternity success. UHC!!
Only-NeverInSweden.blogspot.com
Is it an accident that the most generous countries, Sweden, Denmark, etc., are also the ones where the citizens also rank highest on the happiness scale? Studies show that personally generous folk are also the happiest. It seems to hold true for countries also.
7
Agreed, Mary Ann. They are happy countries, and also more homogenous ones. It makes me sad to think that it is somehow across our gaping differences in the USA that we get caught up in fear and the resulting, often violent, reckless distractions fear manifests. Kristof’s article is a wonderful reminder of an American path worth veering back onto.
1
You make me think of some lines from Seamus Heaney's "The Cure at Troy":
History says, Don't hope
On this side of the grave,
But then, once in a lifetime
The longed-for tidal wave
Of justice can rise up
And hope and history rhyme.
So Hope for a great sea-change
On the far side of revenge.
Believe that a farther shore
Is reachable from here.
Believe in miracles
And in cures and healing wells.
5
There are decent people around the world that are prepared to do their part in making a better world with better people. They want the same things that we want, education, maternal care, preventative health care, work, etc.
But nothing substantial will happen until we win the looming World War Trump, the all out assault on democracy by the ultra wealthy. They seek to create an unregulated world in which they can exploit every aspect of our economies. Their primary means of imposing their will on the people is the corruption of elected officials by legalized bribery.
Before we do anything we will have to break the stranglehold that wealthy donors have on our democracy. The first step is to pay for the campaigns of bona fide candidates for federal, state and local elections, That is step one. Corporations, the most wealthy "persons" in the world would no longer be able to hold elected officials accountable for their actions by withholding campaign money.
This is a war, World War Trump.
5
If I thought that calling off the impeachment inquiry would mean that the USA redirects its efforts to resume the global fight against disease, poverty and climate change I would cancel the inquiry yesterday but we all know that the two are not on the same continuum.
The world no longer looks to the US on leadership for anything, be it the environment or even human rights, and that seems perfectly acceptable to far too many of our elected officials and Trump.
4
Reducing infant mortality is a great accomplishment in the short run. However without population control, all these extra children in the third world will grow up and have children of their own. Can the world really support 9 or 10 billion people? Not likely, especially if you take global warming into account.
4
If it requires all of our time and resources next year to get the very dangerous man named Trump out of power, so be it. It seems that it will definitely take a big effort. Then maybe our country can get back to more noble pursuits.
3
The elephant in our living room is so large, so noisy, and given so much attention (and many of us feel so helpless in the face of it) that it is easily possible to forget what is being done by many, or what can be done.
Can we somehow manage a "Velvet Revolution" in the United States so we can have our government return to focusing on the problems of the day, and return to being participants and not just spectators? I think we're banking too much on hoping one Democratic savior can do it.
2
National and world leaders who will take their nation and world forward instead of enriching themselves is becoming an endangered species in the current world.
3
Indeed, as Cory Booker says, we have a crisis of empathy, not just in America, but our attitude about the world. That is how we can elect Trump, punt the Paris Agreement, slash environmental regulations, do nothing about epidemic gun violence, and yes, stand by as millions die needlessly.
8
It's time the world looked at preventing unwanted pregnancies rather than trying to keep up with the results of too many people being born who end up starving or dying from disease. The world is rapidly reaching a breaking point unbeknownst to most of us in the developed world, but it is going to effect us in the near future. As with climate change, overpopulation will result in mass migrations, social upheavals and breakdowns in every corner of the world. Our politicians and most people living the good life in developed nations refuse to imagine what could possibly go wrong. Our planet is fragile but ultimately our planet will control the outcome. Only a few of us are currently paying attention.
5
And the three men I admire most
The Father, Son, and the Holy Ghost
They caught the last train for the coast
The day the music died
And they were singing
Bye, bye Miss American Pie
Don McLean, American Pie
Whether it's health care, gun control, the environment or nuclear disarmament, the Republican Party representing at least 40 percent of the American people will remain a powerful dominating faction in this country regardless of the outcome of the 2020 election.
2
@A. Stanton - Singing your song on the trolley taking me from my ferry to downtown Gothenburg.
The question remains, what kind of pie will the 2020 GOP bake.
Only-NeverInSweden.blogspot.com
Citizen US SE
1
Some days I am uplifted reading about the good which has been done for the world through public health measures.
But other days, I remember the work of Hermann Muller, the 1946 Nobel laureate for his work on understanding the capacity of radiation to induce mutation. Among other things, he reminded us the prevalence of a condition in a population depends on the balance between things which increase it, like radiation, and things which decrease it, like the deleterious effects of having a condition. He postulated we might be soon spending 100% of our GDP on dealing with genetic diseases.
And, it many ways, we have worked to prove Muller right. High-risk OB clinics around the country struggle to get insulin-dependent diabetic mothers to have successful pregnancies which, while individually joyful, are only increasing the cohort of diabetics in the population.
Reduction in deaths in childhood also is not an unalloyed good if we fail to deal with climate change or political conflicts which can allow them to become victims of famine or war.
But, I return to the parable of the man throwing starfish washed ashore in a tempest back into the sea. A passerby tells him he cannot possibly throw them all back so he asks, "Why do you bother? What does it matter?" His response, while hurling another starfish into the surf: "It matters to this one."
5
Advocate a selfish position: give away vaccines: moreover pay people to take them. Ebola will almost certainly learn to be more contagious human-to-human if it is not kept out of the human population: an epidemic would be devastating. The more people (and animals) that have the flu the easier it is for the flu virus to make somewhat different flu viruses that will evade our immune systems again. The flu in the US costs about 80 billion a year. Vaccinating all humans on the planet, every year, would cost about that. Let's use our wealth, power and knowledge to selfishly advance the battle against global infectious disease.
2
As a ground level implementer in the fight against HIV/TB and Malaria in Swaziland during the height of the pandemic I remain ever grateful to the worldwide effort of governments, particularly that of the USA to provide the medicines and expertise necessary to save 1000's of lives of adults with children, and children I personally love. The extreme individualism of me first, only my country matters, etc. goes against everything that is Christian and humanitarian. I don't understand how so many Americans who call themselves Christian can reconcile their attitudes of me first, and let everyone else fend for themselves.
6
Nick Kristof, you espouse the desperately needed kind of global leadership and multilateral assistance to save lives, improve education and address the plight of the poor and ill in all countries of this world. Leaders at the United Nations last month committed themselves to Universal Health Care Coverage by 2030.
Health systems have failed in the United States. Assistance to the poor and sick among us must be job one, not preventing immigration from countries to our south that have been blighted by climate warming. President Donald Trump and his Republican followers cling to the destructive power of authoritarians who only care about the richest 1% of our population and deride climate change as "a hoax".
President George W. Bush in 2007, illustrating your column, spoke about his world AIDS initiative, PEPFAR. Our 43rd President started the catastrophic still ongoing war in Iraq in 2003. George W. Bush and Tony Blair were flawed world leaders in their time.
Today we face far more flawed leaders in the US and UK in he persons of Donald Trump and Boris Johnson, both wild hairs and mad men irreparably meddling in the lives of Europe, England and America.
Removing Donald Trump from our presidency, by impeachment, by law, and soon, is the only remedy to his appalling misgovernance of the United States of America.
Death has dominion these days. Death by famine, war and global epidemics and climate change will surely prune Earth's population.
1
You’ve hit the nail on the head here - Trump, Boris Johnson and Xi Jinping worship only at their own altars (our Australian PM Scott Morrison included). They are men who like the sound of their own voice. When will we have leaders who will govern?
1
@CC C We will have leaders who truly govern and care when we actually choose them instead of the creatures we have been choosing in recent times. The leaders are a reflection of the people they "govern",
4
Thank you,Mr.Kristof for the pep talk which we badly need.Trump spends all of his time demonizing those from foreign countries for bringing disease to our shores.It would never occur to him to improve health outcomes abroad.I have never detected one ounce of compassion or caring in him.While we are on the subject of health care and the enlightened efforts of other countries, we need to remember that the United States is no longer the leader in longevity, education and live births.We not only neglect the world but are not keen on setting an example in our own country.
3
Nicholas,
I like this positive article. Like a ray of sunshine on a Sunday morning.
But, I have a question born out of critical, rational thought.
Why is saving human lives such a big priority at this point in human history and evolution?
There are nearly 9 Billion humans on the planet, and, at this point, those humans have destroyed most of the ecosystem that supported their original evolution.
Serious question: Does keeping more of them alive make sense?
Let me know what you think in a column at some point.
Because, at this point the more humans we keep alive, the fewer species that we rely on for life there will be.
Perhaps keeping more humans alive is a sure way for humans to go extinct? Along with every other species of animal on the planet.
9
@Michael
This is my question also.
Trust in our institutions have been greatly eroded by privatization and Milton Freedman. Trust in science has been destroyed by the avarice of pharmaceutical corporations and the fecklessness of the FDA, and the CDC, the government agencies they basically run for their own profit. The ill health the industrial, fossil fuel driven agribiz has nationally and internationally, been supported by our billionaire class and USA government their campaign money has paid for. The healthcare system has profited greatly from the suffering this system has caused. The eco system has too, with compromised drinking water and the loss of the majority of our birds and insects. We are next. The "family" of Christian Right type has infiltrated the highest levels of our government and of other countries in our nation's name with impunity. Either political party will do for them. At the moment, Trump is their instrument. The tragedy is, Trump is simply involved in a major power grab which citizen supporter don't understand. Both parties at the top are in it to have control over this vast corrupt international corporate power structure. The children matter little to them. And wars make lots of money.
2
@Carolyn Egeli - Welcome back. A long missing "BravE Little State" voice.
Larry L.
Very thoughtful article indeed but I don’t know how universal health coverage will be achieved throughout the world by 2030 even if a number of reasonably well to do countries contribute 0.7 % to global fund as long as corruption exists at all levels in plenty of countries. It’s literally impossible to achieve the goal under such circumstances.
I am aware of certain positives as mentioned in this article on account of certain programmes carried out by developed countries in under developed and developing countries Inspite of facing certain hurdles.
These programmes will be much more beneficial to the people at large if the donor countries insist for effective implementation of the same or if the concerned global organisations directly implement the said programmes instead of allotting funds to the concerned countries.
2
Thank you for such a clear concise recitation of the virtue of humble humane empathy in action.
Access to basic quality affordable healthcare should be a universal human right.
An emphasis on pediatric prenatal and infant care will lead to longer healthier human lives. A declining birthrate and longevity will make gerontology increasingly important as a medical specialty.
Beginning with prevention of infectious and chronic human diseases. A combination of diagnosis and vaccination should follow adequate nutrition and basic sanitation.
Access to clean fresh drinking water along with sanitary human waste and sewage disposal is essential.
3
@Blackmamba - Hi I have written your paragraph 3 at least 100 times here in comment land, usually accepted. Today 4 submissions, one on that are not appearing. Same for an earlier reply to yo noting thar I used your 9/21 TCW comment at Only (below).lf you do not want it there let me know.
Larry L
Only-NeverInSweden.blogspot.com
Citizen US SE
Leveraging medical intervention, especially research and vaccines, through government action is a noble cause. But has Mr. Kristof forgotten that responding to the rapid climate change from man-made carbon pollution, that we are now experiencing, has become the most important cause requiring not just our government's intervention, but an alliance among all governments to cooperate in this to be effective.
As AOC just stated (see her town hall meeting on cspan) we as Americans have been the "best" in the past, and now it is urgent that we do that again.
1
TRUMP DOESN'T CARE. When people understand that fundamental reality, they will then be able to understand that he's not going to do anything for the little guy or for the big world. He literally only care about himself.
4
We can save the lives of children even though there are too many people on the planet and our leaders are destroying the ability of the planet to feed and shelter them by allowing global warming and ecological destruction to continue with only minor and unenforced limits.
We should be talking to people about having fewer children, praising those countries whose population is slowly declining, and making national political and economic plans on how to deal with declining population and the end of what economists call growth. We should also be preparing to deal with possible global food shortages and rising sea levels.
Since we are not doing much of these things, it is odd to be concentrating on saving children and other people. It is as if, if we save the children, they will live long and decent lives. But this will only happen if we do much more for them (and ourselves) than just help them survive infancy and childhood.
5
Mr. Kristof,
Thank you for giving us good news about George W. Bush. The three Abrahamic religions teach us to love our neighbors, including people who have done evil things, as Mr. Bush undeniably has. It helps our efforts to love if we remember that people who have chosen to do evil can turn about and choose to do good.
Schools need to be well supported and also to teach each child:
The world needs you!
Your goal is to help make the world a better place.
Become your best self so you can accomplish that goal.
Studies show that those who volunteer- that is, learn that they have something to GIVE, are less prone to suicide, and are happier and healthier.
1
I believe Qatar and the UAE also donate over 0.7% of national income; it's not just the few European countries listed.
Ultimately, aid is just a palliative though, and no substitute for economic development. I saw an interesting list of improvements in life expectancy in all countries, and the medium/large countries that achieved the largest gains in life expectancy since 1950 are the Middle Eastern petrostates, China, the Koreas (interestingly, both of them), Turkey, India, and Bangladesh. None of these countries received significant humanitarian foreign aid. Instead, their humanitarian improvements came naturally as a byproduct of economic growth, namely the discovery of oil in the Middle East and industrialization in the other countries.
Our policy towards poor countries should be focused on promoting long-run economic growth, such as through free trade to encourage poor countries to pursue specialization and encouraging technology and skill transfers to boost their economic capacity, rather than just alleviating short-term humanitarian problems.
1
I remember watching Robert Kennedy giving a stump speech 50 years ago, he spoke compassionately about the poor and the less fortunate in our world. How times have changed. I worry that too many of us have become more callous and disillusioned, less giving and much more polarized. There seems to be no shame, for some, to display a distain for the poor and blame them for their misfortune. We need leadership to show compassion, not selfishness. I hope that the next election will give us a leader who cares more for the world and has more compassion for those in need. We can change things. I believe that the more we read about or see compassion the more likely we will be to show it to others. This country and the world needs more voices like yours, Mr. Kristoff, to bring to light to those who need help. Thank you.
11
Nicholas : As rightly pointed out by a number of commentators, there are too many ills within the system that badly need to be rectified. One of them being lack of affordable healthcare or universal healthcare as you call.
America is blessed with plenty of greenery and land. In fact it has thrice the size of land India has and population is just one fourth of India. What a blessing !
Till recently we were in Ann Arbor, MI as tourists. We hardly found people walking on the sidewalks either in the morning or in the evening on any given day including weekends whereas we grabbed the golden opportunity with both hands mainly because we, Indians are very much aware of the significance of fresh air that too on hassle free sidewalks, which we lack badly in India at plenty of places especially in cities and towns.
I am aghast at the size of cups either for drinking soda or for drinking coffee, tea etc and for eating ice creams. Isn’t one of the main reasons for illness countrywide ? Are there any public awareness programmes in this regard ?
1
What does it mean to "save" a life, when we are already overpopulating the planet at a rate, that threatens our very own existence. We are already 7.6 billion, this is not just enough to keep our species alive, this is way to much to coexists with our environment in a sustainable equilibrium. We don't need miracles to get more of us, we need miracles not to consume all the natural resources, that god has provided us.
We need leaders, who have the courage to put it straight, saving lives means destroying our planet.
4
You hit the nail on it's head. Solidarity ought to be the name of the game, given that no chain can be stronger than it's weakest link. That a rich country (i.e. these United States) gives financial assistance to poorer countries in need must not be considered an act of compassion, justice instead. Just look at cruello Trump withdrawing assistance to Central American countries, where people are leaving, partly escaping from gang violence, but also from the violence of poverty, some of it due to the climate changes we, the more advanced nations, are causing 'preferentially' by our unprecedented oil and gas consumption. If we continue to trample on justice, social peace shall remain just a distant dream.
1
If you already have money, you can afford morality. Otherwise, greed is a good motivator. You want to help with climate change? Provide economic incentives for businesses to develop viable solutions. The same goes for vaccines and other medical advances. We should encourage the private sector to support politicians who think along these lines, so public tax dollars are directed toward positive global initiatives. We can write and we can talk. But money always walks the walk.
10
Hello Mr Kristof.
Respectful book idea: How did these acts of “leadership” ACTUALLY occur? Folks reading this piece might conclude that Messrs Bush and Blair were courageous gentlemen leaders who gallantly created the Global Fund, GAVI or PEPFAR.
Never happened. Never going to happen.
The book will document how these initiatives were actually created, refined and then rammed through the political system by a small group of dedicated activists who worked 80 hours a week for years!
By the time the ideas reached Bush and/or Blair or Sarkozy or Merkel, the activists had spent years preparing the necessary domestic constituencies so that those leaders saw that their “leadership” was not risky to their political future.
Why is that a good book idea?
Because many good people want to advance certain policies. They believe the way to do so is to ask their leaders for leadership.
Alas. This is exactly the wrong way to do so. Folks at the top never innovate.
Margaret Mead was correct. It’s always a few highly motivated people (steve jobs called them the crazies) that make this sort of deep change and save this many lives. As she also showed, anyone can do it IF and only IF they work at it like the aforementioned activists.
Thats the inspiring story. Not mr Bush or Mr Blair.
If you write the book, maybe some young activists somewhere will read it and get to work with the correct strategy!
16
@Wyoming Observer
Thanks so much for this:
"Margaret Mead was correct. It’s always a few highly motivated people (steve jobs called them the crazies) that make this sort of deep change and save this many lives. As she also showed, anyone can do it IF and only IF they work at it like the aforementioned activists."
I've been saying this in several comments to this piece.
Maybe you can add a comment to Christine McM and Funky Irishman.
I suggested they team up. Between them they regularly get hundreds of recommends almost every time they write (as of now, Christine's main post is up to nearly 70).
Imagine if they - and perhaps a few other top commenters - settled in a particular topic they were passionate about. There are now just over 4 million digital subscribers to the Times, and a significant number of them say that the comments are among the major reasons they subscribe.
So Christine, Funky I and whoever else joins them have one of the most amazing and respected soapboxes on the planet. I'd love to see them use it in a more focused way.
Maybe you could drop them a note (they're both published in response to this column) and encourage them also!
3
@Don Salmon
Don, if I had a recommendation for that topic of cause, I'd opt for it to be the provision of free, effective birth control to all who want it throughout the world.
And, of course, funds should be made available to research new methods of birth control that could be even cheaper and more effective.
I realize in a lot of the religiously motivated world this is a big ask. But I suspect if we can mitigate the continued exponential increases in population then we might actually have a chance to also mitigate the problems of climate change and resources degradation.
There's nothing wrong with promoting the health initiatives that Nicholas talks about here or green energy initiatives or any other cause to make lives better, but I suspect we can do much more to make lives better if we had fewer lives to make better. Because if we don't limit our reproduction, it's likely natural processes in the form of pandemic or starvation or drought will do it for us at some point--and not in a gradual way.
2
@Glenn Ribotsky
Here's another idea - for Nicholas Kristof's next book (after this latest one!).
With the enormous resources of the NY Times behind him, the book might be entitled: "The News, and What You Can Do About It" (I'm sure he can come up with a better title, but for now....)
you know how the Time provides wonderful background info? Such as, right now, on the historical and legal knowledge necessary to understand impeachment?
Why not have an on-going series in the Times - to be written up in Kristof's next book - with two parts:
(1) background for major issues such as climate change, healthcare, education, immigration, etc
(2) links to sites that provide information about what you can do - in your own personal life, in your neighborhood, town, city, state, etc
The 'what you can do" might include all the customary things, political involvement, contacting representatives, etc. But it should also include an endlessly growing number of things that readers (commenters - this will be interactive) suggest.
The single most important thing, though, is this:
As Francis Moore Lappe observed during her epiphany at the UC Berkeley library when she realized there is NO problem with food supply. We have all the food we need, but people in need don't get it...
Similarly, we KNOW all the solutions. Everyone knows about over population. But aren't willing to do what it requires.
it's a psychological (or if you prefer, spiritual) problem.
Let Kristof write about that!
1
Elsewhere in this paper is an essay about how residents of rural Arkansas refused to pay for library services. The article explains that residents don't think much of government for any purpose. Why do we think these citizens have any concern for any global program?
90
@Aging Hippie Yes, I take your point, but in fact there was a remarkable coming-together in the early 2000s of bleeding heart liberals and bleeding heart evangelical Christians. They made real progress together on issues like human trafficking, AIDS, malaria and so on. President Bush's PEPFAR initiative reflected lobbying from evangelicals in places like Arkansas. So I share your concern about isolationism and chauvinism, but I also think there are sometimes opportunities to surmount them.
79
@Aging Hippie When I read Monica Potts story about Clinton and Van Buren County, Arkansas, it occurred to me that Ms. Potts had missed something -- talking about how the people there work together and how those people get together and decide what they will work on.
Here is a story about people in rural and small town West Virginia working together. I hope you will have the time to read it.
https://theintercept.com/2019/05/18/west-virginia-populist-governor-campaign-stephen-noble-smith/
1
@Nicholas Kristof
Now if everyone could just come together on the importance of family planning for our over populated world, along with the other programs you talk about (in poor America as well as the 3rd world), then we would really be talking progress.
20
The problem is that too many of us wear bifocals but never raise our heads to see anything beyond reading distance. Don't get me wrong; reading is essential but, absent awareness of the real world people are reading about, the activity is useless.
Who cares about Ebola or West Nile virus? Nobody, until such illnesses reach us in our back yards by which time remedy will be exponentially more costly than timely preventative action.
As for climate change, leave it to Greta; she'll fix it for the rest of us. We can keep shopping.
51
@John LeBaron Thanks for your comment. You have a way with words--I may steal the bifocal analogy in a future column! :)
35
@Nicholas Kristof. Thank you. Feel free; I'd be honored.
"We" have not lost interest in helping children, saving lives, educating and housing them and providing clean water and other necessities. It is certain leaders who are not interested, particularly those who espouse a nationalist agenda such as Trump. Most if not all Democratic presidential candidates recognize that it is in America's interest to help poorer countries or want to do it simply because it is the right thing to do.
The problem is the nationalists and the libertarians who believe that each community if not each family should do everything for themselves, which is nonsense in a global society.
20
Thank you, Nick. We are being bombarded with the message, me, me, me! Our president feeds off this selfish theme. He did not create it, but he is using it to further his ego.
5
This is absolutely right. My Bill Cook Foundation, www.billcookfoundation.org, is funding small programs to teach healthy practices to mothers in rural Zimbabwe and in a slum in Lima, Peru. It is small scale, but this is how we start and how we try to bring attention of health-related issues to a broader audience.
16
How could anti-intellectualism ever go wrong, when it continuously wins so many votes?
“Ebola has been spreading in eastern Congo for more than a year. If it suddenly bounces to Europe or Asia, we’ll belatedly realize that our safety in America depends on improving health systems in Congo.”
If Ebola ever ‘bounces’ to Europe or Asia, it will likely have already been transmitted to enough carriers so that the virus would do more damage than any notion of ‘safety’ would allow for. Establishing quarantines for a pathogen like Ebola is not a simple undertaking, and we’re living at a time when our nation is lead by simpletons.
8
Thanks for this reminder that there are some issues which are neither partisan nor stop at any border. We have a common cause as humans, period. And it raises the question - ultimately, what should power really be used towards, if not for the betterment of humanity?
17
"If these countries can manage it, why is the most powerful country in the history of the world stymied?"
Because America has lost its way on any number of fronts.
First, we're so polarized we've lost the impulse as well as the experience of working across the aisle on healthcare issues.
Second, America is run by extremely wealthy people for whom healthcare access is no problem, so why tie up the treasury on a "socialist" initiative, when you can just spend more on military hardware?
Third, America is increasingly corrupt. The insurance lobby and drug manufacturers maintain a stranglehold on politicians, resulting in the fact that healthcare is demagogued but never solved.
Fourth, the nation's priorities seem to lie in making the wealthy even richer rather than addressing the needs of "average Americans" and their struggles.
I could go on and on, but the case is clear: those currently in power don't value universal access the way the majority of us--and the world--do.
158
@ChristineMcM
Yes Christine, but is there anything each one of us - you and me - can do about it?
I think there are many many things we can do - and things that could possibly affect large numbers of people.
Think, for a moment, if you had a long-range vision, given the numbers of people who regularly recommend your comments, what a difference you could make!
9
@Don Salmon: I'd be interested in your ideas. I have one vote, period. I've marched, protested, written, donated (to candidates and charities whose values I share), you name it--the average citizen really can't make a difference to change the tide of all those issues I discussed in my post. The power of money is too omnipotent, and it favors the election of Republicans (you're from a red state, I'm sure you agree) who like to keep it that way. Donating part of the federal budget to medical research and causes that benefit ordinary Americans isn't normally a Republican choice, whereas Democrats do believe in such choices.
44
@ChristineMcM Thanks for your comment, and I largely agree. The fact that the US has had declining life expectancy for three years in a row, and that our health metrics are among the worst in the industrialized world, is a reflection of the key point you make: America has lost its way. Incidentally, this is a key point in a book that Sheryl and I have coming out on Jan. 14, "Tightrope." It's a cri de coeur, so keep an eye out for it!
88
I often read Kristoff’s columns and I have noticed they range from brilliant and riveting to detached, even disingenuous. Regrettably, I would categorize this piece in the latter grouping. Interestingly, Kristoff has engaged in the same willfully flawed comparison between the United Stated and destitute nations I have observed in other work.
Ethiopia and Chile are not “moving towards” anything which can be described as universal health coverage. Medical care in these second/ third would countries is abysmal and would invariably constitute malpractice if it existed anywhere in the western world, including the United States.
Like the author, I support universal healthcare, but there are ways to plead your case without irrationally suggesting that nations where people live on a few dollars a day are somehow more advanced, at least medically, than the United States.
There is a reason people in Chile and Ethiopia, at least those who can afford, seek medical treatment elsewhere.
3
@Mark,
You must have affordable health insurance. I'm a native-born American citizen in my early 60's, and must get much of my health care outside the U.S. because it is now too expensive for me here.
4
I do. I work and so does my wife and we have health insurance. I am sorry that you don’t have affordable healthcare but if you live in Colorado you are not looking hard enough ( assuming you go to Canada) as there are many options available either through work or generally.
1
@Mark
He means universally available. I'm sure the level of health care in many of these poorer countries is nothing short of pathetic, but the comparison is in the outlook. They are more advanced in their outlook, at least if you believe in a society where everyone benefits and not a zero-sum everyone for themselves' sort of society where only the lucky benefit.
As a comparison, in this country, once a child turns five or six, parents are expected to have their children schooled. Home school, private school, public school, whatever. There are requirements. And, if none of these options pleases a parent, they can educate their kids abroad, but at least something reasonable is universally available here.
Health care? It's a scramble at best, and before the ACA there were 20 million or so people with no health coverage at all. With the ACA, self-employed people could get health insurance...but the costs can be absurd. Anyone who owns a business that provides health benefits knows that businesses usually pay 2/3 and the employee 1/3. That obscures what health care really costs here--which is about 15-20 thousand dollars a year.
I envision a nation where we can all walk to the corner clinic and get some help without getting bankrupted. Is it really too much to ask?
1