The State of the World Atlas [ff]. Dan Smith

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and are deployed to

      provide health care for all, that is no guarantee that our patterns of

      behaviour will be healthy. For that is a matter of personal responsibility and

      individual action; government can make it easier or harder, can educate

      the citizens or neglect the issues, but in the end it is impossible to enforce

      healthy behaviours.

      Even so, people’s health is improving. There is still too much suffering from

      curable and preventable conditions and, in many countries, the way that

      mental and psychological disorders are handled primarily by silence and

      taboo is as big a health scandal as any. But medical science is advancing,

      the sequencing of the human genome has been worked out, the genetics

      of cancers are being unlocked, and new treatments are being and will be

      developed. The progress is encouraging but there is further to go because

      many of these conditions have social causes – lifestyle diseases whether of

      poverty or spreading prosperity. What is required now is to increase the

      capacity to address those causes.

      HEALTH OF THE PLANET

      On top of all this, there is growing awareness about the unfolding crisis in

      the natural environment. Compared to the other events that have shaped the

      spirit of our time, changes in the natural environment are slow moving. By

      the standards of 21st-century political culture, they do not deserve the name

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      of crisis at all – but the timescale in which they should be understood is

      much longer than a four- or five-year political cycle, which is the maximum

      we are used to thinking in.

      Of the five key issues that we must as a world community resolve in order

      to prosper, our relationship to the natural environment is the most tangled,

      the one in which knowledge is most essential to understanding, and the one

      that has the highest stakes – yet the one on which we seem unable to act

      on the scale that is needed. Though we cannot yet make out all the details

      of the interaction between different components of this crisis – between

      the different ways in which we are damaging the environment – we can

      clearly see the critical moment bearing down on us. Yet generating a united

      and viable response is currently beyond us. Calm reflection reveals that, on

      the basis of what we currently know, there is time to act effectively as long

      as we act now. But each day that passes increases the depth and scale of

      change that is required.

      PROBLEMS & SOLUTIONS

      These five key challenges are in principle all amenable to solution. In one

      sense, that is illustrated simply by there being successful approaches to

      significant aspects of three of the five. Problems remain in the realms of war

      and peace, rights and respect, and people’s health, but progress is visible.

      There is less war, though violent conflict persists. There is more democracy

      and more respect for human rights, though abuses persist and the

      transition is often dangerous. Improvements in treatment for many of the

      major ailments are available, though lifestyle diseases are on the increase.

      Undernourishment is slowly reducing as a problem, but obesity – perhaps a

      different kind of malnutrition – is now a global epidemic.

      What holds us back from pressing through to greater improvements on these

      three fronts and to sorting out at least some of the big issues of wealth,

      poverty, and the natural environment is the condition of our politics and our

      international political institutions. In Europe in the years since 2008 we have

      seen signs of a breakdown in the fundamental relationship between citizens

      and state – the implicit bargain that power is both real and accountable.

      There is now such a deep resentment about taxpayers being forced to pay

      the cost of the failings, incompetence and, in some cases, apparent crimes in

      the major banks that it is building towards refusing consent to be governed.

      The social and economic elite has shown a combination of incompetence

      and the arrogance of impunity, and would-be political leaders continue to

      cosy up to that elite so shamelessly that they are threatening the continued

      viability of the contract of government.

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      It is, in the end, unlikely that this will erupt into any kind of revolution

      and, if it does, the odds are that it will be profoundly unpleasant for

      ordinary people. But it is the kind of deep-seated problem that may make

      it next to impossible to generate new policies and approaches to prevent

      environmental degradation and successfully address the other major issues.

      Our enemies in trying to generate new and better approaches are inequality,

      unfairness and social exclusion, short termism, and blinkered allegiance to

      norms and policies that used to be functional. Anything and everything

      that limits the amount of knowledge that can be brought to bear on a

      problem, and the number of knowledge-holders that can get engaged, is an

      obstacle. Part of this problem

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