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Killing ourselves with softness
On Wednesday this week, while the global village was consuming
the last of its chocolate Easter eggs, a World Health Organisation forum on “the
challenge of non-communicable diseases” opened in Moscow. The explosion of
chronic diseases such as diabetes, heart disease and cancer -- in many cases
diet-related -- is “an impending disaster”, the UN body announced. “I mean a
disaster for health, for society, and most of all for national economies,” said
WHO Director-General Margaret Chan in her opening
address.
It must be at least a couple of decades since we started talking
about “diseases of affluence”, but that term is now obsolete. The chronic
health problems of the most developed countries have spread to the developing
world, outpacing communicable diseases such as malaria and AIDS in every region
except Africa (and even Africa will catch up by 2020). Chronic diseases, many
of which are preventable, accounted for 63 per cent of the 57 million deaths
worldwide in 2008. Of those 36 million deaths, 80 per cent occurred in low or
middle income countries.
As we know from the mammoth healthcare debate that the
United States has been engaged in, even the wealthiest economies are groaning
under the growing burden of disease. Average health
spending in the OECD countries was 9 per cent in 2008, but the US figure
was 16 per cent, or $7,538 per person. It will be more now. Factors driving
this trend in the richer countries include technological change, people’s
expectations and population ageing. But unhealthy lifestyles are the biggest
drivers of them all, and, sadly, we have exported this problem to the poor --
without the technology to palliate it on the whole.
The worst of it is that we know perfectly well what we are
doing wrong: eating too much; drinking too much; eating and drinking the wrong
things; consuming more calories than we can use through daily activities;
smoking; watching television instead of exercising…
Is there anyone -- any adult -- in the world who is able to
buy a packet of cigarettes, or a box of Kentucky fried chicken, or another
bottle of vodka (remember, the WHO summit is taking place in Moscow, the world
capital of deadly drinking), anyone who is able to turn on a TV set, who does
not know that consuming that product to excess will damage their health? Young
children might have an excuse for drinking too much soda pop and vegetating in
front of the small screen (negligent parents) but, by adolescence, even third
world youngsters are likely to have heard their first healthy diet messages
from the authorities.
Even without public health campaigns the use of reason, the
feeling that one’s body has become a burden to carry around, or just looking in
the mirror, should alert us to the need for restraint and moderation. The
trouble is that those concepts confront us with the awful truth that we are not
only physically unfit but also, and even more, psychologically unfit to look
after our own health.
How many people under the age of 60 have heard of the virtue
of temperance? How many have been brought up to exercise it? Of the billion or
so people of any age who attend church or synagogue or mosque regularly how
many even hear a homily on the subject?
On the other hand, how many in the younger generations have
been reared and educated in the school of instant gratification, where a bit of
nagging gets you all the TV time and all the bottles of pop you want, and where
even the most dangerous and degrading forms of self-indulgence are condoned by
the ethic of harm limitation. When adolescents are taught that it is fine to
follow their sexual impulses so long as they use a condom, why should they say
no to any other impulse? Why should they not stuff themselves with fast-foods,
get drunk and smoke whatever is to hand? So that is what they do.
Since authorities at the highest level are implicated in the
culture of self-indulgence, it is no wonder that WHO boss Dr Chan did not
address it in her pep talk this week. Instead she lambasted “corporations that
are big, rich and powerful, driven by commercial interests, and far less
friendly to health” than public service entities. “Forget collaboration with
the tobacco industry,” she adds pointedly. “Never trust this industry on any
count, in any deal.” Well, some of us feel like that about the sex education
industry.
What we need, says Dr Chan, is laws to control those demon
industries, plus corner stores in slums that sell fresh produce and not junk
food, urban design that encourages walking and cycling, safe playing areas,
affordable essential medicines…
Certainly we need all those things. But we also need
something more basic -- a philosophy of life and not just a philosophy of
health. It is no accident that an irresponsible attitude to the body has grown
as recognition of its Creator has declined. Even many apparently religious
people don’t seem to know that the fifth Commandment (Remember? Thou shalt not
kill…) obliges us to respect and care for our bodies -- because we do not simply
“own” them like a piece of property but receive them as part of the gift of
life for which we must finally give an account.
That sort of talk offends many today, but it is difficult to
see how the substitutes for religious duty can achieve the desired outcomes:
walking/cycling past the fast-food outlets and eating our fresh vegetables and
pulses at home. The “right to choose” doctrine tells us that our bodies are
indeed private property over which we have sole jurisdiction, even to the point
of disposing of another life in the womb. (Don’t tell me what I can eat or not
eat, whether I can smoke or not!) Evolutionary biology and psychology have sown
the idea that we are merely the product of our genes and environment. (It’s not
my fault!)
What’s left to do? Engineer genes and the environment to the
point where we could not but make the healthy choice? But would not every
government in the world be bankrupt before this brave new world was achieved?
Dr Chan says that the rise of chronic diseases “calls for
some serious thinking about what the world really means by progress.” She is
right. I have done some thinking and here is my idea. Progress would be when
the World Health Organisation recognises that not only food and tobacco
corporations need to be controlled, but that individuals need to be controlled,
by themselves; when the WHO tells governments to support families and
institutions that teach their members self-control -- out of respect for their own
bodies and the body politic.
Carolyn Moynihan us
deputy editor of MercatorNet.

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