Are we capable of acting as a global community? We have an exceptional window of opportunity to show that we can. The United Nations has embarked on a seminal historical process called "The World we Want" to define what our common priorities for collective action should be over the next 15 years. Mindful of the UN Declaration which starts with "We the people," people from all around the world, supported by social media, are contributing to the conversation which has been termed the Post2015 process. It follows on from the Millennium Development Goals adopted in 2000, which have their deadline in 2015. What are some key mind-changes emerging from this conversation?
First: Politicians and electorates need to accept that in a global world we now have both national and global interests - and governments must be held accountable for both. The challenge is to 'manage the world's production and consumption patterns in more sustainable and equitable ways. Reducing poverty can no longer been seen separately from the need to protect "earth's life support". There is no away in which to throw things any more. In health challenges include for example health security and the recent outbreaks of H7N9 and NCoV; the global spread of non communicable diseases, the threat of anti microbial resistance and unacceptable and unsafe working conditions as in the textile factories and mining industries of the developing world.
Second: There is a convergence of a set of key principles that form a global health ethics. A wide range of priority health challenges are mentioned in the global debate: HIV AIDS, maternal health and non communicable diseases to name but a few. But more importantly health is considered a human right (including sexual and reproductive rights and freedom from gender based violence) and the global equity gap in health is framed as a major issue of social justice, as is the universal access to water and food. Governments and institutions should respond to this narrative of rights and justice -- as must global companies.
Third: It is not sufficient to string a set of priority health challenges together -- we must have the courage to think beyond health and embrace a broad notion of sustainable development. No matter how important some health issues might be, global health is dependent on a wide range of determinants and many other priority issues - for example education, water, food, energy, and environment -- which will impact on any heath goals we might consider. Production and consumption patterns - the commercial determinants of health -- and the role of transnational companies will need to receive much more focus. People and planet are as inextricably linked as are poverty reduction and the protection of "earth's life support" as recently expressed in a key contribution in Nature.
Fourth: Our debate must start not end with governance. Why? The stakes are high: we must learn how to govern a global system in the making more fairly. No longer can "the West" write the roadmap of global governance and development. No longer can we pretend that development is a purely technical not a political process. We need to ask hard questions: why was it possible within 10 years to have coverage of 540 million cell phone users in Africa and still not have managed to reach immunization coverage of all African children or bring malaria bed nets to everyone. Just as the UN system was "created" so will the new governance be shaped by political will and courage - and the 88 percent of the world's population in emerging economies and developing countries will insist on having their say.
Fifth: The priority focus needs to be on the global public goods we ALL require in relation to health, climate, population food, water, energy, conflict -- they are the building blocks for our future. In consequence such a global system requires reliable institutions related to three big pillars:
- A vigorous and fair global economy
- Environmental sustainability, sustainable production and consumption
- Global health and wellbeing
Sixth: We will require an agreement how to jointly finance the global public goods we prioritize as a global community, not just through governments but with the contribution of other global actors. This will need to be related to the size of the global GDP -- the gross world product (GWP) in 2012 - which is the combined gross national product of all the countries in the world -- totaled approximately $83.12 trillion. The stability and the rule of law supported through a strong multilateral system benefits global markets, therefore they should contribute. The global health market alone is at a volume of $6.5 trillion. The budgets of UN organizations pale in comparison, for example WHO's budget is two billion dollars a year.
Smart sovereignty means boldly reforming and strengthening global institutions in order to ensure that they can deal reliably -- and with legitimacy -- with globalization and global crisis. We need a systematic strengthening of multilateralism, also in health. Let's continue to work on the mind-changes necessary to move forward.
This post is part of a series produced by The Huffington Post, the University of Wisconsin-Madison's Center for Investigating Healthy Minds and the Global Health Institute in conjunction with the Change your Mind, Change the World 2013 conference. This series of dialogues on global health, sustainable well-being and science & happiness will feature his Holiness, the Dalai Lama, and other thought leaders on May 15, and will be live Webcast on May 15 at 9:30am (CST) and 2pm (CST) via www.cmcw2013.com.