The big question for this segment is what challenges does the Anthropocene throw at living standards and health of populations? [MUSIC] We've come to a time in history which some have called the modern era and others describe as post-modern. Regardless of contemporary titles, we're clearly in the Anthropocene, the era when human activities are having a significant global impact on Earth's geology and ecosystems. Leaving aside contested challenges of definition, and those about dating the Anthropocene, in health and medicine, we're between a rock and a hard place. We've exploited the huge scientific advances and technological achievements which benefit human health for some populations of the Earth. But the Anthropocene brings with it accelerating risks for populations in both rich and especially poor countries. There are polarized views on whether the Anthropocene represents a world of opportunity or the death of civilization as we know it. Whichever way we look at it, the Anthropocene has clear and present ramifications for the health system. For individual and human population health and for living standards which contribute to healthy populations. First, the negatives. At the center of risks to human health lies climate change. Perhaps we should give it its more controversial but accurate label. It's global warming. Extreme heat events are increasingly responsible for deaths, in rich and poor countries. But especially those which are already near the equator. Such as Africa, Austro-Asia, South and Southeast Asia, and South America. Many countries in the tropical zones, are poorer countries, such as India. Those comprising Indochina, for example Vietnam, Cambodia, Laos and those in Sub-Saharian Africa. These are disproportionately affected. Temperatures have already risen by almost a degree on average. And as they rise further, the pressure of heat waves, oscillating climates inducing storms, hurricanes, and drought, all exacerbated by temperature increases, will cause huge challenges. Another major impact of climate change in the Anthropocene would be rising sea levels. This too disproportionately impacts on developing countries and low lying poorer countries, such as Bangladesh. While there'll be lots more sea water, global warming means that melting Himalayan and polar ice means less access to clean water. So the wrong sort of water will lead to serious sanitation and health problems. Populations are rising faster in poor countries than rich countries. But overall, the Earth's populations are continuing to grow. This leads to a number of Anthropocene stimulated problems in population dense regions and countries. Such as more likelihood of infectious disease transmission. For example, malaria, Zika virus, HIV AIDS, STDs, and emerging infectious diseases from previously unidentified organisms. Environmental consequences of Anthropocene behaviors also pose issues. Overcrowding in cities increases carbon emissions creating a positive feedback loop. As people leave drought induced or otherwise marginal arable land and head for the cities. Pollution and smog in cities, such as those in rapidly urbanizing China, feature heavily on evening news broadcasts and are evocative. And in some ways, represent the poster child for what the Anthropocene means to many people. Although extreme poverty is falling in many places, there are still some 9.6% of the world's population, around 700 million people, living on less than US $1.90 per day. In other words, extreme poverty. Another 4.4%, or 300 millions people, are in absolute poverty. Poverty leads to may deleterious outcomes including reduce life spans, hungry, stunted growth amongst children, and unacceptably high infant, and maternal mortality rates. Although the burden is mostly shouldered by poor countries, the Anthropocene is also associated with challenges, and difficulties, for the rich world. Rapidly aging populations, such as those of France, Japan, Canada, and Switzerland, need more healthcare. As life spans increase, a bigger proportion of older people will be living with cancer and other chronic diseases. Being rich also comes with so called lifestyle diseases. Including dementia, diabetes, obesity, and excessive drug and alcohol consumption. So living longer and being wealthy is not a universally good thing. Simply put, older people wear out, and it's costly to treat lots of them. Health and medical personnel and a bigger proportion of GDP will need to be assigned to cope with the tsunami of care needed Second, we turn to the positive effects of the Anthropocene. The main ones emerge from the rise of science and technology. Human ingenuity is now encoded, not in simple stone tools or relatively straightforward hunting and gathering techniques, as it was for millennia, before 10,000 years ago. But in technology and science, we've been truly innovative as a species. We have the capacity to run studies, analyze big data, and understand the world we inhabit. We've created much of our own destiny with the help of technology and scientific advances. Motor vehicles, modern music, modern skyscrapers, stock exchanges, universities, biochemistry, gene therapy, advanced motor transport and space craft moving beyond our own gravity, such as those at Jupiter and beyond Pluto right now. These are amongst only some of the more prominent of advances that come immediately to mind. These are symbols of our success in the Anthropocene. They've made life better and more interesting for many people and psychologically healthy. And created meaningful jobs and careers for many people. Feeding the modern innovative capacity of humanity, arising from science and technology, into the health of populations and living standards, has not been cheap or easy however. Yet GDP has been rising for hundreds of years and now we can pay at least in some societies for new diagnostic capabilities. Extremely smart and effective drugs, very beneficial treatments and procedures and electronic databases for storing information about our unique genetic profiles and disease histories. The emergence in use of innovative methods that translate modern technology into advance health procedures and outcomes for patients haven't stop there. For example, diseases like syphilis, smallpox, many cancers and heart disease are no longer a death sentence. Another example is personalized health aids, which are now ubiquitous, at least in wealthy societies. We can monitor our heart rates and vital signs while exercising, measure how far we walk, and calculate our calorie intake. All of this, now, underpins a health system that learns, provides feedback to individuals and populations on their health status, prevents or cures disease, and is ripe with promise for future advances. The only limits are the boundaries of human ingenuity and the value we place on committing expenditure to healthcare compared to allocating resources to other parts of the economy. And, of course, the capacity or willingness of individuals to pay. In concluding the Anthropocene poses many challenges but also provides the opportunity and potential for humanity to be innovative and solve complex health problems in ways that wouldn't be possible without the technological advances of the Anthropocene. In many places, human health is improving. Associated with rising living standards, technology, and amazing diagnostic, genetic and therapeutic advances. But it's at greater risk with environmental and climate changes. And inequality seemed to continue to plague us. So health status is unequal within countries and across the developing and developed worlds. One penultimate thought. Can we continue to justify developing a world of Anthropocene haves and have nots so far as human health, well being and living standards are concerned? If we do want to solve that challenge, how will we go about it? And finally, here's the inevitable problem I've never completely reconciled in my own mind and grapple with frequently. Is it the case that humans are smart enough to purpose design the world in which we live, including creating modern health care with all its capacities and contributions. But not smart enough to solve the problems that have emerged as a result of all that ingenuity. [MUSIC]
