As preliminary arrangements are made to convene an international conference of nations and states to discuss how to implement new, cooperative relationships between indigenous peoples and metropolitan populations, agenda items will undoubtedly include such matters as climate adaptation and economic globalization. Within this new framework for discussion and negotiation, global dialogue on how to meet the needs of all humankind will, for the first time, take on a holistic tone, incorporating such issues as traditional knowledge, property rights, spiritual values, and climate refugees.
Central to this new world order, but not specifically delineated in early efforts at defining adaptation protocols, is the issue of public health. As peoples and populations are uprooted due to dramatically altered climatic and economic conditions, providing public health services to the displaced becomes an international institutional challenge; as epidemics occur due to collapsing public health systems concurrent with the breakdown of modern states, preventing pandemics from the misuse of pharmaceuticals, malnutrition, and mobilized masses of traumatized populations becomes an international institutional crisis.
Maintaining food, health, and housing security under such a situation requires significant levels of international cooperation, as well as massive reallocation of resources from warfare to healthcare. Doing this under the best of circumstances is problematic; given the likelihood of concurrent religious hysteria and outbreaks of civil war, the need for self-restraint by militarized societies cannot be overstated.
In Laurie Garrett’s 2000 book Betrayal of Trust: The Collapse of Global Public Health, she writes, “We live in a world in which new human pathogens emerge and old infectious diseases once thought conquered can resurface with a vengeance.” Noting that public health must take into account the complexities of science, politics, sociology, economics, religion, philosophy and psychology, Garrett asks, “Can it still be assumed that government can and will protect the populace’s health?”
Noting that public health infrastructures were not terribly resilient in the face of societal stress and economic difficulty, Garrett forewarns, “…an unstable, corrupt society is inevitably a public health catastrophe.”
In the present era of malign neglect and rampant corruption at the highest levels of business and government, it is a dire warning indeed—in terms of public health, safety, freedom, and life itself. So vital to societal stability and so vulnerable to political disorder, public health in either sense — physiological or psychological — when in crisis, can bring down a government.
In the decade since her book was published, Garrett’s research has taken on new
significance. Climate change and globalization have accelerated
exponentially. Her cogent remarks take on new meaning. Not least of
which is her admonition that, “To build trust there must be a sense of
community. And the community must collectively believe in its own
future.” When it comes to global public health, that community is all