Remembering who owns the river

Abstract

We have discovered the elixir of life. For the first time in human existence we now know how we can avoid disease, make our lives healthier and more fulfilled, and even fend off the grim reaper himself (at least for a while). We may not have joined the immortals – many traps and snares continue to prey on us – but we are beginning to learn some of their secrets. Why then are we failing to grasp these heady opportunities? WHO data show that nine out of ten of we Europeans are dying of lifestyle diseases; that is diseases caused by our own choices – self-inflicted diseases. Despite the all too familiar consequences for our bodies, we continue to smoke the tobacco, swallow the junk food and binge on the alcohol that is killing us. Yes, there are systemic drivers at work – commercial marketing, corporate power, inequalities, addiction – but we don’t have to collaborate. No one holds a gun to our heads and commands us to eat burgers or get drunk and incapable. This paper argues that public health progress – and human progress more widely – depends on us solving the conundrum of this self-inflicted harm. The urgency of this task increases when we consider our irresponsible consumption behaviour more widely, and that it is not just harming our own health but everyone else’s too. Most egregiously anthropomorphic climate change is being caused by the free choices we in the wealthy global north make to drive SUVs, go on intercontinental holidays and accumulate a foolish excess of stuff. It need not be so. Historical experience and two millennia of thinking show we are capable of better. We have moral agency and we can make the right choice even when it is the difficult one. Indeed, it is this capacity and desire ‘to follow after wisdom and virtue’, to rebel against injustice and malignancy, that makes us human and cements our collective identity. In the last century this realisation was focused by the terrible events of the Second World War and resulted in the formation of the United Nations and the Universal Declaration of Human Rights. Importantly these rights do not just protect us from oppression but enshrine in international law our entitlement to be an active participant in the process of progressive social change.