The Lancet was founded 200 years ago as a medical journal.
But the creation of a publication also means the birth of a concept. Its original intention was to serve as a weapon for social reform,
a political weapon to promote health as a concept in the public domain, which is what we are trying to do today, to reshape for a new generation, a new century, and a series of new challenges facing human beings the philosophy. We wanted to make a diagnosis, and we identified five themes that we called “health focus areas”: climate and health, universal health coverage, child and adolescent health, mental health and health research, which we believe have been neglected in the past , and extremely critical to our future.
Climate affects nearly every aspect of health, to varying degrees. The climate is the environment in which we live. If the climate changes, everything about our lives will change, including the crops we can grow and the water we can get. People are exposed to a vector-borne disease to which they have not been exposed before. Most of our progress since the Industrial Revolution has been achieved essentially by extracting fossil fuels. And we have a very positive narrative about it: thinking that extraction of fuel is good and all the developments are positive. There is some truth in saying this. Many people were lifted out of poverty, and medical science advanced enormously.
But the problem is that this development has now begun to the point of causing damage. It can be said that climate change is like a chronic disease for us today. In response to the climate crisis, we need to lead by example. If we can decarbonize our health systems on a global scale, we can make a huge contribution to reducing future climate emergencies. In fact, the best time for us to act was 20 years ago, and the next best time is now.
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We can make some changes, and they can happen very quickly. Scientific evidence can only go so far and we need to act. For the first time in human history, we have the opportunity to eliminate preventable deaths of mothers and babies within a generation. Politicians are known to love holding babies, but that doesn't always translate into action. Children in this age group are often inarticulate and unable to speak up for their health needs.
Older children can express their ideas, but we often fall on deaf ears. They often don't have much political capital. In the 1980s, newborns and infants were often operated on without anesthesia. The doctor will sedate them unconscious, but will not give any pain medication. Because everyone thinks that newborns and babies don't know pain. And those who truly see these children as individuals are calling for change in this regard. Research is the engine that drives progress. Of all human inventions, science produces the reliable knowledge that gives us the opportunity to solve the problems we face.
We still have a lot of work to do in terms of public participation trials. The universities or colleges that do the trials tend to be located in big Brazilian cities, and I've seen this in Brazil, Peru, and Mexico.
Therefore, people who need several days to get to the test site will never participate in such experiments. It's not good for everyone. We are going through a rampant anti-science phase. Diseases that have been all but eliminated through vaccination are making a comeback. I think academia, including myself in it, we need to take responsibility and communicate better. Our history has not been all smooth sailing. The Lancet was founded in 1823, at the height of the British Empire. The Lancet undoubtedly profited from slavery and colonialism. So we need to make amends for that, but we also need to look to the future, because colonialism has not completely disappeared from the stage of history so far. What we are dealing with is a different kind of colonialism.
The rich and powerful still dominate this world. We need to make sure that we don't just privilege the rich and powerful. We need to hear and learn from all peoples and all cultures. Everyone must be able to have a place in this global conversation. We want to accelerate improvements in the availability, accessibility, acceptability and quality of global health care. The absence of universal health coverage has devastating effects on millions of people around the world. My great-grandfather came to America at the turn of the nineteenth and twentieth centuries to work in sweatshops in New York. He lost an eye in the factory, without access to basic health services. My family became very poor as a result. Such things still exist today. Everyone should have the right to basic health care, regardless of ability to pay. Unfortunately, the vast majority of countries do not have anything like universal health coverage. If these people's health is not protected, it will still affect the overall health of society, and someone is paying the price. There are success stories for universal health coverage on every continent, so there is no reason why countries should not strive to achieve universal health coverage.
In our society, we place too much emphasis on the importance of physical health and pay little attention to the spiritual dimension of health. Society affects mental health, and mental health affects society in turn. We cannot address mental health issues without addressing the stigma and discrimination against people with mental disorders. We need social support like laws and regulations, not just talk, not just access to health care. We need laws and regulations to help decriminalize mental health issues. If we don't take the time to treat their mental health well, it could become a big problem in society in the future. One of the things we've learned during COVID-19 is that the world can change fundamentally when needed. We are all beginning to understand that my health depends on your health, and your health depends on my health. We are interconnected. We have an opportunity to prevent problems in these areas from turning into multilayered, complex, and long-lasting crises. These health focus areas are the main drivers shaping the health of the global population.
We hope to focus on these five focus areas, to ask some tough questions, to get some answers, and we hope to use this anniversary to spread those answers to the world..
