It's A Wonderful Life

Born of the European mid-winter festivals, the countries of historic Christendom and those they colonised, will celebrate the very nominal birth of their founder today. A large portion of those will engage in truly gluttonous levels of feasting and inebriation, and engage in the ritualised and comercialised exchange of mass produced gifts that carry a hefty price-tag, working on the selfish principle that charity begins at home. A few perhaps, in more private moments, may have thoughts of gratitude at their good fortune in life. But gratitude by itself is not enough; recognition of one's own beneficial circumstances is merely a metaphysical prayer unless combined with an altruistic resolve for transformative justice; the peace, security, and wealth of the few must become the same for the many. With such thoughts in mind, a survey of the sufferings of 2017 and their trajectory is an apt reminder.

As part of a general trend, armed conflicts continue a general trajectory towards being lower in intensity and longer in time [1]. The Syrian Civil War had a fall from around 50,000 deaths in 2016 to under 25,000 in 2017, mainly due to a brokered cease-fire at the end of last year. It is still. however, the most violent region in the world today and at a similar level to the ongoing war in Afghanistan. Deaths from the Iraqi civil war has almost halved to just over 12,000 for the year, now surpassed by the Mexican drug war. The ongoing conflicts in Northern Rakhine state in Myanmar, the Somali civil war, and the second Libyan civil war, are also noted in their deadliness. All in all, some 100,000 people were killed in wars this year across the globe. Nearly all of these were civil wars, insurgencies, and involving various non-state actors, with the exception of relatively minor border wars between India and Pakistan, Pakistan and Iran, and Israel and Palestine. Formal wars between States has been largely resolved; the ability of States to satisfy their responsibility to protect their own citizen remains far from complete, not the least aided by proxy wars fought between the great powers who misuse genuine grievances for national liberation, civil liberties, and democratic rights, to further their own geopolitical advantage.

War is, of course, dramatic and violent born of disputes of political power. The slow remorseless loss of life due to malnutrition is far more deadly, and usually the result of economic inequality and lack of development. After many years of decline in absolute and proportional numbers, undernourishment is still prevalent and even increasing [2] affecting 815 million people or 11 percent of the population and causing the death of several millions, despite the fact that more than enough food is produced to feed everyone. Rates of adult obesity head towards 30% in North America, Europe, and Oceania (perhaps counter-intuitively, often in the poorer households in such regions). The reduction in world starvation was largely attributable to deliberately interventionist policies aimed at poverty reduction, political stability, and, often overlooked, women's education and political rights in the developing world. The recent increase in global starvation is mainly attributed to outbreaks of violent conflict, especially in Nigeria, Somalia, and Yemen.

The biggest killer worldwide however - as it has been for many years in succession - is heart disease and stroke [3] which combined as vascular diseases represent at least fifteen million of the world's deaths, although this has variation according to economic development. For low income countries, it is various communicable diseases that are the largest group, especially lower respiratory tract infection. Age is the most important risk factor in vascular diseases, followed by sex (men are more prevalent), smoking, and low levels of physical activity. For lower respiratory tract infections there are vaccines (e.g., for streptococcus pneumoniae), antibiotics (e.g., for haemophilus influenzae). It is notable that the pneumococcal vaccine is not heavily applied in those countries which suffer the greatest effects of the streptococcus pneumoniae disease. It was only this year, for example, that India included it in its Universal Immunisation Programme [4].

War, famine, and pestilence - three of the four traditional "four horsemen of the apocalypse". The fourth, death, is a curiosity as the other three are certainly causes of death in their own right. But in a contemporary context, where the productive capacity of modern industrialisation pushes the limits of the environment to absorb heat and pollutants, 'death' can be reinterpreted as environmental death. Scientific opinion has issued a dire "second warning" [5], noting a 50% decline in freshwater resources per capita since 1992, declining marine catch, declining forest area, a collapse of vertebrate species abundance to less than 50% of 1970 figures, increased CO2 emissions, temperature increase, and human population. The only decline - and a significant one - has been in ozone depleters. The most comprehensive study on the effects of pollution concludes that it kills nine million a year, mostly in impoverished countries.

Some may argue that raising this list of mostly preventable deaths for the year is in poor taste in festivities of merriment. But that is precisely the point, for it is wiser and better to visit those in the house of mourning rather than the house of feasting. It is not just through wilful ignorance that such suffering occurs, but also a lack of discussion among those who have it in the power to act - including all who are reading this piece. It should be, and can be, in our resolve to determine the best possible means to end suffering and promote the dignity and worth of all people. It is tentatively suggested here that the best method would be a worldwide fund derived from resource values as the common and equal inheritance of all, and as voluntary donations by nation-states and individuals have shown to be consistently ineffective in providing the necessary capital resources. But having the discussion and engaging in action is the most important step, for if we fail to do this not only will people here and now suffer, our future reputation will be tarnished in recognition of our failure to act. We may yet change these shadows so shown by an altered life. Honour it with your heart, and keep it all the year.


[1] See, for example, the Uppsala Conflict Data Progam of Uppsala University, Sweden.

[2] Food and Agriculture Organization of the United Nations, The State of Food Security and Nutrition in the World, 2017

[3] World Health Organization, The Top 10 Causes of Death, 2017 (FP 2015)

[4] The Hindu, Pneumonia vaccine to be part of immunisation drive, May 14, 2017

[5] William J. Ripple Christopher Wolf Thomas M. Newsome et. al., World Scientists’ Warning to Humanity: A Second Notice, BioScience, Volume 67, Issue 12, 1 December 2017, Pages 1026–1028,

[6] The Lancet, The Lancet Commission on pollution and health, October 19, 2016

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