International public health operates around a clear set of dogmas, protected by maintaining taboos on discussion of subjects that might undermine them. This may seem backward or even alarming, but it is entirely logical. For a quarter of a century, the industry has been dominated by private investors and corporate interests who are attracted to a market for which products can be coerced and mandated without restrictive advertising standards. The growing narrative around climate and health promises to be the apogee of this approach.
Taboos and dogmas
Human societies always maintain taboos. Some seem to have arisen by common consent, some are driven from above, but it can be hard to identify their origins. Do cultural taboos on pre-marital sex or homosexuality, for instance, originally arise from the bulk of the population, or as restrictions imposed by religious or political authorities? Did a requirement to acknowledge the Earth as the centre of the Universe reflect popular sentiment, or drive popular sentiment? Did the Inquisition in Europe grow through popular prejudice, or was it purely an organ of authoritarian control?
The Enlightenment supposedly brought Europe out of the Inquisition, and while true in some ways it is also an illusion. Safe Spaces in university campuses are areas where the Inquisition persists. So are the protests against drag queen book readings, and the protests against the protests against drag queen book readings. We don’t need to think an Inquisition is right or wrong, just acknowledge that we all put limits on freedom of expression and filter which ideas can be shared.
The public health climate Inquisition
Public health professionals see themselves as Children of the Enlightenment rather than Children of the Inquisition. We claim the side of commonsense rather than taboos and dogma. We think this sets us aside from the general public, who are easily persuaded through ignorance to entertain the rantings of charlatans.
Because we are educated and progressive, and health is so important, we claim a right to bypass much of the conversation that Enlightenment normally requires. We need to fast-track things to the truth because they are so important, and we are so knowledgeable about them. While this may seem reflective of the inquisitors of old, we hold that there is a fundamental difference; they were wrong, and we are right. Comparisons therefore simply show the ignorance of the accuser, whom we then label far-Right or otherwise reality-denying. Climate change and its effect on health is a good example. This will become clear by explaining the official public health industry position on this area, critical both to continued human existence and to securing future funding.
Exchanging truth for permissible narratives
The public health professions, not least at the international level, are adamant that climate change is an “existential threat”. Dogma states that this is almost solely driven by human activity, particularly the burning of the fossil fuels on which the last few hundred years of technological and medical progress have relied. It also implicates traditional meat diets in driving the climate. The Director-General of the World Health Organisation is adamant that this must be his organisation’s priority. Two hundred medical journals considered it so important that they abrogated editorial standards to publish a letter highlighting various controversial claims as dogma; as example, a rapid increase in elderly deaths “due to heat” that ignored the simple increase in the total elderly population that accounted for most of this change, whilst far more die of cold. The letter’s authors were not ignorant of this – they just consider the issue so important that it is worth misleading the public in order to gain a required response.
So, this is where we are on climate in the public health sphere. We are funded, as a group, to impose someone’s dogma. “The Science is settled.” We are still all in favour of human rights and evidence-based policy, but consider ourselves entitled to ignore them in order to protect them.
To explain further, it is useful to list what is deemed acceptable in the international public health industry to secure a salary and serve our funders:
- The climate is warming, and this will have overwhelmingly negative consequences on health.
- Human activity – particularly burning of fossil fuels and farming for meat – are the primary drivers of climate change through CO2 emissions and emissions of nitrous oxide, methane and other greenhouse gases.
- If we don’t reduce emissions (reach Net Zero), we will face mass human death and potentially extinction.
- A warming climate is increasing pandemic risk.
- A warming climate is increasing extreme weather events, with a rising impact on health.
- Warm days, though common where most people live, pose an extreme threat to health.
- Climate change is driving increased malaria (see later), increased tuberculosis (previously thought due to poverty) and infectious diseases generally (irrespective of their continued overall decline).
- A warming climate could raise sea levels and enlarge deserts, destroying human settlements and agricultural land, causing mass starvation and forced migration.
Taken at face value, this list constitutes a compelling reason to reach Net Zero carbon emissions and force a change in diets. A delay through continued open debate would make outcomes worse. As a result, we have formed them into dogma and enforce this, protected by a series of taboos, including the following (which, to protect public safety, you can delete later):
- Climates changed frequently in the past (e.g. Medieval warm period, Roman warm period, 6,000 years ago (tree line further north near the Artic Ocean) etc., and these were not driven by anthropogenic CO2.
- Reported acute infectious disease outbreaks have been decreasing over the past decade rather than increasing.
- Mortality from acute weather events has plummeted over the past century.
- Rising CO2 has increased global plant growth, which is a contributor to our ability to feed eight billion people, a feat many considered impossible.
- A warmer climate will likely extend productive agriculture in cool temperate regions such as Eurasia and North America, increasing food availability.
- The main driver of infectious disease and shorter life expectancy in low-income countries is poverty. The reason Western people live longer is because they became richer, and this happened primarily through the burning of fossil fuels – coal, oil and gas – in industry, transport, farming, construction, sanitation and in the manufacture of fertiliser and medicines. Wealthy countries still burn many-fold higher volumes of fossil fuels per person, and correspondingly release more CO2, than poorer countries where people live much shorter lives (see graphic).
- Over three billion people still rely on wood-based cooking (or burning dung) and this is a major cause of deforestation and regional climate change and desertification (e.g. in East Africa), indoor air pollution (that contributes to over a million deaths per year) and impoverishment and physical risk for women (who must walk miles to collect wood).
- China and India are rapidly increasing their coal-burning capacity and CO2 outputs to achieve the benefits that wealthier nations have, and this will far outweigh CO2 reductions achieved in the West or forced on other poorer and less powerful countries.
This second list is demonstrably true. But such is our concern and discipline (we prefer these terms to “fear” and “cowardice”) that we don’t discuss them in open forums. Even poverty reduction, once integral to public health, is now taboo in the context of climate change. Public acknowledgement that Net Zero policies entrench poverty and inequality would put the entire narrative at risk.
Malaria as an example of a false example
Malaria is interesting as it exemplifies public health’s move to dogma over debate. I have been in forums of malaria ‘experts’ where they agree in small groups that there is little compelling evidence associating climate change with worsening malaria, but in a subsequent plenary none will question this claim. I have been pushed to falsely implicate climate in a report for a major international health agency as a driver of worsening malaria, though it was agreed the evidence on which the report was based did not support this. As a profession, lying is deemed acceptable if the subject is important enough. One agency claiming this justifies another to highlight it, which can then be used as evidence of consensus by the first. More funding all round.
It was popular 15 years ago to call malaria “a disease of poverty”. It is. It also requires a warm moist environment to support the mosquito vector. Warmth improves mosquito survival and, importantly, reduces the time taken for the parasite to mature in the mosquito before it can infect another human. However, malaria is no longer endemic in Singapore and is now rare in Malaysia because they have become wealthy. Money allows access to insecticide-treated bed nets, diagnostics, medicines and good supply lines, which stop malaria. However, it still kills over half a million children every year.
Malaria has indeed spread in the highlands of Papua New Guinea and Ethiopia as a warmer climate has allowed mosquitoes to live at higher altitudes. However, countries further from the equator that should be most impacted by a warmer climate allowing mosquito habitats to move north and south are seeing the greatest progress in malaria elimination.
On a global scale, malaria mortality has risen since early 2020, with progress having slowed or reversed some years earlier. There are many contributors to this. We have growing resistance to the insecticides used in bed nets and house spraying (alternatives are more expensive), some increasing resistance to major antimalarial medicines and there are genetic changes in the parasite that have made it harder for some blood tests to detect them. A diversion of human resources occurred from malaria programmes to (demonstrably pointless) COVID-19 vaccination programs. There is also a reduction in funding in real terms, and an increasing funding gap to provide access to the core interventions – nets, spraying, diagnostics and drugs – that malariologists consider essential, whilst at-risk populations increase due to high birth rates.
This complexity is becoming harder to discuss. Now, climate change is proclaimed the major threat to health, soon to “overwhelm the world’s health systems”, and WHO and partners are prioritising reaching Net Zero. It is not that climate change is irrelevant to malaria, but that the malaria community is unable to actually weigh it and proposals for its mitigation in an objective manner. Net Zero policies will logically exacerbate poverty, increase transport costs, increase malnutrition and thereby drive higher overall malaria mortality, but such discussion is taboo.
We can choose slavery or science
So, the issue of health, climate and CO2 is complicated. One way to cope with complexity is to ignore it. WHO now adopts this approach, and literally invents a narrative, maintaining that “ever increasing climate-mediated disasters create humanitarian emergencies where infectious diseases can take hold and quickly spread”. This creates media headlines but loses the trust of rational people once they are exposed to reality.
A rational assessment may even conclude that, through increasing the human food supply, rising CO2 and warmer temperatures may provide an overall health benefit. Or, they might be outweighed by negatives of warmer temperatures: some areas may lose rainfall, some may see more floods. But stopping this would depend on the current global warming episode being almost entirely due to human emissions while those in the past were not (interesting) and then these causes being remediable without causing net harm to over eight billion of us, which is highly unlikely.
In public health we do not discuss this, as it is awkward. We maintain this taboo for one of two reasons:
- The consequences of a warming climate are so dire that the risk is not worth taking. We therefore consider a relative few of us in wealthy countries have the self-assumed right to impose our solutions on the rest of humanity, keeping them in poverty while we thrive. Or:
- Wealthy donors, with influence over public health priorities and important investments in climate change-related technologies, expect us to do so. Our job includes selling their product.
The first reason is essentially fascist, whilst the second is cowardice. Either way, we are acting falsely and disingenuously about climate change and health, and we all know it. We label the second list of bullets above as misinformation and censor it. If we argue that we are doing this for a greater good, we therefore see this within the hierarchical, feudalist model that allows a few to dictate restrictions and poverty on the many. We have chosen the side of the Inquisition, not the Enlightenment.
Alternatively, we could embrace the truth, however dangerous and worrisome, through a rational and open discussion. Rather than throwing abuse and derogatory remarks at those who hold a different line, we could examine our own position and weigh it against theirs. This might help restore trust in public health, but it could also wreck our careers. It all comes down to where we place ourselves, and others, in a hierarchy of values. We can play it safe and be slaves to an Inquisition that oppresses and impoverishes the many, but benefits a few including ourselves. Or we can risk following the truth wherever it may lead. But that, in the current climate, would take courage.
Dr. David Bell is a clinical and public health physician with a PhD in population health and background in internal medicine, modelling and epidemiology of infectious disease. Previously, he was Director of the Global Health Technologies at Intellectual Ventures Global Good Fund in the USA, Programme Head for Malaria and Acute Febrile Disease at FIND in Geneva, and coordinating malaria diagnostics strategy with the World Health Organisation. He is a Senior Scholar at the Brownstone Institute.
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I’m sure there are well meaning people working in “public health” – lots of them perhaps. But I don’t think anything will ever convince me to give my support to any initiative or organization that labelled itself “public health”.
“Public Health” is actually a good thing. In wealthy countries it enabled the eradication of preventable diseases like Malaria. What it is we need to be worried about is the hijacking of bodies and institutions in the pursuit of political agenda’s. In the case of climate that is “Sustainable Development” and “Net Zero”.
It should be good but I have zero confidence that the hijacking you mention can be prevented.
Yes but it is the hijacking that is the problem not the idea of public health. As regards climate all institutions have been hijacked —science, education, all government departments, art, media, and virtually everything else you can think of. So eg we would not say that the arts or education are bad things. Only the hijacking of them is bad.
I think publicly funded bodies that set out to “do good” will get hijacked so the less we have of them, the better.
So you want “less” public schools? “Less” public fire brigades and police? “Less” public hospitals. ———-I am a small government person myself but I think you are rather taking things to extremes.
Bodies are only being hijacked by the progressive left, and it is they we should be attacking, not the actual bodies.
The bare essentials only that the market is not able to provide sensibly/affordably. The NHS is a disaster, but in any case it’s concerned with treating sick people, which isn’t quite the same as “public health”.
“Public Health” gave you vaccinations for everything from Small Pox to TB. ———-But I think we are wasting our time here. We are playing with words. —–Notice I say “we” not you. —–Perhaps we should focus our attack on this parasite new government, because if we both want smaller government that doesn’t interfere in our lives then we now have the very opposite.
Never a waste of time debating with a fellow sceptic. I think we agree on who the enemy are and where we should focus our efforts. If there is ever a winding back from the gigantic state and all of its tentacles, it almost certainly won’t go as far as either of us would like! I guess my point is that the political branch struggles to implement what it purports to want even regarding the most basic and fundamental or services it directly controls never mind all the other do-gooding institutions that it funds. As for vaccines, I don’t know enough to comment. Sanitation and food hygiene I would be ok with but when the state starts wanting to nudge my private health choices I have to say no. Have a good day!
“The Director-General of the World Health Organisation is adamant that this must be his organisation’s priority”…….Bet he isn’t adamant in private, and I bet he also has a private Jet.
Great article, and I have been saying all of those things since about 2007. Climate Change dogma is based on faith and emotion rather than fact and reason. It is a political agenda that requires it’s own facts and makes statements of certainty about things where there are none. It will all the time make claims that are a tiny smidgeon of the truth and will turn that into a planetary emergency. The Malaria scaremongering is typical of this idea that people must be filled with fear in order that they accept the politics masquerading as science. Malaria used to exist in the UK, Holland, USA etc and what wiped it out was good public health enabled by prosperity. It is not a disease of climate yet that is what we are repeatedly told and it all seems plausible because it is told to us as if it is common knowledge with this air of authority because “all scientists agree”. This is FALSE and matters of science are not decided by a show of hands from government funded data adjusters and climate modellers.
A friend said to me one time “Why would governments tell us there is a climate emergency if it isn’t true”? ———This is the crucial question that everyone needs to ask. I asked it in 2007 and what I have found is that Climate Change and its solutions are the biggest pseudo scientific fraud ever perpetrated. ——-My friend asked me that question because he is getting his information from mainstream news who are presenting a particular narrative, and he, like most people think that these news channels (like BBC, SKY News) are doing investigative journalism on this issue and so can be trusted. But once you read books like “Hubris” Michael Hart, —-“Watermelons” James Delingpole, —-“Energy and Climate Wars” Economides and Glover, ——“Taken by Storm” McKitrick and Essex, —–“Climate Uncertainty and Risk” Judith Curry etc etc you realise very quickly there is a completely different story altogether. You may disagree with that other story, but like my friend, how can you disagree with it if you NEVER HEAR IT?
Very true. And the reason why the politically driven “Climate change” is clearly nonsense, is simply its basis on CO2.
The personalities driving this global policy originally needed a scientific term to justify and promote their novel idea and they chose CO2, a gas everyone had heard of but few know very much about.
They forgot, and presumably did not know at the time, that human beings are simple animals which require oxygen to breathe, whereby we convert some of that oxygen into CO2 as part of the biological process of life.
In fact, we all exhale 100 times as much CO2 as we inhale: simply put, we are all CO2 generators – with every breath we breathe.
So, using CO2 as the basis for all evil is idiotic and requires the extinction of all animal life, not just human life.
And then one can discuss the logarithmic relationship between CO2 and its greenhouse effect, or the research showing CO2 at high atmospheric levels has a cooling effect, or the far greater effect of water vapour on the climate (the public would never have accepted water being the source of all evil), and so on and so forth.
Leave the climate alone! We are far too stupid to fully understand its workings and we are frighteningly arrogant if we believe we can control it.
Finally, to your list of authors, I suggest you add Patrick Moore (ex Greenpeace), Ian Plimer and Gregory Wrightstone.
Yes but we can argue about science all day. We can talk about feedback loops, logarithmic rather than linear effects, climate sensitivity to CO2, models full of speculations regarding a myriad of parameters etc etc but we are mostly wasting our time because this issue isn’t and never was about science in the first place. The science is just the excuse for the policies.
I am just trying to find ways to open people’s eyes to the obvious. We are animals, therefore we exhale CO2, therefore CO2 cannot be harmful.
Having said/written that, I have not been able to convince people with science PhDs! Very frustrating!