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Offline: Myths of partnerships and collaboration
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Maurice King
British Academy
Offline: Myths of partnerships and collaboration
Londonstills.com/Rex Features
The printed journal includes an image merely for illustration
We are “pathetic followers of fashion”. So concluded John Cleland, professor of medical demography at the London School of Hygiene and Tropical Medicine. He was speaking last week at a symposium to mark World Population Day. The fashions that we follow push what really matters off political agendas. Family planning matters. By 2050, the world’s population will have grown from today’s 6·9 billion to 9·2 billion—a 32% increase. The greatest absolute increase will be in Asia (1·1 billion people; a 26% rise). The greatest proportional increase will be in sub-Saharan Africa (a 103% rise; 890 million people). Africa has 35 countries with fertility rates above four. West Africa is especially vulnerable, with little progress in expanding family planning services. But countries can change, even without poverty reduction or better education. Between 1977 and 1993, Kenya expanded contraception coverage from 7% to 33%, reducing their fertility rate from eight to 5·4. The balance between birth and death is part of society’s fragile balance between order and chaos, compassion and cruelty, and cooperation and division. Any conversation about population is also a conversation about the fundamental rules of life. The way we live with one another or against one another. The way we see our futures in the shadows of our past. Family planning needs a champion. Who will it be? John Cleland suggested Bill Gates. I would hope the new UN agency, UN Women. * One great advocate for greater attention to population is Maurice King. He circulated a leaflet outside the symposium last week entitled “Demography is corrupt!!” He writes: “I have already sent the definitive paper…to The Lancet three times, on the third occasion with 60 African signatures…If it is rejected a fourth time, I intend to mount a vigil to the death on its doorstep… What a privileged way to die!” *
Getty Images
Queen Square is remarkable medical real estate. In a beautiful, secluded quarter of London, the National Hospital for Neurology and Neurosurgery is without question one of the world’s leading centres for neuroscience. Yet its very seclusion means that the 218
neurological expertise to be found there does not always get its due attention. The precarious position of Queen Square clinicians has long been a problem. In 1900, led by J Hughlings Jackson, physicians revolted against a brutal Board of Management. The hospital’s director, Burford Rawlings, feared that the vivisectionist interests of doctors would destroy the hospital’s ability to persuade wealthy donors to part with their money. Queen Square managers argued that “the hospital’s experiments were performed on the poor for the benefit of the rich”. And that “large sums of money have been actually withheld from the hospital on account of this fear”. Hughlings Jackson wrote to The Times and The Lancet to protest. He called the hospital’s Board dangerous, defective, autocratic, and evil. The chairman of the Board replied by branding the doctors as useless in their general conduct of life, hopeless with money, and worthless in their opinions. The doctors were nothing more than “hewers of wood and drawers of water”. Over dinner with a group of Hughlings Jackson’s heirs recently, it is clear they do not labour under similar managerial discourtesy or disrespect. On the contrary. They have radical ideas about Queen Square’s future. * The UK’s Liberal–Conservative Government has tossed out the science of public health. In its place comes a belief that the scourges of most modern diseases in the rich world—junk-food manufacturers—will be our saviours. The food industry is dancing in the streets. There are, of course, warm words about “partnership” and “collaboration” between food corporations and the health community. Here is Graham Baxter, chief executive of the International Business Leaders Forum, writing in The Guardian: “our experience is that responsible businesses are willing and able to engage voluntarily with government and society at large in order to innovate and adapt their business models and thereby play their part in making our world more sustainable”. Could somebody please explain what this impenetrable verbiage means? Nothing more, I expect, than no action and zero outcome. Richard Horton [email protected] www.thelancet.com Vol 376 July 24, 2010
Maurice King
British Academy
Offline: Myths of partnerships and collaboration
Londonstills.com/Rex Features
The printed journal includes an image merely for illustration
We are “pathetic followers of fashion”. So concluded John Cleland, professor of medical demography at the London School of Hygiene and Tropical Medicine. He was speaking last week at a symposium to mark World Population Day. The fashions that we follow push what really matters off political agendas. Family planning matters. By 2050, the world’s population will have grown from today’s 6·9 billion to 9·2 billion—a 32% increase. The greatest absolute increase will be in Asia (1·1 billion people; a 26% rise). The greatest proportional increase will be in sub-Saharan Africa (a 103% rise; 890 million people). Africa has 35 countries with fertility rates above four. West Africa is especially vulnerable, with little progress in expanding family planning services. But countries can change, even without poverty reduction or better education. Between 1977 and 1993, Kenya expanded contraception coverage from 7% to 33%, reducing their fertility rate from eight to 5·4. The balance between birth and death is part of society’s fragile balance between order and chaos, compassion and cruelty, and cooperation and division. Any conversation about population is also a conversation about the fundamental rules of life. The way we live with one another or against one another. The way we see our futures in the shadows of our past. Family planning needs a champion. Who will it be? John Cleland suggested Bill Gates. I would hope the new UN agency, UN Women. * One great advocate for greater attention to population is Maurice King. He circulated a leaflet outside the symposium last week entitled “Demography is corrupt!!” He writes: “I have already sent the definitive paper…to The Lancet three times, on the third occasion with 60 African signatures…If it is rejected a fourth time, I intend to mount a vigil to the death on its doorstep… What a privileged way to die!” *
Getty Images
Queen Square is remarkable medical real estate. In a beautiful, secluded quarter of London, the National Hospital for Neurology and Neurosurgery is without question one of the world’s leading centres for neuroscience. Yet its very seclusion means that the 218
neurological expertise to be found there does not always get its due attention. The precarious position of Queen Square clinicians has long been a problem. In 1900, led by J Hughlings Jackson, physicians revolted against a brutal Board of Management. The hospital’s director, Burford Rawlings, feared that the vivisectionist interests of doctors would destroy the hospital’s ability to persuade wealthy donors to part with their money. Queen Square managers argued that “the hospital’s experiments were performed on the poor for the benefit of the rich”. And that “large sums of money have been actually withheld from the hospital on account of this fear”. Hughlings Jackson wrote to The Times and The Lancet to protest. He called the hospital’s Board dangerous, defective, autocratic, and evil. The chairman of the Board replied by branding the doctors as useless in their general conduct of life, hopeless with money, and worthless in their opinions. The doctors were nothing more than “hewers of wood and drawers of water”. Over dinner with a group of Hughlings Jackson’s heirs recently, it is clear they do not labour under similar managerial discourtesy or disrespect. On the contrary. They have radical ideas about Queen Square’s future. * The UK’s Liberal–Conservative Government has tossed out the science of public health. In its place comes a belief that the scourges of most modern diseases in the rich world—junk-food manufacturers—will be our saviours. The food industry is dancing in the streets. There are, of course, warm words about “partnership” and “collaboration” between food corporations and the health community. Here is Graham Baxter, chief executive of the International Business Leaders Forum, writing in The Guardian: “our experience is that responsible businesses are willing and able to engage voluntarily with government and society at large in order to innovate and adapt their business models and thereby play their part in making our world more sustainable”. Could somebody please explain what this impenetrable verbiage means? Nothing more, I expect, than no action and zero outcome. Richard Horton [email protected] www.thelancet.com Vol 376 July 24, 2010