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New reports identify big-picture challenges for health – locally, nationally and globally

Introduction by Croakey: As the health sector looks to the year ahead, three new reports identify some of the big-picture, interconnected challenges to protecting and advancing health, at local, national and global levels.

The reports, from the World Economic Forum, Oxfam International, and the Reuters Institute for the Study of Journalism, sound the alarm on climate and environmental collapse, the threat of increasing conflict, the rise of the oligarchy, monopoly corporate power and inequality, and assaults on social cohesion.

They also highlight the danger and unreliability of news and information systems, and the wide-ranging impacts of Artificial Intelligence (AI), including its potential for entrenching misinformation and disinformation, and driving conflict.

Read together, the reports highlight the importance of health advocates contributing to policy and public debates across diverse areas, including democratic integrity, corporate regulation, taxation, environmental protection, peace-making, misinformation and disinformation, and media policy.

They also underscore the escalating pressures and complexities facing leaders across sectors, both in 2024 and the years ahead.


Melissa Sweet writes:

The spread of misinformation and disinformation, leading to a further widening of societal and political divides, is the most severe risk facing the world over the next two years, according to the latest World Economic Forum (WEF) assessment of global risks.

The 19th annual edition of the WEF’s annual assessment of global risks – for the year ahead, the next two years, and the next decade – highlights that the world is undergoing multiple long-term structural transformations, including the rise of Artificial Intelligence (AI), climate change, a shift in the geopolitical distribution of power, and demographic transitions.

“As constant upheaval becomes the norm, decades of investment in human development – and human resilience – are slowly being chipped away, potentially leaving even comparatively strong states and individuals vulnerable to rapid shocks from novel and resurgent sources,” it cautions.

The report is informed by surveys of 1,490 experts across academia, business, government, the international community and civil society (conducted last September and October), as well as insights from 11,000 business leaders in 113 economies, WEF colleagues, and a series of workshops from May to October last year.

It puts a heavy emphasis on the challenges posed by AI, especially the implications for our news and information systems, warning that easy-to-use interfaces to large-scale AI models “have already enabled an explosion in falsified information and so-called ‘synthetic’ content, from sophisticated voice cloning to counterfeit websites”.

“Malicious actors can leverage a superhuman breadth of knowledge to conceptualise and proliferate dangerous capabilities, from misinformation and malware to biological weapons, threatening human rights and safety in a myriad of ways,” it says.

The report says that recent technological advances have enhanced the volume, reach and efficacy of falsified information, with flows more difficult to track, attribute and control.

“Synthetic content will manipulate individuals, damage economies and fracture societies in numerous ways over the next two years.”

Even as the insidious spread of misinformation and disinformation threatens the cohesion of societies, the report warns that the speed and effectiveness of regulation is unlikely to match the pace of development.

To date, the precautionary principle (prudence in the face of uncertainty) has largely not been applied in the development of AI, as regulators have erred on the side of innovation. There is a risk, the report warns, that some governments will act too slowly, facing a trade-off between preventing misinformation and protecting free speech, while repressive governments could step up regulatory control to erode human rights.

Global risks ranked by severity over the short and long term: “Please estimate the likely impact (severity) of the following risks over a 2-year and 10-year period.”

“The speed of advances, depth of market power and strategic importance of the industry will continue to challenge the appetite and regulatory capacity of governance institutions.”

Images showing top ten global risks over next two years, and next ten years

Democracy at risk

Over the next two years, close to three billion people are expected to head to the electoral polls across several economies – including Bangladesh, India, Indonesia, Mexico, Pakistan, the United Kingdom and the United States –  and the report warns that the widespread use of misinformation and disinformation, and tools to disseminate it, may undermine the legitimacy of newly elected governments.

The implications of these manipulative campaigns could be profound, threatening democratic processes. If the legitimacy of elections is questioned, civil confrontation is possible – and could even expand to internal conflicts and terrorism, and state collapse in more extreme cases.

Beyond elections, perceptions of reality are likely to also become more polarised, infiltrating the public discourse on issues ranging from public health to social justice. Divisive factors such as political polarisation and economic hardship are diminishing trust and a sense of shared values.

Other risks associated with AI include its contribution to growing inequalities, bias, discrimination and job losses, as well as criminal use and cyber-attacks, while deeper integration of AI in conflict decisions could lead to unintended escalation of conflicts.

“If states incorporate AI into nuclear weaponry, this would significantly raise the risk of accidental or intentional escalation over the next decade, with potentially existential consequences.”

Sources for the report see technological power in the hands of the unelected as a bigger concern than power concentrated in government. “The influence of Big Tech companies is already transnational, competing with the likes of nation states, and generative AI will continue to catalyse the power of these companies and associated founders.”

The report warns that if monopoly- or oligopoly-led profit maximisation is the primary objective of AI deployment over the next decade, “the consequences for applications across healthcare, education, military, legal and financial sectors will be vast”.

In healthcare, for example, as the volume and granularity of health data increases exponentially, the commercialisation of related data pools for downstream AI applications could compromise individual privacy and erode trust in healthcare systems.

For 2024, two-thirds of respondents to the survey nominated extreme weather as the top risk faced in the coming year. Environmental risks feature heavily in the top 10 risks identified for the decade ahead.

“The pace and scale of climate-change adaptation efforts are already falling short, with societies increasingly exposed to environmental impacts to which they may be unable to adapt, fuelling displacement and migration,” says the report.

Nascent mitigation technologies, while attractive in some respects, could have unintended environmental and social consequences, with implications for legal liabilities, geopolitical dynamics and the climate agenda.

Image showing how different stakeholders rate risks, including civil society, international organisations, academia and the private sector
Severity by stakeholder over the short term (2 years)

Spreading conflict and inequality

The world has become significantly less peaceful over the past decade, with the attention and resources of global powers likely to be focused on three hotspots in particular over the next two years: the war in Ukraine, the Israel-Gaza conflict and tensions over Taiwan.

Escalation in any one of these hotspots would radically disrupt global supply chains, financial markets, security dynamics and political stability, viscerally threatening the sense of security and safety of individuals worldwide.

All three areas stand at a geopolitical crossroads, where major powers have vested interests: oil and trade routes in the Middle East, stability and the balance of power in Eastern Europe, and advanced technological supply chains in East Asia.

Each could lead to broader regional destabilisation, directly drawing in major power/s and escalating the scale of conflict. All three also directly involve power/s reckoned to possess nuclear capabilities.

While the WEF report highlights some of the interconnections between global risks, it does not systematically investigate the upstream determinants of these (perhaps not surprising given who informed the report).

However, the latest OXFAM report on global inequality, released on the first day of the annual World Economic Forum summit in Davos, Switzerland, makes a powerful case for tackling concentrated corporate and monopoly power and the super wealthy in order to address growing inequality and planetary destruction.

It says we are living through “a new era of monopoly power” in which a small number of ever-swelling corporations wield extraordinary influence over economies and governments, with largely unbridled power to price gouge consumers; suppress wages and abuse workers; limit access to critical goods and services; thwart innovation and entrepreneurship; and privatise public services and utilities for private profit.

“Private monopolies are not an abstract phenomenon; they have a huge role in shaping the lives of ordinary people around the world – influencing how much we are paid, the foods we eat and can afford, which medicines we can access, and which human rights are realised (or violated).”

Corporate power is also driving climate breakdown, says the report, which is titled ‘INEQUALITY INC. How corporate power divides our world and the need for a new era of public action’.

“Many of the world’s billionaires own, control, shape and financially profit from processes that emit greenhouse gases, and benefit when corporations seek to block progress on a fast and just transition, deny and spin the truth about climate change, and crush those who oppose fossil fuel extraction,” it says.

Most urgent priority

The Oxfam report says “a radical increase in equality must be humanity’s most urgent priority”.

“Rapidly and radically reducing the gap between the richest and the rest of society is vital to ensuring a good life for all, on a planet that is flourishing, not struggling to survive,” it says.

The report calls on governments to set national goals and plans for inequality reduction and better capture the impact of their policies on reducing inequality, with the aim of ensuring the total income of the top 10 percent of the population is no more than the total income of the bottom 40 percent.

Systematically projecting and measuring the distributional impacts of public policy and private-sector activity could enable evidence-driven policy to reduce inequality, says the report.

It’s a timely call as the Federal Labor Government knuckles down on inequitable tax cuts, in the face of opposition from health groups and civil society groups, with ACOSS today writing to the Prime Minister and Treasurer urging the tax cuts to be scrapped and funds instead to be invested in a “desperately needed” cost of living package for people on lower incomes.The Oxfam report says that runaway corporate power and runaway extreme wealth have been contained and controlled in the past and they can be again; it advances “three concrete, proven and practical ways to make the economy work for all of us”.

These are:

Revitalising the state, as “a strong, dynamic and effective state is the best bulwark against corporate power and a remedy to correct market failures”, and as the provider of public goods, the regulator of private enterprises, the lead investor for several sectors, and a maker and shaper of markets.

Regulating corporations and radically increasing taxes on rich individuals and corporations. Reducing the wealth of the richest and the number of super-rich people could also reduce their dominant influence on politics and policy.

Governments using their power to reinvent and repurpose the private sector, to create and promote a new generation of companies that do not put shareholders first and that are owned and governed in the interest of workers, local communities, and the environment. No economic aid or government contracts should be given to companies that are missing their net zero targets, paying below living wages, or dodging taxes.

Power in numbers

Key points from the report include:

  • Since 2020, the richest five men in the world have doubled their fortunes. During the same period, almost five billion people globally have become poorer. Hardship and hunger are a daily reality for many people worldwide. At current rates, it will take 230 years to end poverty, but we could have our first trillionaire in 10 years.
  • If each of the five wealthiest men were to spend a million US dollars daily, they would take 476 years to exhaust their combined wealth.
  • Seven out of ten of the world’s biggest corporations have a billionaire CEO or a billionaire as their principal shareholder.
  • Globally, men own US$105 trillion more wealth than women – the difference in wealth is equivalent to more than four times the size of the US economy.
  • The world’s richest one percent own 43 percent of all global financial assets.
  • The richest one percent globally emit as much carbon pollution as the poorest two-thirds of humanity.
  • Billionaires are now US$3.3 trillion or 34 percent richer than they were at the beginning of this decade of crisis, with their wealth growing three times as fast as the rate of inflation.
  • This wealth is concentrated in the Global North. Only 21 percent of humanity lives in the countries of the Global North, but these countries are home to 69 percent of private wealth, and 74 percent of the world’s billionaire wealth.
  • More than 11 percent of the world’s billionaires have either run for office or become politicians. A study on the policy preferences of about 3,000 policy proposals from thirty European countries over forty years shows that proposals supported by the rich were more likely to be implemented that those supported by the poor.
  • Together, 148 of the world’s biggest corporations that Oxfam has data for made nearly US$1.8 trillion in profits in the 12 months leading up to June 2023.
  • The