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Hey, everyone, a quick note before we start the show, 20/20 has been a really difficult year for everyone and we so appreciate your support and listening to our show. If you do happen to have extra money and are inspired to donate to our show, you can go to donate unprogrammed indicator. We will use that money to continue to look at the economic effects of covid-19 and talk with people all across the country about their experiences.

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Thank you so much and happy holidays, NPR.

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Everyone stays in Cardiff here. This is the indicator from Planet Money for most of human history. The trends of globalisation and urbanization have been both a blessing and a curse.

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You can think of globalisation as countries trading more with each other and more people traveling between countries. And urbanisation is the rise of cities in which people work and live closely together. These two trends can make the world a richer place because they make the global economy more productive, more efficient.

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But at the same time, because both of these trends increase human contact, they connect the world. Historically, they have also made the world more vulnerable to infectious disease, to a pandemic. In other words, or at least they did until the 19th century.

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That's when better sanitation and especially advances in medicines like antibiotics and vaccines started to make globalization and urbanization safer. But ironically, these advances also increased the amount of globalization and urbanization in the world so that if an infectious disease ever did, you know, slip through the cracks, the global economy would suffer terribly, just like it's suffering now.

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Charles Kenny is a senior fellow at the Center for Global Development, and we spoke to him earlier this year, not long after the coronavirus had just broken out all across the U.S. And we are re-entering that show today because his new book about the past and future of fighting infectious diseases is about to come out. It's called the plague cycle, the unending war between humanity and infectious disease. And in his book, he reaches some really interesting conclusions.

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I think one of the sad things that's probably fairly clear by now is this isn't going to be the last time that we find a new disease. So I hope there are some lessons of how to react better to the end of the covid-19 pandemic, but also lessons on how to do it better next time.

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And one of the arguments Charles makes is especially provocative, which is that even though globalization and urbanization can spread disease more quickly, they have also become powerful forces in fighting against infectious diseases. And rather than trying to reverse these trends, the world says Charles should actually embrace them.

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After the break, Charles tells us why and how. This message comes from NPR sponsor Avalere, providing cloud based sales tax solutions for businesses of all sizes of Alara automatically integrates with more than 700 ERP and e-commerce systems. Learn more at Avalere, a dotcom slash indicator.

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Charles, your argument is not just that globalization was made safer by improvements in sanitation and medicines that started in the 19th century, but that actually by the 1960s and 1970s, globalization itself actually started becoming helpful in the fight against infectious diseases.

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So tell us what started happening back then in the 60s and 70s instead of this kind of foul effect of globalization spreading disease? Finally, globalization is actually a force for preserving health and improving health. We see global efforts to roll back malaria. We see the global smallpox campaign, which is successful to wipe out smallpox. We see vaccination campaigns against measles and diptheria and pertussis and all sorts of different diseases that are killing millions. And finally, we start seeing life expectancies worldwide converging.

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We see average life expectancy worldwide is now above 70 years, which is way above, you know, double what it was for most of history.

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So, Charles, given what you just said, I take it that you do not think that the response to the spread of coronavirus or to other infectious diseases is to do less globalization or less urbanization?

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Gosh, no. I think the right solution is to double down. And the reason that the right solution is to double down on globalization and urbanization is because they are also the infrastructure that allows us to respond far better to infectious disease than we have in the past. If you really want to stop infectious disease spreading worldwide, you have to go back to pre Colombus times, right? It only took a few caravans crossing the sea and arriving in the new world to bring a whole bunch of infectious diseases from Europe and Africa to the Americas.

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It's just implausible to imagine we could ever go back to a level of globalization that would really stop diseases spreading eventually. If the disease is the type that's going to spread worldwide. So what we need to do is make sure that globalization is a force not only for spreading disease, which I admit it is. It certainly speeds up the spread of disease to being a force that helps us control those diseases as they spread. And frankly, it is already we just need to do more of it.

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Yeah, I mean, Charles, obviously one of the arguments in favor of globalization traditionally has been that it makes the global economy more efficient because countries can each specialize in the thing that they're best at making. And in the case of coronavirus, the U.S. does not typically make most of the medical equipment that it needs to fight the virus. It imports most of that equipment. And so if trade is limited right now, it's going to hurt the U.S. And it also applies to the idea that the U.S. would ban exports of its own stuff, its own equipment, because then other countries could retaliate and not export their stuff to the U.S. And so it would it would make little sense for countries to start limiting trade with each other at the very moment that everybody is scrambling to get the equipment that it needs.

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But it's not just about, you know, sort of trade being a good thing in that we're all benefiting from globally more efficiently produced personal protective equipment. It's the the response in terms of research and development of cures. So one of the things that the World Health Organization is doing is organizing a global research effort to look at effective treatments for covid-19. And that really matters because covid-19 comes and goes in ways from one place to another, as we've seen already.

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If you want to have really big numbers of people involved in a trial in order to get really accurate results on what works and what doesn't. Having trials going on, the same trial going on in multiple different countries and multiple stages of the waves of covid-19 means you can get much better results, much faster. You know, the fact is that the first successful tests for whether people had covid-19 or not didn't come from the United States. They they came from China and other countries in the World Health Organization to help spread the knowledge about how to do those tests worldwide very first.

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So we're already benefiting from globalization in terms of speeding up our ability to respond to the threat of covid.

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Yeah, I got to say, though, Charles, it seems like the world is not really taking your advice right now. I mean, the advice that there should be more international coordination and exchange and trade, because, for example, we have seen bans on exports of goods and there has been a lot of distrust aimed at the global institutions, especially, that are tasked with helping fight this disease. Especially the World Health Organization, so let me just ask, though, how would you grade the world's response so far?

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Basically, I'd say it's been pretty grim and pretty much better than any response we've had before in history. And a large number of countries under the auspices of the World Health Organization have got together and said that we're going to try and do this in a way that has sort of the maximum benefit as fast as possible. And that is, again, a sign that we're doing better than we have in the past, not as well as we should be doing, but better than we have in the past.

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The tests have been shared. The research is being shared. The you know, the findings of what works and what doesn't is largely being shared worldwide. And that's fantastic.

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News is the indicator was produced by Camille Peterson and Nick Fountain Indicator's, edited by Paddy Hirsch and is a production of NPR.