Science and charity: the

purpose of medicine and

the meaning of health

Richard Horton

The Lancet

December 12, 2014

“I think I have

found out the

simple way by

which species

become exquisitely

adapted to various

ends.”

“Man in the distant future will be a

far more perfect creature then he

now is.”

“And fast by hanging in a golden chain

This pendent world.”

Book ll, Paradise Lost

“I think the odds are

no better than 50/50

that our present

civilisation will

survive to the end of

the present century.”

Our Final Century (2003)

DOES HUMAN HEALTH

HAVE A FUTURE?

The Great Divergence

“Humanity’s escape

from death and

deprivation began

around 250 years

ago.”

PRECONDITIONS

Corruption

Incompetence

Insecurity

Degradation

Poverty

Invasion

ECONOMIC

DECLINE

Economic

Crisis

INITIAL

BREAKDOWN

Conflict

Privatisation

Disease

Decline

Depopulation

INSTABILITY

ADVANCED

BREAKDOWN

Fracture

Civil war

Social chaos

Famine

Fragmentation

COLLAPSE

RESILIENCE/

ADAPTATION

Vision

Solidarity

Transformation

STABILISATION

RECONSTITUTION

Recovery

Cultural memory

New Beliefs

RECONSTRUCTION

SUSTAINABILITY

RESILIENCE

Food

Security

Economic

Systems

Disease

Political

systems

CivilisationsExtreme

Events

Water

Population

Social

stability

Peace

Physical

Systems

Human

Systems

“See with what heat these dogs of hell

advance

To waste and havoc yonder world, which I

So fair and good created, and had still

Kept in that state, had not the folly of man

Let in these wasteful furies…”

John Milton, Paradise Lost (Book 10)

GLOBAL HEALTH

GLOBAL SCIENCE

GLOBAL SOCIETY

GLOBAL SOLIDARITY

GLOBAL SUSTAINABILITY

GLOBAL IDENTITY