Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations

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Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
Now for the Long Term
The Report of the
Oxford Martin Commission
for Future Generations

                           1
Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
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Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
Now for the Long Term
The Report of the
Oxford Martin Commission
for Future Generations
October 2013

Members of the Commission:

Chair: Pascal Lamy, former Director-General,         Luiz Felipe Lampreia, former Minister of              Peter Piot (Baron Piot), Director, London
World Trade Organization                             Foreign Affairs, Brazil                               School of Hygiene and Tropical Medicine; former
                                                                                                           Executive Director, UNAIDS
Michelle Bachelet, former President of Chile;        Liu He, Minister, Office of the Central Leading
former Executive Director, UN Women                  Group on Financial and Economic Affairs,              Martin Rees (Lord Rees of Ludlow), former
                                                     People’s Republic of China                            President, The Royal Society; Fellow of Trinity
Lionel Barber, Editor, The Financial Times                                                                 College, University of Cambridge
                                                     Kishore Mahbubani, Dean and Professor in the
Roland Berger, Chairman, Roland Berger               Practice of Public Policy, Lee Kuan Yew School        Amartya Sen, Nobel Laureate and Thomas W.
Strategy Consultants                                 of Public Policy, National University of Singapore    Lamont University Professor, and Professor of
                                                                                                           Economics and Philosophy, Harvard University
Ian Goldin, Director, Oxford Martin School;          Trevor Manuel, Minister and Chair of the
Professor of Globalisation and Development,          National Planning Commission, South Africa            Nicholas Stern (Lord Stern of Brentford),
University of Oxford (Vice-Chair)                                                                          President, The British Academy; IG Patel Professor
                                                     Julia Marton-Lefèvre, Director-General,               of Economics, London School of Economics
Arianna Huffington, President and Editor-in-         International Union for Conservation of
Chief, Huffington Post Media Group                   Nature (IUCN)                                         Jean-Claude Trichet, former President,
                                                                                                           European Central Bank
Mo Ibrahim, Chair of the Board,                      Nandan Nilekani, Chairman, Unique Identification
Mo Ibrahim Foundation                                Authority of India; former CEO, Infosys

                                                     Chris Patten (Lord Patten of Barnes), Chancellor,
                                                     University of Oxford; Chairman, BBC Trust

The Commissioners are acting in their personal capacity. They were selected because of their breadth and depth of expertise, their geographical reach, and
their extensive leadership experience gathered over many years in large organisations, multilateral negotiations and complex national and global institutions.

This report represents the collective views of the Commission, and does not necessarily represent the individual opinions of any single Commissioner or
the organisations to which they are affiliated.

The Oxford Martin School Commission Secretariat was led by Natalie Day (Head of Policy), with Anushya Devendra (Communications and Policy Officer)
and Dr Travers McLeod (Policy Adviser). This report was published by the Oxford Martin School.
Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
5    Abbreviations

    6    Executive Summary

    8    Introduction
     9     Governing for the future
    10     One world; many cultures, perspectives and identities
    11     About this report

    12   Part A: Possible Futures
    13     Megatrends
    14       Demographics
    15       Mobility
    16       Society
    17       Geopolitics
    18       Sustainability
    20       Health
    22       Technology
    24     Challenges
    24       Society
    26       Resources
    29       Health
    31       Geopolitics
    33       Governance

    36   Part B: Responsible Futures
    37     Looking Back to Look Forward
    37       Lessons from Previous Successes
    41       Lessons from Failure
    44     Shaping Factors: What Makes Change so Hard?
    44       1: Institutions
    45       2: Time
    48       3: Political Engagement and Public Trust
    52       4: Growing Complexity
    53       5: Cultural Biases

    56   Part C: Practical Futures:
         Principles and Recommendations
    57     1: Creative Coalitions
    57        C20-C30-C40
    57        CyberEx
    58        Fit Cities
    58     2: Innovative, Open and Reinvigorated Institutions
    58        Decades, not Days
    58        Fit for Purpose
    59        Open up Politics
    59        Make the Numbers Count
    60        Transparent Taxation
    60     3: Revalue the Future
    60        Focus Business on the Long Term
    61        Discounting
    61        Invest in People
    62        Measure Long-term Impact
    62     4: Invest in Younger Generations
    62        Attack Poverty at its Source
    63        A Future for Youth
    63     5: Establish a Common Platform of Understanding
    63        Build Shared Global Values
    65     What Next?

    66   Endnotes

    84   Acknowledgements

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Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
Abbreviations
AIDS     Acquired Immunodeficiency      G20     Group of Twenty                 NPCs     National Planning
         Syndrome                       G30     Group of Thirty Consultative             Commissions
ASEAN    Association of Southeast               Group on International          OECD     Organisation for Economic
         Asian Nations                          Economic and Monetary Affairs            Co-operation and
BEPS     Base Erosion and Profit        GATT    General Agreement on Tariffs             Development
         Shifting                               and Trade                       OGP      Open Government
C40      Cities Climate Leadership      GAVI    Global Alliance for Vaccines             Partnership
         Group                                  and Immunisations               R&D      Research and Development
CDOs     Collateralised Debt            GDP     Gross Domestic Product          RGI      Resource Governance Index
         Obligations                    HIV     Human Immunodeficiency          SARS     Severe Acute Respiratory
CEO      Chief Executive Officer                Virus                                    Syndrome
CERN     European Organization for      IFPRI   International Food Policy       SMP      Single Market Programme
         Nuclear Research                       Research Institute                       (Europe)
CFC      Chlorofluorocarbon             IFRS    International Financial         TB       Tuberculosis
CGIAR    Consultative Group for                 Reporting Standards             TRIPS    Trade-Related Aspects of
         International Agricultural     IHR     International Health                     Intellectual Property Rights
         Research                               Regulations                     UDHR     Universal Declaration of
CO2      Carbon Dioxide                 IIAG    Ibrahim Index of African                 Human Rights
CPI      Corruption Perceptions Index           Governance                      UN       United Nations
CSIRO    Commonwealth Scientific        ILO     International Labour            UNDP     United Nations Development
         and Industrial Research                Organization                             Programme
         Organisation                   IMF     International Monetary Fund     UNEP     United Nations Environment
DNA      Deoxyribonucleic Acid          IP      Intellectual Property                    Programme
ECOSOC   Economic and Social Council    IPCC    Intergovernmental Panel on      UNESCO   United Nations Educational
         (United Nations)                       Climate Change                           Scientific and Cultural
FAO      Food and Agricultural          IUCN    International Union for                  Organization
         Organization                           Conservation of Nature          UNFCCC   United Nations Framework
FCF      Committee for the Future       LPG     Liquefied Petroleum Gas                  Convention on Climate
         (Finland)                      MDGs    Millennium Development                   Change
FCTC     Framework Convention on                Goals                           UNICEF   United Nations Children’s Fund
         Tobacco Control                NCDs    Non-Communicable Diseases       WGIs     Worldwide Governance
FDI      Foreign Direct Investment      NGOs    Non-Governmental                         Indicators
FSB      Financial Stability Board              Organisations                   WHO      World Health Organization
G7       Group of Seven                 NHS     National Health Service         WIPO     World Intellectual Property
G8       Group of Eight                         (United Kingdom)                         Organization
                                                                                WTO      World Trade Organization

                                                                                                                          5
Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
Executive Summary

    As the world slowly emerges from the                  Part A, Possible Futures, identifies a number      In Part B, Responsible Futures, the Commission
    devastating Financial Crisis, it is time to reflect   of interacting megatrends, grouped under           examines historical drivers of transformative
    on the lessons of this turbulent period and           seven headings: demographics (large, ageing        change, such as the existence of crisis, shared
    think afresh about how to prevent future              populations); mobility (urbanisation and a         interests, leadership, inclusion, institutions and
    crises. The Oxford Martin Commission for              growing middle class); society (inequality and     networks, partnerships, as well as goals and
    Future Generations focuses on the increasing          unemployment); geopolitics (power transitions);    prizes. From campaigns to protect the ozone
    short-termism of modern politics and our              sustainability (resource insecurity); health       layer and reduce tobacco use, to the European
    collective inability to break the gridlock which      (shifting burdens of disease); and technology      Single Market and the Millennium Development
    undermines attempts to address the biggest            (information and communications revolution).       Goals, there are many examples of where
    challenges that will shape our future. In Now         These megatrends apply the world over,             disparate groups have come together and made
    for the Long Term, we urge decision-makers            reinforcing old and generating new sets of         significant progress. At the other end of the
    to overcome their pressing daily preoccupations       challenges.                                        results spectrum, the Commission considers
    to tackle problems that will determine the                                                               less successful characteristics of modern
    lives of today’s and tomorrow’s generations.          The Commission then considers five categories      politics, including the tragedy of the commons,
    Dr James Martin, the founder of the Oxford            of challenges that arise from these megatrends     a lack of intergenerational vision and awareness,
    Martin School, highlighted that humanity is at        that are likely to shape our future:               the absence of global oversight, and vested
    a crossroads. This could be our best century          1. Society: How can growth and development         interests. Following these insights, Part B sets
    ever, or our worst. The outcome will depend              be made more sustainable and inclusive?         out five shaping factors that make positive
    on our ability to understand and harness the          2. Resources: How can food, energy, water and      change so difficult:
    extraordinary opportunities as well as manage            biodiversity be made more secure?
    the unprecedented uncertainties and risks.            3. Health: How can public health infrastructure    1. Institutions: Too many have struggled to
                                                             and processes respond to the needs of all?         adapt to today’s hyper-connected world.
    Our report identifies what these challenges           4. Geopolitics: How can power transitions be       2. Time: Short-termism directs political
    are, explains how progress can be made, and              the basis for fresh forms of collaboration?        and business cycles, despite compelling
    provides practical recommendations. The               5. Governance: How can businesses,                    exceptions.
    Commission outlines an agenda for the long               institutions and governments contribute to      3. Political Engagement and Public Trust:
    term. Our case for action is built in three parts.       more inclusive and sustainable growth?             Politics has not adapted to new methods or
    The first, Possible Futures, identifies the key                                                             members.
    drivers of change and considers how we may            Part A also highlights what is known about         4. Growing Complexity: Problems can escalate
    address the challenges that will dominate this        possible responses to these challenges.               much more rapidly than they can be solved.
    century. Next, in Responsible Futures, the            New targets on growth and employment,              5. Cultural Biases: Globalisation can amplify
    Commission draws inspiration from previous            and a focus on youth workers and flexible             cultural differences and exclude key voices.
    examples of where impediments to action               workplaces are presented. The importance
    have been overcome, and lessons from where            of resource transparency and information
    progress has been stalled. We then consider the       sharing is reiterated, as are measures to
    characteristics of our current national and global    counteract climate change. Goals to reduce
    society that frustrate progress. The final part,      non-communicable diseases (NCDs),
    Practical Futures, sets out the principles for        remedy deficiencies in public health systems,
    action and offers illustrative recommendations        implement agreed best practice, and partner
    which show how we can build a sustainable,            creatively with the pharmaceutical industry
    inclusive and resilient future for all.               are stressed. Countries are advised to
                                                          identify shared interests, update institutions
                                                          and develop cybersecurity capacity as they
                                                          navigate structural transitions in international
                                                          politics. Better governance will aid this quest,
                                                          particularly if technology is used creatively,
                                                          indicators are improved, and business is rewired
                                                          to invest for the long term.

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Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
Part C, Practical Futures, contains the              3. Revalue the Future: Existing institutional
Commission’s Agenda for the Long Term.                  incentives should be rebalanced to reduce
It is arranged around five principles, with             bias against future generations. This can be
practical examples proposed to illustrate each          done in four ways:
principle. Some build on possible responses          • Focus Business on the Long Term: ensure
to the challenges identified in Part A. Others          companies and financial systems give greater
respond to the shaping factors outlined in              priority to long term “health” and look
Part B, and seek to address deeper political and        beyond daily or quarterly reporting cycles.
cultural factors that obstruct a longer-term         • Discounting: future generations should not
engagement. We provide indicative examples              be discounted against simply because they
of principles and proposals that advance the            are born tomorrow and not today.
interests of future generations and promote          • Invest in People: remove perverse subsidies
resilience, inclusiveness and sustainability. The       on hydrocarbons and agriculture, and redirect
Agenda is as follows:                                   support to the poor.
                                                     • Measure Long-term Impact: create an index
1. Creative Coalitions: Responding to this              to track the effectiveness of countries,
   century’s challenges will require multi-             companies and international institutions on
   stakeholder partnerships. The Commission             longer term issues.
   suggests three:
• C20-C30-C40: a Coalition of the Working            4. Invest in Younger Generations: Greater
   comprising countries, companies and cities to        attention should be given to promoting a
   counteract climate change.                           more inclusive and empowered society,
• CyberEx: a new early warning platform to              particularly for younger generations. Two
   promote a better understanding of common             priorities should be:
   threats amongst government, corporate and         • Attack Poverty at its Source: break the
   individual users.                                    intergenerational cycle of poverty through
• Fit Cities: a city-based network to fight the         social protection measures such as
   rise of non-communicable diseases.                   conditional cash transfer programmes.
                                                     • A Future for Youth: countries should invest in
2. Innovative, Open and Reinvigorated                   youth guarantees to address unemployment
   Institutions: Institutions and processes             and underemployment.
   should be renewed for the modern operating
   environment. Five steps are suggested:            5. Establish a Common Platform of
• Decades, not Days: invest in independent,             Understanding: The ability to address
   accountable institutions able to operate             today’s global challenges is undermined by the
   across longer-term horizons.                         absence of a collective vision for society. To
• Fit for Purpose: incorporate sunset clauses           remedy this, the Commission urges renewed
   into publicly funded international institutions      dialogue on an updated set of shared global
   to ensure regular review of accomplishments          values around which a unified and enduring
   and mandates.                                        pathway for society can be built.
• Open up Politics: build on initiatives such as
   the Open Government Platform to optimise          The Commission applauds the remarkable
   new forms of participation and transparency.      progress of past decades: on balance, the
• Make the Numbers Count: establish                  world’s population is safer, healthier, more
   Worldstat to improve the reliability and          productive and cooperative than ever.
   availability of statistics.                       Nevertheless, much work remains to be done.
• Transparent Taxation: address tax abuse and        Now for the Long Term aims to stimulate
   avoidance through a Voluntary Taxation and        action and debate. Commissioners look forward
   Regulatory Exchange.                              to engaging with governments, businesses,
                                                     NGOs and civil society in order to take these
                                                     ideas and recommendations forward in the
                                                     months and years ahead.

                                                                                                         7
Now for the Long Term - The Report of the Oxford Martin Commission for Future Generations
Introduction

8
NOW is the best time in history to be alive.           The empowerment of people through                    countries. Government and business leaders
Our world has experienced a sustained period           investment in education and other forms of           tend to focus on the short term, which offers
of positive change. The average person is              human capital is critical for sustainable and        quicker and potentially easier payoffs at lower
about eight times richer than a century ago,1          inclusive growth. Entrepreneurs and investment       political cost.
nearly one billion people have been lifted out of      thrive when not only infrastructure and
extreme poverty over the past two decades,2            innovative capacity is developed, but when the       The aim of the Oxford Martin Commission for
living standards have soared, life expectancy has      rules governing society are also transparent         Future Generations (“the Commission”) is to
risen, the threat of war between great powers          and fair. Given the scale of the challenges          identify the scale of the challenges humanity is
has declined, and our genetic code and universe        and the prospect of very positive but also           facing and to offer suggestions as to how they
have been unlocked in previously inconceivable         possibly disastrous change, the response of          may better be managed. We believe that we
ways. Many of today’s goods are unimaginable           governments, businesses and citizens should          can and must do a much better job of securing
without collective contributions from different        not be to become more short-sighted. The scale       the opportunities and mitigating the risks.
parts of the world, through which more of              of the opportunities and risks requires more         The Commission seeks to draw attention to a
us can move freely with a passport or visa,            attention to the future and a more far-sighted       growing gap between knowledge and action on
provided we have the means to do so. Our               attitude. In an increasingly integrated and          many of today’s challenges, identify why action
world is functionally smaller, and its possibilities   hyper-connected world, our individual future         has slowed, and suggest pathways to move the
are bigger and brighter than ever before. Never        depends more than ever on our collective future      global agenda forward.
before have so many people been optimistic             and our capacity to work together to deepen
about their future.3                                   our understanding of the critical challenges.        Governing for the future
                                                       We need to ensure that we have the skills,           The Commissioners have come together out
While the future is full of opportunity arising        tools, institutions and social fabric necessary to   of concern for the future. We agree governing
from the extraordinary advances of recent              navigate safely through the hazardous fog of         requires a dual vision: a commitment to address
decades, it is also highly uncertain and               the future.                                          current needs and to build the foundations for
characterised by growing systemic risks. In                                                                 vibrant generations in the decades ahead. This
many cases, these risks are the consequences           As the late French politician Pierre Mendès          responsibility transcends obligations to today’s
of our success, arising from rising incomes,           France used to say, “gouverner, c’est prévoir”       citizens: it also relates to future generations and a
population growth, interconnectedness and              – governing is looking forward, or foreseeing.       broader societal ideal of trusteeship that requires
technological advances. Risks arising from             Preparing for the future, however, seems             us to leave the world better than we find it.5
the plundering of our planet’s natural capital,        a luxury for today’s governments, who are            This is a unique time in history. Our younger
growing inequality, and the potentially                increasingly preoccupied with the present;           generation is the first to live free of the scars
devastating results of accidental or deliberate        indeed, many governments even “live with their       of previous global wars. Given extraordinary
use of new technologies are among the                  eyes on the rear-view mirror, refighting ancient     advances in knowledge and scientific
reasons we urgently need to deepen our                 battles and reigniting ancient enmities”.4 An        understanding, today we are more aware than
understanding of the threats posed by                  inability to “look forward” characterises much       ever of the implications of our actions on future
business as usual.                                     of modern politics, especially in democratic         generations, not least in areas like climate

                                                                                                                                                                    9
change and biodiversity. And we could arguably         to the transformational changes which will         One world; many cultures,
     be amongst the last generations able to do             characterise our lifetimes and shape the future    perspectives and identities
     anything to stop the long-term devastation of          for the next generations. Taking a longer view     Globalisation is not new but the global breadth
     our planet. Soon it may be too late. We hold a         is no panacea; striking a sustainable balance      and depth of its impact has changed. Many
     unique responsibility, arising from our advanced       between short‑term and long‑term interests is      asserted globalisation would result in greater
     knowledge of the implications of our actions           key. Currently, there is a lack of understanding   homogenisation of customs and cultures, which
     and the potential that our actions could create        on the conditions under which long-term            may have assisted in developing a common
     or prevent irreversible damage to the livelihoods      thinking might be improved.9 Existing structures   understanding and agreement on how to
     of future generations. This report aims to help        bestow a higher value to immediate returns on      address today’s challenges.10 In fact, in some
     us step up to this unique responsibility for the       investment. Some of these returns exacerbate       cases, the opposite appears to have transpired:
     benefit of those alive today and in the future.6       the risks and social consequences posed by         globalisation has not been “equated with
                                                            longer-term challenges and delay collaborative     homogenisation or uniformity” but has found
     Justice Weeramantry, former Vice President of          action on them.                                    “localisation as its counterforce”.11
     the International Court of Justice, reminded us
     that civilisations across the ages have “refused       The debate about the future, however, is not       Since the Second World War, there has been
     to adopt a one‑eyed vision of concentration on         simply about the virtue of long-term thinking.     great progress in building trust and momentum
     the present”.7 Sustainable development, he has         This is a debate about what is owed to future      on a number of national and international
     argued, “is one of the most ancient ideas in the       generations. The Commission does not intend        challenges. This has often been done by focusing
     human heritage”.8 Evidence of long-term thinking       to settle this debate. We accept there are         on mutual interests, not just between people
     comes in a variety of forms, whether it is in          a range of good reasons to care about the          but also among cities, nations and businesses.
     defence, health care, fiscal planning, demography,     interests of future persons, and to reflect on     Such a capacity has been necessary “to perceive,
     migration, the environment, or governance              the extent to which such interests should be       recognise, and deal with differences, conflicts,
     structures more generally. Governments                 protected, considered, restored or enhanced        and oppositions and to arrive at workable
     regularly make long‑term commitments, such             by those of us living today. No one system         solutions to the problems and challenges
     as in education, welfare and infrastructure,           of government has a monopoly on thinking           that result from an accelerating process of
     though these are not necessarily guided by a           about, or governing for, future generations,       globalisation”.12 For the most part, however,
     longer‑term view or explicitly mandated to             even if certain systems may prove more             today’s challenges are even more intertwined
     address difficult long‑term questions.                 adept than others. We, the Commissioners,          and beyond the scope of national jurisdiction.
                                                            drawn from different parts of the world, are       Many of these challenges, not least those
     Uncertainty about the future, the never-ending         united by a desire to harness the opportunities    related to climate change, are the by-products
     immediacy of pressures at our doorsteps and            presented in today’s world for the benefit of      of industrialisation and economic growth.
     the rapidity of change in today’s society make it      current generations, whilst also ensuring that     While the already advanced economies have
     easier to rationalise living in the eternal present.   we leave the world in a better position for        generated many of the externalities, much of
     Changing course towards the longer term                our grandchildren, and the generations that        the burden going forward will need to be shared
     requires society to devote sustained attention         succeed them.                                      by the developing world, whose rapid growth is

10
compounding challenges such as climate change            necessary to tackle challenges common to all and      categories are used to illustrate key challenges
and resource scarcity. Our hyper-connected               requiring national and wider cooperation may need     that need to be grappled with, the links between
world requires unprecedented collaboration.              to occur incrementally.                               them, and how they might be addressed.
Reaching consensus on a path forward requires
a deep understanding of “how the one world               About this report                                     PART B: Responsible Futures seeks to diagnose
affects the many and how the many worlds                 This report aims to contribute to the ability of      why gridlock and a lack of political will for change
affect the one”. This, in turn, necessitates a           national and local governments, international         persist on many challenges where action is
deep awareness of local and regional cultures,           institutions, businesses and the broader              imperative. It draws lessons from examples where
perspectives and identities, and how they are            community to understand and navigate these            impediments to action have been overcome,
responding to each other in an era in which              competing tensions in order to grapple with the       and also considers why certain efforts have
cooperation is a prerequisite for progress.13            major long-term issues of today. It examines five     failed or stalled. Five shaping factors that impact
                                                         sets of challenges requiring concerted attention.     the ability to get things done are identified:
Individuals often take as a starting point difference,   The Commission does not attempt to provide            institutions, time, political engagement and
not likeness: we often define ourselves largely          one-stop solutions and we are aware of the            trust, complexity and culture.
based on what differentiates us from those we            wide-ranging arguments regarding the right
encounter.14 This “precedence of difference              course of action. Today’s challenges are deeply       PART C: Practical Futures builds from the
over sameness” has important, and perhaps                complex and interconnected, and will require          possible and responsible futures suggested in
misunderstood, consequences for the conduct              multiple and sustained actions in order to be fully   Parts A and B, and offers practical, overarching
of multilateral dialogues and negotiations on the        addressed. Our aim is to highlight areas where        recommendations to overcome the gridlock of
longer-term challenges identified in this report.        action could be taken if the political will were      modern politics and shift mindsets towards the
As Commissioners, we have observed that                  mobilised to do so, and how it could be taken. We     long term. The recommendations are arranged
globalisation can sharpen cultural contrasts and         try to understand why action has become more          around five key principles: creative coalitions;
invoke stronger claims for localisation.15 While the     difficult and provide recommendations which we        innovative, open and reinvigorated
interconnections made possible via a globalised          hope will be useful in terms of moving forward        institutions; revalue the future; invest
world provide hope for “economical, ecological,          the agenda for future generations.                    in younger generations and establish a
educational, informational, and military forms of                                                              platform of understanding.
cooperation”, this environment can also trigger          The report comprises three parts:
“a counter-reaction to what people experience
as a threat”.16 Such a reaction – defensive              PART A: Possible Futures gives a synopsis of
localisation despite globalisation – might come          global megatrends and introduces the key
from individuals, communities, or take place within      challenges on which action is essential. These
institutions. This means the Commission cannot           challenges are introduced within five broad
be starry‑eyed about the prospect of broad,              categories: society, resources, health,
sweeping changes and position leaps on the               geopolitics and governance. This is by no
challenges it identifies. Movement along pathways        means an exclusive or comprehensive list, but the

                                                                                                                                                                      11
Part A:
     Possible Futures

12
Megatrends

Taking stock

Megatrends mark important shifts in the
evolution of society.17 They tend to persist
over the long term, at times with impacts that
are not immediately evident. Some are more
reversible than others. Megatrends can be
extremely positive, such as poverty reduction,
the emergence of the Internet, longer lifespans
and the decline of great wars. They can also be
negative, as is evidenced by growing inequality
and the rising threats of both infectious and
non-communicable diseases (NCDs). Either
way, megatrends can and often do generate
profound and potentially permanent changes to
the way societies are governed.

Presenting a picture of the future can be risky.
It can leave us jumping at “distant and fragile
shadows” and unprepared when the real world
knocks at the door.18 We know events are often
unanticipated. The future is bound to be full of
good and bad surprises. This does not mean we
should be complacent about what is happening
around us, and ignore what that might mean for
the future.
                                                   Figure 1: Global megatrends in the 21st century
In this section, we identify a number of           Source: Oxford Martin Commission for Future Generations.
prominent global megatrends. Some date back
to before the Industrial Revolution; others
have become influential since the end of the
Cold War. We do not seek to be too predictive.
Ensuring that one is able to seize the positive
opportunities and build resilience against the
downside risks will require an open mind and
constant commitment to discovery and learning.

The megatrends are grouped under seven
headings but are highly interactive. Many
megatrends are slow, whilst the direction of
others may turn or accelerate unexpectedly.
Globalisation underpins them all. Together,
these megatrends are transforming the world
and doing so in a manner that is distinct from
the drivers of change in earlier times.

                                                                                                              13
Demographics

     Over the next century, changes in the world’s
     demography – the characteristics and
     composition of the global population – are
     likely to be dramatic. This is not just about
     gross numbers; it is also about the age, lifespan,
     distribution and activities of people. The world’s
     population has climbed from 1.6 billion in 1900
     to around 7 billion today, and is projected to
     exceed 8 billion by 2025 and perhaps 9 billion by                                      Half the world’s
     2050. Over 60 percent of the global population                                        population lives in
     is likely to live in Africa and Asia by 2050.19                                           this circle
     Approximately 70 percent of the growth is likely
     to occur in 24 of the world’s poorest countries.2

     Ageing nations

     The world’s population is getting older, with the         Figure 2: Global population distribution, 2013
     population over 60 growing fastest.21 In less             Source: Oxford Martin Commission for Future Generations.
     than 40 years, one in every five people will be at
     least 60 years old. Average lifespan is projected
     to be 83 years in the developed world and 72
     in the less developed world by 2050, compared
     with 78 and 67 today, and 66 and 42 in 1950.22
     The overall ratio of old to young is set to almost
     double from current levels, and total numbers of                             60-80 year olds                       over 80s (as % of total population)
     over 60s will more than double from 810 million
     to 2 billion. Ageing will impact certain parts of
                                                                                                                                                           Latin
     the world much earlier, transforming populations:                                         North                                                     America &
     the ratio of the old-age population to the                                Europe         America              Oceania                Asia           Caribbean              Africa
     working population (15-64 years) in Japan is                      35
     already over 38 percent and is projected to reach
     almost 70 percent by 2050, for example,23 and
                                                                       30
     half of Europe will be over 50 by the end of this
     decade.24 Discrepancies in sex ratios have also
     become more pronounced in some places. Whilst                     25
     the longer life expectancy of females is gradually
                                                          Percentage

     diminishing imbalanced sex ratios in many
     populations, Asia is experiencing an increased                    20
     “masculinisation” of society. The difference
     between the numbers of men and women in Asia                      15
     more than tripled from 1950-2005.25

                                                                       10

                                                                       5

                                                                       0
                                                                            2007 2050*        07       50          07      50        07       50         07       50         07       50
                                                                            * Prediction

                                                               Figure 3: The ageing global population
                                                               Source: UN-DESA, World Population Prospects – The 2010 Revision: Highlights and Advance Tables (New York: United Nations
                                                               Department of Economic and Social Affairs), p. 8.

14
Mobility

                                                    Europe
                                                    2009: 664m
 North America                                      2030: 680m
 2009: 338m
 2030: 322m
                                                                                       Asia Pacific
                                    Middle East and Africa                             2009: 525m
                                    2009: 137m                                         2030: 3228m
Central & South America             2030: 341m
2009: 181m
2030: 313m

Figure 4: The rise of the global middle class
Note: m = millions of people. “Middle Class” is defined as those households with daily expenditures of between USD $10 and USD $100
per person. The light blue circle depicts the size of the middle class population in 2030; the dark red circle charts the 2009 middle
class population. Source: Commonwealth of Australia, Australia in the Asian Century (Canberra: Department of the Prime Minister and
Cabinet, 2012), p. 63.

As a share of the world’s population, migration                         vast majority will come from emerging markets,                  percent reduction in South and West Asia).35
today is less prevalent than it has been in the past,                   which are projected to double their share of                    University enrolments in emerging countries
such as during the age of mass migration in the                         global consumption (from one third to two                       doubled between 1996 and 2007, whilst
19th century. Nevertheless, the total number of                         thirds) by 2050.32 Consumers will increasingly be               student mobility globally also increased. Nearly
migrants has grown with the world’s population.                         concentrated in cities within emerging markets.33               four million students studied abroad in 2010,
The birthplace and destination of migrants is                                                                                           almost twice more than a decade earlier. The
constantly changing. Currently, there are over 210                      This emerging middle class could provide a                      overall return on education is also climbing.
million people living outside their country of origin,                  much-needed impetus for balanced global                         Within OECD countries, tertiary-educated
up from 150 million in 1990.26 Remittances                              growth by boosting consumption, investing                       workers earn 55 percent more on average than
to developing countries are estimated to have                           in health, education and renewable energy,                      those with upper-secondary and alternative
reached USD $406 billion in 2012.27                                     and driving higher productivity, sustainable                    post-secondary qualifications.36 As we will
                                                                        economic development, and more political                        see, however, education helps but does not
Urbanisation is also occurring rapidly within our                       stability via increased demand for accountability               guarantee employment – connecting educated
populations.28 In 1950, only three of every ten                         and good governance.34 Whilst this constitutes                  individuals with jobs remains a challenge.
people lived in cities. In 2008, the number of                          a significant opportunity, there is also the risk
people in cities was greater than that in rural                         of an increasing divide between the growing
areas for the first time. Urbanisation generates                        middle class and those left behind. At the same
opportunities particularly in the delivery of                           time, growth in consumption and incomes will
services and public goods but also presents                             add further pressure to our strained resources
sizeable challenges. By 2030, over two billion                          and environment.
people may well be living in urban slums.29 A
dramatic rise in the number of people living in
urban floodplains is also expected, especially in                       Empowerment through education
Eastern and Southern Asia and in Africa.30
                                                                        Access to primary education in particular is
                                                                        regarded as critical to socioeconomic mobility,
Rise of the middle class                                                and for this reason it has been an objective
                                                                        of the Millennium Development Goals
Mobility is not just about geography; there is                          (MDGs). Substantial inroads have been made
also an integral socioeconomic dimension. Over                          this past decade in reducing the number of
the next 40 years, billions more people are                             out‑of‑school children (now about 60 million,
expected to join the global middle class.31 The                         down from 108 million 20 years ago, with a 66

                                                                                                                                                                                           15
Society

                                               2005                                                                                                          2015

                                                                                  Vietnam                                                                          ZAF
                                                                                                                                           KEN                             BDI
                                                                                                                                                          Zambia                 BFA
                                                                                                                                                 Guinea
                                                                                                                                                                                              Haiti
                                                                                           Indonesia                                    MOZ                         PHL
                                                  India                                                                                                                                               MEX
                                                                                              47                                                                                   Pakistan
         Ethiopia                                 456                                                                                            Bangladesh                                     CIV
                                                                                                                                                                                                       Benin
                                                                                                                               Angola    NPL        33
                                                                                                         MOZ                                                                                  MWI
                                                                                                                                                                                                        RWA
         ZAF                                                                                                                  Chad                                       Nigeria
                                                                                    Bangladesh                                                   DRC                       96
                   DRC                                                                                                                                                                        MDG
                                                                                       76                                                        48
                   38                                                                                                                                                                          17           China
                                                                                                                               Niger
                                                                                                        NPL
                                                                                                                                                                                    Tanzania           CMR

                                                                                                                                        Indonesia                                      31
           PHL                                                        Nigeria
                                                                                            Pakistan                                       34                 India
                                                                       102                                                                                                                       COL
                                    China                                                     35                                                               88
                                    208                                                                                                          MLI                               UGA
                                                                                      UGA
                                                                                                UZB
                                                            Tanzania
                                                               34            Brazil                                Sub-Saharan Africa                                    Europe and Central Asia

                                                                        MWI                                        Latin America and Caribbean                           East Asia and Pacific
                                            Niger MDG
                                                                                                                   Middle East and North Africa                          South Asia

                                                                                                                   (Millions of poor people)

     Figure 5: The changing global poverty landscape
     Note: Numbers refer to individuals living below the international poverty line of USD $1.25 a day, figures rounded to the nearest million. The 2015 numbers are forecasts and for a number of
     countries the scale of improvement is indicative of the number of people clustered around the poverty line used in the figure. Source: Laurence Chandy and Geoffrey Gertz, Poverty in Numbers: The
     Changing State of Global Poverty from 2005-2015 (Washington DC: The Brookings Institution, 2011), p. 8.

     Uneven and unequal                                                 countries such as China, India, Russia and South                   Africa43), social exclusion persists (through
                                                                        Africa, it is widening rapidly.40                                  unemployment, poverty or a lack of access
     For the past three decades, there has been                                                                                            to political, economic, educational or societal
     a steady decline in poverty rates in the                           Generational and gender divides                                    processes).44 Exclusion hits the old, the young
     developing world. As highlighted in Figure 5, this                                                                                    and women hardest, especially in developing
     progress is anticipated to continue, not least                     One third of the world’s labour force                              countries. Gender inequality remains a key
     in countries such as China and India. Yet the                      began 2012 poor or unemployed; global                              barrier to economic growth and poverty
     contrast between rich and poor remains stark.                      unemployment is expected to remain over                            reduction. Women and girls account for six out
     Despite overall progress on education, three out                   200 million until at least 2015. According to                      of ten of the world’s poorest and two-thirds
     of every four illiterate adults are located in just                the ILO, over the past five years long-term                        of the world’s illiterate people. According to
     ten countries (37 percent of them in India)37                      unemployment has increased in 60 percent of                        the UNDP, women perform 66 percent of
     and about half of all out-of-school children                       advanced and developing countries where there                      the world’s work, but earn just 10 percent
     are in sub-Saharan Africa.38 According to the                      is available data.41 Young people are 3–4 times                    of the income and own only 1 percent of the
     World Bank, more than 1.2 billion people do not                    more likely to be without a job: the global youth                  property.45
     have access to electricity, including 550 million                  unemployment rate (12.6 percent) is more than
     in Africa and 400 million in India.39 Societies                    double the unemployment rate of the labour
     and individuals are becoming increasingly                          force as a whole.42
     unequal. The Gini coefficient – an imperfect
     measure of the gap between the richest and                         While there has been solid progress on reducing
     poorest – has risen by more than 10 percent in                     extreme poverty (by 2050 it might only
     OECD countries since 1992. In some emerging                        remain a concern in India and sub-Saharan

16
Geopolitics

New world order                                                                                                                        World                        Asia
                                                                                                                                  (Share of output)           (Share of output)
The shift of economic power to emerging                                          100                                                                                                  100
markets is in full swing. Reports suggest that the
GDP of developing countries is now at least equal
to the developed world.46 Developing countries’                                                     80                                                                                80
share of global exports has increased over the
last decade from 33 to 43 percent. Their share
of global foreign direct investments (FDI) inflow                                                   60                                                                                60
                                                     Percentage

has grown from nearly 20 to over 50 percent.47
China and India are on track to have 35 percent                                                     40                                                                                40
of the world’s population and 25 percent of its
GDP by 2030.48 Brazil, Russia, India, and China’s
combined share of world GDP is expected to                                                          20                                                                                20
match that of the original G7 countries by
2030.49 Even if these projections prove too
optimistic, the rise of new economic powers may                                                      0                                                                                0
be expected to lead to a new world order.50                                                                2005                          2015          2025
                                                                                                           Rest of world                                               ASEAN
                                                                                                           North America                                               China
Shared networks now transcend state                                                                        Latin America and Caribbean                                 India
boundaries and render distinctions between                                                                 Euro area                                                   Japan
                                                                                                           Asia                                                        Rest of Asia
North, South, East and West increasingly
redundant. Networks of economic activity as
well as of diaspora communities and students             Figure 6: Share of world output
educated in foreign countries are vital to this          Source: Commonwealth of Australia, Australia in the Asian Century (Canberra: Department of the Prime Minister and Cabinet,
transformation. Increased “brain circulation”            2012) p. 52.
enables the flow of capital, cultures, ideas,
global connections and cutting-edge expertise
around the world, whilst international research
networks and collaborations have flourished.
More than a third of scientific papers published
in international journals are now internationally
collaborative, up from one quarter of
publications nearly two decades ago.51
                                                                                                    55

The global marketplace
                                                     World trade as percentage of world gdp ($us)

                                                                                                    50
The landscape of trade in goods and services
has fundamentally changed since the Second                                                          45
World War, as the General Agreement on Tariffs
and Trade (GATT) shepherded in a more open
and connected global economy. Today there are                                                       40
nearly 160 members of GATT’s successor, the
World Trade Organization (WTO). From 1950–
                                                                                                    35
2007 trade grew by an average of 6.2 percent
per year.52 In 2011 the total value of world
merchandise trade was estimated at USD$18.2                                                         30
trillion.53 Developing countries achieved a share
of over 50 percent of global trade in 2012.54
                                                                                                    25
Trade in value-added goods and global supply
chains ensure exports rely on imports more than
ever, a reality of the global marketplace that                                                           1960              1970              1980     1990    2000              2010
new OECD-WTO data has begun to capture.55
Many of our most used goods and services
are “made in the world”. The foreign content             Figure 7: Growth in world trade 1960–2010
of “Korean” and “Chinese” electronic goods               Source: Andrew McCulloch, “Globalisation and Protectionism Today”, Significance magazine, http://www.significancemagazine.
exported in 2009, for example, was around 40             org/details/webexclusive/2528931/Globalisation-and-Protectionism-today.html.

                                                                                                                                                                                            17
Sustainability

     percent.56 In many sectors, tariffs have declined    governments and businesses, not least due to        The “perfect storm”
     sharply. Less prominent improvements include         the low barriers to entry. Old concerns – such
     more flexible rules on access to key medicines,      as nuclear and chemical weapons – still remain      Sustainability is inherently about the long term.
     improved monitoring functions, and peaceful          serious threats. Nuclear powers operating           It requires the reconciliation of environmental,
     and robust dispute settlement procedures.            outside the Nuclear Non-Proliferation Treaty        social and economic demands necessary for
     Non-tariff barriers are becoming the principal       increase the risk of disaster, either by design,    the sustained survival of humankind and other
     impediment to the movement of a growing              accident, or third party exploitation. The          organisms on our planet. Above all, living
     range of goods and services, and are becoming        other lingering fear is a mismanaged power          sustainably means grappling with the “perfect
     a bigger part of world trade.57 Despite the surge    transition, whereby emerging powers repeat          storm” associated with the inseparability of
     in global trade,58 disagreement remains between      their predecessors’ mistakes by allowing military   water, food, energy and climate.62
     advanced and emerging economies on how               plans to become built-in escalators to war.61
     to reconcile trade with the development and
     environmental agendas.                                                                                                                          ENERGY
                                                                                                                                                 Increased demand
                                                                                                                                                     andby50
                                                                                                                                                   50%      % by
                                                                                                                                                           2030
                                                                                                                                                dem (IEA)        20
     More seats at the table                                                                                                             ea
                                                                                                                                           s ed
                                                                                                                                                     ENERGY
                                                                                                                                                                   30
                                                                                                                                                                         (IE
                                                                                                                                       cr                                    A

                                                                                                                                  In

                                                                                                                                                                              )
     Whilst the state remains the principal actor
     in world politics, there are now almost four

                                                                                                                                                                                       I)
                                                                                                                                                                                       3 0 (IF P R
                                                                                                                      Increa
     times as many states as there were in 1945.                                                                                                    CLIMATE
                                                                                                                                                    CLIMATE
                                                                                                                                                    CHANGE

                                                                                                                      sed de ma
     This increase in players makes international                                                                                                   CHANGE

                                                                                                                                                                                       by 20
     consensus on global challenges harder to reach.

                                                                                                                                                                                  R
                                                                                                                            F O 50%

                                                                                                                                                                             E
     Demand for legitimate governance – often

                                                                                                                                                                                   0%
                                                                                                                      FOOD
                                                                                                                         nd
                                                                                                                                                                           WATER

                                                                                                                                                                          AT
                                                                                                                               OD b

                                                                                                                                                                                  d3
                                                                                                                  Increased demand                                   Increased demand
     through democratisation and transparency –

                                                                                                                                                                    W
                                                                                                                    50% by 2030                                        30% by 2030

                                                                                                                                                                                  an
                                                                                                                        (FAO) y 2                                         e(IFPRI)

                                                                                                                                                                              m
     has grown, as has the concern about fragile                                                                                        03
                                                                                                                                             0(                          ed
                                                                                                                                                                              d
                                                                                                                                                  FAO             ea s
     states. Expectations regarding the roles and                                                                                                     )       Incr
     responsibilities of states reflect changing global
     norms and expectations. The responsibility
     to protect citizens against grave crimes is
     among recent advances. Others include the                                                                Figure 8: The “perfect storm”:
     growing influence of international law in                                                                food, water and energy
     trade, investment and armed conflict. The                                                                Source: Professor Sir John Beddington, Biodiversity: Policy
     rise of international institutions and NGOs as                                                           Challenges in a Changing World (London: Government Office
     key players has also been associated with an                                                             for Science, 2009), slide 19.
     increase in the complexity of geopolitical power
     and international arrangements.
                                                                                                              It takes 1,500 litres of water and almost 10
     Back to the future?                                                                                      megajoules of energy to produce 1kg of wheat,
                                                                                                              and 10 times more water and around 20 times
     It has been powerfully argued that the recent                                                            as much energy for 1kg of beef.63 As incomes
     “decline of violence may be the most significant                                                         rise and the population grows, the pressure
     and least appreciated development in the                                                                 on these resources and the risk of resource
     history” of the human race.59 With two World                                                             insecurity increases rapidly. Climate change
     Wars and the Cold War dominating the 20th                                                                is a risk enhancer in this respect. If business
     century, it is remarkable that wars between                                                              continues as usual, and demand for natural
     the great powers appear increasingly unlikely.                                                           resources race ahead of supply,64 the “perfect
     While overall violence has declined, conflict                                                            storm” will compound an unsustainable cycle.
     has not ceased. At certain times during the
     last decade, 15 major conflicts were taking                                                              Total energy consumption per year is almost
     place at once.60 The majority of wars remain                                                             six times what it was in 1950; per capita use
     civil wars or insurgencies, largely ethnic and                                                           has more than doubled.65 Food production
     nationalist conflicts. Potentially devastating                                                           accounts for close to one third of all available
     tensions still simmer, increasingly driven by                                                            energy,66 and agriculture accounts for around
     religious fundamentalism. The stalemate of the                                                           70 percent of water withdrawals worldwide.67
     Middle East peace process provides continued                                                             Global demand for energy and fossil fuel use
     instability. Increasingly, small networks and                                                            has been projected to rise by as much as 50
     individuals have the capacity to create havoc on                                                         percent by 2030.68 Demand for coal (and
     an unprecedented scale at low cost.                                                                      associated emissions) has been reduced in the
     In today’s security landscape, issues of cyber                                                           United States due to the shale gas revolution,
     or biological warfare are growing concerns for                                                           but current indications show that this cannot

18
Exajoules
                                                      per year
be replicated in the immediate future outside                               600
North America, and ultimately depends on the
relative prices of coal and gas.69 Allied with
this growing demand is the lack of new land                                 500
available for agriculture: 80 percent of arable                                                 Nuclear                       Oil
land in developing countries is already used.70                                                 Hydro-Elect                   Coal
                                                                            400                 Nat Gas                       Biofuels
The energy sector is water intensive too.71
Energy accounts for 27 percent of all water
consumed in the United States outside the
agricultural sector.72 Globally, three billion                              300
people still have inadequate access to water,
even though the MDG of halving the proportion
of the world’s population without sustainable                               200
access to safe drinking water and basic sanitation
has reportedly been met.73 Just 10 countries
are home to two‑thirds of the people without                                100
access to improved drinking water.74 The World
Bank estimates two in every three countries
will be water-stressed by 2025, at which time                                 0
around 2.4 billion people will face “absolute
                                                                                  1820     1840        1860    1880     1900                         1920      1940        1960    1980   2000
water scarcity”. Yet, to feed the world in 2050,
food production may need to rise by some 70
percent,75 which may require 50 percent more           Figure 9: World energy consumption 1820-2010
water.76 Moreover, 40 percent of arable land is        Note: Based on estimates from Vaclav Smil, Energy Transitions: History, Requirements, Prospects, (California: Praeger, 2010)
already degraded to some degree, a problem that        together with BP Statistical Data.
will be exacerbated by global warming.                 Source: Our Finite World, “World Energy Consumption Since 1820 in Charts”, 12 March 2012, http://ourfiniteworld.
                                                       com/2012/03/12/world-energy-consumption-since-1820-in-charts/

                                                                                                 Withdrawal                                                        Consumption

                                                                            800                                                                140

                                                                            700                                                                120

                                                                            600
                                                                                                                                               100
                                                     Billion cubic metres

                                                                                                                        Billion cubic metres

                                                                            500
                                                                                                                                               80
                                                                            400
                                                                                                                                               60
                                                                            300

                                                                                                                                               40
                                                                            200

                                                                            100                                                                20

                                                                             0                                                                  0
                                                                                         2010      2020        2035                                    2010            2020       2035

                                                                                     Fuels                    Power
                                                                                        Biofuels                 Bioenergy                                  Oil
                                                                                        Fossil fuels             Nuclear                                    Coal
                                                                                                                 Gas

                                                       Figure 10: Global water use for energy production
                                                       Source: International Energy Agency, “Water for Energy”, http://www.worldenergyoutlook.org/resources/water-energynexus/.

                                                                                                                                                                                                 19
Health

                                                                           Cumulative total anthropogenic co2 emissions from 1870 (gtco2)                           The past century has delivered remarkable
                                                            0           1000    2000       3000     4000      5000      6000    7000     8000                       advances in health, as is illustrated by the
                                                        5                                                                                                           increase of 4.7 years (male) and 5.1 years
                                                                                                                                                2100                (female) to the average global life expectancy
     Temperature anomaly relative to 1861 - 1880 (°c)

                                                                                                                                                                    at birth between 1990 and 2010.86 The
                                                                                                                                                                    eradication of smallpox, the discovery of
                                                        4                                                                                                           penicillin, the mapping of the human genome,
                                                                                                                                                                    the significant reduction in under-five mortality,
                                                                                                                                                                    developments in genetic technology, research
                                                                                                                        2100
                                                                                                                                                                    and new treatments for HIV/AIDS, TB and
                                                        3
                                                                                                                                                                    malaria, and growing access to health services
                                                                                                                2100                                                and insurance ensure that our potential to live
                                                                                                       2050                                                         longer and healthier lives is greater than at
                                                        2                                       2050                                                                any other point in human history. However,
                                                                                                         2050
                                                                                              2050     2100                                                         translating public health knowledge into
                                                                                       2030
                                                                                                                                                                    practice has been fragmented and fraught with
                                                                                               2000
                                                                                                                                                                    difficulty. Whilst biomedical technology and
                                                                           2010                                                                                     capacity to enhance the quality of health care
                                                        1
                                                                                                                                                                    and prevention have improved significantly,
                                                                                2000
                                                                1950                                                                                                access to health care remains vastly lopsided,
                                                                         1980                                                                                       with the poor and disadvantaged suffering a
                                                        0                                                                                                           disproportionate burden of illness and disease.
                                                                1890

                                                                                                                                                                    We are in the midst of experiencing multiple
                                                            0                  500               1000             1500            2000                    2500      transitions which impact health. These include
                                                                            Cumulative total anthropogenic co2 emissions from 1870 (gtc)                            a demographic transition from a pattern of high
                                                                                                                                                                    fertility and high mortality to low fertility (with
                                                                       RCP2.6                                           Historical                                  the exception of sub-Saharan Africa), an ageing
                                                                       RCP4.5                                           RCP range                                   population, and an epidemiological shift from
                                                                       RCP6.0                                           1%/yr CO2                                   infectious diseases associated with malnutrition,
                                                                       RCP8.5                                           1%/yr CO2 range                             famine and poor sanitation, to chronic and
                                                                                                                                                                    degenerative diseases associated with longevity,
     Figure 11: Cumulative total of anthropogenic CO2 emissions and global                                                                                          urban and industrial lifestyles. These changes are
     temperature change                                                                                                                                             also associated with a turning point in nutrition,
     Source: IPCC, Fifth Assessment Report Summary for Policymakers (Geneva: IPCC, September 2013), p. 36. “RCP” refers to the                                      where malnutrition can be both from famine and
     Representative Concentration Pathway scenario used by the IPCC.                                                                                                starvation as well as from high caloric, nutrient-
                                                                                                                                                                    poor states, as in the case of obesity.87
     It’s the green economy                                                                                     Our ecological footprint now exceeds our
                                                                                                                biological capacity by a record margin.82 By
     Historical, carbon-intensive models of economic                                                            2010, almost one in four plant species were         Lifestyle choices, lifestyle diseases
     growth are unsustainable. Since the Industrial                                                             reportedly threatened with extinction, and
     Revolution there has been a strong correlation                                                             vertebrae species numbers have fallen by a          The growing threat today is NCDs. Most are
     of GDP per capita with CO2 emissions.77 The use                                                            third in the past four decades. Such biodiversity   caused by preventable factors, including poor
     of carbon has yielded extraordinary benefits and                                                           loss is made even worse by climate change.83        diet, obesity and inactivity. NCDs like diabetes,
     none of the now advanced economies would have                                                              Continued population growth will amplify            cancer, heart disease, stroke, and chronic lung
     developed without it, but the negative costs arising                                                       already stretched human demand for land and         disease were responsible for 63 percent, or 36
     from the consequent climate change now pose                                                                water resources, as well as food production         million, of all global deaths in 2008. Described
     a rising threat. Warming of the climate system is                                                          and energy, generating more emissions               as the “invisible epidemic”,88 NCDs are now
     unequivocal. Atmospheric levels of CO2, methane                                                            and heightening human pressures on the              the leading cause of death in the world. Each
     and nitrous oxide are “at levels unprecedented in                                                          environment. As urbanisation continues, the         10 percent rise in NCDs is associated with a
     the last 800,000 years”, and CO2 concentrations                                                            focus of attention will increasingly be on our      0.5 percent lower rate of annual economic
     are 40 percent higher than pre-industrial times.78                                                         cities, which by one estimate are already           growth.89 The cost of treatment for NCDs over
     The IPCC is now highly confident that that the rate                                                        responsible for around 57–75 percent of global      the next two decades, as our populations grow
     of sea level increase since the mid 19th century                                                           greenhouse gas emissions.84 The effects of          larger and live longer, is estimated to be about
     “has been larger than the mean rate during the                                                             climate change and environmental degradation        USD $30 trillion.90
     previous two millennia”.79 If trends continue,                                                             could well undo part of the enormous progress
     cyclone intensity, extreme weather events80 and                                                            made in tackling poverty, particularly because      The costs of lost productivity are even higher.
     global rainfall totals are also expected to increase,                                                      poor people and poor countries are least able       Globally, projections suggest that there may be
     with considerable regional variation.81                                                                    to cope.85                                          a cumulative economic output loss of USD $47

20
50                                                                                              around the world.99 Secondly, as predicted by
                                                                                                                                    Alexander Fleming, certain infections are re-
                                    45
                                                                                                                                    emerging as threats because of growing drug
                                                                                                                                    resistance. Antibiotics were hailed as miracle
                                    40
                                                                                                                                    drugs but due to excessive use, misuse and
Lost output, trillions (2010 $US)

                                    35                                                                                              poor adherence to antibiotic regimens, many
                                                                                                                                    infection-causing bacteria have developed
                                    30                                                                                              resistance against existing antibiotics.100
                                                                                                                                    Combined with the HIV epidemic, this has
                                    25                                                                                              resulted in the resurrection of diseases such
                                                                                                                                    as TB, creating new epidemics that are much
                                    20                                                                                              harder to treat, such as multi-drug resistant TB.

                                    15

                                    10

                                    5

                                    0
                                         2011   2013    2015     2017   2019   2021      2023     2025      2027      2029

                                                High income                              Low income
                                                Upper middle income                      Total, low and middle income countries
                                                Lower middle income                      Total, world

    Figure 12: Projected non-communicable diseases cost by income level based
    on economic growth forecasts
    Source: World Economic Forum & Harvard School of Public Health, The Global Economic Burden of Non-Communicable Diseases
    (Geneva: World Economic Forum, 2011), p.31.

    trillion over the next two decades due to NCDs.                            responsible for 35 percent of all deaths of
    This loss represents 75 percent of global GDP                              children under five.96 Although Africa has seen
    in 2010 (USD $63 trillion). It also represents                             the greatest rate of decline in child mortality
    “enough money to eradicate two dollar-a-day                                rates since 1990, it still has double the ratio of
    poverty among the 2.5 billion people in that                               the next closest region.97
    state for more than half a century.”91

                                                                               Interconnected and infectious
    Although NCDs have traditionally been
    considered diseases of the affluent, it is in                              The focus on NCDs does not mean infectious
    fact poor and disadvantaged populations that                               diseases are a relic of the past. They remain a
    have the highest rates of NCDs in high-income                              significant threat, particularly in today’s highly
    countries.92 Approximately 80 percent of the                               mobile, interdependent and interconnected
    36 million NCD deaths in 2008 occurred in low-                             world. Risks anywhere can be threats
    to-middle income countries. Many social factors                            everywhere. With around 40 new infectious
    play decisive roles in determining the health of                           diseases discovered in the past 40 years, of
    individuals and communities, as was reflected                              which SARS, HIV and different types of influenza
    in the 2011 Rio Declaration.93 The rate of                                 are but three, the concern about further new
    increase of NCDs is, however, occurring much                               pandemics is not a case of if but when.98
    faster in low-to-middle income countries, as
    economic growth and life expectancy rise. Poor                             There are concerning trends surrounding
    education and low incomes are associated with                              infectious diseases. Firstly, rapidly evolving
    rising NCDs in both developed and developing                               viruses such as influenza, ebola, Middle East
    countries.94 Sub-Saharan Africa is facing a                                Respiratory Syndrome – Coronavirus, and
    particularly heavy dual burden of disease, where                           HIV continue to thrive. Such threats are not
    NCDs are rising95 but malnutrition, hunger                                 new; the 1918–1919 influenza pandemic,
    and infectious diseases continue to be grave                               originating towards the end of the First World
    problems. Undernutrition is estimated to be                                War, had a devastating impact on populations

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