It’s hard to judge from a distance, but Paul Ryan, Romney’s choice for vice president, seems like a decent as well as down-to-earth politician  who actually believes in what he says. In US politics that is quite extraordinary, apparently. I have huge respect for politicians who try everything to make the world in which they believe come true. Also, as far as we know, the guy is not known for flip-flopping or cheating on ill wives; he even loves backpacking.  Last week Obama himself acknowledged  that Ryan is a decent man and a worthy opponent.  I applaud the fact that Paul Ryan’s selection might turn this presidential election into a discussion on the long-term future of the US. The election will be on substance, at least to some extent.

Yet, to paraphrase George W. Bush: make no mistake, the global health community, and especially American global health organizations, institutions and scholars, should oppose the Romney/Ryan ticket with all the energy and resources they have. Ryan is not just bad news for Medicaid, Medicare, Obamacare, access to safe abortion in developing countries, and plenty of other social policies in the US and elsewhere. Obviously it’s also anything but ‘fiscally conservative’ and even ludicrous to claim, as Ryan does, that government should shrink but defense (as well as the rich) should get more money. These are all valid reasons to denounce the Republican program. Yet, the most important reason why global health people should fight Romney/Ryan, is because they’re  terrible news for the planet. Basically, a Romney/Ryan victory means it’s game over for the planet.

The Lancet has described climate change as the global health challenge of the century (and probably the coming centuries). If we’re serious about global health, the political implications are obvious.

If it’s true that climate sensitivity  is actually higher than what models have been suggesting so far, and that even if a two degrees rise in average global temperatures can already wreak far more havoc than we thought, you don’t want to imagine the planetary horror runaway climate change  would cause. And if Paul Rogers and many others are right that the 2010s is the crucial decade if we still want to avoid the worst climate scenarios,  we cannot afford another ‘lost decade’ like the 2000s. Given the GOP’s transformation in recent years under the pressure of the Tea Party and corporate and financial sponsors,  a new Republican president would amount to the worst case scenario for the planet. We cannot afford a Republican president and Republican-dominated Congress at this crucial point in time, if most of the party does not even accept the notion of human-induced climate change, unlike the majority of decision makers in Europe and China.

Small government, ultra-light regulation and trickle-down policies will not just cause economic and social hardship for numerous people, as these approaches haven’t worked in the past and won’t do so in the future; they are also the last thing this planet needs at this point in time. Of course, a Democrat president like Obama who often looks paralyzed and weak due to the political gridlock or downright obstruction by the Republicans in Congress might also not be able to save the planet. But even if his climate policies have been disappointing so far, at least he seems to accept the basis scientific facts on climate change, and I bet he understands the dire implications of climate change, if left unchecked.  With a Republican presidency, we can forget about any global climate deal this decade, unless if Jesus himself would tell Mitt otherwise.

Let’s put this in global health terms:  Universal Health Coverage, the most likely post-2015 overall health goal, will turn into a joke (or rather a nightmare)  if the worst climate scenarios materialize. By 2050 we might be scrambling for the survival of entire regions, even countries, instead of infants and children.

Global health stakeholders in the US shouldn’t hedge their bets any longer, based on the now dated assumption that global health needs to be bipartisan. Instead they ought to make it crystal-clear to the public opinion what a Romney/Ryan ticket implies for the future of the earth: a Mad Max world (Come to think of it, that prospect might actually appeal to the Tea Party base and Ayn Rand devotees).

Global health fellows and activists should write opinion pieces, appear in tv shows, and set up a large scale social media campaign; if we mobilize for child survival and malnutrition, why not for the future of the planet? And if Catholic bishops can take an unambiguous stance, why not us?

No doubt Jeffrey Sachs will shout it loud and clear, but the rest of the global health big shots and establishment  (Julio Frenk, Peter Piot, fellows at the Center for Global Development, USAID staff, even Bill and Melinda Gates …) should follow suit. “A vote for Romney & Ryan will harm your children and grandchildren.” A bit like the anti-tobacco campaigns, yes. The by now notorious “granny-over-the-cliff” ad   was a good start (I’m joking, of course, that was a bit “over the top”).

It might not make much difference in the end, as we’re all very skilled in denying news we don’t want to hear. And my Evangelical brother tells me some of the more fanatical Evangelicals still don’t really fancy a vote for Romney, even with Paul Ryan as his sidekick. Global health campaigning against Mitt Romney might also backfire after a Republican win. Yet, there are times when it’s better to say what you believe in, rather than be pragmatic.

Paul Ryan would agree with that, I guess.

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4 Responses to Global health is no longer bipartisan in the US, whether we like it or not. It’s time we wake up to that reality.

  1. Bruno Meessen says:

    Hi Kristof,

    It seems that (national) health care financing will be an important subject for the elections.

    I am afraid that global warming does not suit human beings’ political cycles.


  2. Kristof Decoster says:

    I have to adjust the first paragraph on Paul Ryan, I’m afraid. As soon as he joined the Romney campaign, he began “flipflopping” … (see his stance on Medicare).

    Romney is obviously contagious.

  3. Kristof Decoster says:

    Hi Bruno,

    thanks for pointing that out. It’s even worse: Ryan’s defense budget proposal and Obama’s don’t seem to be all that different either – apparently it’s Mitt Romney who wants to go for a major defense boost (2.3 trillion more than Obama over the next decade)

    But my major point remains: there’s no way America will lead on climate change this decade, with a Republican presidency. And if we still want to have a tiny chance to avert the worst climate scenarios, America has to lead, for example in changing its way of life and consumption patterns, putting in place the right incentive structures for industry, etc. If America does not do its share, the rest of the world will be more than justified in doing the same.

    But the Obama administration has been disappointing on climate change, I agree, and chances are that Obama won’t be able to act more decisively, if he’s reelected, given the current polarisation in US politics. As has been pointed out already many times, the advantage Franklin D. Roosevelt had, was that he had a majority in Congress. Obama does not have that advantage anymore.

    Sach’s solution – a third big party, that would emerge out of social media – seems even less plausible, I’m afraid, in the current circumstances.


  4. Bruno Meessen says:

    Hi Kristof,

    Jeffrey Sachs thinks it doesn’t matter much: both parties’ budgets go for ‘small government’.

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