Imagining a Justice-Based Health System

By Isaac Chotiner, The New Yorker

02 April 20

ennifer Prah Ruger, the director of the Health Equity and Policy Lab at the University of Pennsylvania, studies national and international public-health policies through a moral lens, examining the ways in which world leaders can insure more just health outcomes for their fellow-citizens, as well as for citizens of other nations—and how those two things necessarily intersect. Prah Ruger’s work is influenced by her former teacher Amartya Sen, whose “capabilities approach” to economics—developed with the philosopher Martha Nussbaum—envisions a broad definition of human flourishing, one that transcends indicators like G.D.P.

Prah Ruger’s most recent book, “Global Health Justice and Governance,” published in 2018, examines international crisis responses to past epidemics, such as the Ebola outbreak of 2014. “Public health and health care systems capacity and governance vary considerably across the globe,” Prah Ruger writes. “Like rapidly spreading contagions and global inequalities, this arbitrary patchwork of health systems is morally troubling.” That work is especially relevant today, with the coronavirus pandemic straining health systems around the world, from China to Italy and the United States. In the U.S.—a country that is infamous for the unequal outcomes of its health system—hospitals find themselves overwhelmed with patients and short on medical equipment.

I recently spoke with Prah Ruger by phone. During our conversation, which has been edited for length and clarity, we discussed how different types of health systems have responded to the current crisis, the area where the U.S. shines in keeping its population safe and healthy, and whether health care should be understood as a universal human right.

What have you been thinking about for the last couple of weeks, as this thing has spread, and how does the coronavirus fit into what you study and write about?

The first thing I’ve been thinking about is the underlying principles of justice and equity that we’ve been working on in our approach and in our lab. In the recent book that we just published, the underlying philosophy of human flourishing and the attempt to create the global and domestic conditions for people to have the ability to flourish is very relevant for the current situation. Flourishing is about enabling people to do and be what they want to do and be, and health is an instrumental and an essential part of that. So global public health that protects people’s ability to flourish is an essential part of a just society—a global society and a domestic society.

And so what I’ve been looking for and trying to understand better, as you look globally but also domestically and in our own country, is how are we going about effectuating that or not. So I’ve been advancing a particular approach to that called provincial globalism, in which we look at the intersection or the commonalities between provincial or state or nation or local-based norms and values about equity in public health, and global foci on health and equity. Are those intersecting? Do we have a sense that, globally, we’re really trying to work together, coöperate on the common good to insure people all over the world are able to be healthy, and protecting them and working collaboratively in coöperating? Or are we advancing the status quo in terms of a rational-actor model of global health governance, which has different nations and different countries and different interests advancing their own interests, rather than working together toward the common good of equity and health.

You’re talking about flourishing, and one of the things related to that is something called the “health capability paradigm.” What is that, and how does it fit into the broader idea of a “capabilities approach” to economics?

Well, the health-capability paradigm is a theoretical framework for justice and health, and that is at the domestic level. So, if you think about it in terms of an alternative to a free market, the free market is focussed on allocating goods and services in the economy at the domestic level based on people’s preferences, or their desires for things. So, whether we’re buying computers or phones or chairs or picture frames or whatever it is, we’re advancing our interests in terms of our preferences for those goods and services through the free market. And we’re regulating the market, to a certain extent, to protect consumers.

Alternatives to the free market are looking at a role for other institutions in promoting different goods that we have reason to value in society. The health-capability paradigm puts forward a framework that what we have reason to value—and what we have an interest in, societally and collectively—is people’s ability to flourish and their ability to be healthy. So are the conditions in place? Are there public-health systems and structures that are in place that enable that? Is there a health-care system in place that enables that? Do we have the social conditions, and do people have enough income, and is that income distributed in an equitable way so that people have this opportunity? Are people educated, and do they have jobs?

All of these conditions are necessary for people to be able to be healthy. And what are the principles of justice that apply to the health sector and health-care sector? And so we advanced an approach that looks at advancing a public-goods or common-goods approach to the health sector and health policy, as opposed to a private-goods or private-sector, market-based approach to health and health policy.

We have seen a lot of countries already ravaged by this pandemic. Some have health care that is at least relatively equitable—at least compared to most countries on earth—such as Italy, and others, like the United States, do not. Are there things that you’re noticing from this pandemic about why it’s so important to build as much equity into the system as possible?

Yes, I am noticing some real differences. What we have here is we have a set of natural experiments unfolding before us, right? You have a very good display of different kinds of approaches to public health domestically. And it’s within the context of a global public-health system, or lack of a system. So, for example, we have the contrast between what we would call two typologies. The first is a more centralized public-health policy that has more of a focus on equity and health, and looking across the population, as opposed to a more decentralized public-health policy.

There are real differences between the two, generally speaking. Centralized public-health policy is more planned. It’s more deliberate. It’s more intentional. There are several steps along the way. Centralized governance and authority tends to be federally located in terms of decisional latitude and authoritative standards with national guidelines and triggers. The decentralized public-health policy tends to be very ad hoc, more patchwork, unscripted. It tends to be spontaneous and reactive, and there tends to be a lot of voluntary actors in the mix. And we’re seeing in general a difference in, for example, the United States approach, which tends to be very decentralized, and countries like Taiwan or Singapore, which tend to be more centralized. Other differences are that under a centralized public-health policy you tend to have more uniform standards and uniformity in policies and practices.

So we had this huge variation in the decentralized standards with respect to testing, for example. In a decentralized approach, we have a lot of variations, considerable disorder, more disarray. It’s a little bit messier. And so these are very different approaches to the way we look at public-health policies at the domestic level.

How have these approaches played out during different epidemics?

A good example of that is what we see on the part of a more centralized public-health policy, which is the case of Taiwan. The Taiwanese learned their lessons from SARS, from the prior major outbreak that we had, and, as a result of learning from that, their approach tends to be much quicker. They’re much more alert, and they’ve been much more proactive to this current threat. In fact, they introduced a series of measures right away when they learned early about the severity of the respiratory illness that was coming out of the situation in China, and they started immediately inspecting passengers. They started some quarantine measures. They sent a team of experts, with permission from the Chinese, to fact-find and understand what was going on a little bit better. There was much more of a command, and a controlled set of actions that were introduced, and things were done very, very quickly. They also used technology, using mobile phones to assess people’s locations, and tracking people, and also to report travel history.

On the other side, you see the United States, and some advantages to what we would call regulatory approach. So we are now learning that some of the origins of the coronavirus came from wet markets in China. And that’s the current state of knowledge that we have. And we have in the United States highly regulated guidelines for the sale of different meat products in our food supply. And so we have an experience in the United States, over time, where we learned that the regulatory process is very effective. And it has been. We’ve had some outbreaks in the U.S. We’ve had E. coli, and we’ve had some salmonella and things like that. But for the most part we have been able to regulate our food supply in ways that have been effective for the public health.

So you’re saying that we don’t have the egalitarianism of care, or whatever the phrase might be, but we do have a certain amount of regulatory structure. Are there some countries that have both?

Sure. We are finding that in the European countries we haven’t seen the major outbreaks that are stemming from this lack of regulation, in markets or other kinds of supply chains. But we also have a more egalitarian set of health systems and public-health policies there, as well. Of course, different European countries are different, but, more or less, in the European Union, you do find countries that have a steep basis of solidarity and reciprocity and, some would even say, rights with regard to health care and health insurance in those countries. And they do have a greater effectuation of equity and equity principles in the health sector and health policy.

Your book also talks about places that are not as rich, specifically the Ebola epidemic in Liberia. What did Ebola teach you about these issues that you’re writing about, and specifically about health disparities?

We’ve learned a number of lessons from the Ebola epidemic. One that I think is very important is the recognition of the importance of public health and health-care systems. We know that, for example, in the United States, we actually did have cases of Ebola, but we didn’t have the extent of the cases, and we also were able to treat the cases effectively. We do have high-quality health care in the United States when you have the ability to purchase it, or if you have a very expensive health-insurance plan through your employer, or other kinds of mechanisms, but mostly employer-related health insurance.

And so having high-quality care is good, and we want that, but we want that for everybody on an equity-based or justice-based system, so we’re able to get people diagnosed and information is shared in a transparent and factual way.

We’ve learned that there are a lot of misinformation campaigns there. Certainly, there was misinformation being spread in the Ebola epidemic, about the way it was spread, and what would happen, and who people could and couldn’t be around, and things like that.

Another set of lessons is in terms of development assistance for health. We know that there has been a rapid increase over decades in the investments in health worldwide. There has been a lot of money going into global health, and going from donor countries, either multilaterally or bilaterally, to countries that have weaker health systems. The question is: How effective is that investment? Where is it going? And is it locally owned? Are countries able to develop their health systems and a horizontal capacity? Not just disease-specific, so not just for tuberculosis, or AIDS, or malaria. Are they able to develop their health systems and their health policy in a horizontal capacity, so that they can adjust the resources that they have for any particular epidemic that confronts them? That is a very important part of what we’re learning and understanding, and certainly what the book addresses.

The last part is the importance of the security piece of it. That’s why we see now a greater emphasis in the sustainable-development goals on universal health coverage and universal health insurance. Again, that’s across the entire health system. It’s not just for a particular disease.

What is your ultimate vision? It seems like it would be some global health system or set of rights, along the lines of the way a lot of people talk about universal human rights, which would be enforced with some sort of international legal system. What would be that vision, and what have you seen so far? Because, obviously, we do have the World Health Organization.

The World Health Organization is an important institution. It’s our main United Nations-based organization focussed on health. It is a state-based organization, so it gets its authority from the states around the world. It’s an international organization, and so states provide their interests and support through the World Health Assembly and that kind of a governance structure.

Unfortunately, the World Health Organization, however, is funded through internal support that is based on particular donors and interests, and seventy-five per cent or so is not based on the multilateral pooling system. So, in other words, the ability to make decisions collectively and to put resources toward those decisions collectively is about twenty-five per cent of what the World Health Organization is able to do. That severely compromises the institution. And what we see is other vested interests and other groups having a lot of power and influence through the organization in a way that is inconsistent with global health equity. So an alternative approach is looking at global health equity from the perspective of all individuals on the planet, over the whole entire seven billion people on the planet, and trying to figure out what kind of a structure, privileges, and conditions that individuals live in, regardless of where they are.

And we advanced two different infrastructures for that. We advanced the Global Health Constitution, which is a moral constitution, which is a set of principles of justice and health that sits above the World Health Organization. It’s a coördinating mechanism. It sets global standards and moral standards for the world, and it puts the World Health Organization in the context of all the other different organizations, N.G.O.s, nation-states, individuals themselves, in this collective exercise toward global health. The second institution that we advanced is a Global Institute of Health and Medicine. This institution is an independent organization that is scientifically based, and the reason that we need an institution like that is exactly relevant for the current situation: we need a global master plan of public health. We need to figure out what the major public-health threats are. And, by the way, emerging and zoonotic diseases are some of the most recent public-health threats.

What have you made specifically of the W.H.O. response to the coronavirus?

I think that what we’ve seen is that there’s been a significant underinvestment globally in what we have seen from the latest emerging threats. They’re coming from animals. And we know that. We’ve got SARS, coronavirus, Ebola. And yet we’re underinvesting in the science toward understanding what diseases are prevalent in animals, the scientific basis for the development of treatments and vaccines, and the coördination across different countries toward those endeavors. We do have some investment in it. We have some investment globally. We have some investments, for example, in the United States. We have a whole unit on that at the C.D.C. But we need to recognize, now more than ever, given this latest pandemic, that this is a major area for investment going forward.

Avenger Planet: Is the Covid-19 Pandemic Mother Nature's Response to Human Transgression?

By Michael Klare, TomDispatch

02 April 20

In case you hadn’t noticed, the exploding coronavirus pandemic (we’re #1!) has taken a tad of our attention lately and the definition of “the future” has largely become: When will this be over?

Not surprisingly, then, much real news about our future planet has largely gone missing in action. Take, for example, a story that's received next to no attention in this country, a report on the massive bleaching of Australia’s Great Barrier Reef this year thanks to record warming waters. Think of it as Australia’s oceanic equivalent of the staggering wildfires that burned through parts of that country in such an unprecedented fashion earlier in 2020. And coral reefs around the world, crucial to the life systems that rely on them (and that we humans rely on), are suffering similarly on a planet being transformed by human activity in ways large and small. Among those ways, none is worse than the burning of fossil fuels, still being promoted by governments run by arsonists like Donald Trump.

Almost nine years ago at this site, TomDispatch regular Michael Klare wrote what I now consider a prophetic piece, “The Planet Strikes Back.” In it, he focused on ways in which we humans have been inviting “the planet’s ire,” exploring in particular what was known then about the depredations of human-induced climate change. As he put it at the time, “We inhabit a new place, already changed dramatically by the intervention of humankind. But we are not acting upon a passive, impotent entity unable to defend itself against human transgression. Sad to say, we will learn to our dismay of the immense powers available to Earth, the Avenger.”

In the midst of the present global coronavirus pandemic, that old piece of his came to mind and I asked him to do a 2020 version of it. So take a deep breath, as so many of us sit here in self-isolation of one sort or another, and think with him about this moment, not to speak of similarly difficult moments to come, on a planet that is both endangered in radical ways and truly capable of striking back.

-Tom Engelhardt, TomDispatch

s the coronavirus sweeps across the planet, leaving death and mayhem in its wake, many theories are being expounded to explain its ferocity. One, widely circulated within right-wing conspiracy circles, is that it originated as a biological weapon developed at a secret Chinese military lab in the city of Wuhan that somehow (perhaps intentionally?) escaped into the civilian population. Although that “theory” has been thoroughly debunked, President Trump and his acolytes continue to call Covid-19 the China Virus, the Wuhan Virus, or even the “Kung Flu,” claiming its global spread was the result of an inept and secretive Chinese government response. Scientists, by and large, believe the virus originated in bats and was transmitted to humans by wildlife sold at a Wuhan seafood market. But perhaps there’s another far more ominous possibility to consider: that this is one of Mother Nature’s ways of resisting humanity’s assault on her essential life systems.

Let’s be clear: this pandemic is a world-shattering phenomenon of massive proportions. Not only has it infected hundreds of thousands of people across the planet, killing more than 40,000 of them, but it’s brought the global economy to a virtual stand-still, potentially crushing millions of businesses, large and small, while putting tens of millions, or possibly hundreds of millions, of people out of work. In the past, disasters of this magnitude have toppled empires, triggered mass rebellions, and caused widespread famine and starvation. This upheaval, too, will produce widespread misery and imperil the survival of numerous governments.

Understandably, our forebears came to view such calamities as manifestations of the fury of gods incensed by human disrespect for and mistreatment of their universe, the natural world. Today, educated people generally dismiss such notions, but scientists have recently been discovering that human impacts on the environment, especially the burning of fossil fuels, are producing feedback loops causing increasingly severe harm to communities across the globe, in the form of extreme storms, persistent droughts, massive wildfires, and recurring heat waves of an ever deadlier sort.

Climate scientists also speak of “singularities,” “non-linear events,” and “tipping points” -- the sudden and irreversible collapse of vital ecological systems with far-ranging, highly destructive consequences for humanity. Evidence for such tipping points is growing -- for example in the unexpectedly rapid melting of the Arctic icecap. In that context, a question naturally arises: Is the coronavirus a stand-alone event, independent of any other mega-trends, or does it represent some sort of catastrophic tipping point?

It will be some time before scientists can answer that question with any certainty. There are, however, good reasons to believe that this might be the case and, if so, perhaps it’s high time humanity reconsiders its relationship with nature.

Humans vs. Nature

It’s common to think of human history as an evolutionary process in which broad, long-studied trends like colonialism and post-colonialism have largely shaped human affairs. When sudden disruptions have occurred, they are usually attributed to, say, the collapse of a long-lasting dynasty or the rise of an ambitious new ruler. But the course of human affairs has also been altered -- often in even more dramatic ways -- by natural occurrences, ranging from prolonged droughts to catastrophic volcanic activity to (yes, of course) plagues and pandemics. The ancient Minoan civilization of the eastern Mediterranean, for example, is widely believed to have disintegrated following a powerful volcanic eruption on the island of Thera (now known as Santorini) in the 17th century BCE. Archaeological evidence further suggests that other once-thriving cultures were similarly undermined or even extinguished by natural disasters.

It’s hardly surprising that the survivors of such catastrophes often attributed their misfortunes to the anger of various gods over human excesses and depredations. In the ancient world, sacrifices -- even human ones -- were considered a necessity to appease such angry spirits. At the onset of the Trojan War, for example, the Greek goddess Artemis, protectress of wild animals, the wilderness, and the moon, stilled the winds needed to propel the Greek fleet to Troy because Agamemnon, its commander, had killed a sacred deer. To appease her and restore the essential winds, Agamemnon felt obliged -- or so the poet Homer tells us -- to sacrifice his own daughter Iphigenia (the plot line for many a Greek and modern tragedy).

In more recent times, educated people have generally seen coronavirus-style calamities as either inexplicable acts of God or as explicable, if surprising, natural events. With the Enlightenment and the Industrial Revolution in Europe, moreover, many influential thinkers came to believe that humans could use science and technology to overpower nature and so harness it to the will of humanity. The seventeenth-century French mathematician René Descartes, for example, wrote of employing science and human knowledge so that “we can... render ourselves the masters and possessors of nature.”

This outlook undergirded the view, common in the last three centuries, that the Earth was “virgin” territory (especially when it came to the colonial possessions of the major powers) and so fully open to exploitation by human entrepreneurs. This led to the deforestation of vast areas, as well as the extinction or near-extinction of many animals, and in more recent times, to the plunder of underground mineral and energy deposits.

As it happened, though, this planet proved anything but an impotent victim of colonization and exploitation. Human mistreatment of the natural environment has turned out to have distinctly painful boomerang effects. The ongoing destruction of the Amazon rain forest, for example, is altering Brazil’s climate, raising temperatures and reducing rainfall in significant ways, with painful consequences for local farmers and even more distant urban dwellers. (And the release of vast quantities of carbon dioxide, thanks to increasingly massive forest fires, will only increase the pace of climate change globally.) Similarly, the technique of hydraulic fracking, used to extract oil and natural gas trapped in underground shale deposits, can trigger earthquakes that damage aboveground structures and endanger human life. In so many ways like these, Mother Nature strikes back when her vital organs suffer harm.

This interplay between human activity and planetary behavior has led some analysts to rethink our relationship with the natural world. They have reconceptualized the Earth as a complex matrix of living and inorganic systems, all (under normal conditions) interacting to maintain a stable balance. When one component of the larger matrix is damaged or destroyed, the others respond in their unique ways in attempting to restore the natural order of things. Originally propounded by the environmental scientist James Lovelock in the 1960s, this notion has often been described as “the Gaia Hypothesis,” after the ancient Greek goddess Gaia, the ancestral mother of all life.

Climate Tipping Points

Posing the ultimate threat to planetary health, climate change -- a direct consequence of the human impulse to dump ever more greenhouse gases into the atmosphere, potentially heating the planet to the breaking point -- is guaranteed to generate the most brutal of all such feedback loops. By emitting ever more carbon dioxide and other gases, humans are fundamentally altering planetary chemistry and posing an almost unimaginable threat to natural ecosystems. Climate-change deniers in the Trumpian mode continue to insist that we can keep doing this with no cost to our way of life. It is, however, becoming increasingly apparent that the more we alter the climate, the more the planet will respond in ways guaranteed to endanger human life and prosperity.

The main engine of climate change is the greenhouse effect, as all those greenhouse gases sent into the atmosphere entrap ever more radiated solar heat from the Earth’s surface, raising temperatures worldwide and so altering global climate patterns. Until now, much of this added heat and carbon dioxide has been absorbed by the planet’s oceans, resulting in rising water temperatures and the increased acidification of their waters. This, in turn, has already led to, among other deleterious effects, the mass die-off of coral reefs -- the preferred habitat of many of the fish species on which large numbers of humans rely for their sustenance and livelihoods. Just as consequential, higher ocean temperatures have provided the excess energy that has fueled many of the most destructive hurricanes of recent times, including Sandy, Harvey, Irma, Maria, Florence, and Dorian.

A warmer atmosphere can also sustain greater accumulations of moisture, making possible the prolonged downpours and catastrophic flooding being experienced in many parts of the world, including the upper Midwest in the United States. In other areas, rainfall is decreasing and heat waves are becoming more frequent and prolonged, resulting in devastating wildfires of the sort witnessed in the American West in recent years and in Australia this year.

In all such ways, Mother Nature, you might say, is striking back. It is, however, the potential for “non-linear” events and “tipping points” that has some climate scientists especially concerned, fearing that we now live on what might be thought of as an avenging planet. While many climate effects, like prolonged heat waves, will become more pronounced over time, other effects, it is now believed, will occur suddenly, with little warning, and could result in large-scale disruptions in human life (as in this coronavirus moment). You might think of this as Mother Nature saying, “Stop! Do not go past this point or there will be dreadful consequences!”

Scientists are understandably cautious in discussing such possibilities, as they are harder to study than linear events like rising world temperatures. But the concern is there. “Large-scale singular events (also called ‘tipping points,’ or critical thresholds) are abrupt and drastic changes in physical, ecological, or social systems” brought about by the relentless rise in temperatures, noted the U.N.’s Intergovernmental Panel on Climate Change (IPCC) in its comprehensive 2014 assessment of anticipated impacts. Such events, the IPCC pointed out, “pose key risks because of the potential magnitude of the consequences; the rate at which they would occur; and, depending on this rate, the limited ability of society to cope with them.”

Six years later, that striking description sounds eerily like the present moment.

Until now, the tipping points of greatest concern to scientists have been the rapid melting of the Greenland and West Antarctic ice sheets. Those two massive reservoirs of ice contain the equivalent of hundreds of thousands of square miles of water. Should they melt ever more quickly with all that water flowing into neighboring oceans, a sea level rise of 20 feet or more can be expected, inundating many of the world’s most populous coastal cities and forcing billions of people to relocate. In its 2014 study, the IPCC predicted that this might occur over several centuries, at least offering plenty of time for humans to adapt, but more recent research indicates that those two ice sheets are melting far more rapidly than previously believed -- and so a sharp increase in sea levels can be expected well before the end of this century with catastrophic consequences for coastal communities.

The IPCC also identified two other possible tipping points with potentially far-reaching consequences: the die-off of the Amazon rain forest and the melting of the Arctic ice cap. Both are already under way, reducing the survival prospects of flora and fauna in their respective habitats. As these processes gain momentum, entire ecosystems are likely to be obliterated and many species killed off, with drastic consequences for the humans who rely on them in so many ways (from food to pollination chains) for their survival. But as is always the case in such transformations, other species -- perhaps insects and microorganisms highly dangerous to humans -- could occupy those spaces emptied by extinction.

Climate Change and Pandemics

Back in 2014, the IPCC did not identify human pandemics among potential climate-induced tipping points, but it did provide plenty of evidence that climate change would increase the risk of such catastrophes. This is true for several reasons. First, warmer temperatures and more moisture are conducive to the accelerated reproduction of mosquitoes, including those carrying malaria, the zika virus, and other highly infectious diseases. Such conditions were once largely confined to the tropics, but as a result of global warming, formerly temperate areas are now experiencing more tropical conditions, resulting in the territorial expansion of mosquito breeding grounds. Accordingly, malaria and zika are on the rise in areas that never previously experienced such diseases. Similarly, dengue fever, a mosquito-borne viral disease that infects millions of people every year, is spreading especially quickly due to rising world temperatures.

Combined with mechanized agriculture and deforestation, climate change is also undermining subsistence farming and indigenous lifestyles in many parts of the world, driving millions of impoverished people to already crowded urban centers, where health facilities are often overburdened and the risk of contagion ever greater. “Virtually all the projected growth in populations will occur in urban agglomerations,” the IPCC noted then. Adequate sanitation is lacking in many of these cities, particularly in the densely populated shantytowns that often surround them. “About 150 million people currently live in cities affected by chronic water shortages, and by 2050, unless there are rapid improvements in urban environments, the number will rise to almost a billion.”

Such newly settled urban dwellers often retain strong ties to family members still in the countryside who, in turn, may come in contact with wild animals carrying deadly viruses. This appears to have been the origin of the West African Ebola epidemic of 2014-2016, which affected tens of thousands of people in Guinea, Liberia, and Sierra Leone. Scientists believe that the Ebola virus (like the coronavirus) originated in bats and was then transmitted to gorillas and other wild animals that coexist with people living on the fringes of tropical forests. Somehow, a human or humans contracted the disease from exposure to such creatures and then transmitted it to visitors from the city who, upon their return, infected many others.

The coronavirus appears to have had somewhat similar origins. In recent years, hundreds of millions of once impoverished rural families moved to burgeoning industrial cities in central and coastal China, including places like Wuhan. Although modern in so many respects, with its subways, skyscrapers, and superhighways, Wuhan also retained vestiges of the countryside, including markets selling wild animals still considered by some inhabitants to be normal parts of their diet. Many of those animals were trucked in from semi-rural areas hosting large numbers of bats, the apparent source of both the coronavirus and the Severe Acute Respiratory Syndrome, or SARS, outbreak of 2013, which also arose in China. Scientific research suggests that breeding grounds for bats, like mosquitoes, are expanding significantly as a result of rising world temperatures.

The global coronavirus pandemic is the product of a staggering multitude of factors, including the air links connecting every corner of the planet so intimately and the failure of government officials to move swiftly enough to sever those links. But underlying all of that is the virus itself. Are we, in fact, facilitating the emergence and spread of deadly pathogens like the Ebola virus, SARS, and the coronavirus through deforestation, haphazard urbanization, and the ongoing warming of the planet? It may be too early to answer such a question unequivocally, but the evidence is growing that this is the case. If so, we had better take heed.

Heeding Mother Nature’s Warning

Suppose this interpretation of the Covid-19 pandemic is correct. Suppose that the coronavirus is nature’s warning, its way of telling us that we’ve gone too far and must alter our behavior lest we risk further contamination. What then?

To adapt a phrase from the Cold War era, what humanity may need to do is institute a new policy of “peaceful coexistence” with Mother Nature. This approach would legitimize the continued presence of large numbers of humans on the planet but require that they respect certain limits in their interactions with its ecosphere. We humans could use our talents and technologies to improve life in areas we’ve long occupied, but infringement elsewhere would be heavily restricted. Natural disasters -- floods, volcanoes, earthquakes, and the like -- would, of course, still occur, but not at a rate exceeding what we experienced in the pre-industrial past.

Implementation of such a strategy would, at the very least, require putting the brakes on climate change as swiftly as possible through the rapid and thorough elimination of human-induced carbon emissions -- something that has, in fact, happened in at least a modest way, and however briefly, thanks to this Covid-19 moment. Deforestation would also have to be halted and the world’s remaining wilderness areas preserved as is forever. Any further despoliation of the oceans would have to be stopped, including the dumping of wastes, plastics, engine fuel, and runoff pesticides.

The coronavirus may not, in retrospect, prove to be the tipping point that upends human civilization as we know it, but it should serve as a warning that we will experience ever more such events in the future as the world heats up. The only way to avert such a catastrophe and assure ourselves that Earth will not become an avenger planet is to heed Mother Nature’s warning and cease the further desecration of essential ecosystems.

Michael T. Klare, a TomDispatch regular, is the five-college professor emeritus of peace and world security studies at Hampshire College and a senior visiting fellow at the Arms Control Association. He is the author of 15 books, including the just-published All Hell Breaking Loose: The Pentagon’s Perspective on Climate Change (Metropolitan Books).

Follow TomDispatch on Twitter and join us on Facebook. Check out the newest Dispatch Books, John Feffer’s new dystopian novel (the second in the Splinterlands series) Frostlands, Beverly Gologorsky's novel Every Body Has a Story, and Tom Engelhardt's A Nation Unmade by War, as well as Alfred McCoy's In the Shadows of the American Century: The Rise and Decline of U.S. Global Power and John Dower's The Violent American Century: War and Terror Since World War II.