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The numbers speak for themselves

Are Brean (View bio)

«Post-truth» was the Word of the Year in 2016. It ought not to be in 2017.

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Photo: Einar Nilsen

Language reflects reality. «Post-truth», in our country also called «post-factual», has been selected as Word of the Year 2016 by Oxford Dictionaries (1). Post-truth refers to circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal beliefs (1).

But post-truth has not been the greatest concern in 2016 for those 65 million – close to 1 % of the world’s population – who have been driven from their homes because of war and conflict (2). This is the largest proportion of displaced persons ever recorded by the UN High Commissioner for Refugees. For these, and for the even larger number who have been forced to stay behind, the cruelty of war is a painful reality.

In 2016, Syria was again the site of the greatest refugee tragedy. The UN High Commissioner has referred to the situation as «the biggest humanitarian and refugee crisis of our time» (3). Altogether more than 13 million people have been internally displaced or driven out of Syria since 2011 (3). Two-thirds of those who are left inside the country have no access to clean water, and rapidly declining vaccination rates increase the risk of diseases such as diphtheria and cholera (2). While the global community stands powerless by and the warring parties fight to apportion blame, Doctors Without Borders have in 2016 alone recorded 47 attacks against the hospitals that they support in Syria (4). In a dirty war without parallel, even health personnel have been made targets (5).

The unrest in the region has been reflected in an increasing number of terrorist attacks. In Europe, France was hit hardest in 2016. From 2004 to 2011 there were nine terrorist attacks on French soil, resulting in a total of 11 deaths. In 2016, the country suffered 12 terrorist attacks that caused a total of 90 deaths (6). As a cruel finale to the insecurity felt by the world in 2016, the year of terror ended with the attack on a nightclub in Istanbul on the last night of the year, in which at least 39 people were killed.

In terms of global health and security, 2016 was not without any bright spots, however, largely due to coordinated efforts across national borders: Polio is another step closer to eradication, with only 35 registered cases in 2016 (7). A large outbreak of yellow fever in the Democratic Republic of Congo and Angola was successfully halted thanks to the coordinated vaccination of 30 million inhabitants (8). In December, we received the final confirmation – headed by Norway – that the Ebola vaccine is just as effective as the first reports had indicated (9).

Moreover, as a welcome counterpoint to 2016 as the year of post-truth reality, the results from the Global Burden of Disease study were submitted (10). The sustainability goals of the UN’s Agenda 2030 have been criticised for being difficult to measure. With this, however, the world has obtained a tool to better quantify the global effort for health. As a local counterpoint, Norad, the Centre for Global Health at the University of Oslo and the Journal of the Norwegian Medical Association are now inviting submissions for a series of articles on global health (11). The articles will appear as a continuous series in the Journal of the Norwegian Medical Association during the second half of 2017.

Oxford Dictionaries had a twofold reason for selecting «post-truth» as its Word of the Year: the American presidential campaign and the UK referendum on leaving the EU (1). These political processes had at least two features in common: both were dominated by emotions and rhetoric rather than by facts. Moreover, health was an underlying factor in both of them: one of the main (but false) assertions put forward by the victorious Brexit campaign was that leaving the EU would free up GBP 350 million per week to spend on the beleaguered British health services (12). In the USA, an estimate made by the University of Washington showed that the five health measures of obesity, diabetes, high alcohol consumption, low level of physical activity and low life expectancy in combination were among the strongest predictors of a high voter preference for Trump (13).

Many of the world’s greatest challenges will also be associated with health in 2017. In a complex world, more and better facts about health are needed more than ever. Facts make it easier to target the efforts – and to see their effects. We cannot afford to let 2017 become a year of post-truth.

1

Word of the year 2016 is… English Oxford Living Dictionaries. https://en.oxforddictionaries.com/word-of-the-year/word-of-the-year-2016 (1.1.2017).

2

Mohammadi D. 2016: year in review. Lancet 2016; 388: 2971 – 2. [PubMed] [CrossRef]

3

Syria Emergency. The UN Refugee Agency. www.unhcr.org/syria-emergency.html (1.1.2017).

5

Slagstad K. Også krig har regler. Tidsskr Nor Legeforen 2016; 136: 891. [PubMed]

6

Horton R. Offline: November 13, one year on. Lancet 2016; 388: 2335. [PubMed] [CrossRef]

7

Polio Eradication Initiative. Polio this week as of 28 December 2016. http://polioeradication.org/polio-today/polio-now/this-week/ (2.1.2017).

8

The Lancet. 2017: The unifying power of health. Lancet 2016; 288: 2959. [PubMed]

9

Henao-Restrepo AM, Camacho A, Longini IM et al. Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Suffit!). Lancet 2016. E-publisert 23.12.2016. [PubMed]

10

Reddy KS. Global Burden of Disease Study 2015 provides GPS for global health 2030. Lancet 2016; 388: 1448 – 9. [PubMed] [CrossRef]

11

Call for papers to an Article Series on Global Health 2017. UiO Institute of Health and Society. www.med.uio.no/helsam/english/research/centres/global-health/article-series/index.html (2.1.2017).

12

Eight reasons Leave won the UK’s referendum on the EU. BBC 24.6.2016. www.bbc.com/news/uk-politics-eu-referendum-36574526 (2.1.2017).

13

Illness as indicator. Local health outcomes predict Trumpward swings. The Economist 19.11.2016. www.economist.com/news/united-states/21710265-local-health-outcomes-predict-trumpward-swings-illness-indicator (1.1.2017).

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