Hans Rosling's presentation at the WTO

thank you very much it is an humbling honor to be invited to speak in front of you I'm a professor of global health rather to be precise a recently retired professor in global health and and I I know that I'm not here because I know the content more than anyone else in the room not at all but I think I will introduce myself not as that famous data speaker but as the most important representative in this room I represent the patients this photo is taken at the University Hospital in Stockholm it's an hepatitis C patient and his doctor dr. dalen our professor and hepatology and it's on the 16th of January 2014 indeed it is me I've had a lifelong hepatitis C infection since childhood I have a full-blown cirrhosis f4 and I was going down in decompensation 2012 2013 of the failure with interferon treatment I was dreaming and hoping for the new hepatitis C drugs I was in the front of the queue to get them and 16th of January the first prescription ever in Sweden was written at 8:30 in the morning and I was the patient and I had them been searching for compassionate use of this I tried to move to any country in the world to get into clinical trial but I just didn't fit I was too sick or I was too healthy or I was too old or I was too young I just didn't fit in any clinical trial and my problem was that I needed more than the sovaldi I'm a lucky man I live in Sweden where if you have a severe form of hepatitis C infection with a lot of complications this indeed you get the drug free this is the $1,000 a day drug that I get the prescription I got six-month free treatment I thank the Swedish taxpayers but I needed the other drag also see me previa I had to go together with it and that was still not registered in the European Union although it was developed at a little startup at the Karolinska Institute my real University just about one kilometer from where I'm working but I couldn't get it and I applied for compassionate use and I didn't get it so I had to fly to Japan and with my dear colleague in global health I was introduced and booked a time with dr. Kasumi at the Navitus clinic for travel medicine and according to all rules and regulations I got the three-month prescription of Samia privy and I paid out on my pocket and unfortunately it was half price in Japan compared to Europe and of course I did everything legally you are allowed in Sweden to enter the country with three-month prescription or the drug that has been prescribed to yourself after seeing the doctor you cannot go abroad to buy it yes you have to see the doctor and I was not allowed to have a six-month drug I had to fly back to get the last three months so this is how dramatic it is so having spent decades of my life trying to understand how drug innovation and drug supply should be organized in the world I had to do the problem-based learning myself and Here I am more than one year of the treatment I'm absolutely free of hepatitis C I'm cured and my liver had improved essentially I feel better than I've done in the last 15 to 20 years this is really important what you are doing and I was running wrong along the lake this morning and I haven't been running for 10 15 years so I accept if I the importance of what you are doing and I could not more than anyone else say how important it is that all people who suffer from a disease who are threatened by your disease have the change chance as I had as I had worked almost all my life in in in low-income countries and close to extreme poverty it's humbling to others see me previa is what I got that it's that combination that that saved me now what I want to do here is instead of talking about the core issue or the of the conference I'm going to give you a background how the world is how is our converging world because I call it a converging world where countries actually are getting more and more similar the inequities in the world or decreasing they may be increasing within countries but in the world as a whole they are decreasing and I used to put questions about this but having such a respectful audience today I didn't distribute the answering devices to you but I think I have some set of question and get mine the foundation where I work we have effect fulness project we want to produce fact fulness yes it is a new word in the English language that we have offered it is the idea that you should grasp more or less how things are it's easier that if you base your idea of fact instead of preconceived ideas and ideologies and just look at these questions about the world how many out of 10 people in the world as a whole have electricity at home is it is it one is it five out of 10 that is 50 percent or is it eight nine is it it's not 100 percent I can tell you can I have a little guest by show of hands how many think it's one out of ten how many think it's two out of ten how many think is three out of ten how many think it's four out of ten how many would guess four five out of ten how many things six out of ten how many things seven out of ten how many eight out of how many ninth out of ten it's interesting you answered more or less the same I got I was with Fox News in in in u.s. I was with we live a conference of maternal health and newborn health I've been at big banks it's more or less the same very few people get it the way it is how many out of ten girls in this world are in primary school that is primary school the first four years or the first six years little different in countries meaning girls between h 7h 13 how many after 10 girls are enrolled in school primary school is it 1 out of 10 is it 2 out of 10 3 out of 10 4 5 6 7 8 9 its interest is good you invited me it's 8 out of 10 that has electricity at home and 9 out of 10 girls are enrolled in primary school you are roughly about 25 to 40 years behind your time the way you raise your hands it's interesting because the way you answer this not like wrong it's exactly as it was some decades ago the world is changing electricity is on top of the list of families around the world because there are some few studies unfortunately but listen carefully now having electricity at home improved child survival almost as much as the vaccines just imagining how it improves hygiene when some of the children have diarrhea or vomiting night you can clean up before the siblings have stepped into it and and you can mend the children's clothes in the evening so there are things competing with our drugs and vaccines in improving health you know and and incurrence are in school of course they are women across the world are fighting for their rights and they are successful they step forward and we don't know it that's also very typical progress of women's are not recognized then does it mean that gender is yours not at all it's even worse today because the gender inequity have moved from age 7 to age 13 age 40 and then young girls and young woman's are stopped in the most brutal ways in so many places so so this way of understanding how the world has changed is important I used to ask how many children will there be in the world by the end of this century because UN Population division has made a forecast on which almost all demographers agree it's not sure but more or less the other three options here I have made up look when I was born there was less than 1 billion children in the world children being 0 to 15 it increased like this to the turn of the century 2 billion children 2000 million children in the world now what happens in this world I have also get mine the foundation have made web based services in Sweden they answer like this Norway answer like this Britain like this America like this can you see how well you can study knowledge by web based service these days they have about 10 seconds to reply so they can't use their smartphones and and you get with different web-based survey companies in different countries you get almost the right the same response rate 10% think that number of children stopped increasing 45 30 to 40 percent think it really increase a little slower and about half of them think it will continue increase as it has there's more and more children in the world every day now the interesting thing is that this is the right answer the number of children in the world have stopped increasing it's the biggest event in the history of mankind that was ever completely missed by media there's so many things happening out there in the homes that media's missing education is missing and even a lot of highly professional people in different sectors are missing why is this because most of the young couple under their pillow has either a condom or a pill it's as simple as that 8 out of 10 remember 8 out of 10 yeah and how many of the world children are vaccinated against measles well this is how the Swedes answer this is how to Norway answer this is our us answer and this is the right answer so one only or who is professor of global health in that country so much for my success so much for my success in presenting data we are in a uphill struggle of just keeping up with what happens in the world and when you argue for your wise solution and it's really or in the challenge we are proud now in stock on I'm a member of the Swedish Academy of Science that picked the Nobel Prizes we are proud to award those drugs against parasites we are proud to award the economists now return who has studied poverty you know and we want to award you the price in economics when you have come up with a new business model that can solve this so that we get investments into innovation and we get a business system that everyone who needs to drugs then get access and we return a profit to the investors that's what we want to see when you have found that up you are welcome to stock on and we'll celebrate and life expectancy in the world what is that this is a nice question because I give the answer here Japan has 83 years and unfortunately here I think this was two years ago 48 years lost estimate for for Lesotho somewhere the worst of countries are somewhere between 45 and 50 what is it in the world as a whole in the world as a whole life expectancy is 71 years and the interesting thing with that is that the life expectancy of the world population is closer to the best country than to the worst country we have a skewed distribution of health in the world that is skewed towards the best that's for health for economy it's the other way around so we in public health we can boast we did better than the economists we skewed the world health towards the better but those who deal with the wallet they haven't been as successful but then my friends who are professors in the comics they say yeah that's because you die you know but the real good capital that keeps living forever you know so it's that limit we have for life expect this is so no matter what you know eventually you will die so let me start by showing you the income distribution of the world we have done the following software here in Gapminder and I will try to show it to you in this way didn't change so rapidly because it was mostly the rich who benefited from it even in Britain the children were still down the coal mine and then it started in the next century it dragged away and we got this peculiar income distribution which was at its peak in 1970 we had the poor and we had the rich it was two humps I call it the camel world with two humps and the rich were somewhere between 10 to $20 a day in purchasing power here and the poor was below the poverty line this was the world i met when i was a student and i studied in sweden i studied in india and we saw the world the income distribution of the world after that when it started to converge we called it globalisation but this is the exception historically this is the exception it was a short blink of time in the history of humans some few generations when some countries and region had a distinctly different economic level from the rest of the world that's not how it used to be it was a few few generations and look what has happened here look what has happened when they get more people in Asia and Africa there and now China start the drive forwards the Asian Tigers follow the African lions follows and they we are today no more camel the camel is dead it's a dromedary world we job was one big hump and on the other side of the hump still almost a billion people in extreme poverty and the sunny side the best of where people get their a apatite ICI drugs as soon as they get on the market and they get them subsidized if you are a lucky sweet listen and most people live here in the middle how do we handle how do we conceptualize this world that's what I'm going to to talk about here and I go backwards there yes to show you how this was distributed between the continent as you see on the map up there red is Asia yellow Europe blue Africa green America this was Asia this was Africa this was Americas this was Europe West Europe North American that way Japan and Australia Gapminder foundation is an independent organization we stay away from from business we stay away from government so we can decide which country belongs to which region and we decided that Australia is Asians we think they have to get used to that no and we decided that Turkey was European otherwise Europe would be so small so he has recruited Turkey to get to get the better size of Europe I apologize if her mom is offended by it but this way of looking at things now the interesting thing if I'm honest and I mark the United States can you see that back then I can make the other ones a little listen less intense back then there was almost no overlap in the 1970s the best of in China and the worst of black people in rural Mississippi were more or less on the same level and look what has happened in the first 20 years from 1970 here to 1990 not so much happens because when China starts to grow with these sedating numbers 10% of year but they grow from a low level you don't make much difference that was Africa's experience today very nice percentages but percentages adding to a very low income it doesn't bring you fast forward you have to keep that percentages for decades and decades and decades and and here's still a very modest overlap but look now what happens when China moves on China moves on here and Asia follows India's following here and and and today you can now see that the most Chinese are better than the worst of in United States the majority of the Chinese population is better than the sort of average here you know somewhere here there are still few Chinese that but give them another two decades another three decades and you have a completely new world that talked about slowing down in China is an illusion the you can watch the growth of China going down low from this eight nine percent going down to five six percent that's a sign of success because I'll rather have 6% growth of $10 dollars a day than have nine percent growth of $4,000 and these countries over here just have a modest two or three percent I mean we celebrate in Europe in some country two percent growth so the whole corns we have real division is a very difficult way of counting arithmetic I found out so you have to understand what this is so what we saw was a converging world let me show you what I consider the biggest change in our time the biggest change on our at our time is here babies born per woman back in history it was six babies born per woman that's the normal for humans breastfeeding the way it was sort of by nature intended for humans is two to three years and you get between the conceptions you get about three years you get children 3 to 4 years interval on average 6 per woman some women didn't get any children others got many more for different reasons but average was six you go to the rain forest today you see six children five to six children per woman and then it didn't change much from 1899 I was a college students here 1965 is still five children per woman in the world and why do I take this yes because decreasing the number of children per woman means confidence that children will survive the new idea I'm not proud of how many children I have as a father I'm proud of how well my children are doing and that means for parents for communities for countries for the world investing a lot in each child and helping them to go forward and of course having that condom and that peel below the pillow you know to make it happen so what has happened in the world since 1965 and these data are very good data this is what happened we are down to 2.5 and that's what made the number of children stop increasing which has not been communicated and we know that this will happen we don't know reader how fast and we don't know at which level we will end off we have two children per woman with the world be like Sweden or like Germany Sweden two children per woman Germany 1.5 and here if I divided it in region Europe like everything that happens in Europe didn't happen fast it just started early nothing in Europe's progress was fast it was slow but started early America started later they had the baby boom and then they came down at to Europe is below the replacement level with less than present birth rate in Europe Europe need to double the immigrants and refugees that come in order to keep the population that's why I added Turkey without Turkey Europe doesn't have a chance to keep up yeah I'm a traditional politician I'm not head of an organisation not disabled sorry yes stand beside and observe and Asia mainly got scared Paul Ellis talked about population bombin and this happen China today one point-six India 2.5 the number of children in India stopped increasing almost all girls we are talking 98 99 percent are in school of course those schools for girls some are a miserable quality some even don't have teachers everything but the first step is you get them there they start learning now quality in STG you lead SDG goals now it's to have quality of education and then Africa and many people say well Africa is not changing you just keep up it's coming down change is just rapidly happening and we know that this will happen we don't know how fast Africa will come down we don't know level we will end up it but this is more or less known and I will show you now this four countries I will show you how it changed from the old balance when population did not grow because parents got six children on average and it should triple shouldn't it two parents get six children population should grow like this this is what you see in rainforests but you see no people why because in history and in rainforest today tragically four children died before growing up to become parents themselves it's utterly tragic humans have never ever lived in ecological balance with nature we have only been dying in ecological balance with nature people in the rainforests do not live in ecological balance in nature they die in ecological balance with nature utterly tragic for the first time in history with SDGs we are seeing a glimmering hope in the future that we can live in ecological balance with nature if we produce what we need in a much more clever way and if we become sustainable and what happened with the Industrial Revolution was not that we got less children this is what was in Sweden 150 years ago my grandparents they had 8 children 8 babies born but less died more survived and so the Swedish population was growing the population in the world was growing 25% of the Swedes crossed the Atlantic as both refugees my great-great grandma ground outside Newfoundland not reaching land we are a family of both migrants that died on passage some of them and and here the population increased Sweden filled up Minnesota and we became seven billion in the world it's a short world history I'm making lists and and here what we are now hoping for is to reach the new balance the old balance was controlled by death no good drugs no vaccine no good hygiene the new balance is controlled by love that enormous ability we have due to this new technology to dis to separate reproduction and sexuality the the the intimacy of sexuality can keep a couple together you know and they can decide which night to make love and have sex and which night to make a baby that's fantastic its enormous ly here's a man who's still married to his teenage love you know and and having that living with that possibility you know we are now seeing a new future coming and this is an enormous change in the world and we know that we will end up like this there will be four billion more because of the composition of the world population this is how are distributed today 1 billion in America 1 in Europe one in Africa for in Asia and and and here the pincode is one one one for it will change 2015 no more in Europe and America but one more in Asia and by that the first population growth is over in Asia and Africa will double its population in 35 years and and and up to the end of the century no more in America Europe and Asia and probably three or perhaps four billion more in Africa so it's very clear that the relation between Europe and Africa will change and I have a clear advice to the Europeans already today start being polite to Africans because anyhow if they will be partners friends or enemies anything they'll outnumber the Europeans they will outnumber them so it's better not imitating them the children will not increase but the adults will increase how is that possible how can the adults increase with 4 billions without having any more children we have reached peak child it's because of this now this is deep demography here each figure here is now 100 million 100 million people and these are the European sea age 15 30 45 and 60 this is Europe same amount of people in all age groups these are the children the young adults older adults here in this area I'm in this group 60 plus in Europe America almost the same they are just lacking retired people here in South America it will be filled up in 15 years they will be there look at Africa already today more children than the entire Europe and America together now you see why Europe needed Turkey otherwise it would be too small here this is Africa and even if Africa by some strange magic or whatever will start having two children per woman tonight the real African population will still double can you see that these people are not missing because they died only a few because they died most because they were never born this is like a population pyramid spread out and in Asia the number of children have stopped increasing remember that hit - they hit - now and Africa children is still increasing because they are at 4 so this is what happens in yeah you know in spite of all your drugs the old people die the rest grow older and they have children 15 years have passed the old die the rest grow older and they have children can you see more and more children in Africa less and less in Asia that's why the number of children don't increase and then they all die the rest grow older and they have their children when 2060 they all die the rest grow older and they have their children this is the inevitable fill up of adults the graying of the population in Asia and then just a little a stir in Africa is not you to longer life we already live 71 years on average in this world in China already life expectancy is 75 it's just because of this the demographers call it demographic momentum we call it in Gapminder the big inevitable fill-up of adults these people will be added anyhow and there are these activists who are concerned about the environment who still this day say that you have to stop world population from growing there's no way we can stop this if we are not going to start to kill it's very strange how low the knowledge is about this and this is taking into consideration that fertility rates will be dropping in Africa like this it may happen faster but it may also be that Asian women start getting more children it's not absolutely clear that its lack of gender equity that makes educated asian women marry late if ever and have few children it's not China one-child policy is not it China has China's like 1.6 children per woman with that government policy whereas Taiwan that part of China leave the politics out that part they have one child per woman without any government saying anything to them and Hong Kong has one child per woman because because they they have good access to education for women exist to to work to advance work but patriarchal family values which they wrongly label Asian values they are not they are all patriarchal values which we have had all over the world and we still have more or less I should be more correct saying so this is more or less how the world population there will be longer live soldier I have filed an application to become this one no because I can follow statistics for more years and and and we don't know we really don't know how fast Africa may surprise us in a very fast progress it's there or demographic Institute to say that Africa may dumb down faster so if you look at this like this now GNI per capita let me show you G and I per capita on this axis thousand four thousand thirteen thousand hundred thousand dollar per capita each bubble is a country here and this is length of life I put it here 50 years 60 years 70 years 80 years we have an enormous distribution we have Congo there we have Afghanistan there we have we have this is Qatar to us in Sweden is very irritating that this is Norway Sweden is somewhere here you know they take about 5 to 8 percent of our medical doctors go directly to Norway after we graduate them because salaries are so much nice people are was a little nicer in Norway that's also irritating they have a nutball relaxed at that you dissolve a very beautiful country so it's difficult to compete with them but can you see that we have countries all the way it's a converging world it's not a developed and developing world please stop using the concept developing countries because it has no meaning if I cut this line here at $13,000 to be precise 12700 G and I per capita exchange rate these are the high-income countries it's 1 billion people living in the high-income countries here on this side if I drew another line at $1000 I get the low income countries here 1 billion there are still professionals who use low income countries as a synonym for developing countries exposing enormous ignorant about economy most people in the world live in between here 5 billion people and that group is too big to be handled as one unit talking about middle-income countries is too big let's draw a line in the middle between upper and lower but the Papapa Papapa that was not planned no upper middle income lower middle can you see two and a half billion with China two and a half billion with India and can you see here how health life expectancy improve with money that's why I love money as a professor of public health at the Nobel Prize awarding institution I love money because we know how to use it and if you have all the knowledge what you want to do and you don't have the money you get very little even poor households need money to buy soap and we need money we need to see how to use it the low-income countries have a life expectancy of 59 this is their level some are doing better some are doing worse that is how well they use their money lower middle income countries they have a life expectancy of 67 can you see it's 8 years better some are not so effective in using they are big in equities Vietnam up there is very successful in relation to their their low economy or they have failed very badly in the economic development but succeeded in the human development in upper middle income countries it's 74 can see what the difference and and and and that is because a few of them are down here but most of them this big cluster the front of emerging economy I think some analytical institutions emerging former countries they are up there and this in high-income countries 79 it doesn't make sense to divide the world into developing world and develop at least we need one two three four steps and let me show you now how is the disease burden in these four groups this disease burden here the total square here shows the burden of disease in Dallas that is deaths and disabilities the blue one is non communicable diseases the red one here is a small one it's infections this is injuries cell form suicide and traffic accidents mainly can you see how this is really dominated by non communicable diseases as you know and they have nice amount of money and they have money and most of the innovation produce the drugs which are needed here and when it's good companies and good research they really make breakthroughs as we have seen and they are charged a lot of money for them that's this one let's move to the next group here also non communicable diseases are dominating infections are relatively small also in this area whereas if I go there now non communicable diseases is almost as big as infectious but they still have infections here and if I'm if I move down there you see infections is absolutely dominating now the challenge here the challenge here I want to show is perhaps more dramatic is here look at Vietnam I will compare Vietnam to the United States that we have done you know there have been historical and tragic tragic military conflicts between these countries but if we just if we just take a look at this same here in come on this axis life expectancy there and I mark the United States there we run the United States forward and I have to find Vietnam on this axis this software is free of charge on the net for you to play around with and Vietnam 1965 was there before the war and then it ended up like this you can see Vietnam on their income level world champion in this mid mid way of economy Vietnam today have the same health situation as United States had 1980 they have come non communicable diseases they have cancer they have hypertension they have traffic accident their mental health issues they are just about 25 thirty years behind us in health situation whereas in economy they are back at Lincoln time there are 88 in money so if you are a Minister of Health and you have taken your country out of malnutrition out of infections with good policy education to the people you get punished by getting a non communicable disease burden at the very low income level where you can't deal with it whereas you have the professionals who can deal that's an enormous demanding situation for you to fix the access to drugs to that and it also gives another message of innovation we do not only need an innovation that produce cure and prevention for the non communicable drugs we also need it in the non communicable diseases we also need it that can cure and prevent at a very low cost level I think the intraocular lens is one of the best example for cataract surgery that was a fantastic innovation and the best of all was when Indian polymer chemists could bring down the cost from $200 to 80 cent we need market economy innovation both in finding the new technology and bringing down the cost please please fix that the cochlear implant and hearing devices can be brought down in cost with taking away two zeros they need to be taken down because we now have countries who have this non communicable disease burden at such a at such a low income level and we have countries all the way through so your work ain't easy that's why I offer you a Nobel price if you succeed because you really have to come up with a business plans and stimulation to innovation which is as smart as the best biomechanical in innovation this is the drug cost here people have $500 per person for drugs $100 per person $40 $10 you see the dramatic differences dramatic difference and how can these people deal with the non communicable diseases I hope that one no it's just child Motel if I do shall mortality same here here here here falling stepwise please use the for group the global health observatory at wh so very wisely now T's where mass group they put these four income groups and you can see the indicators in the four income groups the poor people in the world has to be found with access also those for those people who don't have electricity who don't have kids in school who are not vaccinated against me said who don't find contraceptives they live in low-income countries remote rural areas in in the corner of the districts if this is a hospital and the health centers the poor people live in those corners that means that this sustainable development goal 1.1 is very challenging because to reach the lost 10% in extreme poverty is really difficult the lost sleep you know the lost bitten marathon is the most difficult it really take a focused effort and that's another challenge us to get the good drugs which we have out to everyone I think I jumped that one and I would like to stop with this one showing you how the division had been done in developing and developed countries MDG was reported only for developing countries and there was a list for those countries who were considered developing or in developing regions and they should report and the others didn't have to report other people had said that MDG was the low-hanging fruit whereas SDG is the high hanging fruit including the low-hanging fruit in the remote areas that was never reached so how did our system or a UN system which I honor and like so much I was brought up respecting the UN flag more than the Swedish flag yeah I went to secondary school to dog hammer shell the secretary-general and as a young teenager I was present as his funeral when he died in service that had a great impact on us so one of the reason why Swedes stand up for you and is that that feeling respect highly people who work for United Nations different organs know and contribute but how do we do it internally this is how it was divided let me first show you here I have money again thousand dollar $10,000 hundred thousand dollar on a log scale of course compress the money there expanded the money here here's child mortality on a log scale to children that 20 children that 200 dead see once more why I love money the main determinant of falling child mortality is money but you can do distinctly different at one income level if you have a good health system you're down here otherwise you are up there and then this is what we want with the policy but policy can only do so much this bottom no one lives here there is no paradise you can't have a paradise with low GDP per capita don't even think about it and you can't have so stupid policies you end up here if you're rich you know most kids survive there's no way you can be so ugly in your in your policies you end up there now how do we divide it these are the developing these are the developed where is the cutoff and this is the official cut off in the MDG we came down like this it would cut here we thought but then Qatar is over here and Qatar had Poland trees so they became developing and then it goes down here this is quite this is South Korea they are developing and strangely enough Singapore one of the most advanced country on the world is a developing countries that have to report and and then coming up here you can see that this is Ukraine and this is Sri Lanka and Sri Lanka of course is a developing country but Ukraine is developed have you ever seen a cutoff line that goes like this do we have anyone who can write the algorithm this is the intellectual quality of our categorization of the world it's a result of a political process and I respect it I don't criticize outside you and me meetings inside I'm harsh inside I'm hoarse because I love you and we can't work with this you can't have a policy for those countries which are on that side of the line another policy for the others leave it stop using it follow and the the the Big Pharma is more analytic they segment ties the world but they don't segment I sit perfectly I know Gilead will be here in afternoon I learned to live from gilead how they say we can't have different policies in multi tier pricing in Latin America because it's the same language and it will be export you have to consider other things also you can't only have a cutoff you have to be a little more clever but this we can't move forward we must have a fact-based worldview thank you very much my name is Andrew black I'm from the Polish Academy of Science I'm a great admirer of your work and you cheer me up every time I listen to you I think the world is a better place what what does depress me still drugs and narcotics and the way drugs are used in a criminal way I would welcome your thoughts or any considerations that you may have on on this and the influence on the graphs you demonstrated I am NOT an analyst in specific area so I try to avoid becoming guru you know what I really want to do is like the basic road map of the modern world to provide it but what we can see be behind the drug trade is that some rich countries provide a market and if a rich Europe provide a market for for heroin or United States provide a market for for narcotics from America there's no way the other countries can stop it the market is very strong we see it with the unfortunate refugees from the Middle East when when Europe provide asylum right for asylum and deny people a visa so they can travel safely you know we get these tragic boat accidents it's difficult to have a global policy that works when we still have such a lot of inequity between countries and what I say with the progress I see in the world and let me say I didn't have time to really show the progress in Africa what you see in many African countries now is that the upper quintile the top of the countries are progressing very successfully while they may still have rural areas in deep problems or neighbouring countries in civil war when you see that happening it's really it's really that West Europe and North America will be such a small part of the more of the future world it will be less than 10% its marginal the world will be Asia and Africa that will be more than 80% of the world population the center of trade will be Indian Ocean the central world will not be London it will be Dubai and and how would how would I put it like this how would West Europe and America integrate into the modern world to find its place because they are very useful stable nations you know have great research institutions have great civil societies institutional but still have have to be polite when you're in Geneva how would you put it in West Europe in North America there is a toxic combination arrogance and ignorance that leans against each other it's a toxic combination of arrogance and ignorance and and what is not seen that the young talent in Asia Middle East African Latin America is at an almost higher level than you find in West Europe and North America polar may be maybe an exception because you are fighting so hard to catch up after those challenging decades no and we are seeing that in Sweden that that Poland is it is catching up amazingly fast but in West Europe yeah we are good at making Minecraft Spotify you know this nice software they grow out of stock play around we're good at even these softwares I used made by my son and his wife and the team in soccer creative innovation but when it comes to serious work is the rest of the world and how to how to integrate that that's the difficult thing and and and make policies that works for the world and you take up them the most dramatic ones but I would like to add the rest I see some because I lecture this lecture I deliver at the highest level in the financial sector the big banks and the corporations and they are very much focused now on hiring the young talent in in the emerging economies and even beyond IBM go and look for for talented programmers in Savannah Valley in Kenya you know that Africa is catching up and amazing speed in software development also today it's very challenging we all depend on you here in United Nations you have to put the regulations and the treatise is very difficult to find out now because it's not just two groups any longer in Kyoto it was still developing in developed countries there's no such thing any longer there's the upper middle income countries that have their interests I worked in with intellectual property in the cassava plants in agricultural research where Brazil wanted to sit on the intellectual property of a crop that is more important in Africa there was a lot of conflict in between that and it's not so self don't make it simple that it's all stalls it's upper middle income against low income it's lower middle income against fragile nations there's so many different settings and and you just have to be very clever and competent thank you really very much is one of the best percentages I never saw at the UN I please could you explain a little bit more about because you mentioned at the very beginning that inequalities are decreasing in the war but are increasing with some some countries and we see for some point in Europe countries that are going through crisis on how these differences between populations for some point in France the other day I listened there are 8 million people in the poverty level from a population so how this can affect for example in the case of access to medicines for those countries that with population basically are suffering from in cities think yes you use the term poverty and remember that poverty used in nations who are better off the high income is relative poverty it's 60 percent of the median level you know which country in Europe that reduced poverty most in the last 3 to 4 years it was Greece because Greece decreased the median income so much that the poverty line you know fell below the poor people it's very it's very it's very complicated these terms because they are very loaded politically and policy-wise that's why we want to visualize the income distribution this with this tool you are going to see each country where how they are distributed and and and of course access to drugs if they are going to be out of pocket is very much dependent on on your income and the most tragic thing with drug access out of the pocket is that it's almost the main course of pushing people back into extreme poverty that's why we need protection you know because when you have your your mother have a stroke you know your father need the drug for this treatment people will sacrifice and you see these lower middle income countries where there is no successful access to to good medical technologies and still severe diseases III was super Co supervisor for a study on suicide and suicide attempts in Vietnam it's very tragic how young women who now wanted a modern life and they were stopped at the age 15 at the age 17 you know and in panic and sadness they tried to commit suicide but they survived and they were brought to intensive care with very advanced treatment and the family had to pay so it ended up by the family falling down into Depot it is a very dramatic situation you see in countries and never before have we had people at such a low income level understanding and having physical access to the payment the big problem in the world is this people are much more capable than their incomes in West Europe and North America you find a lot of people who are less capable than their incomes they get more paid than they are capable of or compared honey don't smile from Africa hide that nice smile you have to become some more billions because before you can smile like yeah because you all know it you know we know when when we collaborate my colleague was with me here alien an audience that we salsa assistant professor Karolinska Institute working with me with Ebola she told me you know the payment level of the so-called volunteers who came from Europe was above the qualified physicians in the West African countries and the access to treatment was excellent how many were that twenty three twenty three so-called volunteers from Western North America was infected with Ebola they were flown out no one died where is our colleagues in Liberia Sierra Leone and Guinea more than half of them died but they don't have that right so so that is really tough so we are dealing with a world where people live a very many different levels and indeed in a certain way I can't accept that countries in sub-saharan Africa should focus on on equity so much they should focus at the level of the poorest people if they're elite or software developers on international levels if they have surgeons you know who are full capability they must have a salary level which is somewhere close to international alternatives otherwise they won't work they can go out of their position by lifting all groups at the same time with with the remaining disparity what is bad if they are leaders who only focus on the rich one and leave the rest but I think if you look at some of the most successful countries now like Ethiopia which is doing very well fulfilling all the MDGs the income distribution I mean Ethiopia is not shrinking because now it's a it's it's a hot area for investments every bank I lecture till they want to hear about these successful countries in Africa they want to pour money into Africa now which will make it possible for the elite the young talent in Africa to get better salary move forwards and they will drag their countries out of poverty remember Britain did it with their own children in the coal mines as ugly as Britain we will never be that we can't have back but but to think that you can store first thought to have equality that's Pol Pot and no one wants Pol Pot back you know we need to have some sort of inequity in the countries and you need to start to provide advanced medical service you know for heart and and cancer and so on in your country before you can bide it to everyone that's why the universal health coverage to me is a Sunday concept it's a Sunday o Friday for that time for that beam Friday concept you know it's an aspiration but Monday morning you need that bloody budget because otherwise people won't work or you won't get the drugs so we have to define what is the universal health coverage in the world so far it's only one thing there's only one thing that everyone got it polio vaccine that's for everyone in the world and that was a bad priority sorry to say I don't criticize it outside this meeting but inside you go to northern Nigeria to a woman in the remote village and and you offer polio vaccine and she looks at her priority list and she finds in on place 42 and she says I want diarrheal treatment I want vaccines you know my sister died in childbirth my husband has a broken leg I we have all these it has to be not polio plus it had to be basic health service plus polio there's a wrong policy option that's not how we will improve we have to listen to the priority of the people and they know fairly well I've been working 20 years with African institutions in remote parts of Africa took me 10 years to realize that I should listen and not talk and people are so aware they are so aware of the economy they know lean economics how to how to make priorities and what is most important and that you had to deal with at the same time at the same time you need to run clinical trials in countries you need to have an expertise you need to have international competitive researchers in low-income countries at the same time you have their villages at that low level and I think it's very important not just to to say that that yeah we want equity we want these nice things immediately it won't come I also chose asana delima suma that invited me to the African Union and I also what is the difference being a leader in South Africa and being it in artists for the whole of Africa well back in Pretoria we had money here we don't have the money she says we have very meager resources and we depend on others so it's good we have the Europeans and the Chinese and the Indians and Brazilian so we are little more independent these days because we have money coming from differences it's extremely difficult to do this and they're there if you can if you can find you know rational ways of getting drugs cheap to these countries it's very important but at the same time we have to accept it I should make political statement it's intellectually incomprehensive not to offer cancer treatment for the better off not offer that treatment and and you can't do that free of charge there's no way and Union must have pride because the worst thing is take a middle-sized African country if they don't offer cancer treatment people will fly out to Joburg they fly to Dubai they fly to London and you lose that money it's better you have that private hospital in your country and you have that capable people in your country the economy so I am though I am a can you imagine you know public health professor from Texas loving Sweden having 50% of the economy as tax but when I analyze I see that you have to have both at the same time and can we have so that we have one cheap basic forms of for instance insulin that is available for everyone who get diabetes and then those most advanced injection things which are very nice now with automatic testing that's for payment out-of-pocket payment I know that some of the companies novo and so on have developed this way of having one product which exists on two price levels and we really as we said Margaret was very clear companies who run on on investment money must make profits and they must find clever way in which they can earn a little money of providing at a very low cost to the many a little surplus and then they can earn more money on the others who would try to pay it can I tell the story I have some radical students in Sweden they say aha so you lecture to the big pharma yes I do I will go a lecture to Nova artists now nor RTC in Bossa but they don't provide the drugs for the poor well they do something they don't do enough they should focus first they should provide for the pores but I say Volvo don't provide ambulances for the poor the poor countries so why do you expect them no because drugs is more important you should hit them they say should I hit them yes if you are courage as you should hit them ok I'm courageous just tell me who should I hit I will come in there to their their their plants should I go on hitting the AV employees no no no don't the employees hit the CEO well this was the time of Daniel Vasili he's a little older than me and so on yeah I may hit them I can hit them or you see when things get better if I hit Daniel vasila yeah yeah the radical said and someone was more clever so no no no no no they'll just changing hit the board they say in fact I'm going to lecture to the board in the afternoon I can't make all them the security will probably catch me after I've hit the number of them you know but it would make a good video I say should I hit the board and then some clever guy in the back row said no you should hit the shareholders because the shareholder elects the board here now you're talking I said and who are the shareholders in the big pharma it's the pension funds in the rich countries you all go home and hit grandma and hit her really hard because the money that grandma saved on her pension and give to you so you can travel in the summer that is the profit or the drugs for come from that you see this is the complexity we need a system that works we need regulations that works we don't need this old ideology and for that said the radical left I had among my students I find equal stupidity on the radical right that says all we make a patent you should honor the patent don't start with generic drug continue to honor the pattern forever that's stupid of the 20 years honor apparent those who did that research are already dead or retired you should honor fast in some way you should have funds for those who do things you know in business you know money that comes up to 20 years doesn't send the right signal it doesn't send the right signal so what we need is a clever system that can oh and the world is as in equal and it is you can't change the world you can just operate in the world as it is I think I stopped the other words every lecture doors thank you very much

Channel: World Trade Organization

Views: 42,600

Keywords: WTO, World Trade Organization (Membership Organization), OMC, Organisation Mondiale du Commerce, trade, World Health Organization (Membership Organization), WHO, World Intellectual Property Organization (Membership Organization), WIPO, Hans Rosling, Innovation, Access to medicines, TRIPS, Intellectual Property (Literature Subject), Politics (TV Genre), International, Meeting, Conference

Id: 5SqSE9XKgIw

Length: 62min 3sec (3723 seconds)

Published: Fri Nov 06 2015