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Bulletin of the World Health Organization

Print version ISSN 0042-9686

Bull World Health Organ vol.79 n.9 Genebra Jan. 2001 

Books & Electronic Media

The Lugano Report: on preserving capitalism in the 21st century

By Susan George. Published by Pluto Press, London, England, 1999. ISBN 0 7453 1532 1, price: UK £9.99, USA $14.99


The relevance of this book has grown since it was published. Susan George hopes that you are chilled by her Lugano Report – I was frozen stiff. She reminds us that the fossil fuel-based economic activity of the present 2 billion 'haves' who burn that fuel is destroying the world, and that the 9 billion, who by 2050 will want that economic activity, will destroy the world even more. There will be no adequate means of either controlling or sharing that economic activity in a way that the world might support sustainably. Meanwhile, the 'have-nots' who will not enjoy such benefits are likely to become increasingly violent. The market economy is therefore destroyed either way. The sinister conclusion is that we cannot both sustain the liberal free- market economy and continue to tolerate 'the superfluous billions'.

The Lugano report is ingenious. The author imagines that some major commercial companies – the economic masters of the world – have asked an imaginary group of experts to report on the dangers to the survival of the liberal free-market economy – 'the market' – and how these dangers might be dealt with.

These experts start by reminding us that the biosphere or global ecosystem is a closed system, apart from the energy received from the sun, but that the economic activity within it is an open system, which uses inputs of fossil fuel, materials, labour and capital, to produce goods and services – and waste, particularly CO2. As the major greenhouse gas, CO2 is already changing the global ecosystem irreversibly. If the economy is small, the ecosystem can contain the waste and environmental destruction that economic activity causes, so that there are few problems, which are mostly local. But if the economy enlarges so that it approaches the limits of the global ecosystem, there are great problems. Economic activity has increased 25fold since 1900, and at present doubles about every 25 years. The limits of the global ecosystem have already been reached – the world is heating up, the weather is changing, glaciers are melting, trees and fish stocks have already mostly gone. Many species have gone for ever. There is also the prospect of much worse to come, especially if the permafrost melts and releases its frozen methane, an alarmingly efficient greenhouse gas. Once this starts to happen there is the danger of a positive feedback loop which will heat the earth even more. Far from being controlled, economic activity and CO2 production is escalating, as 'the market' globalizes. Large firms take over small ones to become transnational corporations (multinationals), some with economies which are larger than those of many states. Globalization is gathering speed. The World Trade Organization (WTO) hopes to make the world into one single economic system, with no barriers to trade in goods and services anywhere. Even health services are to be privatized and made subject to market forces. 'The market' has, until now, so hugely benefited the 2 billion 'haves' who have been able to enjoy its benefits that economic growth has become the global objective, regardless of its disastrous ecological consequences and the impossibility of its being shared by everyone.

'Nature' – the well-being of the ecosystem – is therefore the greatest obstacle to the future of economic activity. The message has to be 'protect the ecosystem or perish'. Somehow, economic activity and 'the market', particularly their most harmful aspects (fossil fuel consumption), have to be limited if the ecosystem is to continue to be habitable. Since the quantity of economic activity that the biosphere can tolerate is finite – and has already been exceeded – economic activity will have somehow to be controlled and shared among the 9 billion. Sharing is exactly what the uncontrolled market, especially the globalized market, does not do. Such is its behaviour that, in the absence of vigorous redistribution, the rich get steadily richer while the poor get relatively and often absolutely poorer. That control and sharing have to happen. The report points out that, if it does not happen, the world will be destroyed either by the burning of its fossil fuel or by the violence of the 7 billion 'have-nots' who will be unable to burn it. The process would be bad enough were there more hope of controlling global economic activity. As things stand, such agencies as might be supposed to have this responsibility are powerless.

Not a happy prospect! So what should the economic masters of the world do to preserve it for the liberal free-market economy for as long as possible? The experts suavely recommend a vigorous population reduction strategy (PRS), so as to achieve a global population of 4 billion, by assisting the four horsemen of the apocalypse, conquest, war, famine and pestilence, to which they add a fifth, ecological collapse, to do their worst – a nightmare which the author naturally abhors.

What then might be the answers to such gruesome free-market logic? Susan George has little to say. A Tobin tax on financial transfers is long overdue. She is right about the need for population control, but not about the means. The plight of the most miserable have-nots, particularly in Africa, is that they are demographically trapped (search 'disentrapment' on the web), and like China need one-child families, if they are to avoid starvation and violence. If they are to be counselled to have one-child families, we should all have them. If so there needs to be a policy for a 'one-child world', or more practically, a 'one-or- two-child world'. A healthy lifestyle now needs to be a sustainable lifestyle and, especially, a low CO2 lifestyle – 'green health'. So why not update WHO's definition of health? What about 'For the sake of our children and their children, and not only for ourselves, health is a state of complete physical, mental, social, and ecological well-being and not merely the absence of disease and infirmity'?


Maurice King
Research Fellow
University of Leeds.
5 Ashwood Villas Leeds LS6 2 EJ,
England (