2024 Apprehension

I begin 2024 not with optimism, but with apprehension. Apprehension means “anxiety or fear that something bad or unpleasant will happen”, but it also means “understanding and grasping large issues”. In this blog, I argue that we urgently and collectively need to focus on the big picture.

We can’t afford to keep going on like this

In 2024, I believe that we face a historical crossroad. It’s not only a mega-election year in many countries; it’s a geo-politically decisive year as the world faces the highest risk of regional and global war that I have experienced in my entire 44-year life.

Personally, I feel immensely anxious. The state of the world wasn’t great in 2023 – nor has it been great in the 2020s so far, as I briefly outline below. Yet my greatest fear is that we’re not learning any lessons: we are utterly unwilling to change our ways. In this blog, I argue that if we don’t urgently and collectively focus on the big picture – and changes – we’re not just playing with fire, we’re placing global peace, the planet, and all people at grave risk. With “we” I mean every single of one of us – you and me included.

A brief recap of the 2020s

In early 2020, the UN launched a plan for a “decade of action” for the SDGs, to ensure we would meet SDG targets by 2030. As I wrote at the time, the last thing we need is more plans: we need action and change.

By early 2021, COVID-19 had ravaged the world, and the SDGs (and all action plans) were – er – not actioned. Many people argued that the SDGs and required changes were simply not possible during a global pandemic. At the time, together with many other colleagues, I argued that everything was off track because we were clearly unwilling to change. The pandemic had shown just how self-interested and nationalistic we had become.

By the end of 2022, I tried to identify (for myself) what needed to change. I published a personal global health manifesto for 2023, to guide my own work and decisions. During 2023, this manifesto guided what types of projects I worked on, and what issues and changes I advocated for. My thinking was that if I was unable to move the needle overall for global health and the SDGs, at least I’d do my own personal part by walking my own talk. Was it enough?

2024 – A historical crossroad

There are crisis years – crises that are also opportunities, if we use them right. The COVID-19 pandemic was such as case, and we went awfully wrong here as a global community (I’m especially pointing fingers at those of us in the Global North).

In 2024, with geo-politically explosive wars in the Middle East (Israel-Palestine), involving Russia (Ukraine), and potentially China (Taiwan), the situation in the world looks dire. There are also dozens of silent and neglected conflicts and crises, such as a horrendous one unfolding in Darfur. This is not only a crisis year: this is a potentially explosive year – which is why I believe we face a historical crossroad.

My anxiety is not caused only by what is (even though it’s immensely depressing already); it’s apprehension of what may lie ahead of us if we get this wrong (again). If we vote in more autocrats, despots, extremist nationalists, and thereby hammer a final nail into the coffin of universal human rights and the Geneva Conventions. If we (yes: you and me) just continue focusing on our narrow, daily work and don’t feel responsible for engaging on big-picture issues and change.

2024 Hope

Personally, I have found it very difficult to work in 2023. Most of us in global health felt depleted following the pandemic – and many of us depressed by our sector’s utter unwillingness to change. In 2024, looking at the state of the world and what may yet lie ahead of us, I find it even more difficult to just keep going with my normal day job and projects. I know many of you feel the same, because this is a conversation I have repeatedly with colleagues and friends.

These conversations give me hope. Yet most of us feel helpless. How can we engage? What difference can we make? I don’t have answers, but what I feel strongly, and urgently is that we have to engage, and we (again: yes, you and me) have to change what we are focusing our time and energy on. We’ve sadly learned over the past years that our political leaders – not to mention those with money and power – won’t be the change we need. So who is left? Each and every single of one of us.

This is an urgent call to discover your agency. And responsibility. And to engage and act. We can’t afford to keep going on like this.