31 December 2020 – Mukesh Kapila

It is the usual moment to take stock of an expiring year and anticipate the next one. By all accounts, 2020 brought unprecedented turmoil. The orthodox view is to blame COVID-19. Indeed, it tragically caused tens of millions to be infected, sicken or die.  Dysfunctional pandemic responses also caused much collateral damage in terms of lost lives, livelihoods, and liberties. Although the year ends in hope with vaccinations starting in several countries, renewed anxiety about more aggressive variants of SARS-COV-2 cloud an uncertain horizon.  For billions of people, the year began with and ends in lockdowns, and 2021 starts in the same way.

But can the coronavirus be held responsible for all global distress?  Various sombre reports published in 2020 commemorate the passing year. Their analyses and projections, based on pre-COVID-19 data (as this year’s statistics are yet to be collated) indicate a world that was already fast crumbling and the pandemic has simply accelerated the slide.

The Global Humanitarian Overview projects that 235 million will need humanitarian assistance next year  i.e. 1 in 33 people worldwide.  The UN system aims to reach 160 million of them in 56 countries, and appeals for US$35 billion for the job. On past trends, only about two-thirds will get funded.  Meanwhile, the  Global Humanitarian Assistance Report  calculates that international humanitarian flows declined to US$29.6 billion in 2019.  Of course, not everyone is equal: Libya’s UN Interagency Coordinated Appeal was 88% funded while Haiti got 19%.  What happens to the un-counted, un-funded, unreached people in unknown places?

The science of misery measurement has advanced a great deal in recent times. So, we learn from the State of Food Security and Nutrition in the World that the number of undernourished people rose to 690 million in 2019 (9% of the world) – an increase of 60 million in five years. COVID-19 will have added a further 100 million in 2020.

However, malnourishment is just one aspect of wider food insecurity which has trapped 25% of the world or over 2 billion people.  When food insecurity and crises coincide, the result is acute hunger which reached a record level of 135 million people (pre-COVID-19) according to the Global Report on Food Crises.  Meanwhile, the Global Hunger Index assesses some 51 countries to have reached alarming or serious levels of hunger. Statistically speaking, the world is  ‘moderately’ hungry overall (while also on track to have at least 1 billion obese by mid-decade). 

Meanwhile, the Global Report on Internal Displacement counted 33.4 million new internally displaced people in 2019, the highest number since 2012.  That took the total number of internally displaced around the world to a record 50.8 million. Having fled home and hearth due to disasters and wars, the majority are doomed to spend years or decades trying to return home or to re-settle elsewhere. This too has got increasingly difficult: at the end of 2019,  45.7 million people in 61 countries were still stuck in internal displacement, precariously surviving as second class citizens. When displaced people are forced to flee not just their homes but also their countries out of fear of persecution or egregious human rights abuses, they become refugees. These numbered 26 million in 2019 according to the Global Trends Forced Displacement report.

In overview, the preceding ‘Decade of Displacement’ saw 100 million forcibly displaced of which three-quarters are still unsettled as we begin 2021, when we shall commemorate the 70th anniversary of the 1951 Refugee Convention and the 60th anniversary of the 1961 Convention on Statelessness.

Refugees are a subset of international migrants that number around 272 million – up by 80% since the start of the Millennium, according to the World Migration Report . Three or four people out of every 100 in the world today are migrants. But migration is politically demonised even as evidence suggests that orderly migration brings major benefits for both receiving countries with low birth rates who need energetic labour, and for poor sending countries who received some US$689 billion in remittances in 2018. Such remittances exceeded by far the US$149  billion doled out in foreign aid that year.

But there is also a nasty underside to migration. The last Global Report on Trafficking in Persons suggests a steady increase in people coerced into forced labour or into sexual exploitation and forced marriage. This is a highly profitable business criss-crossing the world. Nearly three quarters of victims are female and 30%  are children.  COVID-19 is projected to have boosted human trafficking while reducing opportunities for legal migration.

The interconnected aspects of human mobility and humanitarian desperation are exacerbated by conflicts and disasters. What is happening on these fronts? 

A Global Overview of Conflict Trends suggests that 2019 witnessed 54 armed conflicts involving at least one state party: a record high since World War II. These led to around 50,000 battle-related deaths. More predominant are numerous civil conflicts, many of which have become ever more entrenched and even internationalised. New wars by terror and on terror have also entered the catalogue of violence. 

Taken together,  contemporary conflicts have become more intense over the past decade as measured by the increasing millions of displaced, malnourished, and diseased. They are also more lawless as assessed by the rising tide of violations of international humanitarian law and killings of humanitarian workers. For example, the latest Aid Worker Security Report logs 483 aid workers attacked in 277 incidents in 2019, exceeding all past years. And yet, this is a considerable under-estimate in the age of epidemics when health workers tackling polio, Ebola, and now COVID-19 became particular targets.  Meanwhile, disaggregation of almost one million violent events across 100 countries recorded by the Armed Conflict Location and Event Data Project shows rising political violence, and expanding militias and gangs.  Demonstrations also increased massively while peaceful protests have diminishing effect as politicians exercise impunity when directing state security forces and hired mobs to intervene violently. 

In short, as new and mixed forms of violence spawn and mutate, traditional classifications of war and peace are unhelpful.  The new normal is that of some type of disorder and conflict prevailing in almost every country.

The consequences are unsurprising in the worldwide erosion of human rights,  meticulously documented in the Human Rights Watch World Report.  This argues that many governments’ foreign policies have largely abandoned the cause of human rights while others, faced with their own domestic challenges, mount haphazard, ineffectual defence. Meanwhile, we see the rise of unconstrained surveillance states who practice global censorship and extra-territorial coercion, while campaigning against global norms and subverting the United Nations.  As more and more  governments turn authoritarian, they see human rights as an existential threat to their hold on power. COVID-19 has provided extra excuse for authoritarianism in the name of public health.

Grim granular detail is provided by the Human Rights Measurement Initiative database that covers 197 countries by 5 ‘quality of life’ rights (education, food, health, housing, work), 5 ‘safety from the state’ rights (arbitrary arrest, disappearance, death penalty, extra-judicial  execution, torture) and 3 ‘empowerment’ rights (assembly and association, opinion and expression, participation in government). The aggregate trend is steadily downwards.

The Freedom In The World report marks the 14^th successive year of global reduction in liberties: in 2019, while 37 nations registered a net increase in freedom (greatest in Sudan), 64 declined (furthest in Benin).  Overall, only 43% of countries are now defined as ‘free’, 32% as ‘partly free’ and 25% as ‘not free’. In population terms, just 39% of the world’s 7.7 billion are ‘free’ while 61% are ‘unfree’ in part or whole.  The report comments that “the unchecked brutality of autocratic regimes and the ethical decay of democratic powers are combining to make the world increasingly hostile…”

Turning to other calamities, the International Disaster Database logged 396 natural disasters in 2019 affecting 95 million people  and costing US$130 billion. Heatwaves, wildfires, floods and storms dominated, sparing no corner of the globe. To paint the bigger picture of disasters that are mounting in frequency and intensity: there were 7,348 major recorded disasters since 2000 that affected 4.2 billion people (many repeatedly),  claimed 1.23 million lives, and resulted in nearly US$3 trillion in losses.

The Global Assessment Report on Disaster Risk Reduction provides cogent analysis of growing risk in a shrinking world through the interplay of increasing hazards, elevated risks, and rising vulnerability.  The Global Risks Report locates this in the new normal of uncertainty and turbulence against which difficult but critical judgments are being made.  In an interconnected world, managing risks for mutual benefit, and resisting the temptation to externalise them to others, requires co-operation on an unprecedented scale.  The latest Development Co-operation Report reflects on our intertwined fates in appealing for global solidarity to build resilience to current and future shocks. We see this echoed in the current debates around COVID-19. 

A fascinating insight into manmade risk is provided by a new quantification of humanity’s ecological footprint that has transformed the planet. In 2020, a landmark was reached when the weight of all man-made materials including concrete, steel, and plastic reached 1.1 tera tons. This exceeded, for the first time, the mass of all living things on the planet. Put another way, each week each individual is now accumulating their own weight in “stuff”. 

The latest Provisional State of the Global Climate  report confirmed rising mean temperature (1.2 Celsius higher than  pre-industrial times) and set 2020 to become the second warmest year ever). Greenhouse gas concentrations reached historic highs and sea levels, temperatures, and acidification rose further.

Therefore, the worst kept secret of this Millennium must be that most of our so-called natural catastrophes are due to accelerating climate change. This was the focus for the World Disasters Report which points out that while we were pre-occupied by COVID-19, more than 100 serious disasters struck in the first six months of this year, affecting 50 million people. According to the Lancet Countdown report on health and climate change, vulnerable populations were exposed to an additional 475 million heatwaves in 2019 resulting in 302 billion hours of potential labour capacity lost and significant excess mortality and morbidity. 

How we cope with disasters or shocks is a measure of our ‘resilience’ at individual, community, national, and global levels.  An indicator of this is insurance protection. This is abysmally low: only 4% of economic losses from climate-impacted extreme events in low-income countries are insured, compared with 60% in high-income economies.  According to the sigma Resilience Index, the global insurance protection gap for health, mortality and natural catastrophe risks reached USD 1.24 trillion in 2019.  The COVID-19 crisis is set to reduce global macroeconomic resilience by close to 20% in 2020, and post-pandemic, the global economy may emerge 30% less resilient than in the 2007 financial crisis.

All these factors undermine our traditional expectation that  human development will continue to march inexorably upwards.  The Human Development Report re-evaluates this in the context of the growing imbalance between planet, people, and prosperity. When the standard ‘human development index’ is re-calibrated to take this into account through a new ‘planetary pressures’ adjustment, we see a mixed picture with either stagnation or reversal of previous development gains. Where there is progress, it is only through incurring high unsustainable planetary costs.

The trend is visible with greater clarity in the Sustainable Development Goals Report. There has been progress but, even before COVID-19, all goals were off-track for achievement by the original timetable for 2030.  The Social Progress Index confirms that when  universally important social and environmental outcome indicators are aggregated, the population-weighted world average score improved by a pathetic 3.61 points from 60.63 in 2011 to 64.24 in 2020. Improvements in several (economic) areas were offset by stagnation or regression in other (social) areas. The analysis concludes that, on current trends,  the world won’t achieve the Sustainable Development Goals until 2082 – missing the 2030 target by more than a half-century. And, if the impact of COVID-19 is not mitigated, the achievement of the SDGs will be pushed further back to 2092.

The World Population Dashboard estimates that  there are some 7.8 billion of us on the planet but growth is slowing as the total fertility rate per woman has declined to 2.4 children. When we are born today, we can expect to live for 73 years. The world is ageing fast with approx. 10% of us already over 65 years. However, the World Population Prospects describe considerable regional disparities and women and girls have a long way to go to correct their historic disadvantage. The State of World Population reveals the appalling data that the number of ‘missing females’ has doubled over the past 50 years to around 146 million today because of  deliberate sex selection and femicide.  And after having somehow navigated their birth, record numbers of girls remain highly vulnerable to child marriage and sexual exploitation. Furthermore, 4.1 million girls and women were at risk of female genital mutilation this year alone.

Considering the moment we live in, our scrutiny would be incomplete without special attention to health. The Global Burden of Diseases, Injuries, and Risk Factors Study is the most comprehensive and authoritative monitor of what ails the world. Its 2019 edition and the latest World Health Statistics tell us that healthy life expectancy had increased by a modestly respectable 8% over 16 years before COVID-19 came along. 

Meanwhile, the disease burden has been shifting. What kills most people everywhere nowadays are preventable or reducible non-communicable diseases (NCDs): diabetes, cardiovascular and respiratory conditions, and cancers.  They – with their underlying risk factors of smoking, high blood pressure, obesity and high salt/sugar/fat diets  – account for over 70% of the global burden of disease. The NCDs, together with a rising tide of mental illness and road traffic crashes and industrial accidents, cause the bulk of  prevailing disabilities.

But poor people suffer a double disease whammy as they are also still vulnerable to persistent  vector-borne and communicable diseases such as malaria and tuberculosis. Periodic epidemics and pandemics are also more likely as human-animal interactions increase due to ecological and human behaviour shifts. 

One pandemic that is already among us – and could prove more serious than COVID-19 – is antimicrobial resistance as microbes get more resistant to our usual antibiotics.  The last new antibiotic class that reached the market was way back in 1987. Unlike with COVID-19 vaccines, financial investment to find or make new antibiotics is sorely lacking although at least 700,000 people die annually from antimicrobial resistance with a projected economic impact of US$100 trillion by 2050.

While health is increasingly recognised as a global public good, its principal mode of delivery is yet to take off.  The last Universal Health Coverage Global Monitoring Report  indicates that UHC has slowed over the past decade with only 33-50% of  the world’s population covered by essential health services today. Any gains in service coverage have come at catastrophic cost to individuals as large out-of-pocket spending has increased.  With a billion people spending more than 10% of their household budget on healthcare, this is now a major and increasing cause of impoverishment for desperate people in their moments of greatest need.

A global stocktake of this type cannot do justice to the nuances of the inequities and inequalities suffered by diverse communities and nations. Each of them struggle, survive, and succeed in some measure to overcome adversity in their own ways. How they do so are remarkable stories that deserve their own telling.

Meanwhile, conducting this dismal ‘review of reviews’ objectively was bearable only by suspending one’s finer sensibilities through smothering the human face of the state of the world in a sea of statistics.