In the wake of the tsunami disaster, The Lancet (Vol 365, January 15, 191-193) has an editorial calling for the creation of a “World Institute for Risk Evaluation” (WIRE), noting that “a piecemeal approach to determining human risks would be an understandably reactive but deeply flawed response to this latest catastrophe.”
WIRE would be an independent research-based agency, mandated to assess and adjudicate global risks in general. It would not make judgments about the economic benefits, political feasibility or public acceptability of risk reduction strategies. Regulation would be left to elected government.
Mitigation of global catastrophic risk is a global public good, so we should not be surprised to find that there is currently too little such mitigation taking place. An international collaborative project such as WIRE would help to alleviate this deficit. The awareness of mega-risks created by the tsunami tragedy could provide an opportunity to launch such an initiative. In addition to helping the victims, we could do something to reduce the likelihood of future catastrophes—and not only those related to earthquakes and tsunamis.
Yet while the editorial rightly draws attention to global health (as we should expect from a medical journal), it fails to mention some of the biggest concerns for the human population. To make a serious dent in human death and suffering, we must focus on two really big problems: aging and existential risks.
Threats to global health
The Lancet recognizes the importance of comparing the magnitude of different threats to human life and health, so that we can develop sensible priorities. The editorial notes that the top causes of death are ischemic heart disease (7.2 million deaths in 2002), cancer (7.1 million), cerebrovascular disease (5.5 million), respiratory tract infections (3.9 million), and HIV/AIDS (2.8 million).
We can also measure the burden of harms in terms of “disability adjusted life years” (DALYs) lost. This list is topped by neuropsychiatric disorders and perinatal conditions.
A third way of carving out hazards is by focusing on particular risk factors. In developing countries, the biggest health risks are being underweight, having unsafe sex and drinking unsafe water. In developed countries, the biggest health risks relate to tobacco, blood pressure, alcohol, cholesterol and being overweight.
To reduce death and disability, it makes sense to invest heavily in global health. Many more people die annually of common diseases than from dramatic natural disasters such as earthquakes and floods. Of course, we also need to take into account how much benefit we can get at a given cost, so a cheap warning system that protects against a relatively rare problem might still worth investing in.
But despite the prevalence of the health risks outlined above, and the importance of addressing them, two additional categories of concern deserve the utmost attention from any world body assessing threats to humanity.
Aging and existential risks
The first big risk category that deserves more attention is age-related degeneration, which is by far the single biggest cause of death and disability in the human population. Even in the developing world, heart disease is now the number one killer. Heart disease correlates strongly with age. Other major health problems such as cancer, stroke, arthritis and dementia are also strongly age-linked. Any sensibly prioritized program to tackle human death and disability must place a high priority on research to slow or reverse the degenerative aspects of the aging process.
Aging alone might be responsible for some 100,000 deaths every day, which is approximately half the number of people that succumbed in the tsunami. If one such wave arrived in a different place of the world every other day, tsunami countermeasures would immediately rise to the top of the agenda of all nations. This is ongoing disaster-state is basically the situation we are currently in with respect to human aging, and advocates of global health ought to take every opportunity to reinforce this simple but often ignored fact.
The second big risk category that the editorial does not elaborate on is so-called existential risks—risks to the survival of our species or our long-term potential. These risks include nuclear holocaust, the creation and release of genetically engineered biological weapons, asteroid impacts, high-energy physics experiments, runaway global warming, and more futuristic risks such as the misuse of advanced nanotechnology, badly programmed superintelligent machines, dysgenic upload evolution, simulation shut-down, and the rise of a repressive global regime.
These risks may currently be quite small, but in view of their extreme outcome they still deserve serious attention. The proactive approach that The Lancet proposes for WIRE would be especially appropriate for existential risks, since there would be no second chances.
It is unfortunate that we seem to find it so difficult to take mega-risks seriously until we witness a dramatic catastrophe. WIRE would be especially valuable if it would draw attention to the undramatic disasters that destroy thousands of human lives every day around the globe and to the unprecedented disasters that could destroy our entire species. The establishment of such an institution is a worthy goal for governments and philanthropists.