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This is an article from World Review: The State of Democracy, a special section that examines global policy and affairs, and is published in conjunction with the annual Athens Democracy Forum.
For three days last week, global leaders met in Athens to discuss the challenges democratic governments face around the world — from climate change to social inequality to polarized politics, fraying economic systems and a fraught relationship with technology. In its ninth year, the Athens Democracy Forum, with a theme of “Resilience and Renewal” this time, explored the lessons learned from the overlapping crises and considered ways to manage the economic and social fallout and accomplish the formidable tasks ahead. Here are excerpts from some of the panel discussions, all of which have been edited and condensed.
Health care as a human right
Dr. Paul Farmer is co-founder and chief strategist of Partners in Health, dedicated to community-based health care and treatment, especially focused on resource-stretched and starved areas and countries; chairman of the department of global health and social medicine at Harvard Medical School; and chief of the division of global health equity at Brigham and Women’s Hospital in Boston. He talked to Patrick Healy of The New York Times.
MR. HEALY Paul, you’ve been working to expand and improve health care across the globe for nearly 40 years. I’m wondering, how much closer are we to global acceptance of health as a human right compared with when you really started this work in the 1980s?
MR. FARMER I would say we’re closer now than we’ve ever been before in my lifetime, in any case. And that’s including in the United States, where health care has not been traditionally considered a right. We’re seeing it across Asia, in parts of Latin America, in Europe. And a lot of this has spurred by the dramatic events of the last 18 months, I think. Seeing what it’s like to get through a pandemic when you don’t have a strong safety net has been an object lesson for many.
MR. HEALY In terms of the pandemic — take the United States, for instance — there is still, to some degree, a difference of opinion in terms of responsibilities for what the federal government should do, what states should do, what localities should do, what kind of rules should even be in place. And it feels like health care as a human right sometimes isn’t enough of that conversation. Why do you think that is still the case in the United States and some other countries?
MR. FARMER I think it’s just one of many paradigms that can be use to promote health equity. The others — for example, public health as a public good — are important as well. The idea that there are certain things that a federal government takes responsibility for. And many of the places where I’ve worked, for example in Rwanda, where the real impetus for investing in a national health insurance system and the rollout of a care delivery system, has also been premised on the notion that this is the best way to break the cycle of poverty and disease. So whether you’re looking at health as a human right or public health as a public good, or as health safety nets as a way to break the cycle of poverty and disease, they’re all leading in the right direction.
MR. HEALY Does it surprise you that there has not been over the last 18 months more of a consensus in the United States and some countries of how to approach not just the treatment of Covid but the cost and expense of health care, especially for people who have faced inequities in the health care system before? Or is that lack of consensus just part of, in some ways, a functioning democracy? How do you see that?
MR. FARMER Our struggle between federalism and local rule has been going on for some time. And what we have to reckon with as a nation is, why have we done so uniquely poorly in responding to Covid? After all, we have more resources than most places in the world. And part of that has to do with our patchwork health delivery system, our patchwork health insurance systems, which are also a reflection of this longstanding tension. Yes, there are some cultural issues about notions of libertarianism, a history of hostility to government efforts to intrude in people’s lives.
MR. HEALY Paul, you’ve been involved for years in partnerships — public, private, the donor community, governments — to bring health care resources, clinical support, to countries around the world. What do you think President Biden and the Biden administration need to do to deal with the global vaccine need and campaign? Because there is a real debate in the United States about whether more people who’ve had the shot need boosters, or whether more can be done for other countries.
MR. FARMER First of all, I do want to say on many scores I think the Biden administration is off to a pretty robust start. Obviously, our criterion for defining success is the high rate of vaccination. And we don’t have that. Some of the specific issues are around technology transfer so that there can be manufacturing of vaccines, particularly on the continent of Africa, I would say.
There, you have a setting where there is a total reliance on imports of vaccine — 99 percent of the vaccines used in Africa are imported — and also a very low level of uptake of vaccination that cannot be blamed on hesitancy unless we’re talking about elite hesitancy to put in place mechanisms that would roll out the vaccine. So there’s an area of manufacturing tech transfer where the Biden administration could do more.
Donations are still not working as a means of vaccinating large parts of Africa. The multilateral mechanisms haven’t functioned well enough. So there are lots of areas, I believe, where the administration can make vaccine equity and vaccine diplomacy central.
I also think that there are places nearby the United States, like Haiti, which has been struggling with political disruption, natural disasters and now a wave of refugees being returned to the middle of a crisis. These are also settings in which we should do a better job making sure we can help on the Covid front, but also on the many other challenges that are facing Haiti. And it varies from place to place.
The will to confront climate change
It’s far more dangerous than the coronavirus and more permanent. So why is it so hard for governments and individuals to adopt a sense of urgency about climate change? What alliances need to be built among philanthropists, corporations, activists and policymakers to change course?
Panelists: Ivan Tse, president, Tse Foundation; Matt Brittin, president, EMEA Business & Operations, Google; and Philip Glanville, mayor of Hackney borough of London. Moderated by Liz Alderman, chief European business correspondent, The New York Times.
MS. ALDERMAN Obviously, climate change is one of the No. 1 issues that governments are tackling. We’ve got COP26 [United Nations Climate Change Conference] coming up very shortly in Glasgow. Local and national governments in countries around the world have been making commitments, but there’s much more to do.
Mayor Glanville, one of the questions is what more is it that governments can do to press this forward? You’re helping lead a new green deal. Tell us what has gone right in the initiatives that you have taken, and what isn’t going right, what more it is that you need to do that could also be a model for other cities.
MR. GLANVILLE I firmly believe that it is the local level you have to unlock to ensure that we get not just the action on climate change that we want to see, but the change in our communities, the nature-led recovery that we want, and that also we involve the citizen level in that work. Failure to do that, we will miss the opportunity for social justice, green recovery and green jobs. And what we’ve been doing in London is to think about how we can reimagine the city away from the private car. And there are obviously people who are involved in electric-vehicle transition, and that is an absolutely important act. The problem is, if we just do that we’re transitioning a society based around the private car.
Already in Britain, land-transport emissions have overtaken energy contribution to climate change. And there’s some really stark statistics at a national level. Before Covid every morning 36 million seats in cars were unfilled. So people are driving all around the country, and there are 36 million cars. The average occupancy of a car is 1.2 people. So if we simply take that old model and apply it to a new model, we’re going to invest far too much in E.V.s.
So we have been taking the steps in the city to invest in active travel. So it’s thinking about how we restrict private car use and the most polluting vehicles. London-wide that’s represented by the Ultra Low Emission Zone, which is the mayor of London’s plan to effectively charge the most polluting vehicles to come into the center.
But my borough in Hackney sits just outside the city center, and it has some of the lowest car ownership anywhere in Britain. Some of the highest number, if not the highest number, of trips taken by walking, cycling and public transport.
But it also has some of the worst air. So we’ve been introducing low-traffic neighborhoods, which is where you don’t close roads permanently, but you restrict through-traffic access.
And we’re seeing the impact on air quality, the taking up of walking and cycling. And you also start to get the chance to reimagine what roads can be, so you can de-pave, you can create parklets, you can do urban tree planting, changing what the city is, but also improving its resilience. We’re seeing increased flooding in Europe, fires here in Greece, we’ve seen the impact of heat.
The solutions to that are not concrete and car-based. We need to reimagine what our streets can be and make sure that they’re ready for that transition. It is about being more ambitious than just transitioning existing ways of the transport economy into something far more better and sustainable.
We were in a session this morning that was looking for the big idea. And then you have the practical role of elected politicians who have to take their communities with them, and to be frank, we have to win elections to show that leadership. I think it’s absolutely important though that we show that leadership, but we also invest in the coproduction. So there’s platforms like Commonplace in the U.K., where you’re allowed to go out there and talk about what you like about an area, what you would like to change, how are the different ways of travel impacting on individual lives?
There’s also that sense — and I have it all the time talking as a politician-citizen — I’m not asking everyone to get on a bike. Not everyone can, not everyone is able to, there are issues of disability and equality. What I’m saying is if you are driving around in a private car you should be considering a bike. That frees road space.
The bus is an incredibly important tool here. We need bus prioritization in cities. We need the affordability of public transportation to be invested in. And I think that’s what we’re doing in London is having a holistic approach. It’s walking, it’s cycling, it’s scooting, it’s personal mobility. All of that has a part to play. And if it just becomes a sort of young-people-on-bikes debate vs. people who might have disability or large families in cars, we can’t allow that to happen.
MS. ALDERMAN Let me pivot off that to Matt. Matt, Google has taken huge strides as a company to reduce its carbon footprint. But besides that in terms of searches — the searches that you all see with regard to climate change — can you talk to us about what the top issues seem to be on people’s minds based on what you are observing?
Is there any sort of, backlash or resistance among citizens who recognize that really the only way to deal with climate change is on an individual basis through their own actions, but whose lives would have to be changed fairly dramatically by no longer driving their cars if they’re the only person in them.
MR. BRITTIN I think it’s very clear governments, companies and communities have to work together to tackle these challenges. What we see in consumers searching over the last five years, we’ve seen nearly five times the volume of searches for sustainable goods. If you look at the Edelman Trust Barometer, you see that over 70 percent of people are concerned or fearful about the consequences of the climate crisis.
So we definitely see people turning to information sources to try to make smarter choices. That’s one thing we’re trying to do is help people to be better informed about smarter choices. Second thing for us is the tools that we build. So obviously there are the consumer tools that you know about, like how to insulate your home, or how to find a healthier way to get to work.
So working with cities like Hackney, or I was looking at a project yesterday in Kampala [Uganda] where we’re supporting local engineers to collect data via air sensors about where pollution sits. And I think there’s a big piece here around getting data that allows local decision makers, communities and families to manage their situations better.
MS. ALDERMAN Ivan, as head of the TSE Foundation, talk to us about the role of culture in the overall climate change, not only the debate, but the role that culture is playing and can play in raising the level of consciousness not only among individuals, but among our leaders about tackling climate change in a better, more purposeful way.
MR. TSE I think that there is greater alignment now between governments and consumers. And some of the questions that we look at is how does the cultural sector help move the conversation forward from here? I think we’re ready to focus more on the adaptation side because we realize that climate change is already happening. And I think that we need to develop a lifestyle that helps us adapt to it. The example that we have in the past is the quit smoking/nonsmoking movement, which was a multipronged effort that fundamentally changed the definition of smoking.
It strikes me that it’s not that we don’t really know what to do about climate. What we lack is a collective sense of ethics and the political will to get there. And that’s not something that, perhaps, our minds can fix by themselves. And so what we need to do is essentially amplify the human spirit so that we can address climate change from a different perspective and according to a different logic.
Astronauts who’ve come back have called this the “overview effect.” And so we may have to design a gateway so that climate change triggers a fundamental immune response.
The danger of deep fakes
As deep fakes and other manipulated media become more sophisticated and cheaper to produce, people outside the world of tech are experimenting with them. For some creators, they can be powerful tools for expression. But they can also be used to influence people and sway opinions. Does the mere fact of calling something “art” give people creative license to toy with reality? How do we prepare and protect ourselves, our institutions and our democracies when seeing is no longer believing?
Panelists: Toomas Hendrik Ilves, former president, Estonia; Barnaby Francis (Bill Posters), artist, researcher, author and facilitator; and Ashley Tolbert, senior security engineer, Netflix. Moderator: Farah Nayeri, a culture reporter for The New York Times.
MS. NAYERI I think deep fakes first came to the general public’s attention in 2017 when there were a huge number of videos of celebrities and actors engaging in pornographic acts, which they actually never did in real life, going viral. And so this whole conversation, this whole debate, started getting inflamed right around that time. And nowadays, from what I understand, just about anybody can create a deep fake.
Barnaby, let me turn to you. I know that your artist name is Bill Posters. I wanted to get you to talk about the concept of deep fakes. Because for you, it’s a way of making art, it’s an art form, and I understand that art is about artifice and art is about representing people in a kind of make-believe way. But do you understand the democratic implications or the political implications of the art that you make?
MR. FRANCIS So I created a series of artworks called “Big Data Public Faces” with a collaborator, Daniel Howe. They included a fake video of Mark Zuckerberg of Facebook and various celebrities. The artworks were picked up, went viral and created a furor around the issues that our artwork is connected with, right? Which is about disinformation and misinformation and the way that truth is distributed online, or how our perceptions can be altered by various forms of technologies that are using new media like this. We use the deep fake as a form of that.
MS. NAYERI But then, you can get someone who watches a snippet of your Zuckerberg video in which he’s saying some very ominous things and really believe that Mark said that, run with it and run it on other platforms.
MR. FRANCIS Yeah, of course it’s possible, absolutely.
MS. NAYERI That you’re making art, and art in the artistic context is fine, but then when taken out of the artistic context there are all kinds of dangers.
MR. FRANCIS Absolutely. And that is true for any form of information that’s shared in any forum or information ecosystem online, right? Whether that’s misquoted, whether that’s misrepresented, etc. So the real kind of key component here is literacy and context.
So anything that I share online is contextualized as pieces of contemporary art, you know conceptual art pieces. So there’s always that kind of transparency in relation to the media that’s being shared, right? Unfortunately, we don’t get that in many of the forums or contexts of information that’s shared online as well.
MS. NAYERI Toomas Hendrik Ilves, you’re the former president of Estonia. And Forbes magazine said that while you were running things, Estonia was the most digitally savvy country on earth. You led a digital revolution in your country, and my understanding is that nowadays it’s possible in Estonia to be identified through facial-recognition technology — or not really? I mean, how digital is Estonia?
MR. ILVES In Estonia, all public services, or all interactions between the citizen and the state, can be done digitally, except for getting married, getting divorced, and selling or buying physical property, which is not a bad idea given that two Russian Mafiosi bought apartments in Trump Tower in the U.S. through anonymous [shell] companies.
Everything else you can do online. Last year, when in January I read an article in your newspaper about basically there was a backlog of 3.5 million passport applications after two months of Covid, I said, why a backlog? Well, it was because the offices were closed. Whereas when I go to Estonia I had to renew my passport, I just go online.
I had to upload a new picture because, you know, less hair and more gray, but other than that it was the same. And everything else has stayed the same. I didn’t have to fill anything out. That’s what we do. But in terms of facial recognition, no, not much. But on deep fakes I’m much more worried.
MS. NAYERI If your country is working with facial-recognition technology, let’s say somebody pretends they’re me and they make a video of me doing something criminal, do you know what I mean?
MR. ILVES I think it’s worse than that. I think basically the rise of deep fakes, unlike photography, Photoshopping, because of the movement involved and because you can do it with voice and video, is that it really strikes at the empiricist basis of democracy.
MS. NAYERI Why do you think that’s a threat to democracy?
MR. ILVES Because you can undermine basically anything. You make a fake video of a politician taking a bribe, you can completely discredit people who have been legitimately elected by creating deep fakes. And the problem is the technological solutions to fighting that are fairly limited. So we’re going to have to actually school people to not believe what they see.
MS. TOLBERT I share the belief that deep fakes are worrisome. Although I do stand in the middle of this line that deep fakes are artful, right? So synthesized media, it is a form of art, and it’s been around since the 19th century. But when you step outside of the bounds of that art there are catastrophic risks to deep fakes. A well-timed deep fake can have real impact on an election, on someone’s reputation. So you’re essentially borrowing influence for a momentary motive. And then, once that seed is planted, it’s almost irreversible to basically go back and revert this spread of instant knowledge. So for me it’s the virality, it’s the fact that this line of disinformation and deep fakes, is just too powerful.
The economy the pandemic broke
The ravages of the pandemic have profoundly changed how we work, buy and sell. As we rebuild our economies, should we be focused on a “great reset” to economic models responsible for obscene gaps between rich and poor, or should we use this opportunity to build back better? What could a new economic model actually look like? What kinds of partnerships are needed between the public and private sectors to actually make it happen?
Paanelists: Loukas Tsoukalis, president of the board,Eliamep; Azeem Azhar, founder, Exponential View; and Hervé Berville, member of French Parliament. Moderator: Liz Alderman, chief European business correspondent, The New York Times.
MS. ALDERMAN One of the things we’ve heard frequently since the pandemic broke out was talk about how countries would steer not only through the health crisis, but also grow back from the massive economic crisis. So this mantra of “building back better” has become a new, in many ways, political catchphrase for an agenda that basically aims to better protect public services, tackle inequality and create a more shockproof economy while tackling climate change. Loukis, since we’re here in Greece, you know this is a country like many others in Europe and around the world that has been recovering from an economic crisis, only to be hit by Covid. But now we are seeing a kind of major effort in this country to build back better. For example, you’ve got the digitalization of public services, building investments for a green economy and a major E.U. recovery plan. But is it possible to shockproof Greece or really any other country against future calamities?
MR. TSOUKALIS Surely not. I mean, first of all, let us remember that Greece went through a hellish decade, an economic crisis that led to a reduction of Greek G.D.P. by 25 percent — unprecedented for any developed country in the (postwar period. And then hit by a pandemic. Greece has been recovering and it’s now in the process of not only recovering, but also accelerating the digital and the green transformation of the economy, with the help of the European recovery program. And this is one factor that makes a huge difference with the way Europe and the European Union in particular try to tackle, or not tackle, the two crises. With the euro crisis, Europe took a long time and basically did very little, insisting on the economics of austerity, which worsened the problem in virtually the whole of Europe. Now with the pandemic, European political leaders luckily realized that if they repeated the same experience they had with the euro crisis the risk of the European Union splitting apart would be very high. So that’s why we ended up with an extremely ambitious recovery program, which also leads to the first mutualization of European debt, which is not exactly the (Hamiltonian) moment for Europe, but it’s just an important first step.
MS. ALDERMAN Azeem, obviously one of the major elements in helping to sustain any kind of recovery from the pandemic has to do with the quality of jobs and basically the way companies are operating in society. We’ve seen divisions in society open up, with inequalities becoming even greater since the pandemic started. And you had a column in Wired magazine recently titled “The Exponential Age Will Transform Economics Forever,” which talked about how our inability to understand that we’re living in a moment of exponential change could tear apart economics and society. Can you just explain to us what you mean by that and what are the implications of it at a time when countries are looking for ways to reset their economies from the impact of the pandemic?
MR. AZHAR Where we found ourselves just before the pandemic was still an uncomfortable position in the sense that even though employment levels were very high in most of the richer economies in the world, there were certainly significant questions about the quality of that employment. As we move to apply these exponential technologies and we build platforms like Uber and many others, we see a bifurcation in not necessarily the quantity of workers, but the quality of that work. And when we look at what’s happened during the pandemic, the winners in industry have been those digital network platforms. Amazon added 800,000 workers globally since the pandemic started. And at one high level that’s a great number, that is 800,000 more families with employment. But one of the things that we have noticed, it’s something I write about in my book, is that the relative power between the corporation and the worker has shifted dramatically in favor of the corporation over the last 40 or 50 years as we’ve implemented these advanced technologies. We see that in measures like the labor share of national income, which has been declining in pretty much all over the rich world. And so we sit at a moment where we have to ask whether the traditional orthodoxies of our economics still make sense. Do they serve us? And they perhaps may serve a top-line G.D.P. figure, but they don’t necessarily serve the equity figure.
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