Abstract: The “Planetary Health” proposal discussed here describes a totalitarian vision favoring a data-driven, AI-controlled management of all resources of the world, from the planetary scale down to the microscopic processes in human bodies and in nature. The goal includes the control of behavioral, social and cultural change. However, the concept does not only ignore the concepts of ethics and democracy. It also ignores immaterial qualities such as human dignity, freedom, creativity, consciousness, or love, which are of particular importance for humans. Therefore, such an approach may easily and unintentionally result in violations of the Nuremberg code or crimes against humanity. Proper political action is urgently needed.
“The physician examines the human body and determines whether ... all organs are working for the benefit of the entire organism. We [Dehomag] are very much like the physician, in that we dissect, cell by cell, the German cultural body. We report every individual characteristic ... on a little card… We are proud that we may assist in such a task, a task that provides our nation’s Physician […] with the material he needs for his examinations. Our Physician can then determine whether the calculated values are in harmony with the health of our people. It also means that if such is not the case, our Physician can take corrective procedures to correct the sick circumstances... Our characteristics are deeply rooted in our race. Therefore, we must cherish them like a holy shrine, which we will – and must – keep pure. We have the deepest trust in our Physician and will follow his instructions in blind faith, because we know that he will lead our people to a great future. (Heidinger, 1934).” [1]
The document discussed in the following sometimes reminds of the above quote by Heidinger. It formulates not only a “requirement of preserving the life support systems”, but also makes a number of statements that deserve attention and debate, such as:
1. “Planetary health is defined as health of human civilization and the state of the natural systems on which it depends.”
2. “Health is the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”
3. “We posit that natural resources are the socioeconomic signal of planetary health.”
4. “Humans are strongly health-minded, and are individually and collectively resource-driven…”
5. “Resource justice is defined as a … process about collective and individual relationships encompassing the distribution of rights and responsibilities…”
6. The “ultimate challenge our societies are facing” is to “reconcile the basic needs of populations with the maintenance of the life-support functions of ecosystems…”
7. “Resources, including the human resource, are the matrix of economic and political power systems, of history’s ups and downs, and they have great geopolitical sensitivity.”
8. “Today, critical state shifts are expected around 2030” (talking about “societal collapse”).
9. ‘…inseparable health of nature-societies-people, known as the “planetary health” ”
10. “A socially just and environmentally responsible society ought to consider that Health is a precondition, outcome, and indicator of a sustainable society, and should be adopted as a universal value and shared social and political objective for all.”
11. “… future undertakings in all areas of human life and activities should take a resource-health stress test”
12. “To address these issues, we developed a Resource-Planetary Health Toolbox (RPHT), built on the alliance of natural sciences, legal and social studies, and data and complex system resilience”
13. “The approach is systemic and preventive and transgresses academic, cultural, and political boundaries. It has the ambition to circumvent the above-mentioned barriers…”
14. The objective is to articulate the nature-human relationship on universal health and indivisible human rights and duties, to which health is the basis for a science-informed civilization contract…”
15. “… the price of commodities reflects the true social and ecological costs…”
16. “… building consensus toward social justice and ecological responsibility.”
17. “… the ambition to frame human agency”
18. “… natural and data sciences for monitoring and reporting with institutionalized data systems”
19. “That inclusive design articulates social justice and ecological responsibility by setting the balance between the management through numbers and the government through law”
20. “… systematically monitor and evaluate … locally and globally…”
21. “Enacting resource justice to balance basic needs/poverty, limiting resources, social cohesion, demography…”
22. “cultural shift linking health and wealth”, “socioecological transitions”
While some of these statements may sound right at first, my interpretation is as follows, where the numbering refers to the statements above:
1. While claiming to aim at improving health, it becomes clear that the underlying goal is to manage nature and human civilization, globally. Hybris is one concern here, the possibility of global totalitarianism is another one.
2. It is apparently intended to not only eradicate disease entirely, but also to manage physical, mental and social aspects of everyone’s life. “State of complete physical, mental and social well-being” sounds a bit like everyone would be drugged in the future. It also potentially implies the elimination of pain and of people with diseases. Pain, however, is an evolutionary function that supports learning. Also note that people with diseases typically do not want to die. They often value their lives, as do their friends, colleagues, and relatives. Furthermore, many of the most impressive cultural achievements of our world have been produced by people who were sick, unhappy or handicapped.
3. Here, managing health is further reduced to the problem of managing natural resources. Non-material aspects such as happiness, love, creativity or human dignity disappear from the further consideration.
4. It is suggested that health is the overarching goal of humans, and that they are resource-driven. This again underlines a materialistic approach, which is highly questionable. I do not think that the strive for resources and health is the dominating goal of most people. Personal life achievements are often more idealistic.
5. Managing resources is defined as a matter of the distribution of rights and responsibilities. Consequently, there are no “God-given” human rights by birth anymore. Instead, one needs to earn his/her rights by fulfilling certain responsibilities.
6. Next, the document claims the ultimate goal of our societies would be life support. In a different place, the term “basic needs” is used, which reminds somewhat of the lowest level of Maslow’s Hierarchy of Needs. Accordingly, higher-level needs such as Safety, Love, Belonging, Esteem or Self-Fulfilment would potentially be neglected.
7. Resources are then related to economic and political power systems and geopolitics. Accordingly, human and environmental health become subjects of an economic and political battle for power.
8. It is claimed that we would see societal collapse around the year 2030, if we would not submit the goals of individuals and societies around the world to the logic of planetary health.[2]
9. It is further suggested that nature, societies, and people share one faith, while this is only expected to hold for a tightly connected globalized world.
10. Here, Health is given the role of an universal value, which in a sense replaces the role of God (and, consequently, “Health” is written with a capital “H”). All people are supposed to share Health as the overarching political and social objective.
11. It is then suggested that all areas of human life should undergo a resource-health stress test. This could be (mis-)understood as suggesting to expose societies to diseases and disasters, possibly to identify and get rid of the “unhealthy” and “vulnerable” elements. However, “vulnerability” is part of what makes us human and what makes us social.
12. Apparently, the above is not a theoretical consideration or vision of the future, but a system that has already been built (in parts) by an alliance that ranges from science to law.
13. The system also overcomes and possibly ignores or violates established scientific, cultural and political (probably also legal) frameworks, and it is tasked to prevent certain actions.
14. The goal is a science-informed civilization, in which health is the universal goal. It is reiterated that rights would be tied to duties.
15. This science-informed technocracy is based on attributing “true costs” to everything (including ecological and social aspects of society). This would, hence, imply a utilitarian approach, corresponding more or less to what is known as the “Chinese Social Credit Score” system. (It might be seen as a new kind of all-encompassing capitalism that values all externalities and all individual behaviors on an effectively one-dimensional scale.)
16. Based on this system, social justice and ecological responsibility would be enforced, and all people would have to agree with this.
17. The ambition goes so far as to control human activities.
18. A surveillance-based and data-driven approach is taken, which is institutionalized (probably UN).
19. Societies and individuals would be managed through numbers, and this system would be enforced by law.
20. People and nature would be under surveillance locally and globally.
21. Access to resources would be controlled, social cohesion undermined, and population control established.
22. The overall approach appears to be in the tradition of social Darwinism and sounds somewhat like “Death to the weak(ling); wealth to the strong” or “The rich should live on forever”.
The Anticipatory Brief on “Planetary Health and Global Resources” might, therefore, raise some serious concerns. An even better picture results, when the subtitle “The Cross-Cutting Challenge of All” is taken into account. As the vision of this Anticipatory Brief builds on the vision of basically all other Anticipatory Briefs, this picture encompasses:
I. The data-driven approach builds on a highly detailed “digital avatar” of the world, which probably includes digital twins that map our behaviors and inner workings of our bodies.
II. The digital twins will be fed by surveillance data obtained through the Internet of Things, which will be processed by extremely powerful machine learning approaches and Quantum Computers.
III. This platform will be used to manage all global resources, including our lives, with the goal to achieve “planetary health”.
IV. Such an approach will probably also include the use of nanotechnology, an Internet of Bodies, genetic engineering, as well as mind control approaches to steer thoughts, emotions, and behaviors[3] as well as the implementation of a new ethics based on the logic of the “trolley problem” (“morality engineering”).
Hence, the other Anticipatory Briefs may be considered to specify how the “Planetary Health” goal would be technically accomplished.
Criticism
Even though the paper is relatively vague, the idea shines through to „eliminate“ or „eradicate“ disease (and probably also „misbehavior“[4]). I do not think that this would work or that such a world would be desirable to live in. The following sections will provide a detailed criticism of some of the major scientific and political issues implied by the Planetary Health vision outlined above.
Limitations of a Data-Driven Approach
First of all, we need to learn from the shortcomings of data-driven approaches in the past, which were merely based on Big Data analytics, machine learning and AI.[5] This includes
a. classification errors (false positives or negatives),
b. spurious correlations, identification of random patterns, and overfitting,
c. sensitivity to minor modifications in the dataset or choice of the algorithm applied,
d. lack of robustness, stability or reliability of results,
e. slow learning processes or lack of convergence,
f. underestimation of the danger of wrongly fitting a certain fraction of the millions, billions, or even trillions of variables of future machine learning models,
g. underestimation of the role of diversity/heterogeneity and randomness,
h. underestimation of the role of systemic, functional, or algorithmic complexity,
i. limits of predictability,
j. limits of control,
k. limits of a data-driven approach (as the data volume grows faster than the processing power, the share of “dark data” never processed is steadily growing; consequently, a scientifically informed approach is needed to decide what data should be processed and how),
l. limits of a techology-driven approach (there are many ways how to use digital technologies),
m. limits of a transhumanist view (humans are not biological robots),
n. limits of a positivistic approach (non-material and hardly quantifiable factors are often neglected, including those that make us human, such as consciousness, freedom, creativity, love, solidarity, or human dignity...).
Other Scientific Flaws
A. Our immune system is generally highly robust, because it is being challenged by diseases all the time. The absence of diseases would probably weaken our immune system. In other words: health is not the result of absence of diseases, but a result of successfully coping with diseases. It is the result of interspecies interactions.
B. The current “Planetary Health” approach dramatically underestimates the roles that self-organization and emergence play for our well-being and a healthy state of nature.
C. In complex dynamical systems, global optimization and control approaches often perform worse than approaches based on flexible adaptation to local needs.
D. The great(er) performance of natural systems is often based on coordination, cooperation, co-evolution, synergy, and symbiosis.
E. A good illustration is the role that the microbiome plays for our health. Decades ago, it was believed that it was a good idea to disinfect everything in order to kill bacteria. In the meantime it is known that we could not exist without bacteria. In fact, there are about 10 times as many bacteria in our guts than cells in our body. These bacteria form an ecosystem that benefits us: it does not only digest food and make calories, vitamins, and minerals available to us, but it also is an important part of our immune defense.
F. Rather than pursuing a surveillance-based, data-driven, AI-controlled Planetary Health approach, it appears more promising to follow a symbiotic „ecosystem“ approach, considering also environmental, social, contextual and non-material factors (including mental and psychological ones).
G. Overwriting the operation system of our society, culture, mind, and body appears to be a radical, ideology-driven approach (aiming to “play God”) rather than an approach that is scientifically sound and recommended.
Political Issues
The “Planetary Health” proposal promotes first and foremost the interests of a medical-industrial complex.[6] There is a great lack of transparency and participation. It is entirely unclear what role, if any, democracy and human rights or human dignity will have in this framework. A global utilitarian optimization of planetary health and resource use would probably lead to phenomena such as organ harvesting against the will of people and algorithm-based triage decisions, as it is already reported from certain countries.
The spread of triage methods, which were developed for wars and war-like disaster situations, in everyday contexts is highly concerning and questions civil-ization altogether. People who are not counted to be “system relevant” by the algorithms in use would not stand good chances to get access to important resources. They would probably die early, as the planetary health approach would reward health, while punishing or trying to eliminate disease. The result would be technical selection benefitting genetically and otherwise gifted people. Eugenics would be a likely side effect.
Given the above as well as the so-called over-population of planet Earth and the lack of sustainability of our current economy, the management of highly sensitive personal/health data and medical treatment by private companies would be highly problematic. There would be obvious conflicts of interest, for example, when there are budgetary or other constraints that make patients’ interest unaligned with commercial interests of insurance companies and businesses in the health sector. The danger of crimes against humanity undoubtedly exists, particularly as there seems to be a lack of accountability for the algorithms used.
Imagine, in the future, someone would (be able to) apply technologies to our bodies or brains against our will, in favor of a proposed superior goal such as “Planetary Health”. Wouldn’t that be the mother of all nightmares? Is there any way to ensure that humans would not be experimented on against their will or exposed to unnecessary health risks? Otherwise related threats may largely outweight possible benefits.
In a data-driven and surveillance-based age, humans are increasingly managed and controlled similar to things. This strongly contradicts human dignity. For example, current Corona measures are deeply traumatizing to hundreds of millions of people around the world, probably more than even 9/11.
Perhaps the reason is that many of the ideas and technologies proposed or used in the context of planetary health have originally been developed in military contexts and labs. However, a civil society or civil-ization should not be based on military technologies, principles, or thinking, because this might quickly lead to an authoritarian, if not totalitarian framework of society.
For the governance of the highly networked techno-socio-economic-environmental systems of today we urgently need new organizational/societal frameworks and a lot more social innovation.
Judgement
The Anticipatory Brief on “Planetary Health” describes the most totalitarian vision I have ever come across. It appears to favor a brute-force, data-driven, AI-controlled management of all resources of the world, from the planetary scale down to the microscopic processes in human bodies and in nature. The goal includes the control of behavioral, social and cultural change. However, the concept does not only ignore the concepts of ethics and democracy. It also ignores immaterial qualities such as human dignity, freedom, creativity, consciousness, or love, which are of particular importance for humans. Therefore, the application of such a tool may easily and unintentionally result in violations of the Nuremberg code or crimes against humanity.
The proposed approach also seems to ignore many years of complexity and systems science, which has shown that self-organizing and evolutionary processes often outperform optimization approaches, in particular if synergistic or symbiotic processes are enabled. Resource optimization follows the logic of resource scarcity and implies a competition for and redistribution of limited resources. As a consequence, the proposed approach may put a large number of lives at risk. Biological, social and cultural processes, in contrast, often manage to overcome and outperform this logic of zero sum games (as a circular and sharing economy does).
Despite the above mentioned shortcomings, the flawed thinking behind the proposal already seems to drive political processes and technological developments worldwide. Behind great promises for the future, a highly concerning picture of society and its future is revealed. As a consequence of this new thinking, the very foundations of democracies, human rights and freedoms are at stake. It seems necessary to pull the emergency brake. In the light of the above, the Big Data and AI infrastructures built for the Planetary Health project should be seized and put under the control of The People of the world or otherwise be dismantled and turned off.
[2] This is basically the narrative of the Agenda 2030.
[3] Integrating Behavioral Health – The Role of Cognitive Computing
[5] A famous example is Google Flu Trends: celebrated as one of the big success stories of Big Data Analytics in the beginning, the service has been switched off and taken off the Web, as it was not sufficiently reliable.
