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A View from the Magic Mountain

Alfred Sommer, MD, MHS 

Like many of today’s chic resorts, Davos got its start as a tuberculosis sanatorium. Thomas Mann put the town on the map in The Magic Mountain, in which he describes the peculiar social organization of the sanatorium where his wife sought treatment—principally exposure to sunlight and clear, cold mountain air. Today, tuberculosis is routinely cured with antibiotics, and Davos is synonymous with the annual meeting of the World Economic Forum.

The Forum’s public persona reflects its members: dues-paying CEOs of many of the world’s largest companies. But much of its sparkle originates from the presidents, prime ministers and other potentates providing perspectives on the political and economic environments within which big business functions. A cartoon in the International Herald-Tribune on January 26, 2005—the day this year’s meeting opened—showed two prosperous attendees reading a sign outside the snow-ensconced conference hall: “Theme of the 2005 Meeting: Make Huge Money and Sleep Well.” One participant quips to the other: “Every year the same theme.”

Having attended the Forum for years (as an invited participant and not a dues-paying member), I discovered that this year’s theme, “Taking Responsibility for Tough Choices,” proved to be anything but business as usual. “Global health,” including tuberculosis, had returned to Davos.

The unofficial but recurrent theme was the need to seriously address the Millennium Development Goals (MDGs), originally established by over 180 nations at a special session of the United Nations in 2000. The “world” pledged demonstrable reductions in hunger and poverty and advances in global security, education and health by 2015. Each year the Global Governance Initiative (GGI), which monitors progress in terms of financial commitments and partnerships, releases its score card at Davos. A score of “10” suggests the world is on track to meeting the MDGs. I chair the GGI’s Expert Group on Health, whose goals include reducing child mortality by two-thirds; reducing maternal mortality related to pregnancy and childbirth by three-fourths; and stemming and reversing the epidemics of HIV/AIDS, tuberculosis and malaria. We’ve never rated global progress on the health goals higher than a 4. Worse still, almost all progress is being made in countries that already enjoy the best health.                                     

Few Davos participants had ever heard of the MDGs. Until this year. A plenary town meeting allowed 700 participants to select the world’s most pressing priorities. “Health” received a write-in vote that placed it among the top 8. Over the next few days, health effectively shot to the top of the list, beating out frontrunners “poverty” and “climate control.”       

The first day’s main panel featured the likes of Bill Clinton, Bill Gates, Tony Blair, and Presidents Thabo Mbeki (South Africa) and Olusegun Obasanjo (Nigeria). The discussion, “Africa and Poverty,” quickly focused on health. Someone opined that health was perhaps something that could be achieved in isolation. But as I had noted in Global Agenda 2005, the WEF’s annual compendium of priority issues for the coming year, we cannot achieve the health goals without also making progress on other MDGs: reducing hunger; expanding primary education, particularly for girls; and providing at least a modicum of security.                    

Speaker after speaker took solace from the outpouring of support for tsunami victims. President Obasanjo noted, “I thought the milk of human kindness was sapped—the world was suffering massive donor fatigue.” The response to the tsunami gave him courage and hope. Perhaps, but the world tends to notice sudden dramatic events, while chronic, ongoing disasters (HIV, tuberculosis, obesity) become background noise.  

Talk again turned to health during a panel discussion devoted to poverty alleviation, when actress Sharon Stone upstaged panelists by personally pledging $10,000 to the Global Fund to fight malaria in Tanzania. Others added their support and within minutes President Benjamin William Mkapa of Tanzania had over $1 million with which to buy insecticide-treated bed nets.   

Near the end of the meeting, a senior New York stock exchange official was heard to complain that “this year’s meeting was about everything but business.” While his quip was clearly well-meaning hyperbole, the “Magic Mountain” was once again focused on infectious disease.