就像我发帖说的那样，上周三我有幸参加了一次有关精神疾病的大讨论，组织方是非营利机构Kaiser Permanente。发表在《柳叶刀》杂志上的《2016年全球疾病负担报告》显示，精神、神经和药物的使用加在一起，已经成为世界上最大的致病因素，在人类因健康损失的时间里，这些因素占了十分之一。但华盛顿大学全球精神健康问题著名专家、美国国立精神卫生研究所前高级主管帕米拉·柯林斯说：“尽管如此，大多数有精神疾病的人并未得到最低限度的治疗。”这个问题一方面是因为精神疾病仍然不合理、不公平而且残酷地和坏名声以及羞愧感联系在一起，另一方面则是因为对这种疾病认知不足，既缺乏了解和资金，也缺乏治疗渠道。但无论原因可能是什么，在任何地方都能感受到绝望情绪带来的不断加深的危害，比如波及面甚广的抑郁负担，比如自杀人数的稳步上升，再比如对阿片类药物的滥用已经达到令人警惕的水平。Kaiser Permanente旗下医疗体系的研究确实表明精神疾病是多么的普遍，而人们对它又是多么的缺乏认识。该机构首席执行官伯纳德·泰森在达沃斯的讨论会上告诉我们，因为身体上的症状而到基层医疗机构诊治的患者中，近三分之一的深层原因看来都和精神问题有某些关联。参加这场讨论会的还有柯林斯、剑桥大学公共健康高级研究员蒂内·范博特尔和Kaiser Permanente精神健康部门负责人唐·莫迪凯。除此之外，随着全球人口老龄化，老年疾病也汹涌而至，比如阿尔茨海默病和其他形式的痴呆症。精神和大脑疾病带来的负担正在快速增大，而且将给国家医疗体系和病人看护者增添巨大压力。上周我主持的另外两场健康主题会议同样把这个问题作为关键话题——其中一场是探讨医疗保健所谓的价值范式，另一场则是就老龄化和圣路易斯华盛顿大学医学院院长大卫·珀尔马特的精彩对话。
The 2018 World Economic Forum in Davos, Switzerland, just wrapped up a short time ago. Here are a few things I learned over the past week during this gathering of globally minded leaders, thinkers, builders, connectors, and teachers.
1. The mental health disorder time bomb is upon us.
As I mentioned in post, I was fortunate to participate in a powerful discussion on mental health on Wednesday, sponsored by the nonprofit Kaiser Permanente. When taken together, mental, neurological, and substance use (MNS) disorders are the world’s leading cause of disability, according to the 2016 Global Burden of Disease study, which is published annually in The Lancet; they’re responsible for one in every 10 lost years of human health. But “despite this, most people with a mental disorder do not receive minimally adequate care,” says Pamela Collins, a renowned expert on global mental health issues at the University of Washington and a former top official at the National Institute of Mental Health. Blame the above, in part, on the stigma and shame that is still—irrationally, unfairly, and cruelly—associated with mental illness; blame the rest on a lack of recognition of the diseases in question, a lack of understanding, a lack of funding, and a lack of access to care. But whatever the reasons may be, the harm of hopelessness is being felt everywhere and in greater amounts—from the widespread burden of depression to steadily increasing suicide rates to the alarming epidemic of opioid misuse. A study of Kaiser Permanente’s own care system, indeed, showed how pervasive and unrecognized mental health issues can be. KP CEO Bernard Tyson told our Davos panel—which also included Collins, the University of Cambridge’s Tine Van Bortel, and KP’s mental health leader, Don Mordecai—that in nearly a third of primary care visits for patients presenting with physical symptoms, the underlying cause appeared to be related in some way to a mental health issue. Throw into this mix the coming deluge of age-related disorders like Alzheimer’s and other forms of dementia, as populations around the world get grayer, and you have a fast-growing burden of mind and brain disease that will fall heavily on both national healthcare systems and family caregivers. This was also a key point brought up in two more health sessions I moderated this week—one on the so-called “value” paradigm in healthcare and the other, a fascinating conversation about aging with Dr. David Perlmutter, dean of the Washington University School of Medicine in St. Louis.
2. Cars won’t just be autonomous in the near future, they may also be burning in the street.
At Marc Benioff’s annual Salesforce lunch in Davos—one of several hot-ticket events the company hosts at the Swiss gabfest each year—five seers from industry and beyond offered visions of the future…in three minutes or less. Joe Kaeser, CEO of Siemens, had one of the starker (and darker) predictions, warning that we will likely “have either the best society ever built”—with a happily “completed Fourth Industrial Revolution”—or one of the angriest: a world with bitter, left-behind citizens and “the biggest trade war we’ve ever had.” There will be “no middle ground,” he said. “We’ll not only have self-driving cars, we’ll have burning cars.” Kaeser, who leads a company with more employees than Google, Apple, Microsoft, and Facebook combined, said the new economy must find worthy and essential roles for the untold millions of current workers who will be disrupted out of their jobs when the age of AI, robotics, and digi-everything fully arrives. “We have to figure out what to do with our people,” he said.
3. Everybody loves blockchain.
The World Economic Forum shuttle buses that ferry meeting-goers from hotels to the Congress Center and back are rolling vessels of small talk in a Babel of tongues. It’s a reminder of what a missed opportunity it is that we Americans aren’t required to be proficient in anything but English. (In Switzerland, a land of four official languages, nearly two-thirds of citizens speak at least two of them every week.) But in this polygot melting pot of business pooh-bahs, government grandees, and media loudmouths, there was one English word I heard over and over: “blockchain.” And yes, it came up in one panel discussion after the next. The bottom line? Everyone is excited about blockchain technology, naturally. Most would be hard-pressed to tell you why.
4. Smart data will help end malaria.
From 2000 to 2016, the number of malaria cases worldwide dropped 60%, thanks to a large global public health effort, a number of tireless nonprofit NGOs—and frankly, effective leadership and smart, targeted spending from organizations like the Bill & Melinda Gates Foundation. The first of those two Gates, Bill, offered his take this week on what would allow us to eliminate this scourge by 2040—which is a real possibility, he says, if we keep relentless energy and focus on the effort. As expected, it will require the usual arsenal of anti-mosquito bed nets, anti-malaria drugs, new anti-malaria drugs that can overcome resistance to existing anti-malaria drugs, an anti-malaria vaccine (if we’re lucky)…and probably, if we’re being wholly candid, an anti-mosquito genetic tool that will rewire this much-despised insect’s DNA to prevent the breed from either carrying the malaria-causing parasite, spreading the disease, or reproducing. (We’ll save that debate for another time.) So what’s new on the wish list? More sophisticated precision data tools to understand how, where, and why infections are spreading, where mosquito populations are thriving, whether prevention strategies are working or not, and where we’re making progress or backsliding. Said Sue Desmond-Hellmann, CEO of the Gates foundation: “We need smart data and analytics to guide the path.”
5. Companies still want to make a difference.
Readers of Brainstorm Health Daily—and of Fortune on the whole (which I hope you all are…)—know that we have chronicled a deeply important movement in the corporate world: an effort to do well while doing good. Each year, we highlight 50 big companies and a bunch of up-and-coming ones who have aligned their corporate mission in some way with the broader one of improving the planet, fixing what’s broken, and otherwise helping humankind. We call it the “Change the World” list, and we’ve created a new live-action program and conference to foster this work, called The CEO Initiative. Well, as was eminently clear in a week at Davos, this imperative is alive and kicking on a global scale. On Monday night, I had the privilege of awarding the Fortune Award for Circular Economy Leadership to the CEO of Philips, Frans van Houten. The recognition program, which was created and is still sponsored by Accenture (I’m not quite sure how this became a “Fortune” award—but thanks, Accenture), was replete with examples of companies large and small putting environmental sustainability at the forefront of their strategic business planning. And last night, at Fortune’s annual CEO dinner at Davos, the message on mission was just as resounding, I’m happy to report.
6. Surprise: Tech may make us better humans.
“Technology will find the one voice that loves you.” That was the out-of-the-box and yet strangely true-feeling prediction of musician/artist/poet Will.i.am, who (like Joe Kaeser) was one of the assembled prophets at the Davos Salesforce lunch yesterday. We will continue to be inundated with new digital devices that urgently attach themselves to our lives, he said. But somehow, in this inhumane procession of machines, one will emerge that speaks to you as no other, and that listens to you as no other. It will be the one that loves you—and that helps you rediscover your own humanity. Of all the predictions that afternoon, this was my favorite.
7. Teleprompters may save the world.
On the closing day of the World Economic Forum, President Trump delivered, in sober words and subdued tones, a 16-minute speech that, while replete with self-praise, seemed to soften the hard edges of his “America First” manifesto. Though I wouldn’t swear to it, the President did not appear to stray from his prepared remarks, glancing left and right at the twin teleprompter screens flanking the podium as he spoke. I suspect that’s a good thing. The earth is perhaps calmer today because of it. Its bannered nations are still apparently trading with one another and sharing ideas. The idea of a world economic forum feels a hair less divisive now than it did in the anticipation of Mr. Trump’s remarks. The famed gathering at Davos will live to see another year, I imagine—and I hope to come back to be part of it.