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Fighting the Diseases of Want and Plenty

Many of the diseases associated with either affluence or poverty are avoidable, but modern medicine is concerned primarily with treatment, not prevention. What is needed is a new approach to promoting health that focuses on biology, environment, and behavior.

BERLIN – “Diseases of want” arise from poverty, while “diseases of plenty” are associated with affluence. Many of the illnesses in each category are avoidable, but stopping them will require a revolutionary change in our approach to medicine.

Diseases of want are avoidable because poverty is avoidable. We have the technical expertise to eliminate extreme poverty simply by sharing information, generating relevant skills, and redistributing a small fraction of economic resources. Our failure to overcome diseases of want thus reflects not a lack of knowledge, but rather a lack of will. And it is this unwillingness, not the diseases themselves, that we must address.

By contrast, diseases of plenty – such as obesity, tobacco-related illnesses, depression, diabetes, and various types of cancer – arise because our affluent lifestyles make us ill. Such illnesses also are avoidable, but again, we lack the will to conquer them. They occur because our approach to medicine is fundamentally wrong. Once we have understood this, we will be better able to tackle diseases of want as well.

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