Category Archives: Life & Health

Ebola in Goma

Assessing the risks faced by the city of Goma in the Democratic Republic of Congo (DRC) would go well beyond the norms of the insurance industry. On January 17, 2002, a large part of the city center was destroyed by an eruption of Mount Nyiragongo, about 20 kilometers (12.4 miles) to the north. Volcano hazard is not a significant risk factor for many towns and cities – and nor is Ebola. Goma is exceptional in being at risk from both.

Outbreaks of Ebola have occurred in the DRC sporadically in 1976, 1994, 2003, 2007 and 2012. The most recent outbreak started on August 1, 2018, and even with the infection of 2,500 and the deaths of more than 1,700, the Ebola virus is still not contained. Endemic hostilities in the DRC make it hard for health organizations to track contacts of those infected, and to operate treatment centers without fear of military attack. Health workers expose themselves daily to lethal infection – and should not be exposed also to armed assault. But they are – two health workers were killed in mid-July.

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Ebola Epidemic: Confirmed Cases in Uganda

Situation

It has been reported that the current Ebola Virus Disease (EVD) epidemic, which has caused over 1,300 confirmed deaths in the Democratic Republic of the Congo (DRC) since its onset in August 2018, has now also caused at least one confirmed death in neighbouring Uganda.

The number of confirmed deaths has been steadily increasing since the onset of the outbreak, though since March there has been a notable increase in the reported number of deaths per week. A recent trend shows a slight decrease from the peak, with the current situation report recording 50 deaths among confirmed EVD cases in the past week (Figure 1 below).

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NHS Funding and the Hope of Living Longer

On March 13, 2019, the U.K. Chancellor of the Exchequer, Philip Hammond, warned in the House of Commons during his Spring Statement, that a “… cloud of uncertainty was hanging over the U.K. economy.” Reminiscing of a sunnier time for the U.K. economy, in the Budget speech in March 2000, Gordon Brown announced a substantial increase in government spending on healthcare. The Chancellor’s ambitious plan was that health spending would rise by more than a third in real terms over a five-year period, by 6.1 percent per year over and above inflation.

To inform and support this program, he commissioned a review of the long-term trends affecting the U.K. National Health Service (NHS). Based on wide-ranging academic research, this review, which was published in April 2002, had a long-term time horizon of twenty years, extending to 2022. The author of this review was Sir Derek Wanless, a professional banker, who was also a highly gifted mathematician – an important attribute for reaching robust quantitative conclusions on long-term NHS funding.

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Brain Fitness as a Driver of Longevity

Around 100 million people watched this year’s Super Bowl on February 3, which was a low-scoring game where the much faster play of the Patriots’ quarterback, Tom Brady, compared with his opposite number LA Rams’ Jared Goff, was a decisive factor. Few in the television audience would have known that the veteran quarterback had special cognitive training to enable him to perform so well according to the mantra: think slow, play slow.

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Civil War Drives the Spread of Ebola

The worst outbreak of Ebola in the DRC (Democratic Republic of Congo), Africa’s second largest country by area, with a population of over 77 million, has already claimed several hundred lives, and there have been more than three hundred and fifty cases.

Many of the Ebola cases have been in Beni (pop. ~230,000), a major city in North Kivu province, close to the Ugandan border. DRC is a failing state, where the government regime is weak, and cannot prevent militias from pillaging DRC’s abundant mineral resources. One such militia is the ADF (Allied Democratic Forces), which was formed in neighboring Uganda in the 1990s, and operates in the mineral-rich border area in North Kivu province.

The geography of the disease spread is intriguing for epidemiologists. Officially declared on August 1, 2018, this is the tenth outbreak of Ebola in DRC since 1976, but this is the first time that Ebola has affected the far northeast of this vast Central African nation. A crucial risk factor hampering the control of Ebola in this region is the conflict over mineral resources. This has limited the number of inhabitants who can be vaccinated, and restricted the access of health response teams, who are exposed to personal danger such as physical assault and kidnapping. Indeed, insecurity was a factor delaying the alert to the actual start of the outbreak, which was several months before the official declaration.

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Mapping 500 Trillion Dollars of Insured Exposure

RMS has just completed a two-year exercise documenting all the different types of insurance that are available in the market and a classification system for all the assets that they protect. This is published as a data definitions document v1.0 as a standardized schema for insurance companies to have a consistent method of evaluating their exposure.

This project, in collaboration with research partners Centre for Risk Studies at University of Cambridge, and a steering committee of RMS clients, involved extensive interviews with 130 industry specialists and consultation with 38 insurance, analyst, and modeling organizations.

The project will enable insurance companies to monitor and report their exposure across many different classes of insurance, which globally today covers an estimated US$554 trillion of total insured value. The data standard will improve interchanges of data between market players to refine risk transfer to reinsurers and other risk partners, reporting to regulators, and exchanging information for risk co-share, delegated authority, and bordereau activities.

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Reimagining the 1918 Pandemic

Ask any child, a world without Walt Disney would be unimaginable. Born in December 1901, Walt was sixteen years old when he caught the 1918 pandemic influenza — and survived. A century has passed since the great 1918 pandemic, in which tens of millions died, the deadliest in history. When an anniversary of a major event comes round, we can ask what if the event were to occur today.

Catastrophe modelers can also reimagine the event being different from what it actually was. This counterfactual perspective leads to important insights into pandemic risk, which have only recently emerged from virological research.

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Lassa Fever Outbreak in Nigeria

A few years ago, West Africa was struck by an epidemic of Ebola, which killed more than ten thousand people in Liberia, Sierra Leone, and Guinea. The first case of Ebola was a child who had been playing in a bat-infested tree. From him, the disease rapidly spread from person to person in a chain reaction of contagion. A quite different type of hemorrhagic disease is Lassa fever, which was first identified in 1969, and named after the town in Nigeria where the first cases were observed.

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Purpose before Profit: The Rise of Impact Investing

I had the privilege of following Ben Brookes onto the Exceedance main stage in 2015. I can’t remember a word of my talk, but something Ben said while I was watching him from the green room has stayed with me ever since:

“Some, like Aubrey de Grey, believe that the first person to live to 1,000 has already been born.”

If that sounds to you like the claim of an oddball biogerontologist, you’re not alone. I for one remember scratching my head quizzically at the time.

All the same, it certainly got me thinking. If we’re going to live that long, we’re going to need something worthwhile to keep us busy. We’re all going to need to find a purpose; a focus for our energies.

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Why We’re Getting Better at Changing the World

Photo by Blue Origin

Let’s start by celebrating goal achievement.  Last week, Jeff Bezos’ Blue Origin rocket successfully took off—and then returned back to Earth.  Mission accomplished. But, from 100 kilometers above the Earth’s surface, looking back at our planet, what’s the state of our global goal achievement?  Do we even have goals?

I ask this as over 50,000 delegates descend on Paris this week for the 21st Conference of the Parties to the United Nations Framework Convention on Climate Change. Or more simply, COP21.

COP21 offers the unique prospect of 196 countries achieving a (sort of) legally binding agreement on climate change: to keep global warming below 2°C by reducing greenhouse gases. But what would a “good goal” for COP21 look like and would it ever be achieved?

Set your goal. Measure it. Achieve it.

It’s easy to get cynical about achieving BHAGs (Big Hairy Audacious Goals), but maybe a template for success has emerged. In 2000, the United Nations agreed to eight BHAGs through its global Millennium Development Goals. Goal number four was to reduce child mortality by two-thirds within 15 years across 138 developing countries.

A 50% reduction in child mortality in 15 years

In 2010, Hans Rosling’s celebrated TED talk outlined a two million annual reduction in child deaths under the age of five within a decade, down to 8.1 million per year. By the end of 2015, we will be below six million deaths per year, almost halving in 15 years.  That’s still too high, and many countries will miss the two-thirds reduction target, but nonetheless it is a huge improvement.


Source: IHME

As Rosling points out, the Millennium Goals were strong due to measurable targets. Clear targets, at individual country level, have driven the ability to lobby for increases in financial resources for clean water, immunization and antibiotics, motivated by strong partnerships and innovations in service delivery.

A goal for climate change

Rio in 1992 is remembered for establishing climate change as being caused by humans, and more specifically, primarily the responsibility of the industrialized countries.

Source: Wikipedia/EU Edgar Database

France, as host, wants to build on the momentum of Rio, but also learn lessons from past summit failures.  So, much of the COP21 framework has been defined and negotiated in advance. Francois Hollande has already agreed with top-polluter China on a mechanism to monitor cuts every five years.

The squabbling that characterized Copenhagen in 1999 will be minimized, and high expectations set for those attending, such as encouraging heads of state to arrive at the start, rather than jetting in at the end.

Frequent communication with every country participating has been critical. As conference chair, Laurent Fabius, French Foreign Minister told the FT last week “Negotiators sometimes hold firm positions that only ministers can unlock, I know their bosses – I see them all the time. We talk often, it helps”.


Infographic: Who has pledged an INDC so far, and what percentage of the world’s emissions are covered. Credit: Rosamund Pearce, Carbon Brief, based on EU data

Paris will pull out all the stops to get an agreement, but will we be willing to accept the short-term costs and constraints to slow down climate change?  The answer is probably yes.

So what are the lessons for COP21?

As Jeff Bezos’ Blue Origin extreme rocket recycling shows, individual changes in our daily behavior such as recycling and energy conservation can affect climate change, but ultimately, changes need to be government led, especially around energy generation and emission control. Whether world leaders are ready to be held legally accountable for missing their climate goals is an ongoing issue.

Nonetheless, as the Millennium Goals show, clear and well-defined targets, annually measured (“are we there yet?”) create momentum to drive change forward. The success of COP21 will be defined by whether emerging sub-goals are specific, measurable, achievable, realistic, and time bounded. Now that would be smart.