Building a shock-resistant planet in a world of such great difference

I had a rare opportunity to speak with innovative people questioning whether global immune technologies seeking to find systemic solutions to global pandemics can help build a shock-resistant planet. Such technologies include those that "can detect a novel pathogen in the air, water, or soil of the Earth and rapidly sequence its DNA or RNA"[1] to neutralize the pathogen before its damaging effects begins, and in a sense entirely bypass the limitations we have seen with governments in managing diseases like COVID – 19. This conversation can be retrieved from https://bit.ly/2ZNiSqU. 

I live in a continent that shoulders one-quarter of the global disease burden, has less than 2% of the world doctors, invests less than 1% of global health expenditure, and is among the continents with the lowest access to healthcare services in the world. While these impressive innovations towards "precision medicine" seek to prioritize preparedness, prevention, and confinement of disease outbreaks, I often wonder the extent to which such innovations can genuinely be global in a world of such significant difference.

The global health sector is predicated on an exploitative model that prioritizes profits over people. As such, it has built a curative system that is mostly available to those who can pay, and which has proved to be unsustainable with occurrences of global pandemics like SARs and COVID-19, especially among the poor. For any such system to work optimally, it must avail health as a public good and a right while collectively working towards the achievement and maintenance of good health through preventive healthcare that is inherently less costly. This value-based health system would have to centralize the needs of people to produce consistently superior outcomes at the lowest cost. This means universal access to high-quality medical care, patient safety, convenience, cost containment, and ultimate satisfaction in services rendered for the collective wellbeing of all to remove the threat of global infections effectively.

Problem-solving technological innovations have been vital in making enormous strides in the health sector. However, technology has not been without its challenges. A first critical concern is the relationship between humans and machines. Weak collaborations between people and machines resulting from technological misuse - which occurs when people overly rely on automation inappropriately, or technological disuse - which occurs when people do not fully appreciate the benefits of automation, have become increasingly costly and catastrophic in as far as they compromise people's safety. WHO acknowledges that the diffusion of innovations is a major challenge because of: user perceptions - on the benefits of change, on uncertainty levels, on compatibility between values and current needs, as well as on simplicity of use. This means that the process of acceptance and diffusion has its own pace, rules of the game, and complexity level. For the successful and accelerated interface between humans and technology, trust becomes a critical factor. Just as trust aids relationships between people, it also guides and influences reliance and use of the said technology, its mastery, and the extent one feels a sense of security when using the technology, especially in complex and uncertain situations. This means that the way certain technologies are introduced is critical in building or undermining trust.

A predominant characteristic of the health model that has been pursued over time is the top-down prescriptive approach of creating solutions by the 'power holders' because they have the resources and the capacity to do so. The only problem with this approach is that it now has to create solutions for cross-border challenges that manifest differently in different cultures and communities. As such, automated systems have to genuinely understand the users' unique situations in different parts of the globe to design truly inclusive and adaptive systems. This can only be achieved through new processes that are mutually collaborative and participatory – to co-design and co-produce unique gap-filling solutions that value diversity and incorporate indigenous knowledge to build true resilience. Therefore, the system's effectiveness will only be achieved with the dismantling of hierarchical, bureaucratic, and egocentric institutions and constructing transformative ones that are responsive and agile enough to bring about the needed change. The only question here is, are the beneficiaries of the current global order able to shift to the required paradigm?

References 

Berwick, D. M. (2003). Disseminating innovations in health care. Jama, 289 (15), pp. 1969-1975.

Hoc, J. M. (2000). From human–machine interaction to human–machine cooperation. Ergonomics, 43 (7), 833-843.

Lee, J. D., & See, K. A. (2004). Trust in automation: Designing for appropriate reliance. Human factors, 46 (1), 50-80.

Porter, M. E. (2009). A strategy for health care reform—toward a value-based system. New England Journal of Medicine, 361(2), 109-112.

Porter, M. E. (2010). What is value in health care?. New England Journal of Medicine, 363(26), 2477-2481.

World Health Organization. (2006). The world health report 2006: working together for health. World Health Organization.

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[1] for more information visit the Atlantic Council website. 

Resist the status quo bias

In Kenya and Africa at large, politics is a filter through which many, if not all, things are perceived. However, when COVID-19 took over our lives in March, politicians who claim to have all the answers, momentarily went suspiciously quiet while the media fumbled to get enough news items. At that point, COVID-19 was beyond political maneuver and beyond anybody’s control – evidence that politics is not everything. Given the magnitude of uncertainty or the looming impact of the pandemic, one would imagine that we would be rational enough to suspend selfish interests and focus on minimizing the ensuing devastation of the pandemic. Strengthening our health systems, critically working through economic recovery, revamping people’s welfare, and reducing debt, as we help flood victims, among other crises, should be the natural order of things. Instead, we are back to the politics – of reviewing the Constitution, fostering tribal unity, or ousting those threatening political party interests, etc. Just as quickly as we forgot about the locusts, we have pretty much moved on from the issue of the Coronavirus to amplify non-issues.

Kenyans must internalize one thing – that the political agenda has nothing to do with resolving critical life issues. Instead, it has everything to do with maintaining the privileges of the powerful and their beneficiaries. For that to happen, the systems of power, like the Constitution and the electoral system, have to continuously be recreated to align with these interests. The dominators also have to legitimize the process by crafting a generalized acceptance. By framing these trivial political issues (in comparison to the unaddressed issues) as urgent and life-threatening to the dominated group, they work at building a narrative that suspends logic to achieve consensus. That is why for example, the so-called ‘Luhya leaders’ have no problem defying the COVID rules or spending so much money flying across the country to meet and claim tribal solidarity (which by the way could easily have been done through zoom). The narrative portrayed is that a lack of urgent tribal harmony will lead to political decimation faster than a COVID related decimation. The narrative is crafted to make the community believe that the urgency applies to them, while all this time if the peasants truly mattered to the politicians, the resources would have been consolidated to help flood victims. The same applies to the proposal to review the Constitution in the middle of the current crisis – it is crafted to literary imply change. However, it has nothing to do with changing the fate of poor Kenyans, most of whom are economically desperate at this point. It is about entrenching political dynasties and maintaining the status quo. 

What Kenyans must understand is that the constant messaging through imagery and metaphors translates the trivial agenda into urgent beliefs and priorities for the dominated group, hence reinforcing the abnormal values, ideas, and practices as the norm. Before long, we are all (including the so-called elite) sucked into this endless but redundant game of analyzing and reanalyzing the logic of their political agenda, which is further amplified by the media. We do not realize that our engagement only gives politicians the social consensus they need to keep dominating and continuously taking us for a ride. Stephen R. Covey said, “most of us spend too much time on what is urgent and not enough time on what is important.” Kenyans have to collectively decide what important and endeavor to change the priorities.

Dr. Katindi Sivi

African futurist 

How COVID-19 has destroyed the false narratives we tell ourselves

All African countries, including Kenya, latched onto the ‘Africa rising’ narrative peddled in the early 2000s after a series of labels and terminologies like the hopeless continent, basket case, or lagging. The reason for the Africa rising narrative was the economic growth of between 2.5% and 5% experienced by several countries, and which was higher than what was experienced even in developed countries. Unfortunately, economic growth, measured in gross domestic product (GDP), is an accounting system that calculates the value of production (of both goods and services) in a given period while GDP per capita divides that value by the total population. GDP, therefore, does not really indicate the sustainability of the sectors driving the economy or the wellbeing of the population, and that is why two countries with the same GDP can have different poverty and inequality levels. 

The Africa rising narrative has been good for many African politicians because it made their regimes look good, as they ranked higher in various global indicators. Many countries, including Kenya, went as far as rebasing their GDP in 2013, in an attempt ‘to capture a more accurate estimate of the size of the economy.’ As a result of the rebasing exercise, Kenya increased its per capita income from $994 to $1,246, which indicated an improved economic performance, often mistaken to mean higher standards of living. The implication of this ‘growth’ was that Kenya was no longer categorized as a low income but as a low middle-income country way before the projected timeframe stipulated in Vision 2030. By rebasing, Kenya became one of the largest economies (fourth) on the continent. The Africa rising narrative also promoted the idea that the continent had a growing middle class. This group is associated with more affluent lifestyles of increased consumerism of luxury goods, and it was projected to rise to 42% of the population by 2060.

All these ‘look good’ efforts did not change the fact that the growth was largely based on the export of primary commodities that are vulnerable to global shocks and foreign direct investments whose profits are largely repatriated to the home countries of the companies. It did not change the fact that only one-third of the population had wage employment or the fact that the so-called middle class in Africa (defined as those earning between USD 2 to 20 per day, and which constitutes the poor in other countries of the world) is only one salary away from poverty. 

COVID-19 has destroyed this false sense of privilege among urban households and exposed the blatant lie of Africa’s socio-economic demarcations, particularly those categorized as non-poor. It has exposed the precarious nature of their jobs vis-a-vis consumer behavior, which does not coincide with perceptions of a middle class that should sustain domestic consumption and growth in the future (even when out of an income for some time). The fact that this crisis is driven by the loss of income (projected to affect 75% of the population in Kenya) rather than rising food prices that have characterized previous global crises buttresses the vulnerability of urban households. As such, the resilience of rural households will be much higher compared to their urban counterparts because of expenditure patterns. 

What is my point? The stories we tell ourselves matter. By choosing these singular narratives of entire hopelessness or escalation of a continent’s economies, we legitimize false realities and build our future on falsified hopelessness or faulty hope – what Chimamanda refers to as the danger of a single story. This calls us to train ourselves to see things beyond the surface, to question interests and the assumptions that we make about the narratives we observe, read or hear about, and creatively make linkages. 

Dr. Katindi Sivi

African futurist 

Thriving in Turbulence...How do we handle disruption?

My youngling (she is three) keeps saying, “when conona vinus ends, we shall do ….”. Like her, we say it loud or deep-down wish that we could miraculously snap out of whatever this is and get on with life as we knew it. It is hard to come to terms with the fact that there is a breaking of the norm because human nature dislikes change and the disruption of known patterns and routines we effectively control. However, whether we like it or not, life will never be the same again. The question is, how do we cope with the uncertainty of not knowing the full impact of COVID – 19 on our personal lives or in the future? How do we adjust to significant, life-altering changes we have no control over?

First, we must expect and accept that this and many other disruptions will be part of life. It will be helpful to spend time anticipating some of the things that could change and processing possible responses. This is not for purposes of deepening the panic but for purposes of preparedness, which helps navigate unexpected challenges better than when one is in denial. Second, there is no use trying to fit square pegs in round holes. We need to throw out most of the standard rules that may have worked in the past, with the understanding that new situations require different responses. This realization calls for a willingness and openness to unlearn, learn, and re-learn. The third is the adoption of a beneficial mindset that keeps us away from obsolete assumptions, which often block us from seeing emerging realities. Hope is vital, but we must be cautious about being too optimistic, believing the future is always positive and, therefore, not entirely paying attention to possible interruptions. Too much pessimism, always believing that the future is bleak, will cripple us from seeing the many opportunities we could take advantage of. On the other hand, believing that the future is given and so passively approaching it with the belief that we cannot do anything about it, makes us play the victim. Forth, we must create new rules for this new season or adapt to the ones that work for us. 

Being agile enough to quickly adjust to possible solutions before a crisis happens means that we proactively catalyze the required action to survive and thrive. Ultimately, we must accept that the Covid-19 disruption will re-shape the social, political, and economic structures as well as alter how people think and behave forever. It is imperative for all of us to move away from what used to be and consider what our society might come to look like – we have a chance to collectively re-set a preferred alternative to what was not working in the past. 

Dr. Katindi Sivi

African futurist and founder of LongView consult. 

Set me free: The story of Ajem

https://www.youtube.com/watch?list=UUUyY2nS9jtBeLLut53JaKqA&feature=player_embedded&v=NuhovSZLTts

Enemy of the state? with Katindi Sivi-Njonjo

http://www.youtube.com/watch?v=sT-bjOASnNs&feature=share

Kenya: So Rich Yet So Poor, Is Turkana Selling Its Due?

Article featured in the Star newspaper on 29 November 2013
see: http://allafrica.com/stories/201311290270.html

Imagine a place that is linked to the origin of humankind; is one of the world's leading archaeological sites and is now a World Heritage Site; has preserved wildlife fossils, which include the giant tortoise and the 20-foot long crocodile; is home to one of the smallest tribes on earth who still wear goat or fish skins and accessorize with fish bones or fish teeth; has the world's largest permanent desert lake which is also the world's largest alkaline lake; has an island with scenic crater lakes each harbouring its own kind of animal species like flamingos, crocodiles and tilapia; has sand dunes that measure over 40 feet high that are surrounded by palm trees; has a forest;is rich in wild life; has commercially viable oil deposits and a lot of water. Well, what do you think about this place? I think it is too good to be true. I think it should be one of the world's biggest attractions.

Unfortunately it is not. The people from this place, when compared to a Kenyan of average status (which is not that great), are two times poorer; fifteen times less likely to get a formal job; thirteen times less likely to earn more than seven thousand two hundred shillings (Ksh 7,200) per month; four times less likely to learn how to read and write; seventeen times less likely to have a primary education; sixty three times less likely to have a secondary education or above; three times less likely to have access to clean water; sixty three times less likely to have access to sanitary facilities; eighty two times less likely to live in a house with a cemented floor or a mabati roof; three hundred and thirty six times less likely to live in a house with stone/brick walls; thirty four times less likely to cook with cooking gas (LPG), bio fuels or electricity; and no chance on using electricity.

These are a lot of 'less likelies' for such a rich place but regrettably, these are the contradictions a person born in Kotaruk/Lobei in Loima Constituency, Turkana County, has to live with. 

While on one hand the opportunities and resources in this county can be a blessing and thus the county has the potential to make incomparable sums of money to kick-start economic growth, eradicate poverty, raise literacy levels, improve health indicators, ensure food security, access to clean water and sanitation, create jobs to increase household incomes and purchasing power, enable the transfer of technology, improve infrastructure and encourage the flourishing of other related industries; on the other hand, these resources could be a curse.

World over, the resource contest for opportunities by the elite most often leads to poor governance, high corruption, a culture of rent-seeking, devastating health and environmental consequences at the local level and intensified conflict to divert attention as the resources are looted. This might be already happening in Turkana County.

The southern part of the county is under siege with armed militiamen from the neighbouring Pokot community recently holding three police camps hostage. While it may be assumed this is the usual age old difference over land, pasture, water and cattle, it is important to interrogate the extent to which there is political will to ensure that the abundant resources here mutually benefit all the people of Turkana.

Recently some companies prospecting for oil in Turkana County  applied to be exempted from paying taxes both to their country of origin and the Kenyan Government. They are known to have built a few schools, health centres and sunk a few boreholes in Turkana County. On the basis of these they argue that they should be allowed to extract Turkana County oil without paying their dues to either the County Government or the National Government. Should this be allowed? Corporations are known to spend little money on local communities in what is commonly known as 'Corporate Social Responsibility', then proceed to extract valuable natural resources worth billions of dollars after which they leave. In most of these cases the local communities are left worse off because they were not skilled enough to take up the opportunities provided. The infrastructure left often collapses and the unchecked extraction of natural resources leads to extreme environmental destruction.

It is important that the Turkana County Government is cognizant of their role in providing adequate social services to improve the welfare of their citizens. Sustainability and equitable distribution of resources should therefore be at the forefront otherwise the custodians of the birthright of the Turkana people will be sold off for the proverbial 'bowl of soup' and the owners forever remain condemned to poverty and lack.

Katindi Sivi-Njonjo is an African Futurist, a Social Researcher and Policy Analyst, a Gender Budgeting Practitioner and the Programme Director at Society for International Development (SID) - East Africa. Katindi was instrumental in the recent launch of "Exploring Inequality in Kenya" Report by SID East Africa and The Kenya National Bureau of Statistics (KNBS). For more information about the report, please visit: http://inequalities.sidint.net/kenya/