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Gavin: Hello and welcome to the hundredth episode of the Lancet voice. I'm Gavin Cleaver here with my cohost, Jessamyn Bagenal, and we couldn't be happier to welcome you to this milestone episode. Before we carry on with this week's episode, where Jess and I are going to be chatting with Editor in Chief of The Lancet, Richard Horton, we'd sincerely like to thank everyone who listened to this podcast over the last three and a half years.
We launched in the somewhat auspicious month of March 2020, I don't know if you remember any of the news that was going on then, and it's been a genuine pleasure to host and to produce this podcast in the years since and to watch it grow, and I'm really looking forward to another hundred episodes of chatting about health with guests from around the world.
Now that's out of the way, we thought as this is the hundredth episode, we'd take a break from the spotlight podcast that we've been doing all year and get Jessamy and I back in the studio to talk with Richard Horton about the SDGs, COVID, global health, AI, and everything that we've been covering for the last few years.
Please as ever, drop me an email at podcasts at lancet. com with any feedback and anything you'd like to hear on the podcast. So without further ado. Here's Jessamy and I talking to Richard Horton.
Jessamy: It's our 200 year anniversary, and we've got this whole programme of work. We're just over midway through. What have been some of your highlights?
Richard: I think the highlight for me is something that people out there don't see. We've got 24 journals across the Lancet group, and they all work very much separately from one another.
We come together a few times a week to discuss papers and to share stuff, but we do work pretty much in silos. And the beautiful thing about the 200th anniversary is that we've seen our journals working in silos. across themselves. They're working together. For example the Weekly has been working with Lancet Planetary Health, Lancet Public Health, Lancet Global Health in thinking through what we do about the climate crisis.
For universal health coverage, all kinds of journals have been jumping into that debate. Research for Health includes all 24 journals. And I think one of the lessons that comes out of that is that when I talk to colleagues, they've really loved the fact that they've been working across disciplines.
And I think this is going to completely change the way we work at The Lancet in the future. I was just talking this week, in fact, with someone about the fact that we need to keep these collaborations going through into 2024 and beyond. So I think what it's going to do, it's going to sharpen our ability to identify.
important themes that we want to pursue at the journal. We've got these five themes this year. And then we're going to ask what do we want to do next year? What are some of the priorities in health that we want to focus on and how can we assemble our journals and our teams to look at what those problems are and to identify content or events or webinars, whatever we want to decide?
to shine a spotlight again on, on that particular subject. I think the lesson for me from this year is that it, that what we've done has sparked an unusually flourishing period of creativity at The Lancet, and we want to keep that spirit alive in the future.
Gavin: It's interesting, isn't it?
Because human health and kind of the problems facing medicine and human health, none of them really exist in silos.
Richard: They don't. But, I think a good critique can be made of medicine that it's very much, it's organ focused very much. If you're a gastroenterologist, then your interest is the gut.
If you're a cardiologist, your interest is the heart and nephrologist, the kidney. And so the practice of medicine is either focused on a particular organ or focused on a particular disease. That's how hospitals are arranged. That's how the academic community is arranged. And functionally it makes a lot of sense, but you can see how it also restricts the ability to have multidisciplinary collaboration to address what can be extremely complicated problems that you have in health.
So I think this is a good balance to the, what is often a very pragmatic way of organizing journals and research. It's a good balance to that, to mix it up a bit. The organs of The Lancet working in harmony. Yes, and even sometimes in disharmony, because tension that comes out of collaboration, different goals, different perspectives, actually is also very good.
I think it's been a tremendous year so
Gavin: far. From a health perspective, and looking outside The Lancet, what's really stood out for you so far this year?
Richard: The major transition has been out of COVID and back into the real world of where we were before COVID. And how do we, how are we different in 2024 to where we were in 2019?
And what's the balance sheet? And the balance sheet is inevitably a mixed one. On the negative side, I think we've been in a period now of de development. All the progress that we were making on the sustainable development goals is either stalled or is actually reversing because inevitably global focus has been drawn elsewhere.
Money has flowed, has been directed elsewhere. And we need to get back with the program that we had before. And that's gonna take a lot of time and it's not gonna turn around in 12 months. And almost certainly all the targets we'd set ourselves for 2030 are unachievable. So that's really bad, and it's going to require enormous political commitment at the time of global economic pressure, war in multiple regions of the world and how do we deal with that?
But on the plus side, I think that, certainly in the medical community, We have learned that there's a, there's an enormous power that we can bring by working more closely together. The, again, the potential of collaboration across countries was really intense and immense during the course of the pandemic.
And we need to capture that interdependence, that collaborative capacity and somehow bottle it and use it for the future. Thank you. And not allow some of our politicians to divide us and to pit us against one another. And I think that's the, that's my worry about the geopolitics post COVID, that actually countries are more divided now than they once were.
And I think what we can do in the medical and health communities is to bring peoples together to recognize the common problems we have and to realize that cooperation is the way forward. So Let's work out what the balance sheet is. Let's protect the things that have gone well, and let's fix the things that have gone badly.
And we need a ruthless, we need to be ruthless about that. And there have been failings in science too. And we need to be ruthless about explaining what those failings are.
Jessamy: Thanks Richard, just moving back to the SDGs. They'd be blown out of the water. We don't think we're going to make them. Do we need to extend them?
Do we need to revise them? What should be our approach?
Richard: So the SDGs were I think a perfectly rational response to the Millennium Development Goals a kind of re diagnosis of the predicaments facing the world to make them more inclusive of a much broader range of problems. Positive. Step forward there.
I think what the mistake was that, again, a bit like the Lancet's 24 Journals, we produce 17 goals. And I can remember, in, in the run up to the SDGs, in the health community, we were praying will we in the health community even have our own goal? And then when we got SDG 3, it was like, phew, we got it.
And now this is our goal. Everybody clear out. This is our space. We don't want anybody else to touch it. And so we ended up again creating a bunch of silos. And so we didn't look what's the relationship between health and education, between health and gender equity, between health and peace. We didn't really look for those, again, those collaborations across the goals.
So I think that was a an understandable error. Where we are now where people are already meeting within the United Nations to plan what comes after 2030. I think we need to, let's just get through the next 5, 6, 7 years to 2030. Do the best we can on the goals we have. But I think the really intensive, focus now needs to be thinking about where we go after 2030.
And that's going to require, I think, a very different approach to what we call sustainable development. It's going to be much more about the interconnections between these different fields. It's going to be much more about creating a resilient planet. It's going to be much more about thinking of how you address the, because one thing the pandemic taught us was how embedded inequalities hold populations at terrible, indeed mortal risk.
How we really put inequality at the center of the future of development. I think those are, we already know some of the principles that need to shape the post 2030 world, and now we need to make sure that we're at the table debating that. What I worry about is that you've got a bunch of well meaning, but nevertheless, bureaucrats sitting within the United Nations, plotting 2030, and we need to make sure this is a truly global conversation that brings in communities from all four corners of the planet.
Not just development experts, but civil society, academia, government, private sector. Everybody needs to be involved in the conversation to work out what we're going to do. So that starts today. Did you feel more positive
Gavin: about achieving the SDGs before COVID?
Richard: Yes, I really did. I really did. I really felt that, of course, there were some that were going slower than others.
But I really felt that we made such great gains during the Millennium Development Goal period. And I think we had got a pretty good, accurate diagnosis of where we needed to do better. For example, putting mental health much more at the heart of SDG 3, putting air pollution much more at the heart of SDG 3, neither were anywhere in the MDG era.
So I really felt we got a good handle on, on what we needed to do. And I did feel that there was political commitment and I did feel that money was flowing. The financial crisis of the mid 2000s didn't help, but I really felt that governments were positive. But then we had the era of Trump. And then we had the era of Brexit, and then we had the era of COVID, and all of that spirit of cooperation and goodwill crumbled and fragmented and actually atrophied and we've really yet to put it back together again effectively, and what we now have is we have this, the crazy tension between the U.
S. and China, we have the Russia Ukraine war, we've got a planet that's really really at war with itself and that is absolutely not a stable platform for even talking about the SDGs, let alone
Gavin: doing anything about them. Not to mention the the rapid advancements in climate change that we've seen this year around the world.
Richard: Moving much faster than anybody had predicted this whole idea of tipping points was exactly right. You get to a certain moment, and then things move very fast, and that's what seems to be happening right now. The days where people said you can't attribute a climate event to climate change, that's gone.
People are saying, no, you absolutely can. But there's an apathy, there's still a resistance to change. Look at the debate that's taking place in the United Kingdom today. Everybody's saying, no, net zero, forget it, it's impossible, we can't achieve it, we need to slow down, we need to focus on what the public wants, which is to deal with the cost of living crisis and put this green agenda to one side.
Not recognizing that the solution to the economic challenge we have is actually a green agenda. And that rapid energy transition though there is short term cost in that. will yield long term benefits and gains.
Jessamy: Richard, I wanted to ask you along these lines about a reflection that I heard a couple of months ago, and I think it feeds into what you're saying, but it's maybe a slightly cynical view of it.
And that's that, the Millennium Development Goals and the early SDG period, really what we were doing was picking the low hanging fruit from health systems, and we made gains almost by accident because. It was the low hanging fruit. And now we're in this period of multiple crises. There's apathy.
We've had various global events. And it's really hard. The view that there were all of these gains that we made, they were just by accident. And so we can't draw any lessons from them almost. And we have to start afresh. What do you think about that?
Richard: I would definitely challenge that.
I think, if I take, for example, MDG 4 and 5, child and maternal health, the gains that we made around reducing child mortality and maternal mortality were made because there was a concerted effort over many decades. To bring interventions to populations that had no access to those interventions.
Whether you're talking about vaccination programs, to strengthening health systems so that children who have a respiratory infection get access to health care, to better antenatal care for women during pregnancy and then subsequently, skilled birth delivery, that whole program of work over about 20 years yielded massive reductions in, for example, child mortality went from about 12 million a year to now about 5 million a year.
Maternal mortality fell dramatically too. Now I'm not saying either of those issues have been solved. Indeed, I'll come on to why there's still a problem there in a second. But in fact, the concerted medical public health efforts. gave confidence to politicians to put their reputations into supporting programs for maternal and child health.
Gave confidence to governments to invest in those programs because they could see that they would get a rapid return on those investments. So that was all amazing success. Now there was then a very, I think we did make a mistake. Because we went from these very vertical programs to absolutely right, in theory, we wanted to strengthen health systems, and so Dr.
Tedros comes into WHO, and one of his three pillars is universal health coverage. In fact he's said on repeated occasions that everything needs to lead back to universal health coverage. And he is right. He's right on paper, but the problem is that if you're a government, try to decide where to invest your money with an electorate who wants to know that you get a good return on investment.
What does universal health coverage really mean? See, if I'm at the Global Fund, I can say that if you give me money so that I can buy this number of bed nets or this amount of antiretroviral therapy, I know what the return on that investment is going to give me in terms of life saved. Universal health coverage, I can't tell you that.
Although we are right technically to advocate for stronger health systems, I fear that in doing so, we have lost the high level political will. Go back to the MDGs, there was literally a competition between heads of state for who could be in the lead on global health, across all political parties. So Jens Stoltenberg for the centre left from Norway, David Cameron centre right in the UK.
In Canada, you had the government there, quite a right wing government, Stephen Harper, supporting maternal health, including reproductive health interventions. What was going on there? So there was an enormous confidence. Ban Ki moon choosing every woman, every child as his signature health initiative.
Now, tell me a G20 leader who's in the front lines supporting health. There isn't one. There's a reason for that. And the reason for that is that, unfortunately, the financial investment case for health has not been compelling for them to take the risk to lead on health. And I think we have, unfortunately, been our own worst enemies.
We got carried away with our success at the end of the MDGs, and we lost sight of the fact that fighting for health is a political fight. It is not a technical fight. And if you want to win the political battle, you have to think tactically about what persuades politicians to act. And it's not having a beautiful plan, which is not going to be attractive to them from their narrow political view.
So I do think we need to pivot. And we need to pivot back to a balance between vertical and horizontal initiatives. And I think if we don't do that, that we are going to lose the
Gavin: political fight. Do you think that target setting that you were talking about there, seeing a kind of proven return on investment, as something that moves the political argument, do you think that hinders health?
The goal of overall improving human health?
Richard: It's very important that the indicators don't become targets, because then you can lose the focus. So for it, let me give you an example. You could say that an indicators for maternal mortality are antenatal care and skilled birth attendance, and then good postnatal care.
So those are going to be how we're going to measure, numbers of times that you see a health professional during pregnancy. having good emergency obstetric care facilities available in a hospital facility and then having good postnatal care. Those are your indicators and maybe they become your targets, but what you're actually trying to do is to reduce maternal mortality and reduce near misses.
of mortality. And following those indicators doesn't always lead to reduce maternal mortality. We've published work in the past that show that even when you get interventions that tick the indicator box, they don't necessarily, to, to a clinic, to a woman in pregnancy, that doesn't necessarily reduce maternal mortality.
So you have to think more holistically because then it's about, about, for example, the quality of care. Which is a very difficult thing to measure. Quality of care, quality of training of health personnel, the level of training of health personnel, very hard to put that into a metric that you can track.
We do need to be, we do need to be careful about how we measure our
Gavin: progress. It's difficult to encapsulate politically that stuff as well, isn't it? In a kind of, where we're chasing votes and we're writing things in manifestos.
Richard: But yes it, it's, I would argue it's very difficult to encapsulate universal health coverage political, because what is it?
It's three words that doesn't have a human being at the centre of it. Whereas when I'm talking about under five mortality, that's about a real live child. maternal mortality, a real live woman going through pregnancy, somebody living with chronic disease, a real life person who's got a cancer or a cardiovascular condition.
So if we depersonalize health in the way that unfortunately, I think we have, then again, for a politician, that's a much more difficult arena to persuade his or her treasury department and his or her voters to support, the public are quite skeptical of development assistance, quite skeptical of supporting things like the global fund, look at the global fund, what happened to the global fund, they had a replenishment target last year of 18 billion.
Every replenishment prior to last year, they achieved their target, they got just over 15 billion, they didn't get it. We don't just have the Global Fund Replenishment, we have Gavi Replenishment, we now have the Pandemic Fund, we have the Global Financing Facility, we've got all these multiple financing mechanisms.
Great. But the budget for global health hasn't grown accordingly. And so how do you persuade governments to invest in these multiple channels? It's difficult. And that's where I think you have to humanize the arguments to show that there are real people at the end of these financial discussions.
Jessamy: Is anybody else learning those lessons and do they apply to clinical medicine outside of science?
Richard: I am this is dangerous territory. I'm talking about the little community of global health in the world. And I got into, I've had a few attacks about this. But let me take you, let me go back to 40 years ago.
It won't surprise anybody that when I was a student, I might have been on the sort of left of student politics. But there were lots of people on the left of student politics where I went to university. And we We all had very strong views, and it was very factionalized, and, there, there were, it doesn't matter which factions, but there were a lot of different groups that thought they had the truth, that they owned the truth of what left politics meant and so we had wonderful debates amongst ourselves, and we loathed one another and we fought with one another, and and the enemy was the other left group that you weren't in.
And what of course that allowed when it came to our student council was that the people on the right just sailed through and won every single vote and completely trashed the left because we were divided. And it was only when somebody came along and created what he called the broad left movement, where we, We basically recognized our differences, but for the greater cause, we united.
Now, in global health at the moment there is an understandable feeling that we need to critique ourselves. There needs to be a sort of meta global health and that global health emanates from perhaps a well meaning place. But nevertheless, doesn't challenge the established order of power in the world, that it's a very Anglo American, English language, Anglophone discipline that it's not truly inclusive of all nations indeed that it's got elements still of racism, of colonialism of genocide attached to it and that this this whole edifice of global health is somehow sick and diseased and is never going to be able to address Equity, the right to health, social justice issues.
Now that is a perfectly good debate to have and I want to be part of it And I've indeed written about all of those issues in The Lancet So I'm fully signed up to that, that, then that need to look at ourselves in the mirror and critique who we are. However, it's really important that we don't forget who the enemies are of health in the world.
And I don't believe that people working in global health today wherever the world they're working, whether it's in the United States or in Kenya or in Australia or in China, I don't believe they're the enemies. They are doing their best to work on the subject that they're dedicating their lives to.
And our task is to identify who the real enemies are. And we know what the enemies are. We know that the enemies of Health for the Future are the fossil fuel industries. We know that the enemies of the future, of the present, indeed, are the A brand of conservative politics that wants to restrict the rights of women to have a safe abortion and roll back reproductive rights.
We know that the enemies of health are people who are passing homophobic laws in countries where we should be supporting freedom of speech. We know the enemies of freedom of speech are stopping the ability to have debates about the direction of society and they're locking pro democracy protesters up.
We need to be very careful about where we. About the direction we go. Because I worry that if we say to ourselves, global health is basically fundamentally flawed and can never achieve, the objectives that it set itself. We've really set ourselves up for failure. I think personally feel that what we need to do is say, yes, we need to have a good, robust critique of who we are and what we're doing, but we really need to point ourselves towards the forces that are undermining health and make sure we work together.
And that's unfortunately the lesson of COVID that, I think Our governments in the West have very different views to, say, the government of China about how to organize society. And those political differences absolutely are real, and we need to debate them, and we need to hold China accountable for what it does, and they will hold us accountable for what we do.
But when it comes to health and the issues that affect health of peoples, we need to work together. And I feel that about, I'm afraid I feel that about the global health community. We're in danger of destroying ourselves by getting the diagnosis wrong.
Gavin: I think we wanted as well to ask you a little bit about COVID, which we touched on at the start of the podcast.
So WHO declared an end to the international health emergency. in May 2023. So we had essentially three years and a few months. Of the pandemic until WHO declared it over an inverted common, which we can get onto in a second. But what do you think are some of the most important things that we learned from that three years of this kind of in the modern era, unprecedented international health crisis?
Richard: The first thing to say is yes, he was absolutely right to end the public health emergency of international concern. And it's right to say that it's not a pandemic in the way that it was, but it's still It's still an acute health emergency in many parts of the world. Although we're not doing the measurement in the same way that we used to there are still almost a million cases recorded every week.
And there are still, there's still people dying of COVID 19. This is around, this is endemic on the planet now. We still need to figure out our, how we're going to maintain our response to it and not let our guard down. Indeed, I was on the I was on a call yesterday with one of our editorial colleagues.
I won't name who it was, but one of our colleagues. just gone down with COVID. And not very well at all. It's there. In terms of lessons, the lesson that I've really, I really want to press as being the number one lesson of COVID to me, is that this was not a simple pandemic of a virus.
That this was a much more complicated phenomenon than anybody, anybody is really talking about with implications that go to the heart of the kind of society that we live in. And of course, that's why nobody wants to talk about this because it's, the issues that it raises are so big and so fundamental about the way we live together.
And to put it simply, that it's not a pandemic, it's a syndemic, a synthesis of, yes, a viral epidemic, and then also an epidemic of non communicable diseases on the social gradient of inequalities and multiple inequalities, whether they're socioeconomic, whether racial, gender a whole set of gradients that we need to address.
If we're truly going to create a a pandemic resilient society, We have to not just protect against a virus. We also have to make sure we're a healthier population. And we have to address inequalities in our society. Now, let's deal with the inequalities thing first, because that's the bit that's the hard one.
Addressing inequality needs to, in my view, needs to be the number one agenda item for every single government on the planet. It is what makes our societies fragile and weak. When you've got a division between an economic elite and people who are living in deprivation, the bigger that gap, the more fragile your society will be.
And brittle societies, cannot withstand shocks like COVID 19. So for a government, it's got to be the number one issue. And it's not, it's actually not even just about pandemic resilience. It's about any kind of hit that a society will take, including an economic crisis, including a climate crisis, including a war, whatever the threat is to the wellbeing of a society.
The deeper the inequality in that society, the more brittle that society is. We have to then ask, why are we not addressing inequities and inequalities in our societies? And this is an interesting philosophical question, because you could say it's down to a few different reasons. Is it because it's just too hard to do?
We as individuals don't have the means to address them, we would, we'd want to, we'd be there on the front lines changing society if we could, but how do you reverse those forces of capital, which create inequality. So there's that. Or maybe it's something a little more disturbing.
Which is that actually, we don't want to. Deep down, we're quite happy with the way things are. That actually, we say one thing, but we don't do anything because our lives are quite comfortable. The three of us, our lives are pretty comfortable. And maybe we've accepted. embedded to the norms of our society deep into us, and we don't want to change.
Now, I'm not blaming the three of us for the world's problems, but what I'm saying is that, that maybe human beings are, don't want to disturb the status quo. So we, there's a complicated debate in there about who we are. I once described the pandemic as a moral provocation, and I think it is. It's raised questions about who we are as human beings and what we want to be and what our societies should be.
And I don't think we've even begun to grapple with those questions. It's just side relief that we got through the last three years and returned to some kind of normality. But now's the moment to really ask the tough questions.
Gavin: Can we do that? Yes. As, in fact, as this is the hundredth episode, looking back a little bit.
It's striking to me how optimistic at times Jessima and I sounded hosting some of these podcasts, thinking about how we could rebuild the world better now that we were focusing on the inequalities, on the key workers that were keeping societies running. It was a lot of hot air, wasn't it? We've come out the other side.
And inequality is worse than it was before COVID.
Richard: So one of, one of the one of the places I love going more than any other in the world is to visit friends who live in the Occupied Palestinian Territory. Friends we have this Lancet Palestinian Health Alliance. We did the series some years ago.
And one of the, one of the words that they taught me of living life under occupation was neither optimism nor pessimism, but something they call pes optimism, that you, of course, if you live life under occupation, you're just pessimistic because it's this is, you're living your life. If you live in Gaza, you live your life under siege.
If you live in the West Bank or East Jerusalem, then you certainly don't have freedoms that you would have say in this country. But to survive, you have to be an optimist. You have to think that the next day is going to be better than the day before. Otherwise you're not going to get up. The idea of pest optimism, I think, is a very powerful one, and I feel that's where we are today, after the pandemic.
We're in a period of pest optimism. Yes, we should be pessimistic, because being pessimistic is what should motivate us to change. At the same time we have to have a little bit of optimism, otherwise if you don't have optimism, you don't think you can change. So you need the pessimism to motivate you to change, and you need the optimism to make you realize that you can achieve change.
The two go together.
Jessamy: So this year, it's been very dominated by generative AI. And we know that you have asked Chat to UPT about the future of the Lancet, and it was reassuring, which we were all pleased about. Are you a pessimist or an optimist about this wave of technology and where it's going to take us?
Richard: I have a call every week with somebody who's quite close to Bill Gates. And Twitter's going to love that. What? X style. Sorry. And this friend tells me that Bill Gates sees generative AI as the most important development after the user graphical interface or whatever it was called. So I, yeah, I do think this is massive.
Am I an optimist about it? I think on balance, I'm an, I am an optimist about it. I think in the field of healthcare, it could be enormously, it is being enormously powerful and generating possibilities that we didn't have before. Certainly, there was a paper published in Science just in the last week or so, showing how generative AI can lead to massive increases in productivity, for example, in the workplace by.
doing routine administrative by helping with routine administrative tasks, which free up human beings to do more creative things. So I think in terms of our quality of life, it could be massive. The problem is, as my friend says, if you plug generative AI systems into the internet, that could be the end of humanity.
So we do need some form of regulation. And I'm encouraged that the UN Secretary General has called to put together a panel to create something a bit like the International Atomic Energy Authority, a global body that can regulate and govern AI. The concern is that it's going to be very difficult to regulate some it's not quite building a chat GPT isn't like building a nuclear reactor.
So I'm not saying somebody in their bedroom can do it, but it's going to be harder to regulate than maybe previous entities. But I think on balance I am optimistic, or maybe I should say
Gavin: pessimistic. You gave evidence to the UK COVID inquiry recently. Which people can watch on YouTube.
Are there any insights or reflections you can share, not only from your evidence, but from the UK COVID inquiry with us? Giving
Richard: evidence that the UK COVID inquiry was a very sobering experience for two reasons. Firstly, that bereaved families were there. They're sitting in the public gallery.
And you have a real sense of the human costs of the pandemic. That this is not just an evidence gathering exercise for the sake of it, that this is actually an accountability mechanism. This is a reckoning of the last three years, and it's not an apology, but it's like a means of reparation to those families to try and explain in the UK's case why, why was it that over 200, 000 people have died from COVID 19 and what went wrong.
And I think for those who came and gave evidence and seemed to say that nothing went wrong and actually, Michael Gove, when he gave evidence after me,
Jessamy: he
Richard: did. And he said, actually, all the problems we were having may just match fit, was his phrase, match fit to respond to the pandemic. And I just thought you could say that.
And then to your right, though, these families of people who lost their lives, I just found that such an appalling betrayal, a betrayal of and this is the second aspect of it, the word truth, because at the beginning of the pandemic. Of every evidence, and I've never had to do this before, you actually have to swear an oath, and you say you're going to tell the truth, the whole truth, and nothing but the truth, and that word, truth, actually having to say that, and say it in front of the families, not just Baroness Hallett or the QC, Casey, who's asking you questions, but you actually have to say it in front of the families, that's a very, that's a big deal, we really felt Okay, I'm not just giving opinions here, writing a column or something, you're really trying to say, okay, what are the truths that we can learn from this whole thing?
And I, the formality of the occasion, And the sincerity of the occasion and the, how somber it was, I actually felt very optimistic that the whole process here could deliver some truths, which could have a profound impact on our society. So I really think that the people who are leading this inquiry are trying to do their very best.
It's a hell of a job. And it's going to take. Years to come to conclusions, but I really think this is what we have to go through. It's a little bit like the Truth and Reconciliation Commission in South Africa, where everybody should feel they can come to the table and without fear say what they did well and what they did wrong.
And, not that they will, in a way that they won't be indicted for it afterwards, but we can learn collectively what we got right. And we all got things wrong. All of we got things wrong. Let's be open about what we got wrong and we can all learn from it.
Gavin: It's a lovely note to end on.
Thank you for talking so openly about that. Thank you for joining us for this 100th episode.
Richard: Let me turn it round. And for you both of you, I you asked me questions. What for you has been the highlight of the year for Jessamyn and for you Gavin? What did what have you found?
Jessamy: I think I'd choose two things one internal and that's along similar lines that you were saying about collaboration I think it's been really lovely to work with other colleagues and You know across the organization at all levels and to give people space and a voice who you know Don't always get that space and voice You but feel equally passionate about what we do here and are completely aligned to our mission.
And that's been great because it just demonstrates the energy that's within the organization. And I think we should definitely do more of that. And then, from an external point of view, one of the highlights, I think, has been the mental health and the suicide. I think that was a really big it was a great webinar.
We wrote a great leader about it. Jonathan wrote that, and I think it
Gavin: was an important You're not allowed to say who wrote the leader. We collectively wrote that.
Jessamy: We collectively wrote that leader. We, I just, it was an, it was a great topic that we really added a lot of value to, and I thought it was a brilliant example of what the spotlight can do.
Gavin: I absolutely love producing the podcasts for the Lancet Voices here. We're doing this as the hundredth episode. But up until 80 episodes, we had a very, we had a very normal format of you and I interviewing. Insular. It might be called. Insular is not the right word, but you and I would interview someone about a particular topic of interest, but this year we've had so many guest hosts and some of the expertise that they've brought on the kind of freshness of their voices and the diversity of opinion.
Have been absolutely amazing. I think I wanted to say that my favorite episode that we've done so far this year was on period poverty.
Jessamy: Yeah,
Gavin: it's a great
Jessamy: one.
Gavin: Which was so excellently hosted by Georgia and Priya. Who both had some experience in the area. And they convened such a great panel of people to talk to and it's exactly the sort of episode that I couldn't have hosted myself with such kind of authority and skill and getting the right people together.
And as we've been talking about throughout, it really highlights the expertise in all these different incredible areas that we have throughout the organization. And yes, hopefully this the spirit of collaboration will will go forwards past the 200th anniversary year.
Richard: So we can capture that and keep it going.
Gavin: Yeah. Absolutely. Yeah, I really hope so. I really hope that we can get a kind of wide variety of hosts and topics for this podcast as well as when we shift back to the normal format next year with with me and Jess, we talk to people.
Richard: Thank you very
Jessamy: much. Thank you.
Thanks
Gavin: so much for joining us for this episode of the Lancet Voice. This podcast will be marking the Lancet's 200th anniversary throughout 2023. By focusing on the spotlights with lots of different guest hosts from across the Lancet group. Remember to subscribe if you haven't already, and we'll see you back here soon.
Thanks so much for listening.