Extracting value, destroying health?

Modern industry and commerce depend on the extraction, processing and transformation of massive quantities of raw materials, often as part of value chains that cross multiple national borders. This process is exemplified by the use of coltan (a metallic ore containing minerals essential to the production of electronics) mined in the Democratic Republic of Congo in mobile phones designed by Apple and assembled in China by contract manufacturers like Taiwanese firm Foxconn. And of course much of the world still runs on oil and natural gas, often extracted with negligible concern for environmental health impacts, especially outside the high-income world, and with subsidies even from countries that profess concerns about climate change.

For the past year, North American colleagues Anne-Emanuelle Birn, Mariajosé Aguilera and (more recently) Leah Shipton and I have been investigating the under-studied question of how extractive industries and what might be called the global extractive order affect health. This has been part of the work of the Independent Panel on Global Governance for Health, an initiative based at the University of Oslo that grew out of a 2014 Lancet Commission on global governance for health. The report of that Commission on ‘the political origins of health inequity’ focused on the ‘power asymmetries’ characteristic of the relevant governance institutions, using a number of examples including the distribution of gains and losses from the financial crisis; the entitlements accorded to foreign investors by trade and investment treaties; and the concentration of power in the global food system, to the detriment of food security for many of the world’s people.

Our work has kept up that emphasis, and we have taken the view that the global extractive order comprises not only mining, oil and gas – the usual suspects – but also a variety of other activities such as large-scale agricultural land acquisitions by foreign actors, and some forms of plantation agriculture. All these activities operate according to similar ‘logics of extraction’, to use Saskia Sassen’s terminology; in all of them transnational corporations and other large investors play dominant roles; and in many cases large-scale corruption associated with extractive projects drains societies of resources that could be used for more equitable development. Control over resources and the revenues they generate is also implicated in originating or perpetuating a variety of armed conflicts.

So far, we have produced an open-access bibliography of more than a thousand relevant sources, available for anyone to use, and an open-access overview article in the journal Health and Place. Other work products are forthcoming, but a large-scale research initiative with more resources than we are now able to mobilise is long overdue. Currently, much of the most important (courageous, and often dangerous) work on these issues is being done by investigative journalists and by civil society organisations like Canada’s MiningWatch (Canada is a major source of mining investment, especially in Latin America) and the UK’s indispensable Global Witness.

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