3 New Words To Know In 2021: WEIRD*, UHI**, and CAMELS***

Camel Theory is about being productive, frugal and responsible in a harsh environment, without losing strength and focus (John Kamara, 2020)

*Western, Educated, Industrialized, Rich, Democratic; **Universal Health Income;*** Capital adequacy, Asset quality, Management, Earnings, Liquidity, and Sensitivity

For most of us 2020 will be remembered as annus horribilis, and as we continue to argue what are the best measures to combat COVID-19, one thing we all agree is that our response, especially in the US, is abysmal.

Whether this frailty is inherent to capitalism or a consequence of a leadership void, the recommendations of what state and federal governments need to do to control the pandemic remain consistently simple: (1) restrict travel, (2) impose social distancing, and (3) increase the availability of personal protective equipment (below).

The least effective interventions are: short term testing measures to improve case detection, intrusive tracing and tracking, land border and airport health checks and environmental cleaning (source)

So why then are we not following these recommendations?

#1: The pandemic is raging in the West because we are WEIRD (White, Educated, Industrialized, Rich and Democratic)

Many reasons can explain why the pandemic, specifically in the US, is handled so poorly.

  1. Chronic underfunding of public health with a just-in-time supply chain has left many hospitals ill-prepared and vulnerable to corrupt purchasing practices.
  2. Decades-long shredding the social safety net has exposed a digital divide forcing millions of essential workers into low-paying, life-risking jobs.
  3. Social-media platforms sow partisanship and misinformation and have become vectors for conspiracy theories.
  4. Racist policies left Indigenous and Black Americans especially vulnerable to COVID‑19, forcing them to tackle with health and financial consequences without government support.

But the resilience of these communities (below), suggest what is needed to limit the virus spread.

Optimism found among African Americans is complex and includes a history of overcoming adversity, having strong community ties, and a continued belief in the promise of education at a time that it has faded among low-income whites. (source)

In a recent book The Weirdest People In The World, Joseph Henrich explains:

“…WEIRD people are highly individualistic, self-obsessed, control-oriented, nonconformist, and analytical. They focus on themselves — their attributes, accomplishments, and aspirations — over their relationships and social roles…”

This ingressive behavior (antonym congressive) of being competitive, winning all the time, being right at all cost, overestimating one’s own abilities and acting in self-interest without caring about the other, has led according to Henrich to isolation, malaise and increased mental anguish.

As a result, non-white communities are gradually narrowing gaps in education and life expectancy, while poor whites, are dying at endemic rates from what has been termed ‘deaths of despair’ (below).

For the white working class, adults without a degree are literally dying from pain and despair. (source)

But it is not only the Indigenous and African American communities in the US that are showing remarkable resilience to the pandemic, it is Africa itself.

#2: Africa is more resilient than you think and is ready for Universal Health Income (UHI)

Trevor Noah in an entertaining segment (below) starts with: “it turns out that there is one place where they do seem to manage the virus better, and that place may surprise you…”

https://medium.com/media/faaf66ab4f45ad7d7ff87c80c7e21829/href

And Trevor Noah is right. Africa is responding well to COVID.

Why?

No doubt Africa’s previous experiences with Ebola and Marburg virus has helped in dealing with COVID-19. African governments have been applying science through public health policies, educating their citizens (70% are under 30), and showing a strong willingness to adopt and deploy new technologies.

Indeed this year the use of health information technology (HIT) has surged and has turned the continent into a digital health hotspot or as the African Union Commissioner Amani Abou-Zeid highlighted:

“COVID-19 crisis has become the single biggest catalyst for digital transformation and has moved digitalisation from a niche market into mass adoption”.

One excellent example of this mass adoption is AfyaRekod (Swahili for Health Record), who developed a self-sovereign, patient-owned, portable electronic health record that allows users, as well as permissioned doctors and health facilities, to capture, store, and access health data in real-time (below).

AfyaRekod, with its COVID-19 geofencing capabilities is downloaded here for free in Mombasa and serves dozens of community hospitals treating millions of Kenyans (source)

What distinguishes AfyaRekod from other electronic health records found in the US and Europe is that this health data is owned by the patient and is ported privately and securely on smart and feature phones.

The idea of health data linked to a self-sovereign identity, is central to the concept of data used as dignified labor, giving patients the opportunity to gain supplemental income, which I refer to as: Universal Health Income (UHI).

The idea of UHI is appealing not only as well-needed income, but more as a way to incentivize citizens to engage in preventative healthy behaviors that have both personal and societal payoffs. In other words:

…UHI transforms people from being passive health service consumers into active health and wealth producers…

and includes them and healthcare workers, in a data economy that is currently open only to corporations and their intermediaries.

UHI is different than universal health coverage (not discussed here) or Universal Basic Income (UBI). UBI is a governmental program that provides unconditional income that is (or should be) sufficient to meet a person’s basic needs. In essence it is akin to the COVID-19 economic impact payment (“stimulus check”), that some advocate to reserve for financial crisis only, whereas others see it as a replacement to welfare programs.

It is beyond the scope of this post to discuss the merits and limits of UBI vs. Universal Basic Services, however direct government transfers to alleviate poverty can replace or complement current programs with conditional transfers, that are unsatisfying in terms of net spendable income.

UHI on the other hand is designed to encourage healthy behaviors (such as vaccinations, prenatal care, periodic or annual check ups) and discourage risky behaviors (like smoking, addiction, not adhering to treatment or in the case of COVID- avoiding social distancing).

But why do we need to pay people to do the ‘right’ thing?

#3: We Need To Start To Think Like Camels, Not Unicorns

Because people, especially now, need more than a ‘nudge’. They need income.

The projected economic impact of COVID-19 is devastating. The increase in extreme poverty rate especially if inequality increases, will undo decades of anti-poverty policies and the global economy might never be the same again.

This is why it is a good time to reimagine our current economic model and try to cure what William Baumol predicted in 1965: Baumol’s cost disease. In essence he postulated that rising worker productivity in manufacturing, combined with technological advances will reduce goods costs, but at the same time increase the cost of labor-intensive services — education, legal, healthcare, media— to unsustainable levels (below).

This price split between manufacturing and service sectors is an unavoidable side effect of rising affluence (source)

Baumol was right.

Fifty years of a non-stop race for growth has created unprecedented concentration of wealth in the hands of few, which is threatening the viability of capital markets (‘K-shape recovery’). COVID-19 has accelerated this trend and nowadays entrepreneurs (“job creators”) find obtaining early stage capital nearly impossible, especially for non-US startups.

In addition, Silicon Valley has cultivated a narrative that elevates innovation and personal freedom over building the collective good. Consequently this encourages investment in predominantly hyper-valued companies — Unicorns ($1B), Decacorns ($10B) and Hectocorns ($100B) — which only works during bull markets and is not sustainable in a post COVID world.

Needless to say that we need a different approach, an approach Marco Lucchina called: the Camel Theory. Lucchina suggested that behind every professional there is a human and as such, has a set of values, where growth-at-all-cost is second to the sense of empathy and social responsibility.

On the other hand Alex Lazarow thinks of Camel Theory as a sustainable way for start ups to survive bear markets and advises managing growth through Capital adequacy, Asset quality, Management, Earnings, Liquidity, and Sensitivity. For Lazarow, life is marathon, not a sprint, and Camel companies should resist “blitz-growth”, and adopt a long-haul view.

This idea of thriving under duress for sustained period of times like the Camel, has been further developed by my dear friend John Kamara, CEO of ADA Labs, an incubator and fusion lab that includes Healthtech, Fintech, Edutech, Agritech, Advertisement and Animation startups (below).

https://medium.com/media/c5bc07726ec857a080175cf8eef4f3a4/href

AdaLab embodies the values of African entrepreneurship (kanju), balanced growth and resilience, by creating Social Technologies — technologies that serve Society — .

Ada Lab’s goal is to encourage co-creation between startups and through it’s AI Center of Excellence (AICE) train 100,000 engineers and create the one million high quality jobs Africa needs.

Final Thoughts

Two and half years ago I wrote that the opioid crisis was not an epidemic, but a syndemic — an aggregation of sequential epidemics — developed under health disparity caused by poverty, stress, joblessness and structural injustice.

No doubt COVID-19 too is not a pandemic, but a syndemic. However this time it is killing not only our bodies, but also our souls.

Soul in Hebrew called ‘nefesh’ or ‘neshama’, comes from the root ‘to breathe’, and COVID-19 has deprived from too many of us our breath.

It is time for radical change or in the recent words of Pope Francis:

“… the antibodies to the virus of indifference… reminds us that we grow by giving ourselves, not preserving ourselves, but losing ourselves in service…”

(While reading this post 58 people have died from COVID-19 in the world)

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Dr. Cahana is a board member at ADA Labs


3 New Words To Know In 2021: WEIRD*, UHI**, and CAMELS*** was originally published in Data Driven Investor on Medium, where people are continuing the conversation by highlighting and responding to this story.