When discussing the greatest threats to humanity, we usually think of cancer, diabetes, or the impact of climate change. Yet, one of the most dangerous epidemics of our time remains invisible: loneliness. It lacks a clear diagnosis and is rarely reflected in global health statistics.

The Metric of Suffering: DALYs

To understand the scale of this crisis, we must first look at the “currency” of global health: DALYs (Disability-Adjusted Life Years). This metric does not simply measure how many people die from a specific problem, but rather how many years of healthy life are lost to humanity. The calculation is straightforward: we add YLL (Years of Life Lost due to premature death) and YLD (Years Lived with Disability or impairment).

Loneliness as a Risk Factor

In the current Global Burden of Disease (GBD) study, which utilizes the DALY metric, loneliness does not yet appear as an independent risk factor. While 88 other factors—ranging from tobacco use to lack of physical activity—are meticulously listed, the lack of human connection is ignored.

However, meta-analyses provide a shocking revelation: the lethality of social isolation is comparable to the chronic consumption of 15 cigarettes per day. It is, in fact, more dangerous than obesity or a sedentary lifestyle.

How Isolation Rewires the Body

Recent research indicates that loneliness is a biological state that fundamentally reshapes our entire physiology. It triggers a neuro-immunological cascade that places the body in a permanent “state of siege”:

• Chronic Stress for Cells: Long-term loneliness activates the sympathetic nervous system, leading to a permanent elevation of cortisol levels.

• The Poison of Inflammation: This phenomenon, known as Conserved Transcriptional Response to Adversity (CTRA), causes white blood cells to upregulate pro-inflammatory genes. We are under internal “constant fire” from systemic inflammation, while our antiviral defenses are simultaneously throttled.

• Proteomic Markers: Studies involving over 42,000 participants have identified specific proteins that mediate the link between loneliness and death. The protein Adrenomedullin (ADM) stands out as a harbinger of heart failure and stroke in lonely individuals.

The Clinical Toll

The consequences of this biological reprogramming are not mere assumptions, but solid clinical evidence. Lonely individuals face:

• A 29% higher risk of coronary heart disease.

• A 32% higher risk of stroke.

• A 50% higher risk of developing dementia or experiencing rapid cognitive decline.

Furthermore, loneliness acts as a silent catalyst for various mental health issues, such as depression, anxiety, addiction, and suicide. It is the risk factor that carries all these afflictions in its wake. When we say loneliness destroys DALYs, we mean it does not just shorten life at its end; it poisons the remaining years through illness and pain.

Part 2: An Epidemic on the Rise

Is global loneliness merely a bleak suspicion or a statistical certainty? Unfortunately, the answer is clear: we are witnessing a global erosion of the social fabric that can, without exaggeration, be called a pandemic. While the modern world connects us technically to an unprecedented degree, this digital hyper-connectivity seems to isolate us emotionally rather than unite us.

A Billion Lonely Islands

Data from 142 countries paints a grim picture: approximately 24% of the world’s populationover the age of 15—representing more than one billion people—feel “very” or “fairly” lonely. This suffering is increasing worldwide, along with the devastating health consequences analyzed in Part 1.

Interestingly, this phenomenon is not evenly distributed:

• In countries like Colombia (14%) or Mexico (9%), loneliness rates are significantly lower due to cultural “buffers”.

• In the West, particularly in the USA and parts of Europe, isolation is hitting full force.

• Even in traditionally community-oriented cultures, advancing urbanization threatens historically protective social structures.

The Loneliness of Generation Z

While one might associate loneliness with an elderly person in a care home, the reality is different: young adults are the most affected group.

• Generation Z (18–24 years): In the USA, a staggering 79% report feelings of loneliness.

• Seniors (over 66 years): Here, the figure is a comparatively moderate 41%.

While older adults often enter isolation through the loss of a partner or physical limitations, younger generations experience a massive erosion of social ties driven by labor mobility, digital stress, and the constant pressure of self-presentation.

The Decay of the Core

A major driver of this epidemic is the “crumbling of the family”. The statistical rise in divorce rates is a primary catalyst for the global loneliness crisis. We are observing a process of atomization:

• The family unit is disintegrating as divorce becomes the norm.

• Generational distance grows as children distance themselves from parents, and vice versa.

• In the USA, single-person households have more than doubled from 13% in 1960 to 29% today.

Everyone is becoming an island—a society of atoms existing side by side but no longer truly connected.

Part 3: The Roots of Isolation – Why Our Relationships Break

To understand loneliness as a global epidemic, we must identify the “pathogen”. This pathogen is not a biological virus, but a cultural mindset that has poisoned how we live and love. The roots of modern isolation lie in the radical transformation of our coexistence by the logic of the market.

Love as an Act of Consumption

The deepest reason for the mass breakdown of relationships is a fatal misconception: the belief that the primary goal of life is to find individual happiness. In this worldview, the other person becomes a mere function. A partner is only considered “right” as long as they fulfill this happiness function.

This follows the psychology of consumption. As with any purchase, the thrill of the new is fleeting. Once the initial euphoria fades or the partner no longer “functions” smoothly, the connection is severed. This pervasive consumer mentality has cast a paralyzing veil over all our relationships.

Emotional Capitalism

Sociologist Eva Illouz describes this as “emotional capitalism,” where market logic invades our most intimate spheres:

• Relationships as Investments: We view bonds as “projects,” weighing costs (time, compromise) against benefits (status, lust).

• The Commodification of Humans: Dating platforms reinforce this by cataloging people like goods on a shelf, creating an illusion of infinite supply.

• The Tyranny of Choice: This “choice economy” leads to commitment issues and superficiality; when a “better model” is just a swipe away, the depth of the current encounter loses its value.

The Accelerated Society

According to Hartmut Rosa, the relentless dynamics of our civilization also drive isolation. In a world geared toward efficiency, we lose the capacity for “resonance”—a relationship with the world where we are truly touched and can be effective. Instead, we face an “alienated” relationship with our environment:

• The Achievement Society: We exploit ourselves to meet imperatives of success and transparency.

• Loss of Leisure Time: True human connection requires time for “unstructured” socializing. In an optimized society, simply “being” with others is seen as a waste of time.

• Workforce Fragmentation: Our economy demands mobility; people who constantly move for work sever their social ties and end up isolated in unfamiliar cities.

We have prioritized autonomy over connection and efficiency over resonance.

Part 4: Paths Out of Isolation

What can be done for a billion lonely people? Solutions range from urban planning to modern psychology, but addressing the issue is a major challenge because it requires dismantling the most deeply rooted structures of our civilization.

“Third Places” and Cultural Codes

Individual escape from isolation is often difficult because we lack physical spaces for encounter. Sociologist Ray Oldenburg identified “Third Places”—spaces outside of home and work—as vital for social well-being.

• The Case of Vienna: The Viennese coffee house, once a “home away from home,” now illustrates the decline of social spaces, as guests sit isolated behind laptops rather than engaging with those around them.

• Missing Scripts: In many Western countries, it is no longer part of the cultural code to simply speak to strangers; we have forgotten the “scripts of interaction”.

• Role Models: Countries like Colombia or Mexico, with their different infrastructures of sociability, could serve as models for easier access to one another.

Dating Apps: A False Solution?

Many turn to digital dating platforms, but sociologically, these are often part of the problem. They follow market logic—”What fits me?”—treating relationships like a car purchase based on consumption rather than a willingness to truly engage with another person. If the main idea of a relationship is “taking,” it remains fragile and reinforces emptiness.

Medicine for the Soul

The healthcare system offers specific approaches to reduce individual burden:

• Social Prescribing: In the UK, doctors prescribe participation in community activities to address social causes of illness.

• ACT and MBSR: Acceptance and Commitment Therapy (ACT) helps individuals accept feelings of loneliness. Mindfulness-Based Stress Reduction (MBSR) can demonstrably reduce inflammation caused by isolation.

Conclusion: Reversing the Cooling of Love

The true solution requires a total transformation of how we live and work together, moving away from calculated relationships toward genuine community. As long as our civilization’s foundations remain built on efficiency, individuals are often left with mere damage control.

To stop the destruction of their health, individuals must accept loneliness as a fact of our time. Lowering expectations of “happiness through consumption” can open space for practical everyday encounters, such as volunteering. If we face the unvarnished truth—that the modern world is a cold place—we can begin to reshape our civilization into a viable continent of community rather than an archipelago of isolation.

Modern medicine and the public perception of health suffer from a massive blind spot. We primarily measure the success of our healthcare systems in “years survived”. The focus remains on terminal illnesses such as cancer or heart attacks. This is where we fight; this is where we invest. However, data from the Global Burden of Disease (GBD) study shows that this perspective fails to adequately reflect the true burden on humanity.

The New Focus: Living Instead of Surviving

The greatest global health challenge of our time is not mortality, but quality of life. It is less about how we die and more about how we spend the decades leading up to it. In this context, mental disorders are a primary factor. While mental illnesses rarely kill directly, they devalue or destroy healthy lifetime on an astronomical scale.

The Tool: DALYs

To make this suffering measurable, the GBD study uses the DALY (Disability-Adjusted Life Year)metric as a unit for lost years of healthy life. One DALY represents one lost year of healthy living. The calculation is based on a simple logic by adding two metrics:

• YLL (Years of Life Lost): Years lost due to premature death.

• YLD (Years Lived with Disability): Years a person lives with a limitation or illness that partially devalues that time.

While classic diseases often produce high YLL values (early death), mental disorders cause gargantuan YLD values(devalued lifetime). These illnesses often burden those affected for decades, stripping them of their ability to fully participate in social and economic life.

2. The Primary Drivers of Disease Burden

According to current GBD evaluations and trends for 2026, the global burden of mental disorders can be narrowed down to five essential categories. Each of these disorders contributes in different ways to the destruction of healthy life years.

• Depressive Disorders: Depression is the global leader among mental burdens. Its enormous statistical relevance stems from two factors: it is extremely widespread and it massively impairs daily functioning. It is therefore considered the primary cause of the massive “Years Lived with Disability” (YLD) burden.

• Anxiety Disorders: Often underestimated, anxiety disorders collectively cause a staggering burden. The decisive factor here is time: since these disorders frequently begin in youth and can persist for decades, they accumulate an enormous number of DALYs over a lifespan.

• Schizophrenia: Unlike depression, schizophrenia is statistically rarer, but the burden per affected person is extremely high. It often leads to severe social and professional limitations. Furthermore, it shows a high YLL share(lost years of life) because life expectancy is significantly reduced by physical comorbidities and a high risk of suicide.

• Bipolar Disorders: These illnesses are characterized by the unpredictable shift between mania and depression. The severity of these episodes ensures that bipolar disorder consistently ranks near the top of GBD statistics.

• Developmental Disorders (Autism & ADHD): Newer evaluations place greater weight on Autism Spectrum Disorder and ADHD. Because these disorders influence life from childhood onward, they generate DALYs over a very long time span.

3. The Age of Vulnerability

The GBD study reveals startling data regarding the 15-to-49 age group. In many industrialized nations, mental disorders are the leading cause of lost healthy life years in the prime of life.

Thieves of Productivity

The data make it clear that mental disorders are not marginal issues but the central health challenge for an active society. They do not steal years at the end of life; they steal quality and productivity in the middle of it.

4. The Gender Gap and Regional Differences

The GBD study reveals another phenomenon: a clear split of mental suffering into internalization (suffering directed inward) and externalization (suffering breaking outward).

The Female Burden: Internalization

Women worldwide bear a significantly higher burden from disorders that play out internally. In GBD statistics, this manifests in massive YLD values:

• Depression: Women are affected roughly 1.5 to 2 times more often than men. This burden often begins with puberty and continues through the entire reproductive phase.

• Anxiety Disorders: This area shows the largest gender gap.

• Eating Disorders: This diagnostic group has an extreme female preponderance. Although case numbers are lower than for depression, eating disorders cause a very high disease burden per individual case.

The Male Burden: Externalization

Men are underrepresented in depression statistics but account for the majority in areas often misclassified as ‘behavioral issues’, which actually express psychological distress:

• Addiction and Substance Use: The burden of alcohol dependence and drug use disorders is often 3 to 4 times higher in men than in women.

• Externalizing Disorders: ADHD and conduct disorders lead to early losses of healthy life years in young men, often due to school dropout or social isolation.

• Years of Life Lost (YLL): Men also dominate the statistics for years of life lost due to premature death (YLL) resulting from suicide and accidents under the influence of substances.

The Suicide Gender Paradox

In this context, the “suicide gender paradox” is noteworthy. Women worldwide have a higher rate of suicide attempts, leading to high YLD values (years with limitations following the attempt). Men, however, have a significantly higher rate of completed suicides, which heavily burdens YLL statistics. Consequently, mental burden often ends more “fatally” for men, while it runs more “chronically” for women.

The Diagnostic Gap

These figures suggest that GBD data might underestimate the male disease burden. This is partly due to masked depression: men often show symptoms through anger or workaholism rather than dejection, meaning the diagnosis is often missed and thus absent from statistics. Additionally, women are more likely to seek professional help, recording their suffering as data points, while silent men remain statistically invisible—often until suicide.

Global North vs. South

Contrary to the assumption that mental stress is a “luxury problem” of wealthy nations, the GBD study clearly shows that the disease burden of mental disorders is high worldwide. The critical difference lies in care: while treatment options exist in the Global North, treatment gaps in the Global South are catastrophic. This raises a fundamental question: are we experiencing a new epidemic, or are we simply learning to better name an ancient suffering?.

5. Causal Analysis: Lifestyle Disease or Discovery?

The answer lies in the tension between our evolutionary heritage and the modern world.

The Discovery and Labeling Thesis

This view assumes that mental suffering has always existed to this extent, but we now possess the tools to measure it precisely.

• Shifting Terms: What we measure as clinical depression today was previously called “acedia” (sloth of the heart), melancholy, or neurasthenia.

• Shift in Burden: As infectious diseases and famine have largely been eradicated, mental health issues have statistically taken center stage. Previously, this suffering was often prevented by early death (YLL) due to physical illness.

• Diagnostic Inflation: Critics also warn that normal human reactions like grief or shyness are increasingly pathologized, artificially inflating the statistics.

The Lifestyle Disease Thesis (Mismatch Theory)

This view assumes that our biology, optimized for hunter-gatherer structures, fundamentally collides with today’s world.

• Maladaptation: Our brains are programmed for movement, sunlight, and small social groups, yet we live in a world of permanent cognitive overstimulation and social anonymity.

• Social Acceleration: The human psyche can hardly keep pace with the rate of technological development.

• Loss of Tribality: While communities used to catch the individual, today’s hyper-individualization leaves people alone with their mental burdens, massively increasing the intensity and duration of suffering.

The Paradigm Shift of Disease Burden

Historically, one thing is certain: we are experiencing a fundamental shift. Formerly, humanity paid its tribute to nature through viruses, hunger, and violence. Today, we pay our tribute to culture. We have bought physical security at the price of permanent psychological stress. A life of high mental burden is not only an individual tragedy; it is also an economic catastrophe.

6. The Economic Dimension (The “Business Case”)

The economic costs of inaction regarding mental disorders are astronomical and far exceed the costs of necessary reforms. Mental stress is a massive macroeconomic factor.

The Trillion-Dollar Bill

Estimates from the Lancet Commission and the World Economic Forum suggest that by 2030, the global mental burden will cost the world economy approximately $16 trillion in lost economic output. This is more than the projected costs of cancer, diabetes, and chronic respiratory diseases combined. Depression and anxiety disorders alone cause an annual productivity loss of about one trillion US dollars.

The Phenomenon of Presenteeism

A central cost driver is “presenteeism”: those affected appear at work but are unfocused and prone to errors due to their mental state. Studies show that this condition costs the economy two to three times more than actual sick days (absenteeism).

Investment and Return (ROI)

Investing in mental health is highly profitable. For every euro a state invests in the widespread treatment of depression and anxiety, approximately four euros return to society through higher productivity and lower social spending.

The Barriers: Why Too Little Happens

Systemic hurdles often prevent these levers from being pulled:

• Time Lag: Costs are immediate, while gains often appear only after five to ten years—a timeframe that usually exceeds political election cycles.

• Category Error: The healthcare system bears the treatment costs, while companies and pension funds benefit from increased productivity. These budget silos prevent a holistic economic approach.

• Stigma: In a civilization based on physical goods, mental well-being is rarely understood as hard, necessary infrastructure like the power grid.

7. Conclusion: Strategies for Solving the Problem

To actually reduce the “mental burden,” repairing the system is not enough. We must address the roots of DALY generation. Five strategic levers must be pulled simultaneously:

1. The Clinical Lever (Task-Sharing): The core problem is the supply gap: in many regions, there is only one psychiatrist per million inhabitants. The solution would be global “Task-Sharing” based on the WHO’s mhGAPmodel: teachers, nurses, and community workers are trained in “Psychological First Aid”. Studies show that optimal access to treatment for anxiety disorders alone could avoid up to 70% of the disease burden.

2. The Structural Lever (Ending Economic Anxiety): Poverty is one of the strongest predictors of depression and anxiety. A global universal basic income would lower the cortisol levels of entire populations by breaking the state of permanent stress-vigilance caused by existential fear.

3. The Generational Lever (Prevention in the “Window of Opportunity”): Since 75% of all mental disorders begin before age 24, schools must become resilience centers. “Emotional Literacy” (emotion regulation and conflict resolution) should be anchored as a core subject, supplemented by widespread screenings to catch trauma before it becomes a chronic “DALY-eater”.

4. The Civilization Lever (Correcting the “Mismatch”): Our modern environment statistically makes us sick. Radical urban design with mandatory green spaces would counteract schizophrenia and depression rates in “concrete jungles”. This would be flanked by digital hygiene (regulation of social media algorithms) and the introduction of a 4-day week to break the stress of an accelerating society.

5. The Innovation Lever (Mental Health Moonshot): Much like historic grand projects, billions must be invested in new breakthroughs. This includes—surprising as it may seem—the large-scale introduction of psychedelic-assisted therapies (e.g., psilocybin) for treatment-resistant cases and the development of non-invasive neurotechnologies for home use.

8. Final Thoughts and Outlook

We must stop viewing mental health as a repair service and begin to understand it as an infrastructure project. We must not only prevent dying; we must start keeping life worth living. This includes one measure we have not yet considered, a factor that acts as a catalyst for almost all the ailments listed here: loneliness. Loneliness is the “silent killer” that does not yet have an ICD code and therefore does not yet appear in the GBD study. We will address it in the next article.

Coffee: The Fuel of Modernity

One example: our ranking of the greatest disease burdens lacks a substance that is currently the most widespread drug on earth: coffee. The fact that caffeine does not appear in the hard statistics of the Global Burden of Disease study has a surprising reason: caffeine simply does not cause a significant number of DALYs (disability-adjusted life years). Unlike tobacco or alcohol, there is no statistically relevant mortality associated with coffee consumption; on the contrary, many studies suggest that as a protective factor against diseases such as Type 2 diabetes or Parkinson’s, it might even produce “negative DALYs”—meaning gained healthy years of life.

Yet, the absence of coffee from the statistics of suffering must not obscure its immense impact on our civilization. Many historians claim that our modern Western civilization, with all its scientific and technological achievements, might not exist at all without this focus-enhancer. Historically, the triumph of coffee marks a radical turning point: it catapulted Europe out of the beer-soaked, long-lasting stupor of the Middle Ages—during which people often drank “small beer” as early as breakfast due to contaminated water—directly into the precise rhythm of the Enlightenment. The “coffee houses” of the 17th and 18th centuries were the birthplaces of modern banks, insurance companies, and scientific academies. Coffee established a culture of cognitive sharpness and endurance that formed the foundation for countless innovations.

Coffee is the drug of focus, the chemical tool of intellectual labor. Whether this permanent state of high focus is ideal for human well-being in the long run, or whether we are merely adapting to an ever-faster world of work, remains an open debate—yet many beneficial thoughts and advancements of recent centuries would have been simply unthinkable without this “wake-up call.” In a world evaluated by the ecological imperative, coffee is the rare example of a substance that fuels our development without destroying the fabric of our lives.

Alcohol: The Social Lubricant

Even with alcohol, the destructive potential of which we have already quantified at 75 million DALYs, we must not entirely ignore the positive side of the coin. Beyond addiction, alcohol has served as a social binder for millennia. It is an integral part of shared celebrations and ritual acts. One can say without exaggeration that it is partly responsible for the formation of countless marriages and partnerships, as it helps people in social situations lower inhibitions and draw closer to one another. Used in moderation, it often serves to strengthen the social fabric on which we all depend. As the Baroque preacher Abraham a Santa Clara aptly noted: “In moderation, alcohol is a friend and promoter of the soul; in excess, however, it is its enemy and destroyer.”

LSD and the Psychedelic Renaissance

Particularly fascinating is the view of the positive effects of hallucinogens, above all LSD. Although it is strictly forbidden in most countries, it possesses a vanishingly low potential for addiction and is praised by numerous Nobel laureates and artists as “life-changing.” For instance, the Nobel laureate Francis Crick stated that he visualized the double-helix structure of DNA while under the influence of LSD. The substance also played a key role at the birth of the digital revolution; Apple founder Steve Jobs described his experiences with LSD as one of the two or three most important things he had done in his life to expand his horizons.

In recent times, scientific research regarding hallucinogens has also reached a radical re-evaluation, documented by Michael Pollan in the book How to Change Your Mind. The results are surprising: in controlled therapeutic settings, these substances show remarkable effectiveness in treating depression, deep-seated addictions, and even easing existential death anxiety in palliative patients. Hallucinogens seem capable of breaking up rigid neural patterns and expanding the circle of empathy and connectedness on a deep, spiritual level.

Conclusion: A Problem Without Simple Reversal

In the fight against the burden of suffering caused by drugs, we must always remember that drugs can also be tools of insight, engines of civilization, and lubricants of community. The problem, in the case of drugs, cannot be solved through simple “prohibitions.” We face the challenge of preserving the benefits for human flourishing while simultaneously fighting the structures that cause dependency and destruction.

Ways Out of the Paradox: Reason Instead of Ideology

What, then—against this background—can we do to at least reduce the massive burden of suffering caused by addictive substances? The first and most obvious step is to make the list of permitted and prohibited substances strictly evidence-based.

The Legacy of Power Politics

To understand why our current drug policy seems so illogical, we must take a journey back to the year 1970. The current form of prohibition lists is not the result of medical insight, but the legacy of Richard Nixon’s “War on Drugs.” As protocols and statements from former government members now prove, the criminalization of substances like LSD and cannabis served primarily to weaken two political opposition groups: the anti-war Left (hippies) and the Black civil rights movement. Since it was legally impossible to forbid being against the war or for equality, the drugs associated with these cultures were banned to provide a lever for arrests and media stigmatization.

This politically motivated system was internationally cemented in 1961 by the UN’s “Single Convention on Narcotic Drugs.” This treaty forced almost all countries in the world into a rigid prohibition regime, from which one can hardly deviate today without violating international agreements—resulting in a legal “tightrope walk,” as we are currently observing with German cannabis legalization.

The Blessings of Substitution

Any attempt to solve the problem that takes the ecological imperative seriously would permit the most harmless drugs and continue to strictly control the most dangerous ones (such as heroin or crack). Such a step could even be beneficial. If people switch from the statistically most dangerous drug (alcohol, with 72 harm points) to significantly less harmful alternatives such as cannabis (20 points) or even LSD (7 points), the cumulative disease burden of society drops massively. Indeed, data from regions with a legal cannabis market show that an increase in cannabis consumption is accompanied by a decrease in alcohol consumption, which perceptibly relieves healthcare systems and police even with minor shifts.

Guided Autonomy and “Drug Literacy”

Secondly, we must move the sale of all drugs—legal and illegal—from the uncontrolled black market into a regulated framework. Controlled distribution in specialized shops, combined with a digital pass system, would make it possible to recognize risky consumption patterns early and proactively offer help before an addiction develops. Parallel to this, a culture of enlightenment—so-called Drug Literacy—must become a core competence starting in schools. Instead of relying on blanket deterrence, we must empower people to learn a responsible way of handling intoxicants. We allow less dangerous drugs but do not leave the consumer alone; instead, we provide support through information and timely intervention.

Yet, all these regulatory measures only treat the symptoms. To truly drain the drive behind addiction, we must dig deeper. We must ask why our “everyday self” is so often perceived as an unbearable burden and how we can alleviate this societal malaise. The most powerful lever lies not in prohibitions or accompanying offers, but in the design of our living space.

Healing the “Rat Park”: Tackling Addiction at the Root

If we truly want to reduce the enormous burden of suffering caused by drug abuse, we must acknowledge an uncomfortable truth: our “discontent in culture” is likely the main reason for the destructive use of these substances. We must perceive addiction less as the moral failure of the individual and more as a symptom of a sick society.

Addiction as Desperate Self-Medication

Modern research shows that there is such a thing as a personality predisposed to drugs. These individuals often suffer from a biological or psychological “Reward Deficiency Syndrome”—their everyday life feels “gray” or painful without help. For them, the drug is not a mere leisure activity, but a medication to alleviate pain. Those who experience their “everyday self” as a prison become addicted faster—first psychologically to fill the void, and eventually physically, because biology demands the artificial state as the new normalcy.

Science provides a startling parable for this: the “Rat Park” experiment. While rats in isolated, empty cages became addicted to morphine-water until they died, rats in a fulfilling environment—the “Rat Park” with space, companions, and opportunities for play—hardly touched the drug. The conclusion is obvious: only unhappy rats become addicted. If we reduce the suffering of people within their “culture,” we remove the breeding ground for addiction.

Lever 1: Overcoming “Non-Species-Appropriate Human Husbandry”

A significant part of this suffering is physical in nature. As we saw in the articles on the “Metabolic Tsunami,” we live today under conditions that contradict our biological needs.” Sick bodies due to malnutrition and chronic lack of movement generate a biological background noise of unease and stress. The solution: in a vital, healthy body that can move and regenerate in a species-appropriate way, the urge for numbing escape would drop massively.

Lever 2: Healing the “Pandemic of Loneliness”

Yet, psychological suffering often weighs even heavier. The data from the Global Burden of Disease study speak clearly here:

• Depressive disorders already rank 10th among global disease burdens (approx. 56.3 million DALYs).

• The cluster of psychological and social burdens destroys around 170.3 million healthy years of life annually.

• Loneliness is today as dangerous as smoking 15 cigarettes a day and is linked to 871,000 deaths annually.

But we are not only experiencing a pandemic of isolation; we are simultaneously experiencing a pandemic of intellectual overstimulation. In a world that is actually standing on the brink, sadness is sometimes simply a sign of a clear mind. When this double despair—from loneliness and frustration—becomes chronic, humans reach for the “biochemical sledgehammer” to briefly knock the weight of existence out of their system.

Conclusion: Freedom Through Resilience

If we were to succeed in reducing the psychological burden of suffering through genuine community, stress reduction, and finding meaning, we would simultaneously tackle the problem of drug abuse at its root. We would heal the social fabric and create a “Rat Park” for ourselves as humans, one that we no longer feel the permanent need to escape. If we succeed, we will be able to enjoy the beneficial aspects of intoxication as tools for insight and celebration. The path to a rational drug policy, therefore, necessarily leads through a more humane civilization.

To grasp the true scale of this issue, we must momentarily set aside our intuitive fears of “criminals” and “illegals”. Instead, we must evaluate the landscape using the objective metric of DALYs (Disability-Adjusted Life Years), which measures lost years of healthy life.

Nicotine: The Leading Cause of Suffering and Premature Death

When asked which drug claims the most victims globally, most people give the wrong answer. The raw data from the Global Burden of Disease study corrects this misconception: Tobacco (nicotine), with a “suffering footprint” of roughly 200 million DALYs, is the world’s leading avoidable risk factor for cancer and lung disease. Year after year, approximately 7.36 million people die prematurely due to tobacco use.

To put that into perspective:

• This is roughly six times the number of people lost annually to all homicides and suicides combined.

• It exceeds total global under-five child mortality (4.9 million) by nearly three million victims per year.

• Nicotine ranks as the third most dangerous risk factor for humanity—far ahead of hunger or unsafe water.

The tragedy is compounded by the fact that one’s addiction harms others: every year, roughly one million people die from the effects of secondhand smoke without ever having lit a cigarette themselves.

Alcohol: The Underestimated Toxin

In terms of healthy years lost or destroyed, alcohol follows tobacco as the next leading cause, consuming roughly 75 million healthy life years annually. Approximately 2.6 million people die every year from its consequences.

While we sit together in the evening, perhaps fearing violent crime or terrorism, the glass of beer or wine in our hands is statistically a far greater threat to our survival than any form of interpersonal violence. Alcohol is not only a massive driver of liver cirrhosis and psychological decay; it is also—ironically—a primary cause of violence, road fatalities, and domestic conflict.

Correcting the Distorted Image of Illegal Drugs

At this point in our data-driven research, we encounter a startling statistical fact: all illegal drugs combined (heroin, cocaine, amphetamines, etc.) cause approximately 30 million DALYs worldwide. This means that legal drugs—nicotine and alcohol—cause nearly ten times as much human suffering as the entire spectrum of prohibited substances.

Researcher David Nutt presented a systematic analysis years ago showing that our perception of danger often has little to do with biological reality. Nutt and his team at the Independent Scientific Committee on Drugs utilized “Multicriteria Decision Analysis” (MCDA) to evaluate 20 substances across 16 harm criteria:

1. Harm to the user: 9 factors (e.g., mortality, health damage, dependence).

2. Harm to society: 7 factors (e.g., crime, economic costs, environmental impact, family conflict).

The result was a global sensation: with a total score of 72 out of 100, alcohol was ranked as the most dangerous drug by far—well ahead of heroin (55) and crack (54). While alcohol may be less destructive to the individual than heroin, its widespread use and massive social fallout (such as violence and economic costs) mean it burdens society more heavily than any other substance.

Danger vs. Actual Harm

One might ask: if tobacco is responsible for nearly three times as many DALYs as alcohol, why does it only rank sixth on Nutt’s list? This apparent contradiction is resolved when we understand that these metrics highlight different aspects of suffering. While the DALY metric measures the total volume of actual health damage in the global population, Nutt’s model evaluates the specific hazard profile of a substance across 16 levels. Alcohol scores so high because it exerts enormous outward destructive power—aggression, domestic violence, and traffic accidents—which experts weigh heavily.

The “Prohibition Noise”

Substances like cannabis or LSD already sit at the bottom of the scale, yet they are arguably still rated too “high”. Under legal, regulated conditions, their hazard profiles would drop even further. Many documented harms are not biological properties of the drug itself, but direct side effects of its illegality:

• The Danger of Impurity: On an unregulated black market, toxic cutting agents cause health emergencies that would not exist under a system of guaranteed purity.

• Dosage Uncertainty: Legal regulation would end the “deadly guessing game” of fluctuating concentrations.

• Social Destruction: Much of the “harm to others” stems from drug-related crime and the social misery fueled by black-market prices and stigmatization.

By filtering out this “prohibition noise”—the symptoms of an absurd policy of bans—we see that we are wasting resources on substances with minimal risk while the damage from legal availability remains enormous.

The Ranking

Here are the 20 substances investigated, ordered by their total harm score (out of 100):

1. Alcohol (72) - (The outlier due to massive social costs)

2. Heroin (55) - (Maximal physical danger to the user)

3. Crack (54) - (High destruction and addiction potential)

4. Crystal Meth (33)

5. Cocaine (27)

6. Tobacco (26) - (Lower social harm weight compared to alcohol)

7. Amphetamines/Speed (23

8. Cannabis (20)

9. GHB (18)

10. Benzodiazepines (15) (e.g., Valium)

11. Ketamine (15)

12. Methadone (14)

13. Mephedrone (13)

14. Butane (10) - (Solvents)

15. Khat (9)

16. Ecstasy (9)

17. Anabolic Steroids (9)

18. LSD (7)

19. Buprenorphine (6)

20. Magic Mushrooms (6) - (The lowest hazard profile)

This list highlights the core problem of our current policy: we treat substances like LSD or cannabis as enemies of the state, while alcohol—the drug with the highest potential for destroying families and economies—remains a socially accepted cultural norm.

Outlook

Tomorrow, we will discuss the solution to this problem. This will be particularly challenging because, unlike other issues we have faced, drug use is also associated with a surprisingly large number of positive effects for society.

Tomorrow’s article: “What Have Drugs Ever Done for Us?”

Modern medicine as we know it—from routine surgery to highly complex cancer therapy—rests upon a single pillar that is often taken for granted: the efficacy of antibiotics. These drugs are the “insurance policy” for the civilizational progress of the last 100 years. However, this pillar is beginning to crumble. Bacteria we thought long defeated are returning with an evolutionary momentum that is causing our technological lead to vanish. For ethical leaders, AMR represents a unique challenge: it is a problem of collective resource use, a classic “tragedy of the commons,” where the short-term benefit of the individual jeopardizes the long-term security of all humanity.

1. The Mathematics of Invisible Suffering: Mortality and Metrics

To grasp the scale of this crisis, we must move away from vague estimates and consult the data from the Global Research on Antimicrobial Resistance (GRAM) study. Published in the journal The Lancet in 2022, this investigation represents the most comprehensive analysis of the global burden of bacterial resistance to date, covering 204 countries and 23 specific pathogens.

The figures are sobering: in 2019, approximately 1.27 million people died worldwide directly from bacterial infections against which no antibiotic was effective. To understand the moral relevance of this figure, it must be placed in the context of other global health threats: direct AMR mortality already exceeds the death rates of HIV/AIDS (approx. 860,000) or malaria (approx. 640,000) during the same period.

For a precise assessment, however, it is essential to distinguish between two statistical concepts that are often conflated in public debate:

• Attributable Mortality (Directly Attributed): This value describes the scenario in which a resistant infection is replaced by a drug-susceptible one. The 1.27 million deaths are therefore those individuals who would still be alive today if their infection had been curable by conventional antibiotics. Here, resistance is the direct cause of death.

• Associated Mortality (In Connection With): This value compares the current situation with the complete absence of an infection. Globally, around 4.95 million deaths were associated with antibiotic-resistant infections in 2019. In these cases, while resistance was present, the patient often suffered from serious underlying conditions. The question here is: how many people would be alive if we could prevent infections altogether?

When measured in terms of suffering—specifically DALYs (Disability-Adjusted Life Years)—bacterial AMR causes the annual loss of approximately 47.9 million attributable healthy years of life. If all associated cases are included, this value rises to a staggering 192 million DALYs. Particularly shocking is that one in five deaths from AMR affects children under the age of five. In regions such as Western Sub-Saharan Africa, the burden is highest at 27.3 deaths per 100,000 inhabitants, making the crisis a matter of global justice.

2. Biological Resilience: When Evolution Works Against Us

The biological basis of this problem is not a technical failure, but a natural evolutionary process that we have massively accelerated through our actions. Bacteria have existed for billions of years and have developed highly effective strategies to survive in hostile environments. Antibiotics attack specific structures of the bacterial cell, such as the construction of the cell wall or protein synthesis. As soon as we expose bacteria to an antibiotic, we create massive selection pressure. Only those germs that possess a protective mechanism survive—whether through the production of enzymes that destroy the drug or through “efflux pumps” that actively transport the active ingredient out of the cell.

The real problem, however, is not the individual mutation, but horizontal gene transfer. Bacteria exchange their “knowledge” about resistance in the form of small gene packages (plasmids) with each other—even across species boundaries. A single resistant cell can thus “infect” an entire population in a very short time. Historically, we find ourselves in an arms race that we are currently losing. When Alexander Fleming discovered penicillin in 1928, he warned in his 1945 Nobel Prize speech that improper use would “educate” bacteria to resist the drug. During the “golden age” of discovery from the 1940s to the 1960s, we seemed to always be one step ahead of the microbes. Yet, since the 1980s, the pipeline for new classes of antibiotics has almost completely dried up. While we rested on the laurels of the past, bacteria have globally networked their defense systems.

3. Systemic Drivers: The “One Health” Paradigm

The increase in resistance is not an isolated problem of hospitals. It is a multifactorial systemic failure made clear by the “One Health” concept: the health of humans, animals, and the environment is inextricably linked.

The Livestock Sector: The Ecological Source of Resistance

The most massive driver is industrial animal husbandry. Globally, approximately 73% of all antimicrobial substances are administered not to humans, but to livestock. In the USA, approximately 80% of antibiotic sales are attributed to livestock farming, with 70% of these drugs classified as “medically important” for humans.

In industrial factory farming, antibiotics often serve three purposes:

• Metaphylaxis: Treating entire herds or flocks to prevent the spread of disease under unhygienic and cramped conditions.

• Growth Promotion: Administering sub-therapeutic doses so that animals gain weight faster—a practice banned in the EU but still the standard in many other parts of the world.

• Therapy: Treating actually sick animals.

Paradoxically, the targeted therapy of sick individual animals accounts for by far the smallest share of total consumption; the lion’s share is accounted for by mass administration via feed and water to compensate for the biological deficiencies of the husbandry system.

That this widespread flooding of the system with active ingredients poses a direct threat to humans is no longer a mere suspicion, but is statistically precisely verifiable. Statistical models show a clear correlation: a 1% increase in antibiotic consumption in livestock correlates with an increase in the human resistance burden of approximately 0.04%. While the direct influence of human medicine (where a 1% increase correlates with a 0.19% increase in resistance) is about five times as “potent” at generating human resistance, the sheer volume shifts the weight: in regions like the USA, antibiotic consumption in livestock is about four times higher than in human medicine.

Put simply: medicine hits more precisely and harder, but agriculture floods the system with such a mass of active ingredients that both sectors ultimately contribute almost equally to the global catastrophe. Additionally, there is the ecological aspect: around 75% of the active ingredients administered to animals are excreted unabsorbed, turning soils and waters into an ideal training camp for resistant germs.

Mismanagement in Human Medicine

Parallel to this, human medicine struggles with its own deficits. Estimates suggest that a significant portion of antibiotics is used for viral infections such as the flu or colds, where they are completely ineffective. A lack of rapid diagnostics leads doctors to often prescribe broad-spectrum antibiotics “on suspicion,” which promote resistance more strongly than targeted agents. In many low-income countries (LMICs), poverty also means that patients receive underdosed or counterfeit medications, which massively encourages the formation of resistance.

4. The 2050 Worst-Case Scenario: Return to the Pre-Antibiotic Era

If we extrapolate current trends, we are heading toward a world where simple infections regularly become fatal once again. Projections from the GRAM study paint a grim picture for the year 2050:

• Mortality: Annual deaths directly caused by AMR are expected to rise to 1.91 million—a dramatic increase of about 50% compared to 2019. The number of associated deaths could rise to 8.22 million annually. In total, more than 39 million people could die directly from resistant infections between 2025 and 2050.

• Demographic Change: While mortality among children is falling thanks to better hygiene, a 146% increase in AMR deaths is predicted for people over 70. AMR will become the central threat to an aging global society.

• Systemic Collapse: Without effective antibiotics, we lose the foundation of modern surgery. Routine procedures such as C-sections, hip operations, or appendectomies will once again be associated with a high risk of mortality. Chemotherapy and organ transplants will hardly be possible, as the immune systems of these patients are left defenseless against even harmless germs.

• Economics: The global economy could suffer losses of up to 2 trillion US dollars annually by 2050.

5. Key Drivers for Change: Ways Out of the Dead End

Despite the dramatic projections, a change of course is possible. The solution lies not in a single technological innovation, but in a systemic transformation.

1. Transformation of Agriculture: We must eliminate antibiotics from the food chain. Countries like Sweden and Denmark show that through high hygiene standards and a strict ban on antibiotics for growth promotion, the lowest consumption values in Europe can be achieved without jeopardizing productivity. The goal for ethical leaders must be the complete abolition of industrial factory farming, as it is systemically dependent on medicinal support.

2. Economic Innovation (De-linkage): The current business model of the pharmaceutical industry rewards the high sales volume of drugs. For antibiotics, this is counterproductive, as we should use new agents as “reserves” as rarely as possible. We need “de-linkage” models where companies receive premiums for the development of new classes of antibiotics that are completely independent of the quantity subsequently sold.

3. Infrastructure and Diagnostics: Investments in point-of-care tests are crucial so that it becomes clear within minutes whether a bacterial infection is present. At the same time, we must improve access to clean water and sanitation (WASH) in the Global South to prevent the emergence of infections at the source.

4. Individual Responsibility: As consumers and patients, we have direct influence. This means: no pressure on doctors for viral colds, strict adherence to the prescribed duration of intake, and rigorous food safety when handling animal products to avoid cross-contamination.

Conclusion

Antimicrobial resistance is not a technical detail of microbiology. It is a benchmark of our ability to responsibly handle a limited, vital resource. Every time we use antibiotics unnecessarily—be it in the stable for cheap meat or in the clinic for a subjective sense of security—we steal a chance of survival from the next generation. As ethical leaders, we must once again understand antibiotics for what they are: a precious asset of humanity that we must place under the protection of a new ecological imperative. The “silent pandemic” must no longer remain in the shadows, for it threatens everything we have achieved in medicine thus far.

· Before we can solve this problem, however, we must first understand it. This is not pleasant; it requires a moment of witness that truly hurts—but it won’t take long.

· Immediately after, we will discuss how “ethical pioneers” have already more than halved the suffering associated with this issue over the last few decades.

· It is in our hands to continue this momentum. There is no reason for despair: all the solutions are already on the table.

I. The Biological Consequences of Poverty

For the bottom 20% of humanity, poverty is not merely a lack of money—it is a biological destiny that begins in the womb and often ends with death in the first year of life.

The Foundation of Catastrophe: When a woman is chronically malnourished, anemic due to iron deficiency, and performs heavy physical labor until the day of birth, she has no reserves left for the child. A low birth weight is the direct consequence. The baby is not simply born “small”; it comes into the world with a biological deficit. Its organs are underdeveloped, and its immune system is virtually non-existent. It has no body fat to maintain its temperature. In a drafty hut, this means the child can freeze to death even at a room temperature of 20°C, as it cannot regulate its own temperature without body fat.

Premature birth in poverty is also a death sentence. In an industrialized nation, an incubator acts as a surrogate womb. In a slum or a remote village, these machines are missing. The lungs are still fused, and the musculature is too weak. The child gasps desperately for air until exhaustion sets in and breathing simply stops. The brain is so fragile that even minor blood pressure fluctuations lead to cerebral hemorrhages. Those who survive often suffer lifelong disabilities.

Another “neonatal disorder” is sepsis: a systemic inflammation—blood poisoning. If the umbilical cord is cut with rusty scissors or a glass shard, bacteria migrate directly into the newborn’s bloodstream. Without a sterile environment, even the smallest wound becomes an entry point. Within hours, the organs fail. The baby becomes apathetic, stops drinking, and the skin turns grayish. The immune system, already weakened by the low birth weight, surrenders immediately. Without intravenous antibiotics, sepsis is a painful but rapid process of internal decay.

But the danger doesn’t just come from within: the next catastrophe, which is actually easily avoidable, is caused by a lack of hygiene. Where there are no toilets, excrement ends up in the drinking water. A child with diarrhea loses fluids and electrolytes at a record pace. They “dry out.” The eyes sink deep into their sockets, and the skin loses its elasticity. A vicious cycle begins, as the only water available to quench their thirst is the same contaminated water that caused the diarrhea in the first place.

If the child survives the first few months, they often suffer from malnutrition thereafter. This triggers two fatal effects:

1. Wasting (Emaciation): The body begins to digest its own muscles to fuel the brain. The child is reduced to nothing but skin and bones.

2. Stunting (Growth Retardation): The body switches to “power-save” mode. Growth stops, but more tragically: the brain fails to develop. The cognitive abilities the child would need to later escape poverty are permanently destroyed by the age of two.

II. The Historical Turning Point: How We Are Already Pushing Back Death

Yet, this biological prison has developed cracks. Alongside the horror exists a second truth: we are currently witnessing the greatest victory of humanity over suffering ever documented. In the last 30 years, child mortality worldwide has been more than halved. This is the result of the tireless work of people who take their moral responsibility seriously—those for whom the life of every child is of equal value, regardless of where in the world that child is born.

The “Kangaroo Revolution”

An underweight baby is no longer doomed without an incubator. We now use “Kangaroo Mother Care.” The child is tied naked to the chest of the mother (or father)—skin-to-skin, 24 hours a day. The mother’s body heat replaces the incubator’s thermostat. Her heartbeat stabilizes the baby’s breathing. The bacteria on her skin colonize the child and build an immune system. This simple, free method, combined with the administration of Antenatal Corticosteroids (injections costing a few cents to help lungs mature), has prevented millions of deaths from suffocation.

The 50-Cent Miracle

The fight against blood poisoning can also be won with the simplest of tools. The Clean Delivery Kit (plastic sheet, soap, a new razor blade, clean string) prevents bacteria from entering the wound during birth in the first place. However, the true game-changer is Chlorhexidine: a simple, cheap disinfectant gel for the umbilical cord stump. In countries like Nepal, this has reduced neonatal mortality from infections by nearly a quarter.

Breaking the Cycle of Contamination

Lack of hygiene is no longer an inescapable fate! In the last 20 years, over two billion people have gained access to clean drinking water. Water no longer comes from ponds but from deep wells, drawn from protected layers of the earth. Parallel to this, the “Latrine Revolution” has prompted entire villages to build toilets. When waste is no longer left in the open, there are no flies to carry pathogens to food. Diarrhea loses its power.

The Invention of “Plumpy’Nut”

Breakthroughs have also been achieved in the fight against malnutrition. While starving children previously had to be connected to tubes in clinics—a logistical challenge in war or famine zones—we now rely on RUTF (Ready-to-Use Therapeutic Food). “Plumpy’Nut” is a paste made of peanuts, milk powder, oil, and vitamins in an aluminum pouch. It is extremely high in calories, requires no refrigeration, and—crucially—needs no potentially contaminated water for preparation. Mothers can now treat their dying children at home. A child who is nothing but skin and bones (”Wasting”) can be back on their feet within three to four weeks with two to three pouches a day.

But it’s not just the fight against “Wasting”; astonishing progress has also been made against “Stunting” (lifelong mental and physical retardation): the widespread fortification of staple foods (flour, salt, oil) with iodine, iron, and vitamin A has pushed it back significantly in many regions.

The Numbers of Triumph

We are not talking about minor improvements, but a historical transformation.

A) Mortality Trends:

• In 1990, approximately 12.6 million children under the age of five died per year.

• By 2022, this number dropped to approximately 4.9 million.

• This means that 21,000 more children survive every single day than did 30 years ago. We have saved over 100 million children’s lives in this period.

B) The reduction in DALYs (disability-adjusted life years):

• While the cluster (Neonatal, WASH, Malnutrition) still accounts for 484 million lost years of life, this value was nearly double two decades ago.

• The rate of years lost to malnutrition has fallen by over 50% since 2000.

• Mortality from WASH factors (diarrheal diseases) dropped by nearly 60% in the same timeframe.

Conclusion:

The catastrophe is real, but it is no longer unstoppable. We have the tools—from peanut paste pouches to 50-cent disinfectant gel. Progress shows that poverty is not a law of nature, but a technical problem we are currently solving. We know exactly how to save a child today. We just have to do it.

III. What We Can Do Now

Poverty is not an inevitable fate; it is a technical and financial distribution problem.; it is a technical and financial distribution problem. We have the medicine, the knowledge, and the money. What is missing is consistent scaling. Here is the plan for the individual and for society.

1. As Individuals: Applying Leverage Where It Is Greatest

Most people donate based on “gut feeling” (e.g., for the local animal shelter). This is honorable, but it doesn’t save lives on a global scale. To be truly effective, one must practice Effective Altruism.

• Donate to “High Impact” Organizations: There are organizations scientifically proven to save the most lives per euro. Instead of donating blindly, use platforms like GiveWell or The Life You Can Save.

• Small Amounts, Massive Impact: 2 euros covers a dose of Vitamin A supplements that protects a child from blindness or death from infections for a year. A few euros fund chlorhexidine kits for dozens of births.

• The “1% Principle”: If everyone in the wealthiest 10% of the world gave just 1% of their income to high-impact charities, extreme poverty and the associated child mortality could effectively become a thing of the past within a few years.

2. As a Society: Political Pressure and Systemic Change

Donations heal wounds, but they don’t change the system. We must act as voters who demand global justice.

• Demand the 0.7% Target: Most industrialized nations (including Germany) have committed to spending 0.7% of their Gross National Income on development cooperation. Hardly anyone sticks to it. We must elect politicians who view this promise as a binding international duty, not a “voluntary handout.”

• Create Fair Market Conditions: We must stop flooding African markets with subsidized agricultural products that ruin local farmers. A society that wants to end poverty must make Fair Trade the norm, not a niche product.

• Patents and Knowledge Transfer: We must promote the export of medical knowledge. If medicines and vaccines can be produced locally, the costs for sepsis treatments or vaccination programs drop dramatically.

3. The Mindset Shift: From Pity to Investment

We must also stop talking about “aid.” We must talk about investing in people and in our future. Every euro we invest today in a child’s nutrition or clean water saves tenfold tomorrow in costs for crisis management, migration, and disease control. It is not merely an act of kindness; it is an act of reason. The progress of recent decades shows: we are already winning this fight. We just haven’t reached the finish line yet. 484 million lost years of life are a call to action.

IV. From Theory to Practice

Here is a selection of the most effective organizations worldwide, which apply exactly the four levers we have discussed. This selection is based on the criteria of Effective Altruism (meaning they have been evaluated by GiveWell or The Life You Can Save)—this translates to: maximum years of life saved per euro invested.

1. Focus: Malnutrition & Immunity

These organizations fight the “silent death” caused by nutrient deficiencies that make children vulnerable to all other diseases.

• Helen Keller International (Vitamin A Supplementation): They distribute Vitamin A capsules to children under five. Vitamin A deficiency is a primary cause of a collapsing immune system. Without this vitamin, a simple infection often leads directly to catastrophe. It is one of the most cost-effective interventions in history. Impact: A few euros protect a child for an entire year from blindness and death.

• Action Against Hunger: They are global leaders in treating acute malnutrition (Wasting) using the aforementioned peanut paste (RUTF). They bring children who are already near organ failure back to life within a few weeks.

2. Focus: WASH (Water, Sanitation, Hygiene)

These organizations interrupt the fecal-oral cycle and stop death from diarrhea and parasites.

• Evidence Action (Dispensers for Safe Water): They install simple chlorine dispensers directly at water points in rural regions (e.g., Kenya, Malawi). People can disinfect their water instantly while collecting it. This massively prevents diarrheal diseases in newborns and toddlers before they dehydrate. Impact: It is one of the cheapest ways to reduce child mortality on a large scale.

• Charity: Water: They focus on building deep wells and sustainable water infrastructure, solving the fundamental problem of poverty—the lack of access to a clean source.

3. Focus: Neonatal Disorders, Sepsis & Maternal-Child Health

This targets the critical first 28 days of life and the health of the mother during pregnancy.

• PATH (Program for Appropriate Technology in Health): They scale innovations like Chlorhexidine for umbilical cord cleaning or the Kangaroo Method. PATH works directly at the intersection of technology and extreme poverty, ensuring that knowledge about sepsis prevention and respiratory support for premature babies reaches the most remote huts.

• BRAC (formerly Bangladesh Rural Advancement Committee): They train tens of thousands of “Community Health Workers” who visit pregnant women in slums and villages. These workers identify high-risk pregnancies, teach breastfeeding and hygiene, and distribute “Clean Delivery Kits.” No one reaches the bottom 20% as effectively as BRAC.

What You Can Do Now: The “Impact Check”

If you would like to act immediately, I recommend a fund that automatically distributes money to the most effective programs:

• GiveWell Top Charities Fund: Your money flows to where scientific analysis shows it is most urgently needed to save lives (often in WASH or nutrition programs).

• The Life You Can Save (International): Founded by philosopher Peter Singer, this organization curates a list of high-impact charities that are scientifically proven to save or improve the most lives per dollar. It simplifies the giving process by highlighting organizations that excel in transparency and effectiveness, ensuring your contribution directly combats the “burden of inequality” and provides the maximum years of life saved per dollar invested.

A concrete example to conclude: With a donation of approximately 3,500 to 5,000 euros to these top organizations, statistically one human life is saved that would otherwise have been lost. That sounds like a lot of money, but think about it: it is about 10 euros a day. How often do we spend larger sums on things that don’t have even a fraction of the significance of a human life?

Is it not fascinating? Today, you no longer have to jump into a rushing river to save a drowning person, or rush into a burning house to pull out a child. With a small amount per day, we can save a human life, year after year.

PS: At the end of the trailer for my—unfortunately never realized—documentary A Life Per Year, I ask the bewildered question: “Could I really save lives if I stopped drinking tea?” The answer is: “Yes.”

The data indicates that this “tsunami” sweeps away approximately 800 million healthy years of life (DALYs) year after year. To grasp the scale: this tsunami claims more healthy years of life than poverty (314 million DALYs) and addiction (325 million DALYs) combined.

The Metabolic Core

The tsunami originates at the point where our metabolism collapses under the pressure of a modern lifestyle. This biological overwhelm is fueled by a small number of risk factors that act like accelerants, triggering disastrous chain reactions.

• Energetic Imbalance (BMI): A high Body Mass Index strains both joints and metabolism; it is the visible consequence of a modern lifestyle that is biologically ill-suited to us. It comes down to too many calories and too little movement.

• The “Silent Killer” (High Blood Pressure): With over 230 million DALYs, this is the invisible leading edge of the tsunami and the world’s primary risk factor. It is driven primarily by two factors we could control ourselves: excessive salt and obesity.

• The Sugar Trap (Blood Sugar & Diabetes): High fasting blood sugar is the physiological foundation for diabetes and vascular damage. It arises primarily from excessive sugar consumption combined with a lack of physical activity.

A Creeping, Unstoppable Wave

Like a tsunami on the high seas, this crisis often begins invisibly—for instance, as elevated blood pressure—but gains massive momentum through systemic factors that reinforce one another.

• The Wrong Fats: High LDL cholesterol calcifies the arteries, often driven by a poor selection of dietary fats.

• The Protective Nutrient Deficit: The problem stems not only from an “excess of the bad,” but also from a “deficiency of the good”. The tsunami causes such extensive damage because our internal defenses are missing: the massive lack of whole grains and fruit deprives the body of essential fiber and micronutrients. Without these barriers, the metabolism collapses under the weight of industrial food.

At the end of the wave lies organ failure, such as chronic kidney dysfunction, which is often the long-term consequence of years of blood pressure and blood sugar stress.

From Behavior to Catastrophe

Behind these medical metrics lies a deep-seated behavioral issue. We live in a world that constantly entices us to eat the wrong things:

• Ultra-Processed Foods: Although “ultra-processed foods” are not a direct GBD list item, they are the delivery mechanism for all the risk factors mentioned above: they are the primary source of excessive salt, isolated sugars, and unhealthy fats, while simultaneously lacking fiber.

• Physical Inactivity: Our biology is designed for activity. The combination of a sedentary lifestyle and high caloric density leads directly to metabolic collapse.

Behind the cold figures of the GBD study lies a radical realization: a large part of what we consider “normal nutrition” is, in truth, the fuel for metabolic breakdown.

The Experiment: The Empty Supermarket

Imagine we were to remove all products from the shelves of a supermarket that have been proven to trigger this metabolic tsunami—and thus mass suffering and death.

• The First Wave: The first wave clears out the salt (ranked 13th among risk factors). Since salt is used as a cheap but dangerous flavor enhancer in almost every industrial product, the shelves for ready-made meals, processed meats, and snacks would suddenly empty—initial proof of how much our “normality” is based on risky additives.

• The Second Wave: Products that drive up blood sugar and BMI are removed (ranked 5th and 6th). This means the end for almost all sodas, sweetened baked goods, and industrial desserts.

• The Third Wave: Everything that promotes LDL cholesterol or fails to provide protective whole-grain nutrients (ranked 7th and 15th) is removed. White flour products and low-quality industrial fats disappear.

The Result: The supermarket would be nearly empty. What would remain is a small but vibrant core of foods that never harm the body, but on the contrary, protect it.

What Will Never Harm You

The remaining “real” foods are not just “healthy”—they are the biological insurance against the greatest killers of the modern age, such as ischemic heart disease (Rank 1) or stroke (Rank 3):

• Legumes: Perfect sources of protein and fiber.

• Whole Grains: A massive lever, as “too few whole grains” causes millions of DALYs worldwide (Rank 15).

• Fresh Fruits and Vegetables: A lack of these is among the largest drivers of the disease burden (Rank 16).

• Nuts and Seeds: Essential fats in their natural packaging.

• Beverages: Water, herbal teas, and unsweetened natural drinks instead of liquid sugar stress.

• High-Quality Animal Products: If consumed, then only in small quantities and from ethical, species-appropriate husbandry to minimize the burden of the wrong fats and inflammatory factors.

The Hedonic Lie: Pleasure Today, Suffering Tomorrow?

At this point, some may worry that healthy eating means sacrificing enjoyment. Regarding this argument, two aspects are worth considering:

• Culinary Intelligence: Fresh, natural foods can be prepared to be extremely enjoyable. We are not giving up real taste; we are merely liberating our taste buds from industrial overstimulation.

• The Total Balance of Life: A pleasure that delights the palate for ten minutes today but causes years of suffering tomorrow through diabetes (Rank 5) or chronic kidney disease (Rank 19) is a catastrophic bargain in the DALY calculation.

The Lever for Moral Pioneers

In the course of this article series, we have spoken with admiration of “Moral Pioneers”. A “moral pioneer” is someone who recognizes that the framework of what is currently politically conceivable—the so-called Overton Window—is too narrow to allow for real solutions, and who therefore courageously shifts that framework.

Today, we must dismantle a food environment that is biologically toxic. The levers are on the table:

• Establishing the Truth: We must understand the “Metabolic Tsunami” as a systemic failure instead of seeking responsibility solely with the individual.

• Structural Prevention: Regulation of salt and sugar content in food (since the intake of these substances is often not a conscious decision by the individual).

• Redesigning Our Environments: Physical inactivity is often driven by urban planning and workplace design, rather than a lack of individual discipline..

Moral pioneers today must find the courage to describe the “normality” of our modern eating and exercise habits for what the data shows it to be: a catastrophe that destroys hundreds of millions of healthy life years annually. To stop the Metabolic Tsunami, we must move from a policy of mere appeals to the individual (”you should eat more fruit”) to structural prevention. The system must be redesigned so that the healthy choice is no longer a matter of discipline, but becomes the simplest and most logical decision in everyday life.

The “Safe Shopping Basket”: Protection Against Self-Poisoning

We must turn food stores into safe zones and implement the following measures:

• Prioritizing Nutri-Score A: Supermarkets will be transformed into safe havens for essential nutrition. There, you will find only products with a Nutri-Score of “A” as standard. This ensures that the normal shopping basket automatically protects against the drivers of the tsunami, such as high blood pressure and blood sugar.

• Speci Restricted Outlets for ‘Harmful Indulgences’: Those who still choose to consume these products will find them in specialized shops, similar to how tobacco is sold. Products with high addictive potential (isolated industrial sugars and highly processed flavor enhancers) will be banned from normal grocery stores. This prevents our biological reward systems from being “hijacked” in passing and protects children especially from lifelong dependencies. We thus protect the freedom of self-determination but separate it from daily basic supplies.

• The Advertising Ban on Biological Toxins: We will ban advertising for products that contribute significantly to heart disease or diabetes to protect children in particular from the consequences of malnutrition. We thus end an absurd paradox: that billions currently flow into the visibility of products that are simultaneously responsible for the loss of around 800 million healthy life years.

Ecological Rebalancing: Prioritizing Farmland for Human Nutrition

We are correcting the misallocation of our fundamental resources.

• Direct Consumption over Feed: Fertile farmland will be used primarily for growing human food (legumes, grains, vegetables).

• Ending Factory Farming: By stopping industrial feed production, meat consumption will automatically drop to a healthy level, drastically reducing the burden of high LDL cholesterol and vascular calcification.

Cost Transparency and Information (Honest Metrics)

These measures make the hidden costs of suffering visible and let them flow directly into the product price.

• The DALY Tax (Cost Transparency): Products will be taxed according to their statistical “footprint of suffering”. High salt or sugar content leads to a levy that exactly corresponds to future costs in the healthcare system (e.g., for cardiovascular diseases or kidney failure).

• Subsidizing Protective Substances: Revenue from this tax will flow directly into making whole-grain products and fruit cheaper, addressing the massive deficiency of these essential protective substances.

• Transparency through Warning Images: Products that demonstrably endanger blood pressure or blood sugar must (similar to tobacco products) be provided with clear warnings and images of the long-term consequences (e.g., dialysis or amputations).

The City as Medicine: Bringing Movement Back into Daily Life

Since physical inactivity is a main driver of the tsunami alongside nutrition, urban planning must also become medicine. This is because a lack of movement is not just an individual failure, but also a result of our environment.

• Active Design Cities: We will rebuild our living spaces so that everyday movement (walking, cycling) is the easiest and fastest option. This directly combats energetic imbalance and high BMI (Rank 6 among risk factors).

• Clean Air: The reduction of individual traffic simultaneously lowers fine dust pollution, which is also among the greatest human catastrophes and currently causes around 225 million DALYs worldwide.

Why This is Politically Viable

This plan is not a “ban on pleasure,” but “protection from suffering”. It implements cost transparency, relieves the healthcare system, and preserves freedom of choice at the same time (anyone who wants “poison” can still buy it). For moral pioneers, fighting for these measures is the logical consequence of the Ecological Imperative: we protect the fabric of life by correcting the structures that are currently destroying it.

Why this Program will Prevail:

• Economic Relief: We stabilize health insurance contributions by tackling the causes of the greatest disease burdens (ischemic heart disease, stroke, diabetes) at the root.

• True Freedom: We free people from biological manipulation by addictive, highly processed industrial products.

• Securing the Future: We protect the “fabric of life” and secure the biological resilience of coming generations.

Moral pioneers who try to solve this problem win twice or three times over. If they lead by example, no longer harming themselves with highly processed foods and too much meat, they effortlessly reach and maintain their ideal weight, gain attractiveness and additional energy, and above all, win a large number of additional healthy years of life.

However, this personal change is only the first step toward a global transformation: whoever fundamentally reforms the food system solves the most pressing health problem of humanity and simultaneously achieves a dramatic reduction in animal suffering and environmental destruction.

By correcting our food system, we also indirectly fight the scourge of hunger and poverty. A system that uses resources efficiently instead of wasting them in factory farming could also end the second-largest human catastrophe (according to the DALY ranking) once and for all.

Our next article will be about this challenge and opportunity.

We have seen how moral pioneers have shifted the “Overton Window”—the framework of what is currently politically achievable—to end slavery or the systemic inequality of women. To effectively protect or repair our social and ecological fabric today, however, we must move beyond our spontaneous intuition, which is often distorted by the visibility and suddenness of events, and turn instead to hard metrics.

In this article, I attempt to develop an initial ranking of the greatest problems facing humanity.

The Metric: DALYs

The “currency” I use to evaluate these issues is DALYs (Disability-Adjusted Life Years), a concept introduced in the previous article. One DALY corresponds to the loss of one year in full health. DALYs are comprised of two components:

• YLL (Years of Life Lost): How many premature deaths does a problem cause? How many years of life are lost as a result?

• YLD (Years Lived with Disability): How many years of life lose their quality because they are devalued by suffering?

The data for this analysis is based on the Global Burden of Disease Study (GBD), produced every two years by the Institute for Health Metrics and Evaluation (IHME) in collaboration with the World Health Organization (WHO).

A Necessary Disclaimer

This ranking is a preliminary approximation. It is a snapshot in time, reflecting which processes caused the largest “suffering footprint” among humans in the year 2023.

Problems that do not yet cause as much suffering but are predictably gaining momentum—such as the climate crisis or biodiversity loss—are not yet fully reflected in this ranking. Furthermore, the suffering footprint of non-human animalshas not yet been included. This ranking is also currently limited to a single parameter: devalued or lost years of life (DALYs). In later articles, I will subject this parameter to a critical review and propose additional metrics. We will then also incorporate “pipeline” problems (climate change, species extinction) and potential but fatal risks, such as nuclear war.

Ranking the 20 Greatest Disease Burdens

First, let’s look at “what” is killing or impairing us. These causes are organized hierarchically and are mutually exclusive at each level.

Ranking the 20 Greatest Risk Factors

While diseases tell us the symptoms, risk factors show us “why” we suffer. These factors represent the “levers” where policy and individuals can take action.

Interestingly, the dangers we fear most—murder, terror, and violence—are absent from this Top 20. Even the roughly 720,000 suicides and 458,000 murders annually cause less global suffering in DALY terms than back pain or headaches. This highlights the need to shift our focus from spectacular events to creeping, systemic catastrophes.

Blind Spots: What’s Missing?

The GBD tables have structural limits because some problems fall through the cracks of diagnostic codes.

• Poverty as the “Cause of Causes”: Poverty leads to contaminated water, malnutrition, and lack of medicine. If “Extreme Poverty” were listed as a risk factor, it would be the undisputed #1 in the Global South.

• Loneliness: The WHO equates the danger of loneliness to smoking 15 cigarettes a day. It is linked to 871,000 deaths annually.

• Antimicrobial Resistance (AMR): 1.27 million people died directly from resistant pathogens in 2019. If listed as its own cause, AMR would be the third leading cause of death globally.

• Violence against Women and Children: Childhood Sexual Abuse (CSA) is a “toxic stressor” that can trigger diabetes, addiction, and mental disorders later in life.

• Climate Change: Current GBD data primarily measures thermal stress (+60% heat deaths since 1990). Indirect consequences—crop failures, migration, and new infection pathways—are still massively underestimated.

“Clusters of Suffering”: Grouping the Data

To make this data actionable, we group it into clusters to better understand the root causes.

1. The Metabolic Tsunami (Diet & Movement)

This is the greatest problem of our time. Our biology is collapsing under a modern lifestyle defined by poor nutrition and physical inactivity.

• High Blood Pressure (Rank 1): The “Silent Killer,” driven by salt and obesity (230M DALYs).

• High Blood Sugar (Rank 5): The pre-stage to diabetes, caused by excessive sugar and lack of activity (152M DALYs).

• High BMI / Obesity (Rank 6): The visible result of an energy imbalance—too many calories, too little movement (128M DALYs).

• High LDL Cholesterol (Rank 7): Clogs the arteries due to unhealthy fats in the diet (100M DALYs).

• Kidney Dysfunction (Rank 8): Usually a late-stage consequence of years of blood pressure and sugar stress(90M DALYs).

• High Sodium Intake (Rank 13): A pure dietary factor that strains the cardiovascular system (41M DALYs).

• Diet Low in Whole Grains (Rank 15): A lack of protective substances that destabilizes metabolism (30M DALYs).

• Diet Low in Fruit (Rank 16): Missing micronutrients essential for vascular health (25M DALYs).

• Total Burden: Approximately 796 million DALYs annually.

2. The Burden of Inequality (The Poverty Cluster)

A moral catastrophe affecting almost exclusively the poorest 20% of the world.

• Neonatal Disorders (Rank 2 of Diseases): Includes preterm birth and sepsis (170M DALYs).

• Low Birth Weight (Rank 4): A mirror of inadequate medical care for mothers (160M DALYs).

• Child Malnutrition (Rank 9): Denies the youngest among us the chance for healthy development (80M DALYs).

• Unsafe Water & Hygiene (WASH) (Rank 11): Avoidable deaths due to a lack of infrastructure (74M DALYs).

• Total Burden: Roughly 484 million healthy life years lost annually.

3. The Addiction Crisis

Substances that trade short-term rewards for healthy life years.

• Smoking (Tobacco) (Rank 3): The leading preventable risk factor for cancer and lung disease (200M DALYs).

• Alcohol Use (Rank 10): Destroys quality of life through addiction, accidents, and organ damage (75M DALYs).

• Drug Use (Rank 14): Causes massive losses of life years, often starting in youth (30M DALYs).

• Total Burden: Approximately 305 million DALYs.

4. Modern Dynamics (Systemic Stressors)

The byproducts of a highly technical, urban, and often isolated way of life.

Environmental Stresses (The Toxic External World):

• Particulate Matter (PM2.5) (Rank 2): Poisoning our air through traffic and industry (224M DALYs).

• Occupational Risks (Rank 12): Hazards such as asbestos, noise, or workplace accidents (77M DALYs).

• Lead Exposure (Rank 17): An often-overlooked toxin that damages cognitive development and the heart (20M DALYs).

• Non-optimal Temperatures (Rank 19): Growing danger from climate change and heatwaves (15M DALYs).

• Sub-total: ~336 million DALYs.

Psychological & Social Stresses (The Devalued Internal World):

• Headache Disorders (Rank 13 of Diseases): Rising rapidly due to stress and modern work rhythms (45.5M DALYs).

• Depressive Disorders (Rank 10 of Diseases): Devaluing millions of life years through deep psychological distress (56.3M DALYs).

• Anxiety Disorders (Rank 20 of Diseases): A growing burden in an increasingly complex world (30M DALYs).

• Domestic Violence (Rank 20): A hidden driver of chronic illness (6M DALYs).

• Loneliness (The “Blind Spot”): As dangerous as 15 cigarettes a day.

• Sub-total: ~170.3 million DALYs (excluding loneliness).

Combined Total Burden: Approximately 517 million DALYs.

5. Biological Resilience (AMR)

• Antimicrobial Resistance (AMR): Undermines the foundation of modern medicine. As a “Hidden Giant,” AMR would represent one of the leading disease burdens with over 1.27 million deaths.

6. The “Outliers”: Risks Without a Clear Cluster

• Road Injuries (Rank 8 of Diseases): The high price of individual mobility (65.1M DALYs).

• Unsafe Sex (Rank 18): An avoidable transmission route for life-shortening diseases (20M DALYs).

• Falls (Rank 15 of Diseases): A specific risk of an aging society (43.8M DALYs).

• Total Burden: These factors collectively cost the world approximately 129 million DALYs annually.

Outlook

In the following articles of this series, we will first shine a light on each of these problem clusters in more detail. We will examine diet and movement, drugs, poverty and infant mortality, environmental and psychological stresses, and antimicrobial resistance.

Next, we will ask how the ranking would change if we added further parameters—such as “flourishing based on Capabilities“ as proposed by Amartya Sen and Martha Nussbaum. Finally, we will incorporate future and potential threats, as well as X-risks (existential risks), to continually refine our ranking.

Our goal in all of this is to recognize and order the greatest problems of the present as clearly as possible, so that we know where to apply the lever—just like those moral pioneers who once fought against slavery.

Next week in our series: The Metabolic Tsunami—How our Western diet is fueling by far the greatest human catastrophe of our age.

We recognized that the same system hindering billions of sentient beings from their unfolding also leaves a massive footprint of suffering in the human world. While the Global South suffers from hunger due to resource scarcity, we in the North suffer from lifestyle diseases caused by pesticide residues, nitrates in drinking water, and an excess of meat and highly processed foods.

It may come as a surprise to some that simply loading a shopping cart in the meat aisle fuels one of humanity’s greatest problems. If that is the case—if we didn’t have the full extent of this issue on our radar—it raises a disturbing question: are there other blind spots? Are there further sources of death and destruction whose scale we are failing to accurately assess?

Perhaps, at this very moment, we are dedicating our time and energy to solving minor problems while overlooking much larger ones? Perhaps we are straining at a gnat while swallowing a camel ...

Since our resources—our time and our money—are finite, the urgent question arises: Where should we deploy them to do the most good? We need a ranking of our greatest problems.

The Tool: A Currency to Measure Suffering

Some of us might instinctively recoil at the idea of “calculating” suffering. Yet the truth is: we compare constantly, though usually unconsciously, driven by headlines or the short-sightedness of the era we live in. To put our Ecological Imperative—to destroy the least and achieve the most good—into practice, we need better-calibrated measuring instruments. We need a compass.

This compass already exists and is used throughout the healthcare sector. The concept of DALYs (Disability Adjusted Life Years), which we touched upon in our analysis of animal suffering, allows us to compare different negative scenarios for humans as well.

The DALY concept merges two metrics:

1. Premature Death: A death at age 20 carries more weight than a death at age 80, as a death at 20 results in more lost years of potential life and, consequently, lost opportunities for unfolding.

2. The Devaluation of Life: Years are not only lost; they can also be devalued by suffering. If we assume that blindness reduces subjective quality of life by 20%, then 20 years of blindness corresponds to the loss of 4 healthy life years.

By adding these values, we make suffering comparable. We ensure that our desire to help becomes effective where we can prevent the most pain.

The Lever

But what are the greatest problems with the largest footprint of suffering? To find out, we must look beyond the diagnoses. Lung cancer or cardiovascular diseases are merely the symptoms of deeper issues. We must look at the risk factors—the roots of the suffering.

The scientific foundation for this is provided by the Global Burden of Disease (GBD) study by the WHO. It calculates the world’s “footprint of suffering” and asks: how many deaths would be prevented if we eliminated a specific factor—such as coal combustion or factory farming?

Recognizing the Killer in the Mirror: When Data Corrects Intuition

In the GBD data, we repeatedly encounter dramatic gaps between perception and reality:

• Worldwide, far more people die by suicide than by homicide (around 720,000 people per year).

• Homicides occur far more frequently within the family or social circle than at the hands of strangers (around 458,000 people per year).

• The footprint of suffering left by terrorism, which we perhaps fear the most, is vanishingly small compared to other violent deaths. The Global Terrorism Index (GTI) recorded 8,352 deaths from terrorism worldwide in 2023.

To put it bluntly: if you—especially as a woman—want to meet your killer, don’t turn on the news. Instead, either look in the mirror (suicide) or into the eyes of the person across from you at the breakfast table (domestic violence).

Factoring in the Future

As we proceed in the next articles to create a ranking of humanity’s greatest problems, we must also include those potential catastrophes that may lie ahead. To do this, we multiply the footprint of suffering of these potential problems by their probability of occurrence.

This allows us to compare problems that are already killing millions today (such as air pollution) with dangers that lie ahead—dangers that may have a low probability but possess the potential to wipe out the entire human race. These are the so-called Existential Risks (X-Risks).

Just as in the mathematical logic of insurance, a total loss of this magnitude weighs more heavily than a smaller problem with a higher probability of occurrence.

Conclusion: From Knowledge to Application

The fact that we now possess GBD data and the DALY metric is a major triumph of moral intelligence. We no longer have to grope in the dark when it comes to alleviating suffering. The Ecological Imperative now compels us to use these facts as our compass.

In the next installments of this series, we will apply this compass and create a concrete ranking: What are truly the greatest problems facing humanity?

Until then, let us use the time for a brief Moral Dry Run, a moment of self-reflection: Which problem on your personal agenda would likely carry less weight when assessed on a DALY basis—and which potentially neglected problem would suddenly take on gigantic proportions?

1. The Thought Experiment: Your Fair Share of the World

To grasp the problem and its—actually obvious—solution, I invite you into a thought experiment. Accompany me to a piece of land that belongs to you alone. Imagine you are standing in the middle of a vast, green football field. This is your personal share of the agricultural land on our planet. If we divide the entire usable surface of the Earth by 8.2 billion people, each of us receives a field of around 6,000 square meters.

Two-thirds of this area—the penalty boxes, the center circle, and large stretches of the wings—consists of grazing land. This area is unsuitable for growing human crops; however, one-third of the field represents 2,000 square meters of precious, fertile cropland. What would you grow on these 2,000 square meters to remain healthy, strong, and vital?

2. A Garden of Abundance

If we use our land wisely, a small farm of astonishing efficiency emerges. For a perfect supply of protein, we would plant local legumes in the center: deep-rooting lentils and space-saving pole beans climbing their supports.

Right next to them, we meet our energy needs with high-efficiency sources: a field of robust oats and a plot of potatoes forming their tubers deep in the earth.

To provide our bodies with essential, healthy fats, we plant blue-flowering flax and nutty hemp on another strip—two local superfoods.

The edges of our field transform into a wonderland of micronutrients: crisp cabbage, colorful vegetable beds, and fresh salads grow in the shade of a few fruit trees, while berry bushes line the fences.

When you precisely calculate the land required for a full, healthy human diet, you reach a shocking realization: we do not need anywhere near 2,000 square meters of arable land to be satiated and healthy. In fact, a fraction of that is enough to give us everything we need to flourish.

Where, then, is the error?

3. The Tear in the Fabric: The Agricultural Crisis

The metaphor of the 2,000 square meters helps us visualize the absurdity of our system. Today, we do not use the vast majority of this field for our plates; we use it for the production of animal feed. Why? Because we keep over 80 billion livestock worldwide—far more than could ever find space on the Earth’s natural grazing lands.

We are simply growing the wrong things, converting plant calories into animal calories at an enormous loss.

Additionally, we produce a significant portion of this valuable harvest directly for the trash bin—whether through lack of infrastructure in poorer regions or the grotesque wastefulness of wealthy nations. This is why we cannot manage with the land we have. This is why we leach the soil and soak it in toxic pesticides. In the service of meat production, we are not only triggering a mass death in factory farms, but a mass death in nature itself.

Through our immense hunger for land and chemical use, we are tearing holes in the biosphere—the very foundation of our survival. Of the nine planetary boundaries of the biosphere, we are already in the process of crossing six. In four of these cases, intensive agriculture is the primary cause; in the other two, it is one of the two main drivers. Whether it is species extinction, the climate crisis, ocean acidification, land degradation, or the disruption of nitrogen cycles—our food system stands at the center of the storm. The root remains the same: the excessive consumption of animal products and the ignorant waste of food.

4. Avoidable Hunger and the Price of Health

The effects of this mismanagement do not only affect nature; they are an attack on humanity itself. When we feed grain and soy to 80 billion livestock, there is not enough left for the 8 billion humans whom we could otherwise easily feed. Hunger in this world is not a matter of fate; it is the logical, bitter consequence of a system that prioritizes meat consumption over human lives.

At the same time, this form of agriculture paradoxically harms the very people for whose enjoyment it was seemingly established: ourselves. In wealthy nations, lifestyle-related illnesses are exploding due to excessive meat consumption. The poor composition of our diets, the toxic load in our food, and an industry that makes us addicted to nutrient-poor, highly processed foods have become the biggest killers on this planet. According to the WHO’s “Global Burden of Disease” study, far more people in rich countries die today from the consequences of this malnutrition than from undernourishment in poor regions.

5. The Path Forward: Technology as a Moral Lever

Theoretically, it is simple to end this madness. On one hand, we must drastically reduce losses—both as individuals and as a society. On the other, we must strictly tie the production of animal calories to sustainably available land and allow animals to live dignified, species-appropriate lives. That means: no feed production on precious arable land.

To satisfy our hunger for meat without sacrificing the planet, we should embrace a technological revolution: Cultured Meat. By growing real animal cells in bioreactors, we obtain meat that is biologically identical but requires no slaughterhouses and no mass destruction of land. This allows us to reclaim valuable ecosystems and stop the suffering in barns and in the wild.

A promising alternative is Blue Agriculture. Algae are true superfoods that grow without fertilizer or freshwater while sequestering enormous amounts of carbon. Especially effective are 3D ocean farms where algae and shellfish thrive in vertical systems. Since shellfish lack a central nervous system and, as far as we know, feel no pain, they offer high-quality protein in a way that cleans the ocean instead of polluting it.

6. The Will to Change

The solutions are on the table. They are tangible, logical, and implementable. What we lack is not knowledge, but the courage to recognize the moral fact: our current system is damaging the web that supports us all. Once we understand the scale of the problem and develop the will to consistently live its solutions and demand them politically, we will allow our capacity for change to grow.

Imagine traveling seventy years into the future. A child sits with his grandfather in a sun-drenched garden. The child holds a digital book on 21st-century history, looks up, and asks with a look of disbelief : “Grandpa, is this actually true? Did you really lock billions of sentient beings in narrow metal boxes and kill them just to eat them, even though you knew they felt pain?”

The grandfather will likely fall silent and lower his gaze. He will feel the same sense of shame we feel today when we think of the “respectable” citizens of the 18th century who went to church on Sundays while whipping their slaves on the plantations on Mondays.

We must face an uncomfortable truth: we are those ancestors upon whom future generations will one day pass harsh judgment. We find ourselves in the midst of the greatest moral scandal of all time, yet we fail to see it because it remains hidden behind the windowless walls of industrial agriculture.

2. The Golden Retriever Test: Our Moral Dissonance

Anyone who has ever lived with a dog or a cat knows that animals are not biological automata. They feel joy when we come home, they show fear, they play, and they seek connection. We do everything to promote the thriving of our pets. We buy them orthopedic beds and mourn them like family members.

Yet, just a few inches away, on our plates, we make a radical exception. Let us subject this moral dissonance to the “Golden Retriever Test” : Would we lock a dog in a gestation crate where it cannot even turn around? Would we cut off parts of its body without anesthesia? Never. Why, then, do we do it to a pig?

Years ago, I designed a concept for a YouTube series called the “One-Pig Challenge”. The idea was simple: a randomly selected person lives with a small piglet for a month, caring for it and getting to know its character. After this time, we ask them the radical question: Are you prepared to have this being, whom you now know, slaughtered for food?

Scientifically speaking, a pig is often superior to a dog in terms of intelligence and social complexity. Nevertheless, we have arbitrarily drawn our Circle of Empathy at a species boundary. This “speciesism”—the favoring of some species at the expense of others—is based on a massive epistemic barrier: a perception filter that prevents us from recognizing a moral fact that is actually obvious.

3. Moral Software: Astrid Lindgren and Flourishing

The great children’s author Astrid Lindgren, who campaigned passionately against animal suffering, once wrote a book titled My Cow Wants to Have Fun Too. It sounds like a children’s book title, but it is, in truth, a profound philosophical essay. In my Ethics of Flourishing, I have described how every living being carries a “potentiality” within itself—a space full of possibilities.

A pig that can never root, a chicken that can never take a dust bath, a cow that never experiences social bonds in freedom—these are beings completely hindered in their flourishing. We do not just take their lives at the end; we rob them of every second of their existence beforehand, denying them the opportunity to realize their nature. In factory farming, we degrade a suffering and striving subject to a mere unit of biomass—a unit we subject, thoughtlessly, to the most cruel treatment imaginable.

4. The Mathematics of Horror: DALYs and Welfare Ranges

To understand the magnitude of this problem, we must move beyond intuitive empathy and enter the realm of hard analysis. Modern research into so-called Welfare Ranges examines how intensely different species can feel pleasure and pain. The results show that a pig feels pain about half as intensely as a human, a chicken only slightly less, and even fish are far from being pain-insensitive objects.

When we apply the concept of DALYs (Disability-Adjusted Life Years)—the metric that counts years of life devalued by suffering or lost through premature death—to our fellow creatures, our worldview begins to shake. In factory farming, almost every second of an animal’s life is 100% devalued by suffering. Added to this is the total loss of nearly all their potential life years through early slaughter.

Even if we were to weight animal suffering extremely conservatively in our moral calculus—say, the pain of a pig counts for only one-thousandth (0.1%) of that of a human—industrial animal farming would still skyrocket to the number one spot among the greatest moral problems of the present due to the gargantuan number of individuals involved.

To grasp the dimensions: every year, over 80 billion land animals are slaughtered for food worldwide. If we include marine life, we are talking about an estimated one to two trillion beings killed every year.

Mathematically, this mass suffering and death is the greatest cruelty humans have ever committed. Every year, in the world’s barns and stalls, we cause more suffering and death than humanity has inflicted on other humans in the entirety of human history.

5. The Overton Window: Of Radical Pioneers and Technological Helpers

How do we deal with this catastrophe of apocalyptic proportions? The history of moral progress shows us the way: we must shift the frame of what is socially acceptable—the so-called Overton Window. This window defines which ideas the public currently perceives as “reasonable”.

Today, it is the vegans and animal rights activists who lead as “Moral Pioneers”. They are often defamed as “annoying” or “extreme,” just like the suffragettes were. Yet, they perform the necessary moral vanguard for all of us. They demonstrate that a life without exploitation is possible and push the edge of the window toward the truth with all their might.

However, we cannot simply wait for everyone to follow them. This is where technology enters as a moral lever, much like the steam engine once helped make slavery economically obsolete. Cellular agriculture—cultured meat grown in a lab—enables a technological solution. As soon as we can enjoy meat without an animal having to suffer or die for it, every moral justification for industrial slaughter collapses. Technology here enables morality; it makes it “cheap” and easy to be good.

6. The Construction Site of the Present: What Is to Be Done

Of course, we cannot simply sit back and wait for lab-grown meat to scale globally. We must repair the ecological fabric now. The path out of cruelty is therefore two-fold:

• Ecological Reduction: We must reduce animal husbandry to a level that is species-appropriate and sustainable. This means only as many animals on our plates as can live in dignity on ecologically sensible grazing lands, such as alpine pastures.

• Investment in the Future: We must invest massively in the research and scaling of meat alternatives to finally decouple pleasure from pain.

7. We Are the Saving Power

Moral progress is not a tea party; it is hard work on our own minds. Expanding the circle of empathy beyond our own species is the next logical step in this development. It is not about immediate perfection, but about a sincere alignment with the Ecological Imperative:

Act in a way that minimizes the extent to which you hinder the flourishing of other life forms.

Every decision at the supermarket checkout, every rejection of a product from factory farming, is an act of intelligence and a victory over our own short-sightedness. When we do this, we restore the web of life upon which we ourselves depend. We stop being the destroyers of that fabric and become its gardeners. We Are the Saving Power.

1. The Paradox of Freedom

Picture a magnificent London ballroom in 1880, where men debate the freedom of the individual, democracy, and the rights of the citizen. It is a world that considers itself highly civilized. Yet, in this very room, half of humanity exists in a state of legal non-existence. Women of that time were legally relegated to the status of children or minors. They could not vote, usually could not freely dispose of their own property, and were considered extensions of their fathers or husbands.

When we view this through the lens of the Ethics of Flourishing, we see a massive, artificial blockage in the social fabric. The system systematically stifled the potential of millions to actively contribute their talents and minds to shaping the world.

Why was this not perceived as an immeasurable scandal at the time? Because it lay behind the veil of familiarity. This veil blocked our ability to perceive: women were not seen as independent subjects with the same rights to flourishing as those granted to men.

2. The Mechanics of the Impossible: The Overton Window

In Article 2 of this series, I introduced the Overton Window. This window limits the range of ideas that the public considers “reasonable” or “acceptable.” Around 1850, the demand for women’s suffrage lay far outside this window. It was considered offensive, even unthinkable. If a woman voiced this demand, the response was not factual argument; she was laughed at or maligned as “unfeminine” and “insane”. Yet, moral progress follows rules.

The process occurred exactly according to the model we study in history books today:

• Circa 1800: The idea is unthinkable.

• Circa 1890: The idea circulates but is considered radical. Intense debate begins.

• Circa 1910: The idea becomes acceptable.

• Circa 1920: The idea becomes law and begins its international triumph.

This shift did not happen because politicians suddenly reached enlightenment. Politicians are rarely leaders — they are opportunists forced to move within the Overton Window to be re-elected. The Overton Window was shifted from the outside.

3. The Intelligence of the Radicals

“Moral Pioneers” were responsible for this: the Suffragettes. Women like Emmeline Pankhurst recognized moral facts earlier than the rest of society. They grasped the obvious: women are human beings with the same potential for flourishing as men. Pankhurst was no theorist waiting for justice in a study — she was personified urgency. Her slogan

“Deeds, not words”

was a declaration of war against the patient politeness that had achieved nothing for decades. She understood that the moral truth of equality was simply being “debated to death” in the polite discourse of salons. Therefore, she chose to use her body and her social status as a lever.

When she starved in prison, she did so not out of despair, but based on the cold calculation of a strategist who had realized: a suffering body on a hunger strike is an argument that is harder to explain away.

Many contemporaries, however, found the Suffragettes “annoying,” “extreme,” or “hysterical.” They disrupted meetings, chained themselves to railings and, in short, were “sand in the gears.” But that was exactly the goal, the method.

The Suffragettes didn’t just disrupt meetings; they destroyed the illusion of harmony in a deeply unjust society. When they smashed windows on Oxford Street or disrupted horse races, they weren’t committing senseless violence — they were betting on a risky escalation: they created “cognitive friction.” They made it impossible for the bourgeois man to enjoy his tea and newspaper without being reminded of the unfinished moral task of the age. Their goal was to drive the costs of the status quo so high that giving in — shifting the Overton Window — finally appeared as the lesser evil.

From the perspective of the Ethics of Flourishing, the verdict is the opposite: these women were not “hysterical”; on the contrary, they possessed a higher form of moral intelligence.

They knew you don’t move a stuck window by knocking politely. You must pull the frame with all your might so that the center shifts. By disrupting the “normal,” they forced society into a “moral litmus test.” Every citizen suddenly had to ask: Is it truly justified to throw these women in prison just because they want a voice? The veneer of social harmony began to crack.

4. The Expanding Circle

The victory of the Suffragettes was a classic victory of the Ecological Imperative:

“Act in a way that minimizes the extent to which you hinder the flourishing of other life forms.”

People finally realized that denying women the vote damaged the fabric of society because it hindered the flourishing of half its members. By winning the right to vote, women expanded the Circle of Empathy and recognition. A growing portion of humanity understood that the “neighbor” is not just the man from one’s own social class, but every human being striving for flourishing.

5. What We Can Learn

What lessons do we draw for our mechanics of change?

• Progress is not a tea party. Moral progress requires polarization to overcome the inertia of the masses. Without the friction generated by radicals at the edges, the moderate center rarely finds the courage to move.

• Delegitimizing the messengers is a symptom of change. When a movement is defamed as “hysterical” or “annoying,” it is often the surest sign that it is beginning to successfully move the edge of the Overton Window.

• The courage to be unpopular is a moral resource. Pankhurst and her fellow campaigners taught us that you don’t improve the world by asking for approval within existing rules, but by demonstrating the moral absurdity of those rules until they collapse under their own weight.

6. The Panorama of Change

Why was I determined to tell this story after speaking about the abolition of slavery and medical progress? Because it adds a crucial piece to the puzzle.

While Semmelweis failed tragically, Zhdanov won through global cooperation, and the Abolitionists achieved moral victory through the lever of economic boycott, the struggle of women shows us that progress often requires uncomfortable, persistent, and active resistance against the status quo.

This completes my Panorama of the Mechanisms of Change. We have learned the tools: scientific insight (Semmelweis), political scaling (Zhdanov), economic boycott (Abolitionists), and the radical provocation of the Suffragettes. We have seen how we, as a species, have learned to feel the pain of the “other” and dismantle artificial blockages. We have learned to successively expand the circle of empathy and rights within our own species.

But what about those beings who have no voice to scream in parliaments, who cannot go on hunger strike? What about the animals? I originally intended to address this — perhaps the greatest blind spot on the moral map of the present — in today’s article. But then it became clear: before we mentally expand the “Expanding Circle” to include animals, we should understand how we overcame the most painful blockage within our own species — the disenfranchisement of half of humanity.

In the next article, encouraged by these historical advances in morality, we will look at one of the greatest, most obvious scandals of our time.

We will examine our dinner tables.

Imagine stepping into the attic of an old farmhouse. In a dusty crate, you find a family Bible from the year 1800. Opening its first pages, you discover not just prayers, but a handwritten chronicle of pain.

There, entries read: “Anna, born 1802, died 1804. Johann, born 1805, died 1805.” These lines are more than ink on yellowed paper; they are a testament to a world that feels unthinkably cruel today. Just two centuries ago, nearly half of all children died before reaching puberty. Death was not a rare visitor; it was a permanent resident in every nursery.

From a moral perspective, this was a catastrophe of immeasurable proportions: a mass loss of lives that were just beginning to unfold. Each child carried an internal program—a potentiality, like the blossom of an apple tree waiting to bear fruit. Through premature death, these tender lives were robbed of all their possibilities.

2. The Hell of Fatalism

Our ancestors accepted the death of children as “God’s will,” an inescapable fate, or simply the “way of the world.” Yet, as long as they believed they were powerless against it, they truly were. There was no perceived reason to act.

Progress—especially moral progress—only occurs when we recognize that such suffering is not a necessity, but something we can and must change. Once we grasped that these deaths were preventable, mass mortality transformed from a tragic fact into a moral task of immense urgency.

3. The Lonely Voice: Ignaz Semmelweis

Moral Pioneers are those who recognize a moral duty before the rest of society is ready to see it. One of the most tragic heroes of this history is the physician Ignaz Semmelweis.

Working in a Vienna maternity clinic in the mid-19th century, Semmelweis was horrified to find that mothers in the ward run by doctors and students died of “childbed fever” at much higher rates than those in the midwives’ ward. He discovered the ecological web before it had a name: the invisible, deadly link between the dissecting table and the delivery room. Doctors were carrying “cadaverous particles”—what we now call bacteria—directly from autopsies to mothers.

Semmelweis acted, mandating a strict hand-washing protocol with a chlorinated lime solution. The results were spectacular: mortality rates plummeted from over 18 percent to just 2 percent. It was a victory of reason over death.

Yet, the unthinkable happened: even these undeniable facts failed to convince his contemporaries. His colleagues felt insulted by the suggestion that their “gentlemanly” hands could be instruments of death. Because this truth remained outside the Overton Window of his profession, Semmelweis was ridiculed, marginalized, and eventually committed to an asylum. Though he died in tragedy, the moral fact he discovered—that hygiene prevents avoidable suffering—would eventually change the world forever.

4. The Power of Collective Action: Victor Zhdanov

While Semmelweis’s ideas only triumphed after his death, the story of Victor Zhdanov proves that cooperation can accelerate progress. Zhdanov is perhaps the most significant person you have never heard of.

In 1958, at the height of the Cold War, Zhdanov—the Soviet Union’s Deputy Minister of Health—stood before the World Health Assembly. He called upon the global community to eradicate smallpox, a plague that had decimated humanity for millennia. In the 20th century alone, smallpox killed an estimated 300 to 500 million people—more than all the wars of that bloody century combined.

What followed was a miracle of cooperation. While Washington and Moscow pointed nuclear missiles at each other, doctors on both sides recognized their radical interconnectedness. Viruses know no ideology. Zhdanov’s initiative broke the ice: the US joined the effort, and American strategist D.A. Henderson took the lead.

By 1980, smallpox was officially eradicated. This campaign has saved between 100 and 200 million lives to date, making Zhdanov arguably the individual who has done the most good in human history. The lesson is clear: when we apply the Ecological Imperative at a geopolitical level—choosing cooperation over conflict—we can make the impossible possible.

5. Hygiene as Systemic Love

We often view sewers, water filters, and vaccines as mere technical achievements. But morally, a sewage system is a monument of systemic love. Regardless of whether it was built out of fear of epidemics or sheer necessity, it functions altruistically today. It protects people you will never meet from diseases they will never contract, marking a victory over cognitive short-sightedness.

Vaccinations are a form of cooperative intelligence. Those who vaccinate do not do so only for themselves; they protect the vulnerable—the newborns and the sick—who cannot build their own defences. This is the Ethics of Flourishing in practice: using science as a tool to minimize the footprint of suffering. We have tamed nature where it was blindly and cruelly preventing the unfolding of life.

6. The Democratization of Life Expectancy

The result of this moral marathon is breathtaking: we have more than doubled global life expectancy. We have wrestled decades away from death. I call this a “moral achievement” because time is the essential resource we need to grow as conscious beings. Today, for the first time in history, most people can live with the near certainty that their children will outlive them. This progress is the foundation upon which our modern happiness rests.

7. The Blind Spot

We might shake our heads at the short-sightedness of those who mocked Semmelweis. We might celebrate Zhdanov as a hero. But every era has its own blind spots.

If hygiene means minimizing avoidable suffering through systemic action, we must ask: Where are we producing suffering today without noticing it? We must extend the principle of systemic love to those areas we currently ignore out of habit—starting with the contents of our plates.

The fine porcelain clinks softly as your spoon touches the rim. How elegant.

Yet, to sweeten this single cup, human beings in the Caribbean had to toil under the tropical sun until they collapsed from exhaustion. The average life expectancy of an enslaved person upon arrival at a sugar plantation was often just a few years. They were literally consumed—burned up like coal in a furnace.

For the lady in our fine salon, all of this is very far away. Effectively, it does not exist. For her, the sugar is simply... sweet. And for the gentleman of the house, it is likely lucrative.

Liverpool and Bristol have grown rich. Parliament is full of plantation owners. The Church declares it to be God’s order. The economists warn that without slave labor, the British Empire would collapse. Slavery is not just “normal.” It is the foundation of the global economy.

Abolishing it seems as utopian then as demanding we switch off the Internet would seem today.

And yet, slavery disappeared (at least as a legal institution). What caused this?

The Myth of Automatic Progress

We often hear today that slavery vanished because it became “obsolete.” That steam engines were simply more efficient than enslaved people. That progress happens automatically.

However, historian Christopher Brown (Columbia University) and other experts have debunked this myth. The truth is more uncomfortable—but ultimately, it gives us courage.

Around 1800, slavery was more profitable than ever. There was no economic reason to end it. From the perspective of the profiteers, the system worked perfectly. It came to an end because a small group of people discovered a Moral Fact that was stronger than any profit.

Moral Pioneers and a Box Full of Evidence

It began with the Quakers, a religious minority who proved to be the ultimate “Moral Pioneers.” They possessed an exceptionally high form of moral intelligence. They did not look at the balance sheets; they looked at the ecological webof humanity.

They recognized the tear in the fabric: “This human being in the field strives for unfolding just as I do. To turn him into a commodity is objectively wrong.”

But insight alone is not enough. You have to actively shift the Overton Window. And this is where people like Thomas Clarkson come into play.

Clarkson is one of the great heroes of moral progress. He rode 35,000 miles through England. And he always carried a box with him.

When he entered a pub or a salon, he would open it. Inside lay thumbscrews and jaw spreaders—devices that made the guests gasp in horror.

But Clarkson showed them something else, something far more important for our Ethics of Unfolding: He brought out artfully woven fabrics, ivory carvings, and musical instruments from Africa.

His message was crystal clear: “Look at this. These are not animals. These are human beings with culture, with talent, with spirit. We rob the world of its art and its mind by degrading these people into tools.”

Together with the first viral image in history—the cross-section of the tightly packed slave ship Brookes—he forced people to look.

You could no longer pretend you didn’t know. Suddenly, the sugar in the tea tasted bitter.

The First Boycott in History

What followed was a mass application of the Ecological Imperative. Hundreds of thousands of Britons stopped eating sugar.

It was the first consumer boycott in history. And people showed it.

Sugar bowls began to appear in households bearing an inscription in gold lettering: “East India Sugar not made by Slaves.”

If you were invited to tea back then, the sugar bowl itself forced you into a moral decision. The porcelain screamed at you: “Which side are you on?” This was the Moral Dry Run at the breakfast table.

And more and more people expanded their Circle of Empathy.

They understood that their pleasure was directly linked to the suffering of another human being—they began to calculate the footprint of suffering.

The Price of Morality

The decisive moment came in 1833. The British Parliament voted to end slavery. But the victory was not cheap.

To placate the powerful slaveholders, the state paid compensation of 20 million pounds. That was 40 percent of the entire national budget at the time. In today’s terms, that would be hundreds of billions.

Imagine if the government were to incur debt so massive that we wouldn’t pay it off until the year 2200—just to end a moral injustice.

The British did exactly that. The loan was effectively not fully paid off until 2015 (!). They bought freedom.

They decided collectively: “We are willing to be poorer so that we can look ourselves in the mirror again.”

Profit was sacrificed to restore the web of life, to enable unfolding.

The Lesson for 2026

Why is this important? Because today we often hear: “We can’t save the climate, it’s too expensive.” Or: “We can’t end factory farming, it would harm the economy.”

The history of the abolition of slavery demonstrates the opposite. Systems do not change merely because they become unprofitable. They change when we recognize that they are wrong.

The abolitionists faced an industry more powerful than today’s oil or meat lobbies combined. And they won.

Not through violence, but through the persistent shifting of the Overton Window and the courage to place Moral Factsabove economic interests.

We learned that human beings are not property. That was the second great step after the outlawing of cruelty (Article 3).

In the next article, we will look at a third triumph. A victory that is so self-evident to us today that we have almost forgotten it: the victory over premature death.

Reading this scene today is viscerally repulsing. We ask ourselves: Were our ancestors psychopaths? Were they monsters? The unsettling answer is: No. They were humans like us; they loved their children and wept for their dead. But their moral software—the internal code that determines who “belongs” to our circle of care and who does not—was programmed differently.

Blindness to the Web

To understand this horror, we must recall the Ethics of Unfolding. This is the principle that life is a networked web where every being has an inherent drive to develop its potential without being blocked by others. For people back then, the “morally relevant web of life” ended at their own front door or, at best, at the city walls. Everything lying outside—animals, criminals, heretics, people of different skin colors—was not perceived as part of the system. They were treated as mere objects.

In the eyes of the public, these beings had no claim to unfolding. Their suffering was not a moral fact—an objective truth that demands a response—but merely irrelevant background noise, a kind of moral static. Human cruelty was not limited to animals. Public executions—the breaking wheel or the quartering of humans—were effectively the “Netflix of the Middle Ages”. Suffering served as entertainment because the Circle of Empathy was drawn extremely tight.

The philosopher Michel Foucault describes this in his book Discipline and Punish, using the example of the regicide Damiens in 1757. Before a curious crowd, his flesh was torn with red-hot pincers, and molten lead and boiling oil were poured into the wounds. Finally, four horses were harnessed to his limbs to tear him apart while he was still alive. The audience watched with fascination, enjoying the spectacle.

This laughter and wonder were symptoms of a massive moral myopia. The onlookers did not see that torturing a sentient being creates a tear in the fabric of existence, nor did they understand that every life strives to avoid pain and to unfold itself.

The Invention of Compassion

But then, something happened that Steven Pinker calls the “Humanitarian Revolution”. Within a few centuries, this public delight in cruelty almost completely disappeared from the Western world. What was it that shifted the Overton Window—the range of ideas and behaviors that society accepts as “normal” or “reasonable”—so massively that burning cats turned from a festival into a crime?

One decisive factor was a gigantic, societal “Moral Dry Run”: the spread of reading. A Moral Dry Run is a courageous mental practice where we actively simulate new perspectives to break through our “epistemic blockades”—the thought filters that make us blind to reality.

In the 18th century, people began to read novels en masse. Literature is, in essence, an empathy machine. It forces us to see the world through the eyes of another and simulates interconnectedness across boundaries. Suddenly, a Parisian aristocrat would step into the mind of a simple servant girl while reading. A wealthy Englishman would suddenly feel for a slave on a cotton plantation. The more we read, the harder it became to see the “other” as a mere object. We realized: “He feels like I do. He strives for happiness like I do”. The Circle of Empathy began to expand rapidly.

The First Stage of the Ecological Imperative

This brings us to the Ecological Imperative: Act in a way that minimizes the extent to which you hinder the unfolding of other life forms. The decline of physical violence was a particularly important step in this direction. Violence is the ultimate blockage of unfolding; a body being tortured cannot flourish, and a life extinguished loses all potentiality.

The fact that we now internationally outlaw torture, have animal welfare laws, and ban corporal punishment in education are all victories for moral intelligence. We have recognized the necessity of reducing our “footprint of suffering”—the measurable impact our choices have on the pain of others—as a moral fact. Suffering is objectively bad, no matter who experiences it.

Why This Gives Hope

Why is this retrospective important for us in the year 2026? Because it proves that human societies are not static. We are capable of learning. We have evolved from beings who laughed at burning cats to beings who write animal rights into constitutions. We have largely broken through our epistemic blockades regarding physical cruelty.

This does not mean the world is free of violence today, but the moral baseline has shifted. What was once entertainment is today a scandal. The Overton Window regarding violence has moved a great deal. And if we could learn to feel the pain of an animal or a stranger, then we can also take the next steps.

In the next article, we will look back once more at a struggle that was perhaps even greater than the outlawing of cruelty. While giving up sadistic entertainment cost nothing, our next topic was about money—a lot of money. We will examine how humanity learned that you cannot own people, and how morality ultimately triumphed over economics.

Now, let’s jump to 1900. A duel between two men to restore their “honor”? Entirely normal. Legally a gray area, perhaps, but socially accepted.

Let’s leap even further back, to 1750. Burning living cats for entertainment? It was a public festival.

When we look back at these things today, we feel a physical revulsion. We find them barbaric, foolish, or insane.What happened here? Our “moral software” received an update.

As I argued in the first part of this series, this moral progress isn’t a random force of nature. It doesn’t happen by accident. It follows rules. And once we understand these rules, we lose that sense of helplessness in the face of a threatening future—because we grasp how we can shape it.

The Window of Opportunity

To understand the mechanics of this change, we have to look at Michigan in the 1990s.

There, a brilliant strategist named Joseph Overton developed a model now famously known as the Overton Window. Overton wanted to answer a simple question: Why do politicians support certain ideas while completely ignoring others?

His realization was sobering yet illuminating: Politicians are rarely leaders. They are opportunists.

Imagine a scale containing every possible idea on a given topic—from “extremely progressive” to “extremely conservative.” Now, imagine a “window” that frames only the small section of that scale which the public currently accepts as “reasonable.”

• If an idea lies within this window, a politician can support it and get re-elected.

• If an idea lies outside the window (in the realm of the “radical” or “unthinkable”), no one in power will touch it. To do so would be career suicide.

This model explains why laws always come at the very end of a process.

Women’s suffrage was unthinkable in 1800. Those who demanded it were considered mad. By 1900, the idea had become radical. People argued about it. By 1915, it was acceptable. And in 1919, it became law.

The law didn’t pass because politicians suddenly grew a conscience. It passed because the window had shifted.

But who shifted the window? We often wait for politics to lead. But the Overton Window reveals a hard truth: Politics cannot lead. It is the caboose of a train that we set in motion—through our thinking, our actions, and our moral reappraisal.

The Hidden Wisdom of Radicals

This is where the Ethics of Unfolding comes into play.

Society often labels those who champion ideas outside the window—like radical animal rights activists or climate protectors—as “annoying,” “naive,” or “extreme.”

But if we take the Ecological Imperative seriously—the fact that we are threads in a networked web —then we must re-evaluate these individuals.

These “Moral Entrepreneurs” aren’t crazy. They often possess a higher form of moral intelligence. They don’t suffer from the “cognitive nearsightedness” that afflicts the rest of us; they recognize Moral Facts earlier than the mainstream.

They identify new paths that promote the unfolding of life and dismantle unnecessary blockages in the web of our coexistence.

Take the suffragettes. They saw the flaw in the fabric before anyone else. They told themselves: “Wait a minute. Women are human beings with the same potential for unfolding as men. Denying them the vote is an artificial blockage of that potential.”

Moral entrepreneurs not only spot these flaws; they have the courage to push the window with all their might toward that truth—even when they are laughed at or attacked.

The Moral Simulator

But before we can shift the “window of normalcy” in the world, we must shift the perspective within ourselves.

How do we transform from mere followers into people who move the Overton Window? It is not enough to be “nice” to those around us. We require a courageous mental practice that I call the “Moral Dry Run.”

The starting point is this: In a complex world, we are often morally blind. We have grown accustomed to suffering—to the homeless person on the subway, to the steak from factory farming.

This isn’t malice; it’s habit. These are “epistemic blockades”—perception filters that obscure our view of reality.

The “Dry Run” is a conscious attempt to break through these blockades. We must actively re-evaluate situations, seeing them anew, simulating them in our minds, and calculating the consequences. We need to practice moral dilemmas the way a pilot practices flight maneuvers in a simulator.

A concrete example? Confronting the “footprint of suffering” in your diet.

The next time you stand before the refrigerated aisle, pause. Don’t just ask, “What tastes good?” Play through the following question: How many individuals had to suffer and die for this product, per calorie?

Compare the pork schnitzel with the beef steak. Compare mussels with sardines.

When you base your decisions on hard facts and advocate for this clarity in your social circle, you are practicing the Ethics of Unfolding. You are training your brain to feel the interconnectedness. You are expanding your Circle of Empathy.

Morality begins small (me, my family). The circle grows (my tribe, my nation). Eventually, it encompasses all of humanity. Today, we stand on the threshold of the next expansion: realizing that animals and future generations must also be part of this circle.

Not out of sentimentality, but because they are part of the web upon which we depend.

The Construction Site of the Present

Why am I telling you this? Because there is a superpower within you that you can cultivate.

The next time you see a debate where someone makes a “crazy” demand, look closer. Ask yourself: Is it truly crazy? Or is someone trying to push the Overton Window toward a new moral fact? Is someone trying to improve the conditions for the unfolding of life?

We live in a time of permacrisis, where the window is swinging wildly. There are forces pushing it backward, toward exclusion and nationalism.

But as Hölderlin wrote: “Where the danger is, also grows the saving power.”

Politics is the art of the possible. Morality is the recognition of the necessary. The Overton Window shows us how to make the necessary possible.

Shifting the window is the process through which that “saving power” grows. It doesn’t begin in parliament. It begins in our minds, with the courage to engage in the “Moral Dry Run.”

In the next article, we will see how this mechanism has historically transformed the world. We will travel back to a time when cruelty was still entertainment and examine how we overcame things that, today, seem like scenes from a horror film.

It’s January 2026, and the usual rituals of self-optimization feel hollow. Normally, we’d be obsessing over private resolutions—more exercise, less sugar, more mindfulness. But this year, these small tweaks seem almost absurd. The moment we look up from our screens, we confront a world that feels like it’s coming apart at the seams.

“Permacrisis” isn’t just the word of the hour; it has become our baseline reality. Destructive forces seem to be compounding exponentially: wars, climate tipping points, societal fracture. To many, it doesn’t just feel like a crisis anymore—it feels like we are steering straight towards an abyss.

In such moments, one is reminded of the poet Friedrich Hölderlin, who wrote a sentence that is more relevant today than ever: “But where the danger is, also grows the saving power.” We often read this merely as a pious wish. But I am launching this series because I am convinced: It is more than that. It is a fact. The saving power is indeed growing. We just often overlook it because it is quieter than the noise of catastrophes.

The Discovery of the Good

I want to venture a thesis that might sound dangerously naïve in our cynical times, yet it is grounded in both philosophy and history: Moral progress is real. We don’t just invent “the Good” the way we invent fashion trends. We discover it—like a law of nature.

Consider an apple tree. It doesn’t just exist; it follows an internal script. It wants to blossom. It wants to bear fruit. It strives for unfolding. We humans are no different. We are driven to unfold our talents, to become the “best possible version” of ourselves. But unlike the tree, we are free in this process—and we are not alone.

We are slowly beginning to understand what has always been biologically true: We are not isolated lone fighters. We are threads in a vast ecological web. Everything is connected to everything else.

From this connectivity arises a simple but radical logic – what I call the Ecological Imperative:

Whoever hinders the unfolding of others damages the web that sustains themselves.

Doing good, therefore, isn’t merely altruism. It is an act of intelligence. It is the rational realization that my own unfolding can only succeed in a world where others are free to flourish, too.

A Tipping Point for the Good?

Why launch this series now? Because I am convinced, that we are standing at a critical juncture. Usually, when we hear “tipping point,” we think of the negatives—climate collapse, democratic backsliding.

But social systems obey the same physics: They can tip towards the good.

Ideas dismissed as “lunacy” yesterday can become the law of the land tomorrow. History proves that this shift often happens with breathtaking speed – the moment a critical mass recognizes a Moral Fact.

This is exactly the process we want to examine together in the coming weeks.

The Roadmap

I invite you to explore the Mechanics of Hope. This isn’t just a series of articles; it’s an investigation. Here is our roadmap:

• The Engine of Miracles: In the next article, we look under the hood of progress. We’ll use the concept of the Overton Window to understand how radical ideas – like democracy or women’s suffrage – mirgrate from “unthinkable” to “inevitable.”

• The Evidence (Looking Back): We will travel to a time when burning cats alive was considered public entertainment. By tracing how we expanded our Circle of Empathy, we will analyze how morality defeated money (the abolition of slavery) and celebrate humanity’s greatest triumph: our victory over premature death.

• The Test (Looking Forward): Then, it gets uncomfortable. We will examine our own blind spots. We’ll discuss our relationship with animals—the topic for which our grandchildren will likely judge us most harshly. And we will ask the ultimate question of the 21st century: How do we align Artificial Intelligence with our values before it’s too late?

My goal for this year is to counter pessimism. Not with “good vibes only,” but with hard analysis and an ethics that places life at the center. It is true: The danger is growing. But the dynamic can change. The saving power is growing too and it grows through us. Through everyone who understands that we belong together.