Thirty years on from Alma-Ata: Where have we come from? Where are we going?

metaphor, the doctor was the drug. Much has changed. Following a period of relative affluence after the Second World War, the Wensleydale of 2008 has gone the way of many other traditional farming communities across Europe: squeezed into recession by the forces of global competition and the unequal impact of the Common Agricultural Policy. The once-isolated farming community has had to adapt to survive. It now milks the benefits of set-aside legislation drawn up in Brussels, which has allowed new industries to emerge: tourism (such as the Wallace and Gromit cheese factory), film (Wensleydale is the setting for the rustic scenes of ‘All Creatures Great and Small’), care homes (many farmers have sold up to the developers of residential and nursing homes), and food and drink (especially the scenic country pub serving real ale). Pickles’ successors in rural Yorkshire battle with the contemporary pandemics of obesity, diabetes, and chronic depression in an increasingly sedentary and socially fragmented population, and with a younger generation who relish the risk-taking of alcohol abuse and dangerous driving. My second theme is Alma-Ata. The name ‘AlmaAta’ means ‘rich with apple’, and today this city is a part of Kazakhstan. But back in 1978, it was a provincial city in Brezhnev’s USSR. Like all Soviet cities of the time, Alma-Ata was a place of food queues and inefficient, nationalised industries, in