Sue Ogrocki/AP

Judge Thad Balkman arrives to give his decision in the opioid lawsuit in Norman, Oklahoma, Aug. 26, 2019. Judge Balkman found Johnson & Johnson and its subsidiaries helped fuel the state's opioid drug crisis and ordered the consumer products giant to pay $572 million.

The legal battle in courtrooms around the country over who is responsible for the opioid crisis, and who should pay to fix it, took two major steps toward a conclusion this week.

On Monday, in the first opioid case to actually go to trial, a judge in Oklahoma ruled that pharmaceutical giant Johnson & Johnson helped fuel the crisis in the state, and ordered the company to pay $572 million this year toward treatment programs and other initiatives.

Barely 24 hours later, reports emerged that the owners of Purdue Pharma, the maker of the painkiller OxyContin, are offering to settle more than 2,000 lawsuits against the company for $10 to $12 billion. Purdue settled a separate lawsuit in Oklahoma for $270 million in March.

More than 400,000 Americans have died from opioid overdoses since 1999. The epidemic’s cost to communities and governments around the country is in excess of $1 trillion. Both Oklahoma’s lawsuit and the consolidated cases against Purdue Pharma place responsibility for the crisis squarely on drug manufacturers, and seek to make them pay for the costs of the epidemic to individuals, communities, and government resources.

But even as some cheer these milestones, the Purdue settlement and Johnson & Johnson verdict represent a fraction of the estimated cost of the opioid crisis in the United States and Oklahoma, respectively. That suggests that the question of who bears responsibility and whether they can be compelled to pay for the fallout remains far from resolved.

“They’ve created the problem, or at least substantially contributed to it, and shouldn’t be allowed to walk away and leave someone else holding the bag,” says Richard Ausness, a professor at the University of Kentucky College of Law in Lexington, but he adds that there has to be a balance. “They should certainly contribute to solving the problem. It should be substantial, but it shouldn’t be enough to cripple them or put them out of business.”

Among the issues remaining to address are how to make these settlements and court rulings proportional and fair; what, if anything, a company can do to make things right; and whether other parties bear responsibility as well, such as pharmacists, doctors, or even the individuals who took the drugs.

Shawna Covington, an Oklahoman who lost her mom to prescription opioid abuse, says she could never understand how it was so easy for her mom to obtain so many drugs. Why, she wondered, didn’t it set off a red flag at pharmacies, where on top of numerous other pills her mother was able to get huge bottles of OxyContin? And it was all done legally, with a prescription from her mom’s long-time doctor.

“I do think it was marketed and the pharmaceutical companies are responsible, yes. But ... the doctor has to take some ownership as well,” says Ms. Covington. “I don’t sit up at night thinking of Johnson & Johnson. I think of this doctor.”

A public nuisance

Johnson & Johnson is the first company to be judged legally culpable for fueling the opioid epidemic. Oklahoma, which has lost more than 6,000 residents to painkiller overdoses since 2000, sued three companies in 2017 but the other two settled out of court.

Judge Thad Balkman ruled that Johnson & Johnson’s “false, misleading, and dangerous marketing campaigns have caused exponentially increasing rates of addiction, overdose deaths and neonatal abstinence syndrome” (NAS) violated Oklahoma’s public nuisance law.

Sales reps for the company were not provided any training “on the disease of addiction ... [or] related to the history of opioid use and epidemics in the U.S. or human history,” the opinion added. Moreover, the defendants sought to convince doctors that patients showing signs of addiction were in fact suffering from undertreatment of pain, and needed more opioids – not less.

Oklahoma Attorney General Mike Hunter, in a phone interview with the Monitor, accuses Johnson & Johnson of waging “a multimillion-dollar brainwashing campaign,” conducted in concert with other drug companies, to convince doctors that opioids were only rarely addictive.

“At the end of the day, one of the most important parts of the judge’s decision was establishing causation and responsibility of Johnson & Johnson for the epidemic in the state,” he says.

Attorney General Hunter says the $572 million award does not reflect “the alpha-to-omega harm” to Oklahoma since the beginning of the epidemic, but rather the costs going forward.

The amount of that award was based on the state’s estimate of the costs of abating the opioid crisis for one year, including treatment costs and rehabilitation programs. The court retained jurisdiction over the abatement proceedings, and appeared to leave the door open to a possible increase in damages.

At Compass Clinic, which provides outpatient care for opioid abuse in Oklahoma City, case manager Rhea Frick welcomes the verdict and thinks drug manufacturers should be held accountable.

“Ultimately I think the drug companies need to push the doctors to educate the patients on the dangers and just exactly how addictive the medications are,” says Ms. Frick in a phone interview, adding that the vast majority of the people they serve – “everyday people” like teachers, ministers, veterans, she says – got addicted after being prescribed pain medication following a surgery or injury. “Nobody is warning them about the dangers of how addictive the medications really are.”

“Public’s first glimpse under the hood”

The trial afforded much more transparency than a settlement negotiation, revealing details that could be used in future lawsuits, said Elizabeth Burch, a professor at the University of Georgia School of Law, in an email. In particular, the public learned about how a subsidiary created a new type of opium poppy that “enabled the growth of oxycodone,” and became the No. 1 supplier not only of that drug but also hydrocodone, codeine, and morphine in the U.S.

“This was the public’s first glimpse under the hood” in the ongoing opioid litigation across the country, she adds.

Balkman’s ruling could be challenged, however. Johnson & Johnson vowed to appeal along with its subsidiary, Janssen Pharmaceutical Companies, and said it had “strong grounds” for doing so, stating that its products constitute less than 1 percent of total opioid prescriptions in Oklahoma, were responsibly marketed, and complied with federal and state laws.

“Janssen did not cause the opioid crisis in Oklahoma, and neither the facts nor the law support this outcome,” said Michael Ullman, executive vice president of Johnson & Johnson, though he expressed “deep sympathy for everyone affected.”

The company also indicated that the judge’s verdict represented a massive overreach of public nuisance law, arguing it ignored a century of precedent. 

Judges in North Dakota and Connecticut rejected similar public nuisance claims earlier this year.

That is no guarantee Johnson & Johnson will be successful on appeal, as Oklahoma’s public nuisance law is unusually broad. But there are other potential weaknesses in the ruling.

“The court didn’t really talk about why Johnson & Johnson – which in the opioid marketplace is a relatively small player – is responsible for all these damages, rather than all these other sellers in the marketplace,” says Adam Zimmerman, an associate professor at Loyola Law School in Los Angeles.

Poster child for an epidemic

Purdue Pharma is a relatively small player, in terms of raw financial resources. Its annual revenues totaled about $3 billion in 2017, compared with more than $81 billion for Johnson & Johnson and $198 billion for pharmaceutical distributor McKesson Corp. last year.

However, Purdue’s OxyContin turned its owners, the Sackler family, into one of America’s richest families, surpassing the Mellons and Rockefellers. 

Together, Purdue and the Sackler family have been branded as the central villains of the opioid epidemic. There have been protests outside the company’s Connecticut headquarters, museums have turned down Sackler family donations, and Harvard University has been asked to remove the Sackler name from campus buildings.

Numerous allegations stretching back years claim the company helped spark the opioid crisis in the 1990s through aggressive and deceptive marketing of OxyContin and its addictive potential. Purdue pleaded guilty in 2007 to misbranding the drug and paid $600 million in fines, and in March the company settled a lawsuit brought by the state of Oklahoma for $270 million.

“For years, members of the Sackler family tried to hide their role in creating and profiting off the opioid epidemic,” said Massachusetts Attorney General Maura Healey Wednesday. “We owe it to families in Massachusetts and across the country to hold Purdue and the Sacklers accountable, ensure that the evidence of what they did is made public, and make them pay for the damage they have caused.”

SOURCE:

The Associated Press, Drug Enforcement Administration

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Jacob Turcotte/Staff

Purdue and the Sackler family have denied the allegations in more than 2,000 lawsuits against them, but said in a statement that while the company “is prepared to defend itself vigorously in the opioid litigation,” it believes “a constructive global resolution is the best path forward.”

According to news reports, they are offering to declare Chapter 11 bankruptcy, and then restructure into a for-profit trust aimed at easing the opioid crisis. The trust would provide cities, counties, and states in the settlement with drugs for preventing overdoses valued as well as the profits from Purdue’s sales, together valued at $7 to $8 billion. The Sacklers would add $3 billion from their estimated net worth of $13 billion.

“The people and communities affected by the opioid crisis need help now,” Purdue’s statement added.

The company’s settlement with Oklahoma earlier this year hinted at its willingness to take long-term responsibility for abating the opioid epidemic, with the $270 million agreement including $75 million to be put toward an addiction treatment and research center. That may still not be enough for the plaintiffs suing Purdue, however.

“They’ve sort of been the poster child for all of this,” says Professor Ausness.

“In terms of their culpability, it probably isn’t [fair] considering the total cost of the opioid epidemic and their contribution to it,” he adds. “On the other hand, what they may be saying is, in effect, ‘This is all we’ve got,’ and if that’s true then that’s all [plaintiffs] are going to get no matter how culpable Purdue is.”

“What is the price?”

The federal government will have its own responsibilities moving forward, says Professor Ausness, particularly now that the opioid epidemic is being driven more by illegal drugs like heroin and fentanyl than prescription painkillers.

And despite the two developments this week, the major questions over who is responsible for the opioid epidemic remain.

“The big problem is a lot of harm is already done,” says Professor Zimmerman. “How do we remediate that problem? What is the price of dealing with that problem? And to what extent are defendants in these cases responsible for this problem?”

In a sense, he says, this is a crisis that “we’re all kind of responsible for,” and it will take broad cooperation to formulate a comprehensive solution.

“This is one step, a small step, toward trying to fix it. But it’s not the only step, it can’t be,” he says. “Litigation will provide one well-needed source of funds to combat the crisis. But hopefully it also sparks a dialogue in our communities and state legislatures and Congress to think about more systemic solutions.”

When French President Emmanuel Macron declared it would be “pointless” to try to deliver the traditional final communique at the G-7 summit he hosted last weekend it prompted some to wonder if maybe the organization itself is pointless.

Leaders of the Group of Seven major economies had been especially riven by conflicting perspectives on global issues from climate change to trade.

But the larger question behind the doubts about the G-7 is whether a Cold War-era grouping based on common interests and values such as democracy, the rule of law, free markets, and human rights still has a global leadership role to play in the 21st century.

One answer might be that a more multipolar and nationalistic world certainly seems to pay less heed to Western leadership. After G-7 leaders pledged $22 million to help fight fires raging in the Amazon rainforest, an indignant Brazil turned the aid down, with President Jair Bolsonaro saying it reflected a “colonial” mentality.

On the other hand, when Mr. Macron issued a surprise invitation to Javad Zarif to the summit’s sidelines the Iranian foreign minister jumped at the offer and met with a number of Western officials. The effort to make headway on the Iranian nuclear challenge even earned a bit of praise from the normally anti-Iran and anti-multilateral U.S. president, Donald Trump.

In the end, the message sent by a summit widely described around the world as a show of disunity and disarray – not to mention American retreat – seemed to be that while Western leadership may be down, it is not out.

What some clever French diplomacy – and progress in forging common positions on key global issues from the environment to Hong Kong democracy – demonstrated is that there is still a role for the leadership and common action of the world’s major democratic economic powers.

“It’s possible for the headlines coming out of this summit to be that Donald Trump and [British Prime Minister] Boris Johnson are the harbingers of the failure of Western diplomacy and that multilateralism in the West is dead – but that’s not what happened at all,” says Jon Alterman, senior vice president in global security and geostrategy at the Center for Strategic and International Studies (CSIS) in Washington.

New circumstances, shared values

“This was not the memorial service for the G-7,” he adds, “this was the G-7 adapting to a new set of circumstances and ultimately moving a number of balls forward on issues of key interest to the major economies and democracies.”

One of the most glaring “new circumstances” is a U.S. president who relishes the role of disrupter and has shown considerable disdain for the traditional American-led, post-World-War-II multilateralism the G-7 embodies.

For Mr. Alterman, the G-7 is a “family” working together on the basis of common interests and values. And what struck him about this summit in the French Mediterranean city of Biarritz is how the family was able to overcome differences – and accommodate an unpredictable “father” in Mr. Trump – to make some useful progress.

“The father’s not playing the traditional role,” Mr. Alterman says, “and yet the members of the family had a useful meal and got stuff done.”

The divisions buffeting Western leadership and doubts about its relevance should surprise no one, some say, given that the conditions that prompted the creation of the G-7 no longer exist.

“The existence of a common threat in the Soviet Union and the pressures of the Cold War were critical, it’s what pushed the allies together and prompted the U.S. to maintain its embrace of Europe,” says Robert Lieber, a professor of government and international affairs at Georgetown University.

The end of the Cold War has indeed denied the Western powers that original common threat, he says, even as domestic political upheaval and the weakening of the Western democracies’ traditional moderate-right and moderate-left parties have contributed to tough times for Western multilateralism.

But what haven’t gone away, Professor Lieber says, are the “underlying shared interests and shared values,” ranging from democracy and free-market economies to freedom of speech and religion and the role of women in society, that make a forum like the G-7 matter.

“Those underlying commonalities and motivating values still give an essential purpose to a community like the G-7, despite the disarray,” Dr. Lieber says.

New leadership model

Still, for some experts in international relations, no amount of adapting to new global realities or accommodating of chaotic and nationalist leaders is going to make a leadership model designed for the 20th century an answer to the challenges of the 21st.

“If what we’re seeing [at the G-7 summit] is indicative of what passes for Western consensus, then no amount of putting lipstick on a pig is going to cover over the inability of Western leadership to address today’s fundamental issues,” says Michael Desch, professor of international relations and director of the Notre Dame International Security Center in Indiana.

To fashion a new model of global problem-solving, Western countries and the world more broadly will have to start by recognizing there is no longer one benevolent superpower ready and willing to shoulder the burden of leadership, Professor Desch says.

“In a period when the U.S. strode the world like a colossus, systems based on one power with the interest and capability of leading were feasible,” he says. “What the world needs today is a way to foster cooperation on critical global issues without a hegemonic power. It will be tough,” he adds, “but it might be the only way to move forward.”

Professor Desch says he did catch a glimpse at the G-7 summit of one potential avenue for global problem-solving. (He says even the word “leadership” may not fit what the 21st century requires.) What may be called for, he says, is the kind of ad-hoc leadership-by-issue that was displayed by Mr. Macron on the Iranian nuclear issue, or even Mr. Trump taking the helm of the China trade dispute, which is a global challenge affecting much more than just the U.S.

“Macron’s invitation to the Iranians to crash the [G-7] party may indeed be the new model for moving issues forward,” he says.

The French president’s gambit did seem to move the nuclear issue’s two main antagonists, Iran and the U.S., closer to direct talks, with Mr. Trump sounding open to engaging with Tehran and even to the idea of some kind of loans to prop up a staggering Iranian economy.

By Monday, Iranian President Hassan Rouhani was insisting that debilitating U.S. sanctions would have to be lifted before he would meet with Mr. Trump. Still, the way Mr. Macron went about “breaking the ice between the Iranians and the Americas … demonstrated extraordinarily skillful diplomacy,” says CSIS’s Mr. Alterman – noting that such diplomatic acumen underscored the relevance of Western leadership.

A place for Putin?

Another initiative that to some might fall into the category of realist thinking for today’s world is President Trump’s insistence that Russia be readmitted to what was the G8 – until Moscow’s invasion and annexation of Crimea in 2014.

The call for welcoming Russian President Vladimir Putin back into the exclusive club received little support. But Mr. Trump hinted that as the host of next year’s summit he could very well issue an invitation to Mr. Putin on his own.

Inviting Mr. Putin might strike some as akin to Mr. Macron’s invitation to Mr. Zarif to Biarritz.

But Georgetown’s Dr. Lieber says, not so. Emphasizing the importance of Western values to the purpose of the G-7, he says there is nothing about Mr. Putin’s leadership of Russia that suggests he has any interest in those values – unless, he adds, it is to undermine them.

The idea of inviting Mr. Putin back in “demonstrates a serious misunderstanding on Trump’s part of what the G-7 is,” Dr. Lieber says.

“When Russia was invited in in the first place it was in a blush of naïve hope that Russia would embrace everything Western Europe represents, from democracy to the rule of law and so on,” he adds. “Obviously that hasn’t happened, so Russia has no place rejoining” the club.

Summer in Seattle offers a luminous respite from the rest of the year. The clouds depart and carry away the rains as the sky shades cobalt blue and the sun casts golden light from Puget Sound to Mount Rainier. The city feels liberated.

Or so residents recall of an earlier time. In the past decade, summer has tended to bring an unseasonal gray in the form of wildfire smoke, trapping the city in a Beijing-like haze for days and sometimes weeks at a time. Last year, smoke from blazes in eastern Washington, Oregon, California, and Canada caused air quality in Seattle to drop to unhealthy levels for 24 days, matching the 2017 total.

The city has responded by designating two community centers and three other public buildings as clean-air centers where residents can take shelter when wildfires turn the skies ashen. The $450,000 pilot project has funded upgrades to each facility’s filtration system to reduce airborne pollutants. Julia Reed, a senior policy adviser to Seattle Mayor Jenny Durkan, who announced the city’s plan in June, explains that recent megafires in the West forced a reckoning with the region’s hotter, drier summers.

“When the smoke came in again last year, it was like, ‘Wow, this is happening – this is climate change affecting our community right now,’” Ms. Reed says. “There was the realization that we need to be prepared for this kind of thing going forward.”

Wildfire smoke has produced the lowest air quality readings ever recorded in a handful of Western cities the past two years, including San Francisco and Portland, Oregon. The rising public health concerns over the increasing size, frequency, and intensity of wildfires have prodded elected officials across the West to seek remedies. Their proposals advance practical solutions that, on another level, counter the dual sense of futility and isolation that climate change can provoke.

United States Sens. Ron Wyden and Jeff Merkley, both Democrats from Oregon, have introduced legislation that would provide federal funding to communities to improve ventilation systems in public buildings and set up emergency smoke shelters. A related grant program would cover the cost to smokeproof the homes of low-income residents.

“What I’ve seen in the region, particularly last summer, is that we’re looking at a wave of clean-air refugees,” Senator Wyden says. “The fact is, this is a public health emergency, and people are getting pounded. There has to be a way to help them.”

Wildfires release particulate matter that can aggravate respiratory and heart ailments. Children and seniors face the greatest risk, and researchers estimate that the annual number of premature deaths linked to wildfire smoke could climb from 17,000 to 42,000 by 2050. 

Most homes in Seattle lack air conditioning and indoor air filters, and even with portable air purifiers available for under $100, the cost can prove excessive for people on a fixed income. The city established three of its clean-air centers in areas with higher numbers of low-income residents, seniors, and homeless people. Ms. Reed describes the new program as an effort to protect their mental health as much as their physical well-being.

“Community cohesion and an understanding that all of us are having to confront climate change is central to this plan,” she says. “We want the most vulnerable people in our community to know they’re not alone.”

“It’s about now”

A strange sort of fog invaded the University of California, Davis on what had started as a cloudless summer day in 2008. Lisa Miller stared out from her office window at the California National Primate Research Center located on the campus.

The midday haze puzzled Ms. Miller, who leads the center’s respiratory diseases unit, until she remembered that several large wildfires were burning in Northern California. She soon realized that the fires presented an inadvertent opportunity to study the effects of exposure to wildfire smoke on 50 rhesus macaque monkeys born weeks earlier.

Ms. Miller has tracked their respiratory health over the years, comparing them with another group of monkeys born a year later when skies remained mostly clear. She has found worrisome results.

The monkeys exposed to smoke showed evidence of conditions that impair breathing, and their immune systems appear less resistant to infection. Ms. Miller offers a caveat to the findings, pointing out that the monkeys, by virtue of living outside, inhaled more smoke than most humans would breathe during wildfires.

“But the bottom line is that it’s the youngsters that are most susceptible to these kinds of environmental events,” she says. “So anything we can do to reduce the amount of exposure of youngsters to wildfires and smoke – whether at home or at school – could have significant impact on their health for a lifetime.”

The nascent health research into wildfire smoke reflects the surging threat that megafires pose to the West. The region’s fire season has swelled to some 250 days, or 105 days longer than in 1970, and wildfires have burned an average of 7 million acres a year since 2000, almost twice the annual total during the 1990s.

This summer, aside from Alaska, fewer catastrophic wildfires have ignited in the West than at the same point in either of the past two years. Fire researchers and climate scientists regard the reprieve as temporary – a cautionary note with particular resonance in California.

The deadliest and most destructive blaze in California’s history struck last November in and around the city of Paradise, killing 86 people and incinerating nearly 14,000 homes. Haze from the fire shrouded Northern California and drifted 150 miles south to the San Francisco Bay Area, where one county opened smoke shelters.

“The air was disgusting,” says Assemblywoman Buffy Wicks, a Democrat from Oakland. “You didn’t want to breathe.” She has proposed legislation to establish clean-air shelters through a state grant program that would cover the cost to retrofit ventilation systems in schools, libraries, and community and senior centers.

“If this is our new normal, we need to address it,” she says. “We need to think about how we can provide safe haven for people on fixed incomes, seniors, and others without access to clean air where they live.”

The state has begun shifting its forest management strategy toward preventive efforts to reduce wildfire destruction. Air quality experts assert that, in similar fashion, policymakers should embrace new methods for shielding residents from smoke.

“The last couple years have made it clear that we have to change our thinking about both fires and smoke,” says Alan Abbs, a legislative officer with the Bay Area Air Quality Management District. The public agency backs Ms. Wicks’ bill. “It’s not just about preparing for the future. It’s about now.”

Emotional oases

Seattle officials have enlisted Dan Jaffe, a professor of environmental chemistry at the University of Washington, to analyze the effectiveness of the city’s clean-air centers. In his work, he has shown that the West’s wildfires nullify much of the progress made in lowering air pollution through reduced vehicle emissions and dependence on coal.

“Most of us live in the Northwest because we like getting outside and enjoying the outdoors,” he says. “To have all that smoke keep coming through, it’s really depressing.”

The mental health effects of extended exposure to wildfire smoke remain even less understood than the physical toll, largely because megafires are a relatively new force in nature.

In one of the few studies to explore the topic, a team of Canadian scientists examined the psychological fallout from wildfire smoke on four communities in the Northwest Territories in 2014. They found that residents admitted to emergency rooms that summer reported feelings of fear, despair, and isolation at higher rates compared with those admitted the prior two years.

The study of how people interact with and react to the environment, including their ability to adapt to climate change, occupies a group of researchers in the Human Dimensions Lab at the University of Montana in Missoula. The city spreads across a valley that fills with smoke from fires for varying stretches every year, and in 2017, residents experienced its worst air quality day on record.

Libby Metcalf, the lab’s co-director, has learned that giving residents a chance to come together to discuss their experiences alleviates anxiety about their fate and the planet’s. “There’s a need to have a community gathering space to share stories about wildfire,” she says. “It’s a way for people to feel like they don’t have to face what’s happening on their own.”

The American Psychological Association has identified communal support as essential to easing the depression, desolation, and resignation that can burden people as they cope with the impact of climate change. The legislation that Senators Wyden and Merkley proposed earlier this year to safeguard communities from wildfire smoke would create a federal grant program to fortify crisis services for physical and mental health alike.

“It’s extremely valuable to bring people together to help them with what they’re going through,” Senator Wyden says. “That’s even more true for low-income people, seniors, and people with health care concerns who might not have the means to get help otherwise.”

For Seattle residents unable to afford air conditioning or a trip out of town, or who lack a support network, the city’s clean-air centers could serve as emotional oases amid the haze. Ms. Reed, the mayoral adviser, views the centers as places suited for collective catharsis.

“All of us see climate change happening right outside our window,” she says. “Coming together is a way to make people feel less helpless.”

Ann Hermes/Staff/File

Students work on writing lessons at an early childhood education center next to a brick kiln in Dharke Bazar, Nepal, in April 2016. Better Brick Nepal, a program aimed at eliminating child labor in brick kilns across the country, set up the education center in 2015.

Almost 100 million more children are getting to have a childhood than at the beginning of the 21st century.

Child labor has dropped by 38% since 2000, according to data from international humanitarian organization Save the Children. “In 2000, there were 246 million children in labour ... compared to 152 million in 2016,” writes Phoebe Marabi, a senior specialist on child protection with Save the Children in Nairobi, in an email interview.

Save the Children attributes that progress to a range of policy efforts. Education, for example, is an essential area. Child labor specialists stress the importance of accessible, high-quality schools. 

Social protections are also important; these can include the promotion of decent jobs for adults as well as family access to health benefits and support. Another factor is the establishment of legal standards around child labor.

The last category, says Benjamin Smith, senior specialist for child labor at the International Labor Organization, a United Nations agency, has been key – especially as national governments organize around the issue of child labor and find ways to mobilize various ministries to move the needle. 

Child labor is a tough, complicated issue. It’s been of concern to the ILO since its founding in 1919, according to Mr. Smith. He says the recent reductions are good news, but should be taken with a grain of salt.

“It is not going fast enough,” he says.

One region where there remains much more work to be done, he adds, is Africa.

“In terms of both absolute numbers and in the prevalence rate, sub-Saharan Africa is a particular concern,” he says. “Africa is clearly where we need a breakthrough if we are going to achieve the elimination of child labor.”

Farming accounts for some 71% of child labor – globally, children also work in mines or warehouses and in commercial fishing. On paper, the majority of child laborers are boys, though the number of girls involved in domestic labor is likely underreported.

Children are forced into work as early as age 5, with cascading negative consequences throughout their lives, from lack of education to health issues. “If more efforts can be channeled on prevention rather than response, then this will push the work further,” says Ms. Marabi.

“The composite of a child who migrates with her family, waking up at predawn hours, working in the hot sun exposed to insect bites, using sharp tools, and having her education negatively affected, is somewhat of a typical one,” says Mr. Smith.

“There is no country ... exempt from the problem.”

When Estelle Getty starred alongside Sylvester Stallone in “Stop! Or My Mom Will Shoot” (1992), the joke was that a senior could be a gun-toting hero. Nowadays, Mr. Stallone is not only older than “The Golden Girls” comedian was when she filmed that role, but he’s still playing an action hero – and not for laughs.

Mr. Stallone is among several veteran actors who are bringing iconic heroes out of retirement. In September’s “Rambo: Last Blood,” the titular hero rises from his front-porch rocking chair to fight invaders at his ranch. Similarly, trouble comes knocking for a grizzled humanoid cyborg (Arnold Schwarzenegger) who lives in a backwoods cabin in November’s “Terminator: Dark Fate.” And in the 2020 TV series “Picard,” a former “Star Trek” captain (Patrick Stewart) leaves his vineyard to reengage with intergalactic politics.

It would once have been unthinkable to greenlight action projects featuring septuagenarian actors in lead roles. But today, retirement age looks very different from what it did a few decades ago. As Americans live longer, healthier, and more active lives, on-screen portrayals of seniors are beginning to reflect that shift. To be sure, Hollywood continues to traffic in stereotypes of older people. But cultural critics say that positive portrayals can help mitigate societal fears about aging and also influence how seniors perceive their own potential.

“Images on screen do affect us in our self-images and what we think we can’t do and should do – what’s appropriate to our age,” says Tim Appelo, film critic for AARP The Magazine. “There’s a phrase from William Blake, the poet: ‘mind-forged manacles.’ People are troubled by manacles forged in their own minds. And I think that TV and movies helped to break those shackles of illusion. ... We can’t all be action heroes, but watching Liam Neeson and Tom Cruise and Helen Mirren do some heroics gives us the strength to do what we want to do in our own lives.”

Back to work, like boomers

At a time when the majority of baby boomers are still in the workforce, it’s apt that many legendary cinematic characters are heading back to work. Older boomers are staying in the workforce longer than previous generations. Since the turn of the millennium, global life expectancy has increased at the fastest rate since the 1960s. Consequently, concepts of retirement and longevity are evolving – even in Hollywood. It’s telling that the premise of “Cocoon,” a 1985 science fiction movie about how alien powers rejuvenate residents in a retirement home, now seems antiquated.

“One of the big jokes was now that they have encountered aliens they’re out dancing,” says Tim Gray, senior vice president for Variety. “If you said to somebody [today], ‘Hey, I know one of my neighbors is 70 years old and goes out dancing,’ people would say, ‘Yeah, OK, where’s the story here?’”

For actresses over age 40, it’s still a struggle to find lead roles in an industry predisposed toward ingénues. But in certain genres, that age no longer means what it once did. Between 1996 and 2015, the average age of action stars was 40, according to movie data analyst Stephen Follows. But in 2015, the last year he tracked those figures, it spiked to 48. Audiences are embracing action films featuring stars who are older than those averages, including Charlize Theron and Sandra Bullock – not to mention Daniel Craig, Jason Statham, Keanu Reeves, Brad Pitt, Denzel Washington, Clint Eastwood, and Mr. Neeson. 

To that list, add Linda Hamilton. In “Terminator: Dark Fate,” the cool heroine battles robots with her bazooka. Indeed, the popularity of veteran actors is sometimes aided by an audience appetite for nostalgia. Cases in point: Mr. Cruise is back on the highway to the danger zone for “Top Gun 2.” Who you gonna call for another “Ghostbusters” sequel? Dan Aykroyd, Bill Murray, and Sigourney Weaver. Harrison Ford, who has already reprised his iconic roles in recent sequels to “Star Wars” and “Blade Runner,” is dusting off his fedora for a fifth “Indiana Jones” movie. 

Chris Pizzello/Invision/AP

Linda Hamilton (left) and Arnold Schwarzenegger, cast members in the upcoming film “Terminator: Dark Fate,” discuss the film during the Paramount Pictures presentation at CinemaCon 2019, the official convention of the National Association of Theatre Owners, in Las Vegas on April 4, 2019.

Reversing negative messages

Inevitably, news about these types of roles conjure up the same sort of jokes that follow the Rolling Stones when it tours. Messages of ageism can be subtly harmful, says Becca Levy, director of the social and behavioral sciences division at the Yale School of Public Health. 

“In our experimental research, we bring older people into the laboratory and we expose them on a computer screen to either positive or negative age stereotypes, and we found that when we activate negative stereotypes, it can lead to different kinds of outcomes including worse memory performance, worse balance, and slower walking,” says Professor Levy. “And then we found when we expose people to positive age stereotypes on a computer screen and we measure variables before and after they’ve been exposed to the age stereotypes, we do find a shift in performance.”

Stories on screen have a social and cultural pedagogic effect, agrees Sally Chivers, director of the Trent Centre for Aging & Society in Peterborough, Ontario. Too often, Hollywood associates age with decline, she says – especially movies about dementia, which stoke fears of aging by insinuating that this could happen to anyone. But screen stories can also have a positive influence. She points to how the Netflix series “Grace and Frankie,” starring Jane Fonda and Lily Tomlin, has shaped how some seniors view late-life romance. Professor Chivers’ book “The Silvering Screen” chronicles how Hollywood has also gotten better at producing stories about the perspectives of older characters even if the stories, such as romantic comedies, are formulaic. 

“If those plots are going to be what dominate, why not have age be part of it rather than this kind of either grotesque horror story, like in ‘What Ever Happened to Baby Jane?’ [from 1962] or humor. Even the ‘Grumpy Old Men’ are just kind of a joke to move the plot along,” says Professor Chivers, referring to the 1993 comedy starring Walter Matthau and Jack Lemmon. “We’ve come a long way since then.” 

AP

Sudanese pro-democracy supporters celebrate a final power-sharing agreement with the ruling military council, in the capital, Khartoum, Aug. 17.

With so many intractable conflicts in the Middle East and North Africa, fewer nations seem to want to play an active part in solving the region’s issues. At least that’s the current assumption. Yet like a white swan appearing on a dark sea, an unexpected coalition of nations formed in recent months to break this pessimism. This unlikely grouping helped set Sudan, a mainly Arabic-speaking country, on a path toward democratic rule.

Last week, Sudan swore in a civilian prime minister, Abdalla Hamdok, for the first time in three decades. Not long after, the British-trained economist made a point of thanking a long list of “partners” who helped defuse a five-month political crisis in Sudan: Ethiopia, the United States, Egypt, Saudi Arabia, Chad, the Gulf states, the European Union, and the African Union. While each of them has different interests in Sudan’s future, they came together with goodwill and defied the region’s malaise about progress.

If they shared a common interest, it was to prevent yet another Arab country from descending into chaos, like Yemen, Libya, and Syria. Yet they also helped achieve something better. Under an agreement signed Aug. 17 between civilian leaders and the military, Sudan will start a three-year transition to democracy, with the military holding on to most of its powers for about the first half.

The agreement is a partial victory for the masses of Sudanese people from all parts of society who protested in the streets beginning in December. In April, they forced the military to oust longtime dictator Omar al-Bashir. Then in June, after one military faction massacred more than 100 protesters, the coalition of nations got to work and forced the two sides to compromise. A complex deal was struck to ease the country toward elected, civilian rule.

Sudan still needs the coalition’s help to make sure the military returns to its barracks and a stagnant economy is relieved of its immense foreign debt. The Arab world does not have many successful models of democracy. Its preferred type of governance remains stuck between Islamist forces and secular autocracies, either military or monarchy. In 2011, the Arab Spring tried to break this mold but failed. Now it has taken a crisis in Sudan to show the region is worthy of international attention and that pessimism need not rule about the Middle East’s future.