The most attentive international observers believed that the first shock events that the planet would experience would result from the climate crisis. In fact, it is the other side of the coin, the ecological crisis, which created this shock.
COVID-19 is not a natural disaster. It is rooted in and driven by the relentless need for growth and the “compete or die” logic of capitalism.
The optimistic view that the virus will die out by the end of next year clearly has no scientific basis in reality. Vaccine inequality will make it likely that more deadly mutations of the virus will emerge in countries in the Global South with an ability to increasingly evade vaccine efficacy.
Currently, 66 countries will not reach the target of vaccinating 40% of their population; and 44 of them are from Africa.
Equally importantly, the fragile public health systems in Africa have been further weakened by the pandemic. It increases the heavy burden of disease and, in doing so, profoundly undermines our ability to minimize the growing number of deaths. In South Africa, that now stands at around 250,000 by the most accurate measure – when calculations of “excess deaths” by the South African Medical Research Council are combined with the official figure of over 90,000.
COVID will continue to haunt us for years to come. The fourth wave, which currently has its epicenter in Europe, has higher levels of infection than before, although significantly lower death and hospitalization rates among those vaccinated. We will need more than the blow to contain this and the pandemics to come. That said, access to the vaccine and new treatments remains a primary concern.
Spread by capitalism
Nations that have developed the capacity to develop vaccines, medical treatments and equipment for chronic diseases have, over the past 50 years, ceded the intellectual property (IP) rights in medicines to companies that have become large international companies. These big pharmaceutical companies have learned that windfall profits can only be made with drugs where lucrative markets exist for daily dosing. This intrinsic logic has acted as a brake on biomedical innovation for diseases that are more difficult to monetize.
Vaccines, by nature, are usually a single dose. So big pharma showed no significant interest, unless of course the state was willing to come in with huge amounts of public funding to reduce the risks of the operation, as with COVID- 19. So, while innovation today is largely spearheaded by universities and state-funded research institutes, the intellectual property generated is transferred to large local pharmaceutical companies. This comes at the direct expense of global public health security. The governments of rich countries increasingly see the role of the state primarily as maintaining the competitiveness of their own industrial base.
These public-private partnerships were reinforced by the intellectual property regimes introduced by the World Trade Organization in the mid-1990s. Its raison d’être is simple: to commodify health; transform the delivery of public health into a business and, in doing so, grant Big Pharma the right to determine who lives and who dies.
The Trade-Related Aspects of Intellectual Property (TRIPS) Agreement is a deeply flawed neoliberal instrument that has stifled innovation and inflicted harm of genocidal proportions on the world’s poor. Consequently, the call for a temporary waiver of the TRIPS Agreement for COVID vaccines and drugs by South Africa and India has gained momentum. We must seize the moment and support the call for the TRIPS waiver. If we can win the battle over waiver, our long war for access to medicine will have a better chance of victory.
COVAX another failed PPP
Covax is another public-private partnership, established to ensure “fair and equitable distribution of COVID 19 vaccines”. Its goal is for each country to be able to access 20% of its total needs from a common pool. High- and middle-income countries would pay top dollar for vaccine supplies, so low-income countries could get supplies for free.
The project failed miserably. Participation by Pfizer, Moderna, and Johnson and Johnson was voluntary, as was country participation. In fact, companies have sought out the highest bidders with the fiscal resilience to place pre-orders (advanced market commitments). The richest countries have thus bought half of the world’s supply planned for 2021 before its production, often on-order. In short, hoarding, leaving COVAX hungry for needed supplies. The vast majority of the world’s population has been left to fend for themselves.
The initiative has been championed by the likes of Bill Gates, the IP warrior of his days at Microsoft and now the healthcare industry’s biggest philanthropist. And he insisted from the outset that massive government investments in COVID vaccines could not undermine intellectual property rights. Profits are estimated at $25 billion for Pfizer and not much less for Moderna and Johnson and Johnson. Meanwhile, AstraZeneca’s ‘non-profit’ jab has arguably been deliberately sabotaged by the wealthy nations club.
Like the COP process over the past decade, COVAX was dominated by big corporations and the club of wealthy nations, the big pharma agenda, and the agencies and governments that support them. A cameo role was reserved for the rest of the world. This ensured that there was no substantial progress towards achieving vaccine equity so essential to suppressing the global pandemic.
With HIV, it took eight years before we had access to HIV antiretroviral drugs that were readily available to wealthier countries. The consequence was the needless loss of 10 million lives.
Most of the people of the world will not see their countries getting enough vaccines until late 2022 or early 2023 at best.
The ecological crisis threatens health
Like most other emerging diseases, COVID is a zoonotic virus – a disease transmitted from animals to humans. This in itself is the direct result of the ecological crisis that has matured during this period.
The most important vector for these viruses has been large-scale agriculture, and in particular industrial animal husbandry. Despite years of alarm bells ringing from many public health experts, public health systems suffered from a glaring lack of capacity, a consequence of decades of underinvestment. This has rendered most states unable to deal with such outbreaks.
In the Global South, health spending has been actively blocked by major financial institutions such as the IMF and the World Bank, leaving continents like ours largely defenseless in the face of pandemics.
Nothing less than a comprehensive and universal public healthcare system is needed if we are to limit the death toll. HIV, TB, Ebola, HN51 and COVID have taught us these lessons the hard way. The threat of disease is now unavoidable. Present and future pandemics, combined with rising temperatures, will intensify the public health crisis and foster deeply political struggles.
The socialist response
We have an obligation to present a clear vision of what is needed to contain the COVID-19 pandemic. The absence of any alternative from the main social democratic and communist parties and from the trade union movement at large at the international level is glaring. Progressive science with a small “s” now provides a framework for climate and health crises. We cannot ignore science, especially where scientists have collectively come to clear conclusions. But we also need to engage it critically, question its assumptions, because it doesn’t operate in a societal vacuum.
Climate Justice puts those most affected by the crisis at the center of the solution. Health justice must do the same. We need a planet where life is good. Cataclysmic events have unfolded around the world in recent years. For us in Southern Africa, the destruction of Mozambique’s second largest city, Beira, and the destruction and severe damage to 240,000 homes in the city and beyond is a warning of what is to come.
Our guiding star is that nothing less than systemic change is needed for long-term protection against the negative impacts of the climate and ecological crisis now unfolding. We hold to a notion of deep and fair transition towards a society based on democratic planning. Guided by science, we understand the priorities for reducing carbon emissions.
At the heart of the solution is the radical shift from the individual and private to the collective. By doing so, we can take society in a democratic and rationally planned direction.
This will require, among other things, public ownership of energy, a massive expansion of public transport, water, housing and land as public goods, the expansion and support of small-scale agriculture. In the context of the pandemic and rising temperatures, unhindered access to medicines and a single, comprehensive and universal health care system. These are some of the critical changes needed. Others include an immediate end to deforestation, a massive reduction in large-scale agriculture, an end to industrial animal farming.
Breaking the power of Big Pharma’s patent monopolies over drugs would be the first step in this direction.
[Rehad Desai is a member of the Global Ecosocialist Network steering committee and a South African documentary filmmaker. His latest film, Time of Pandemics, has just been released, and is freely available for organisations to utilise. This article was first published in Amandla! magazine in December, 2021.]