Most keen international observers believed that the first shock events the planet would experience would result from the climate crisis. In fact, it was the flip side of that same coin, the ecological crisis, which created that shock.
COVID-19 is not a natural disaster. It originates from, and is being driven by, the incessant need for growth, and the 鈥渃ompete or die鈥 logic of capitalism.
The optimistic view that the virus will burn itself out by the end of next year clearly has no scientific basis in reality. Vaccine inequity will make it likely that more deadly mutations of the virus will emerge in the Global South with an ability to increasingly escape the efficacy of the vaccines.
Currently, 66 countries will fail to meet the stated target of vaccinating 40% of their populations; and 44 of them are from Africa.
Equally importantly, fragile public health systems in Africa have been weakened further by the pandemic. It is increasing the high burden of disease and in doing so deeply undermining our ability to minimise the mounting death toll. In South Africa that now stands at around 250,000 according to the most accurate measure 鈥 when the calculations of 鈥渆xcess deaths鈥 by the South African Medical Research Council is combined with the official figure of plus 90,000.
COVID-19 will continue to haunt us for years to come. The fourth wave, presently with its epicentre in Europe, has higher levels of infection than previously seen, although significantly lower death rates and hospitalisation among the vaccinated. We will require more than the jab to contain this and the pandemics to come. That said, access to the vaccine and new treatments remain of paramount concern.
Spread by capitalism
Those nations that have built the capacity to develop vaccines, medical treatment and equipment against chronic illness have over the past 50 years handed over intellectual property (IP) rights to medicines to companies that have become major international corporations. These big pharmaceutical companies have learnt that bumper profits can only be obtained from drugs where lucrative markets exist for daily dosing. This inbuilt logic has acted as a brake on biomedical innovation for those diseases that are harder to monetise.
Vaccines by nature are usually a once-off dose. So, big pharma has not shown any significant interest, unless of course the state has been willing to enter with huge amounts of public finance to de-risk the operation, as with COVID-19. So, while innovation today is largely pioneered by universities and state-financed research institutions, the IP generated is being handed over to locally owned big pharma. This is at the direct expense of global public health security. Governments in rich nations increasingly see the role of the state to first and foremost nurture the competitive ability of their own industrial base.
These public-private partnerships have been buttressed by the IP regimes introduced by the World Trade Organisation in the mid 1990s. Its rationale is simple: commodify health; turn the delivery of public health into a business聽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 proportion on the world鈥檚 poor. Therefore, the call for a temporary TRIPS waiver on COVID-19 vaccines and medicines by South Africa and India has gained significant momentum. We must use the moment and get behind the call for the TRIPS waiver. If we can win the battle around the waiver, our long war to obtain access to medicines will stand a greater chance of victory
COVAX another failed agreement
COVAX is another private public partnership, established to ensure 鈥渇air and equal distribution of COVID 19 vaccines鈥. Its objective is that each country will be able to access 20% of its total needs from a common pool. High- and middle-income countries would pay top dollar for vaccine supply, so low-income countries could obtain their own supplies free.
The project failed miserably. Involvement of Pfizer, Moderna and Johnson and Johnson was voluntary, as was the participation of countries. In fact, the companies sought out the highest bidders with the fiscal resilience to make pre-orders (advanced market commitments). Richer nations in the process bought half of projected global supply for 2021 before it was produced, often over-ordering. In short, hoarding, leaving COVAX starved of necessary supply. The vast majority of the world鈥檚 population were left to fend for themselves.
The initiative was championed by the likes of Bill Gates, the IP warrior from his days at Microsoft and now the single largest philanthropist in the health sector. And he insisted from the get-go that massive government investment in COVID vaccines could not undermine IP rights. Profits are estimated at $25 billion for the likes of Pfizer and not much less for Moderna and Johnson and Johnson. Meanwhile the 鈥渘ot for profit鈥 AstraZeneca jab has arguably been deliberately sabotaged by the club of rich nations.
Like the COP process over the last decade, COVAX was dominated by massive corporations and the club of rich nations, big pharma鈥檚 agenda and the agencies and governments who support them. A cameo role was reserved for the rest of the world. This ensured that there was no substantial progress towards bringing about the vaccine equity so critical to the suppression of the global pandemic.
With HIV it took eight years before we gained access to HIV anti-retroviral drugs that were readily available to wealthier nations. The consequence was the unnecessary loss of 10 million lives.
Most of the world鈥檚 peoples will not see their countries obtain sufficient vaccine supplies until late 2022 or early 2023 at the best.
Ecological crisis threatens health
Like most other emerging diseases, COVID-19 is a zoonotic virus 鈥斅燼 disease transmitted from animals to humans. This itself is a direct result of the ecological crisis that has been maturing during this period.
The most important vector of such viruses has been big agriculture, and in particular factory farming of animals. Despite years of alarm bell-ringing from many public health experts, public health care systems had a glaring lack of capacity, a consequence of decades of under-investment. This has rendered most states unable to confront such outbreaks.
In the Global South, spending on healthcare has been actively blocked by the big financial institutions such as the International Monetary Fund and the World Bank, leaving continents like our own largely defenceless in the face of pandemics.
Nothing less than a comprehensive and universal public healthcare system is required if we are to limit the death toll. HIV, TB, Ebola, HN51 and COVID-19 have taught us these lessons the hard way. The threat of disease is now inescapable. Pandemics present and future, 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 required to contain the COVID-19 pandemic. The absence of any alternatives from the mainstream Social Democratic and Communist parties and the wider trade union movement internationally is glaring. Progressive science with a small 鈥渟鈥 now provides a framework for both climate and health crises. We cannot ignore science, particularly where scientists have collectively come to clear conclusions. But we also have to critically engage it, to interrogate its assumptions, because it does not operate within a societal vacuum.
Climate justice puts the people most affected by the crisis at the centre of the solution. Health justice must do the same. We need a planet that is fit to live on. Cataclysmic events have been unfolding around the world for the last few years. For us in Southern Africa, the destruction wrought on Mozambique鈥檚 second largest city, Beira, and the destruction, and severe damage to 240,000 homes in the city and beyond stands out as a warning of what is to come.
Our guiding star is that nothing less than system change is required for long-term protection against the negative impacts of the climate and ecological crisis presently unfolding. We hold to a notion of deep and just transition to a society that is based on democratic planning. Guided by the science, we understand the priorities to reduce carbon emissions.
At the heart of solution is the radical shift away from the individual and the private to the collective. In doing so we can take society in a democratic and rationally planned direction.
This will require, among other things, the public ownership of energy, a massive expansion of public transport, water, housing and land as public goods and the expansion and support of small scale farming. In the context of the pandemic and rising temperatures, unfettered access to medicines and a single comprehensive and universal health care system. These are some of the critical shifts required. Others include an immediate end to deforestation, the wholesale scaling back of big agriculture and聽the ending of factory farming of animals.
Breaking the power of big pharma patent monopolies on medicine would herald the first step in that direction.
[Rehad Desai is a member of the 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 magazine in December, 2021.]