Decades in weeks: Crises and a search of a new synthesis

Jean-Paul Sartre a French Existentialist Philosopher and a member of the militia fighting the German occupation of France writes in 1944 about the resistance, “Never were we freer than under the German occupation...Resistance was a true democracy; for the soldier, as for his superior, the same danger, the same loneliness, the same responsibility, the same absolute freedom within the discipline.”  

The world under the occupation of COVID19 is undergoing the same experience today. All nations, all classes are facing the same mass fear and mass threat to life. 

Can this unite the world for charting a new order? Bertrand Russell and Albert Einstein along with prominent scientists across the world signed a Peace Manifesto in April 1955, exhorting for a new world order in the dark shadows of the nuclear arms race. Unfortunately Einstein died within one week of signing this manifesto. The scientists and philosopher thinkers had said “The prospect for the human race is sombre beyond all precedent. Mankind is faced with a clear-cut alternative: either we shall all perish, or we shall have to acquire some slight degree of common sense. A great deal of new political thinking will be necessary if utter disaster is to be averted.”

There are some weeks when nothing happens and then there are some weeks when decades happen. These are the weeks when the decade full of history is moving fast forward.  

Devastating world crises have always acted as powerhouses for new philosophies, ideas for new institutions and ways of life. The new philosophical lens can transform a situation of crisis by infusion of new meaning and perspective of life. Alternatively, it may spoil the situation as well. 

The devastation caused by two world wars led to the formation of UNO with a philosophy of one world, one humanity, world security council, and even one social agenda!  

COVID19 has pushed the entire world inside ‘safety bunkers’ of our own houses. The future history is being rewritten out there on the deserted streets, locked factories, empty offices and stunned faces. 

In a matter of a week, the fast pacing, untoppable earth stood still. The human race is experiencing overnight a complete lifestyle change. The way we work, we interact, we think, we valorize, we prioritize. 

This calls for a paradigm change which had been waiting around the corner last three decades. This reminds us what Victor Hugo, a great writer and social thinker of the 18th century has said ‘No force on earth can stop an idea whose time has come.’ 

Why is COVID19 so serious?  

Human history has witnessed serious epidemics such as Bubonic Plague killing 1/3 of European Population, Spanish Flu of 1918-19 killing about 5 crores in the world, of which 1.75 crores were Indians constituting about 5% of the Indian Population. The AIDS-HIV virus has killed 3.20 crore people so far since its major incidence from 1996, an average of about 1,40,000 deaths every year for the last 24 years. In 2009 H1N1 swine flu virus-infected as many as 1.4 billion people and killed more than 151,700 people across the globe.

The Corona death toll at the global level today stands at around 1,68,906 on 21st April. This explains why we have become explosively sensitive to this pandemic. But more than that, the reasons for this, lie in the change in certain objective conditions and also in the changed vision of big powers such as the USA. 

Firstly, the nature of the disease is different. The incubation period of COVID19 ranges between 2-14 days and in most individuals is found to be 5 days; while for Swine flu it was just 2 days. This increases the possibility of the spread of the infection by 2.5 times, faster and larger than earlier epidemics. The ratio of fatality of H1N1 swine flu was much lower than Covid19. 

Secondly, the world has turned more global than what it was in 2009-10. The number of international passengers has almost doubled between 2009 to 2019 (247.5 crores to 454 crores per year). The volume of trade in goods has increased by 33% and so has the trade in the form of services. These figures indicate the increasing physical integration across the globe. This also has heightened the possibilities of the global spread of epidemics at a galloping speed. 

Thirdly, the political vision has undergone a sea change between 2009 though 2019. It is more than visible in the response to a pandemic such as COVID19 as compared to H1N1 (swine flu 2009). Unlike the response of the Obama regime, the US federal government led by Donald Trump was in absolute denial, defiant and even accusatory mode in spite of a serious outbreak in China and cases reported in the USA till it had taken toll of thousands of Americans by the 3rd week of March 2020. CDC (Centre for Disease Control) was ill-equipped for testing lab support to the states. No wonder it was responding too late and too little in spite of the havoc the epidemic was unleashing. The leaders like Trump even chose to produce conspiracy theories and deplorable attempts to characterize the epidemic in a nationalistic and contemptuous manner. 

Fourthly, although the generation of the COVID19 pathogen is an act of nature, the aftermath and trauma it has caused for the human race was more of than avoidable. During the Bubonic Pague (1345), Spanish Flu(1918) pandemics, humanity had no clue of viruses, their vaccines, medicines or even prevention. But COVID19 struck us despite astonishing strides of human knowledge in virology and capability to intervene at flash speeds; it happened despite deafening warning bells rung by SARS and H1N1 epidemics of 2000 and 2009 and echoed by the international agencies such as WHO sponsored Global Preparedness Report Board (GPRB) which in September 2019 said, “A rapidly spreading pandemic due to a lethal respiratory pathogen (whether naturally emergent or accidentally or deliberately released) poses additional preparedness requirements. Donors and multilateral institutions must ensure adequate investment in developing innovative vaccines and therapeutics, surge manufacturing capacity, broad-spectrum antivirals and appropriate non-pharmaceutical interventions. All countries must develop a system for immediately sharing genome sequences of  any new pathogen for public health purposes along with the means to share limited medical countermeasures across countries...”

The Virus is inside the system! 

Three major policy shifts in the last 2 decades are visible across the globe barring a few countries.  

The shift from 'Society Oriented Public Health' to 'Individual Focused Medical Care':

Public health and its research has a prime focus on major threats to the health of populations. Its research moves between the laboratory and the field. It runs on Public service ethic. Its emphasis is on disease prevention and health promotion for the whole community. Medical Care, on the other hand, is thoroughly focused upon individual patient’s disease diagnosis, treatment, and care. Its research is stimulated by the needs of patients and moves between laboratory & bedside. While both are essential components of a countries Health Care system, we have bypassed the Public health aspect for the simple reason that it lacks lucrative profit opportunities for the big corporates.  For example, if one observes the trends in US public health expenditures we see that the per-capita public health spending (inflation-adjusted) which rose from $39 in 1960 to $281 in 2008 and has fallen by 9.3% since then. Public health’s share of total health expenditures rose from 1.36% in 1960 to 3.18% in 2002, then fell to 2.65% in 2014; Public health spending has declined, potentially undermining prevention and weakening responses to health inequalities and new health threats. From the perspective of the private sector, the public health issues symbolize the ‘cost’ and medical care becomes an opportunity for profit. No wonder the profits are internalized by them and ‘costs’ are either externalized or neglected or both. 

The technical capability of research along with the strength of public health institutions has systematically been either hijacked or paralyzed for the want of funding and policy support by this policy shift mimicking what COVID19 does to your lungs inside the body. Consequentially even the international bodies such as WHO were made toothless and proved to be an utter failure of preventive actions on a global scale in spite of some efforts made in that direction. 

The shift Form innovative companies to big corporate giants take over  

The pandemic such as the present one needs a stockpile of protective equipment and local medical supply. The whole of the USA and Europe is craving for the supply of ventilators, N95 masks and PPE suits. The world health professionals and experts alerted by the outbreaks endemics and pandemics of H1 N1 Swine Flu, two variants of Corona Viruses namely SARS and MERS in 2000, 2003, 2010, 2012 warned the governments about the same. Accordingly US agency Centre for Disease Control (CDC) in 2008,decided to have a stockpile of 70,000 small and affordable ventilators. 

After negotiations, the contract was given to a small company Newport from California, specializing in ventilators to supply 40,000 ventilators at $3000 per piece. This design was an innovation and was cheaper than the existing market price of $10,000 apiece. The prototypes were made in 2011 and approved by the Authorities. Everything was moving as per the plan. Things took an adverse turn when Newport was taken over by an equipment manufacturing giant named Covedian. (A shocking irony!!). 

The US government could have taken objection to this takeover in the public interest but chose not to. Covedian cancelled the contract in 2014 mostly to maintain the higher profit margins in selling the ventilators with high prices. Nothing happened for a long time as the issue was not on the priority list of any of the Government Agency. Later somehow the contract was given to Phillips, whose first assignment was due in May 2020!!!.  It should be remembered in due course Covedian was taken over by Medtronics which shifted its corporate office to Ireland, a tax haven, to siphon off the profits from the USA for a clear motive of tax avoidance. 

This example of Covedian killing the innovation and possibility of cheaper ventilators is not an exception, but a rule in the pharmaceutical and medical supply industry. A paper called Killer Acquisitions, published in 2018 by the researchers at Yale and the London Business School observed that in 45 instances per year on average the giant pharmaceutical firms buy out their smaller competitors who are developing rival drugs/ therapies that could cut into the profits of the giants and finally ensure that such better and cheaper innovations never see the light of the day. The purchase of Spark Therapeutics, by Roche in 2018 vividly exemplifies this. This was simply because Spark Therapeutics was successfully testing one-time haemophilia. This treatment was cutting directly into the Roche’s haemophilia drug Hemlibra which is required to be administered every four weeks. No wonder the one-time treatment on haemophilia now is put on the shelf forever so that Roche continues to get enormous super profits at the cost of the mental and financial burden on the haemophilia patients!  

The shift From public medical care to private insurance-based medical care:

It is the privatization health care and its intellectual framework that has failed humanity It is the failure of this ‘profits before people’ approach that has gripped the public policy of the countries across the world for more than a decade from now. Finally, it has exposed the essential contradiction that individual’s health and even medical care is not a private good; but is essentially a public good. The privatization approach based on this myth has finally been exposed to the core. It is this approach that made the healthcare in US and many European countries uncoordinated – and ungoverned. 

Since the epidemic’s onset, hospitals and city and state governments have waged 'bidding wars' over crucial supplies and ventilators, as noted by the New York Times. Now every hospital is for itself: some are resorting to appeals to community for donations of masks. It should be noted that medical care for Covid19 is to be borne by the individual through his /her insurance cover if any. This makes 30% of the US population without adequate or any protection. Only the tests would be free as announced by Trump recently after more than a million are infected. Trump suggested to the state governors to procure respirators, ventilators and all of the equipment – themselves as reported by the New York Times. The privatization approach has made healthcare system an atomized chaos, hospitals  and multi-hospital chains as silos wherein some rich and some poor, each fending for themselves are locked in market competition.

The shift from the global vision of the UNO to LPG vision of the WTO:

After the two devastating World Wars, an international consensus was attempted with the formation of the UNO. For more than 30 years, it enlarged its scope beyond military-security issues by setting the international policy standards and treaties for addressing socio-economic issues such as child care, health care, women’s dignity, drugs menace, international tax havens, eradication of killing diseases and even the issues in unfair international trade etc. 

After the collapse of Soviet Union, and since the formation of WTO in 1994, the entire focus of the world’s big powers was shifted to promote private corporate freedom to globalize their investments, supply chains and profits which is described by the acronym of LPG(Liberalization, Privatization, Globalization.) It led to the commercialization of all public spheres of life including the public goods such as health, education, water, rivers etc. The political economy of the world today is nothing but a living contradiction wherein the capital and corporate houses are governed by global rules of ‘liberalization’ while all vital social and environmental  issues such as employment, public health, pollution are left to be managed locally!! The solutions and strategies for pandemics in form of cures, knowledge and protective equipments are controlled and locked the till the last drop of blood by the Intellectual Property Rights by modern Shylocks, the big corporate houses. At best they are managed by the weak local national governments but not necessarily shared internationally. Thus the ‘powers’ which unanimously decide protocols of capital investment can not come together and finalize a global strategy for the meeting the challenge of a pandemic such as COVID-SARS-MERS-H1N1 in spite of warning bells ringing loud and clear from 2007.

The shift towards private intellectual property rights even with public money:  

The pharmaceutical companies which used to be research-driven innovation-based companies have now turned into IPR(Intellectual Property Rights) based brand managing monopoly giants. It would be shocking to know that even in March 2020 while passing an $8 billion (800 crores) package for COVID relief of which $3 billion (300 crores) would be for research for vaccine-medicine development, the pharmaceutical companies did not accept the clause of losing monopoly IPR if the prices are not found affordable by the Government. 

When thousands are dying of COVID just for the want of vaccines and medicines and even when the state is passing an emergency funding programme worth $3 billions for research, pharmaceutical monopoly giants have not budged an inch from their castles of monopoly rights; all at the cost of public money! There has been a complete shift towards decontrolling the pharmaceutical industry from all of its public obligations. Consequentially, the prices of essential medicines and therapies have skyrocketed in the last 20 years. The super-profits of these companies have become a major health hazard in itself. 

The COVID vaccine and treatment is not an exception to this. 60 Members of US congress submitted a letter to US President on February 20, 2020, to make an appeal to ensure that the vaccines and medicines to be used against COVID should not be granted exclusive monopoly rights to any pharmaceutical company so as to keep the prices of this vaccine low and affordable. It has pointed out that 80% of the research funding i.e. Rs. $700 million has been made from the public money paid by the taxpayers. It is revealed through this letter that the $700million. The letter also points out that unjustifiably high drug prices are one of the most pressing public health concerns the US faces today. It is even more shocking to note that US health secretary Alex Azar made a public statement that in spite of such a huge public expenditure on vaccine research, he would not guarantee that COVID treatments or vaccines would be affordable.  

The search for a new synthesis

Unfortunately, even bigger crises are waiting for us next. The pandemic of COVID may look dwarfed with the melting of polar ice and rising ocean water levels in the years to come. It is inescapable to conclude that what world needs most now is wisdom rather than algorithms of financial investments. We have the means, but the ends and systems messed up beyond recognition in name of penny wise and pound foolish economic 'rationality'. Just as cosmic astronomy needs radio telescope and can not work with optical lenses, the globalized world today needs a new vision, new ideas, a new synthesis. 

Calamities shape societies because systems are created and obliterated. The current world order which is based deregulated markets, the minimum role of governments and ethical concerns in economic activities, global supply chains and the excessive role of global financial institutions, cannot withstand any environmental or health apocalypse. 

This calls for a new cognitive revolution for the human future. As Yuval Noah Harari has observed in his books 'Sapiens' and 'Homo Deus', the success of the sapiens lies in the cognitive revolution. It has led to limitless range of co-operation without physical limits because it binds the people unknown to each other to a common purpose around intellectual fictions-ideas such society, nation, company, god, future, history, salvation, good, bad, value etc. which exist in the minds; but are relied even more than the objective reality perceived by all our senses. Karl Marx also observes in 'The German Ideology' that the ideas when they grip the imagination of masses, become a material force in history.  

COVID19 will and actually is changing the way we work, we interact, we think, we valorize, we prioritize. This is leading us to nothing but a paradigm shift waiting around the corner for the last 3 decades. This reminds us what Victor Hugo a great French romantic poet and thinker of the 19th century had said ‘ No force on earth can stop an idea whose time has come.’ I think the time for the idea of designing a society based on a philosophy of public good, public trust, public ownership, environmental ethics has arrived. 

If deserted streets, locked factories, closed offices and stunned faces are not to be our future, we have to look for new solutions. Just like a telescope in the hands of an intriguing mind targeted at the skies changed world history, humanity needs to project its gadgets and powers in the right direction once again.

_{Ajit Abhyankar is a writer, social activist and a leader of the CPI (M)}