Trump admin forsakes worker safety in false choice over meat supply
Workers voice concerns as meat plant re-opens amid coronavirus outbreaks
Meat plants become COVID-19 hotspots after poor handling of outbreaks
Tuesday, April 28, 2020
"The Trump administration is basically standing on the sidelines coming up with ideas that won’t help us," one person in the industry said.
The latest idea floated last week by President Donald Trump's administration calls for the Treasury Department to create a fund to lend money to struggling oil producers.
By BEN LEFEBVRE and ZACK COLMAN 04/28/2020
President Donald Trump and his advisers are offering a barrage of increasingly urgent ideas for propping up faltering oil producers — but people in the industry are skeptical that anything will come of it.
The administration has so far jettisoned plans to buy oil for the nation's Strategic Petroleum Reserve, nixed an idea to eliminate royalty payments for energy produced on federal lands and dropped a discussion of paying oil companies not to produce oil. The latest idea floated last week calls for the Treasury Department to create a fund to lend money to struggling oil producers — and take partial ownership stakes in the companies while requiring them to reduce their output.
“This is whack-a-mole stuff,” said one oil industry official involved in the discussions, speaking on condition of anonymity to speak frankly about the administration’s efforts. “There is a huge interest to ‘do something’ to help. But it all sounds good until step two.”
Like most parts of the economy, the oil industry has been hard hit by the coronavirus pandemic. The crash in oil prices that saw U.S. crude futures sink into negative territory last week for the first time in history rattled an industry that has weathered booms and busts for decades. Companies that had lifted U.S. oil production to record levels above 13 million barrels per day in recent months have slashed spending, laid off workers and shut down an estimated 900,000 barrels per day of output since the middle of March.
ENERGY & ENVIRONMENT
Trump pledges financial aid to oil industry
BY BEN LEFEBVRE
But even market-driven production cuts in the U.S. and planned reductions by Saudi Arabia and Russia have failed to offset the global collapse in demand, as the spread of Covid-19 has shrunk consumption by an estimated 20 million to 30 million barrels per day.
That has left the Trump administration scrambling to try to prop up a U.S. oil industry the president regularly praises for achieving global "energy dominance."
"The energy business is very important to me, and we're going to build it up," Trump told reporters on Friday.
Two energy industry officials confirmed to POLITICO that the White House and Treasury Department have raised the idea of the government buying stakes in oil companies and forcing them to scale back production, which could push prices higher. Treasury Secretary Steven Mnuchin indicated on Friday that taking equity stakes in companies could be on the table.
But skeptics in the industry say that would be all-but unworkable politically and financially. The government would have to buy enough shares in each company to control its production plan and would be saddled with the debt from businesses that had been in financial peril last year, when oil prices slipped to levels too low for many producers to earn a profit. And the money would most likely have to approved by the Democratically controlled House, which has shown no interest in carving out an aid program for the industry.
The skepticism over that plan comes after Congress rejected the Trump administration's request for $3 billion to buy oil for the strategic reserves. Now, the idea of lending money to companies and taking equity stake in them is drawing derision from several industry executives.
“When I heard that, it was in the context of ‘We could be totally insane and try this,’” said one person in the oil and gas industry who requested anonymity because he or she wasn't authorized to talk to the press. “Are we really talking about nationalizing our oil industry? Is the government equipped to do something like this? The answer is no.”
Spokespeople for the White House, DOE and Treasury Department did not immediately respond to questions.
ENERGY & ENVIRONMENT
Oil prices go negative — and Washington is paralyzed over what to do
BY BEN LEFEBVRE
The only real way the Trump White House could help is to help bring the Covid-19 outbreak under control so the public feels safe traveling again, one industry lobbyist said.
While much of the industry — including the influential American Petroleum Institute — opposes any kind of direct help from Washington, some oil producers are pressing for the White House to step in, including Continental Resources, the shale oil powerhouse company founded by Trump supporter Harold Hamm.
Oil-state senators are also publicly pitching for federal assistance. Texas Republicans John Cornyn and Ted Cruz and North Dakota's Kevin Cramer have all pressed Trump to try to forestall a wave of bankruptcies in the oil industry.
Cornyn, who is up for reelection this year, told reporters Thursday that he met with White House officials on April 17 and talked to Mnuchin to push for more help, including asking Saudi Arabia and Russia to cut more of their own oil production.
“We must do everything we can possibly think of,” Cornyn told reporters.
But Democrats have shot down ideas as quickly as the administration has floated them. Sen. Ed Markey (D-Mass.) and Rep. Nanette Barragán (D-Calif.) sent a letter Thursday to Federal Reserve Chair Jerome Powell warning him to not allow oil companies that were feeling financial heat before the pandemic to use newly authorized federal facilities to pay off their existing debts to Wall Street.
“During the federal response to this unprecedented crisis, we urge you to deploy the Federal Reserve’s resources in a way that protects taxpayer interests and avoids the bailout of an industry that has been struggling under its own short-sighted financial decisions for years,” the lawmakers wrote. “We must protect workers and communities affected by the oversupply of fossil fuels and the resulting downturn in oil and gas prices, but we can do that without carving out special rules for loans to fossil fuel corporations.”
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The Energy Department did pivot from its plan to buy oil for the Strategic Petroleum Reserve to allowing companies to lease some of the reserve's spare capacity for extra oil, an attempt to help alleviate the lack of private storage space that has pushed prices sharply lower. And Trump drew praise for pressuring Saudi Arabia and Russia to end their market fight and reduce oil production earlier this month. But that deal from the "OPEC+" group to curtail 9.7 million barrels per day in May failed to impress the energy markets, and oil prices continued to plummet.
“The OPEC+ deal and the plan to allow companies to store oil in the SPR are mere window dressing,” said another person in the industry, who requested anonymity to speak frankly about the situation. “Companies are failing and the industry is experiencing irrevocable destruction and the Trump administration is basically standing on the sidelines coming up with ideas that won’t help us.”
Still, many in the industry — which has long harbored skepticism about the role of the government in the energy markets — aren't bothered by the administration's inability to come up with a plan to bail out struggling companies.
“Problems always arise when a politician wants to do something or feels the need to do something,” said one industry lobbyist. “More often than not, what they chose to do is the wrong thing.”
Cornyn, who is up for reelection this year, told reporters Thursday that he met with White House officials on April 17 and talked to Mnuchin to push for more help, including asking Saudi Arabia and Russia to cut more of their own oil production.
“We must do everything we can possibly think of,” Cornyn told reporters.
But Democrats have shot down ideas as quickly as the administration has floated them. Sen. Ed Markey (D-Mass.) and Rep. Nanette Barragán (D-Calif.) sent a letter Thursday to Federal Reserve Chair Jerome Powell warning him to not allow oil companies that were feeling financial heat before the pandemic to use newly authorized federal facilities to pay off their existing debts to Wall Street.
“During the federal response to this unprecedented crisis, we urge you to deploy the Federal Reserve’s resources in a way that protects taxpayer interests and avoids the bailout of an industry that has been struggling under its own short-sighted financial decisions for years,” the lawmakers wrote. “We must protect workers and communities affected by the oversupply of fossil fuels and the resulting downturn in oil and gas prices, but we can do that without carving out special rules for loans to fossil fuel corporations.”
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The Energy Department did pivot from its plan to buy oil for the Strategic Petroleum Reserve to allowing companies to lease some of the reserve's spare capacity for extra oil, an attempt to help alleviate the lack of private storage space that has pushed prices sharply lower. And Trump drew praise for pressuring Saudi Arabia and Russia to end their market fight and reduce oil production earlier this month. But that deal from the "OPEC+" group to curtail 9.7 million barrels per day in May failed to impress the energy markets, and oil prices continued to plummet.
“The OPEC+ deal and the plan to allow companies to store oil in the SPR are mere window dressing,” said another person in the industry, who requested anonymity to speak frankly about the situation. “Companies are failing and the industry is experiencing irrevocable destruction and the Trump administration is basically standing on the sidelines coming up with ideas that won’t help us.”
Still, many in the industry — which has long harbored skepticism about the role of the government in the energy markets — aren't bothered by the administration's inability to come up with a plan to bail out struggling companies.
“Problems always arise when a politician wants to do something or feels the need to do something,” said one industry lobbyist. “More often than not, what they chose to do is the wrong thing.”
Trump lies about dire intel he received on virus — and says most people thought it would blow over
April 28, 2020 By Brad Reed
President Donald Trump on Tuesday lied about the dire intelligence assessments that he had received earlier this year about the COVID-19 pandemic, and suggested that most experts actually believed the virus would disappear.
Reuters White House correspondent Jeff Mason reports that Trump was asked about a Washington Post report this week that detailed the stark warnings about the threat of the virus that appeared in the President’s Daily Brief, but which were seemingly ignored for weeks as the president sought to downplay the threat of the pandemic.
Trump responded, according to Mason, by arguing that “most people thought earlier this year that the coronavirus was going to blow over” and then said he would have to “check when the early warnings came.”
In fact, according to the Post, daily intelligence briefs from this past January “traced the virus’s spread around the globe, made clear that China was suppressing information about the contagion’s transmissibility and lethal toll, and raised the prospect of dire political and economic consequences.”
However, sources tell the paper that Trump didn’t take these warnings seriously because he rarely has the attention span to read through the briefs.
Trump, asked about early intelligence, says most people thought earlier this year that the #coronavirus was going to blow over; he says he would have to check when the early warnings came pic.twitter.com/mOJ5Cnvzxd
— Jeff Mason (@jeffmason1) April 28, 2020
However, sources tell the paper that Trump didn’t take these warnings seriously because he rarely has the attention span to read through the briefs.
Trump, asked about early intelligence, says most people thought earlier this year that the #coronavirus was going to blow over; he says he would have to check when the early warnings came pic.twitter.com/mOJ5Cnvzxd
— Jeff Mason (@jeffmason1) April 28, 2020
Will Covid-19 end the age of Big Oil?
by Nafeez Ahmed, 24 April 2020
The Drake Well, Pennsylvania. cc. Trey Ratcliff
US oil prices have dropped below zero for the first time in history. The crisis is a direct consequence of the sudden slump in economic demand as the world locks down due to the Covid-19 pandemic. But given the likely duration of our economic woes, this could well be the beginning of the end for the age of oil.
The global oil crisis is laying bare structural vulnerabilities in the hydrocarbon energy system — and industrial civilization — that Big Oil has obscured for decades. Seven years ago, I wrote in detail about some of those structural vulnerabilities: ‘The shale gas revolution was meant to bring lasting prosperity,’ I warned. ‘But the result of the gas glut may be just a bubble, producing no more than a temporary recovery that masks deep structural instability.’
Read also Nafeez Mosaddeq Ahmed, “The great oil swindle”, Le Monde diplomatique, March 2013.The pandemic has unmasked the unsustainable bubble economics behind the shale boom, revealing an industry with no resilience and inflated on the basis of unrepayable debt levels.
The most important scientific concept needed to understand this is ‘Energy Return on Investment’ (EROI). The metric, pioneered by systems ecologist Professor Charles Hall of the State University of New York’s College of Environmental Science and Forestry, is the foundation of the emerging discipline of ‘biophysical economics’.
EROI is designed to measure how much energy is needed to extract energy from a particular resource. What’s left is known as surplus ‘net energy’, which we can use to support goods and services in the economy outside the energy system. The higher the ratio, the more surplus energy is left for the economy. Over the last decades, that surplus has run increasingly thin.
By the time the world is on the way toward recovering from the Covid-19 crisis, the oil industry will be decimated to an unprecedented degree.
In the early twentieth century, the EROI of fossil fuels was sometimes as high as 100:1. This means that a single unit of energy would be enough to extract a hundred times that amount. But since then, the EROI of fossil fuels has dramatically reduced. Between 1960 and 1980, the world average value EROI for fossil fuels declined by more than half, from about 35:1 to 15:1. It’s still declining, with latest estimates putting the value at between 6:1 and 3:1.
As we use more and more energy just to extract energy from our resource base, we are left with less ‘net energy’ to support financing of public goods and services. This has acted as a background ‘brake’ on the rate of economic growth for the world’s advanced industrial economies, which has also declined since the 1970s.
According to Professor Mauro Bonaiuti, an economist at the University of Turin in Italy, mainstream economics has failed to account for these key ‘biophysical’ underpinnings of the economy: material flows are dependent on energy. Since the 1970s, industrial societies have been in a ‘phase of declining returns’, he argues, measured across GDP growth, EROI, along with labour and manufacturing productivity.
To make up the shortfall, Bonauiti argues, we have kept the economy growing based on accelerated levels of debt. After the 2008 financial crash, a massive program of quantitative easing (QE) drove global debt even higher than pre-crash levels — barely sustaining a much slower level of GDP growth.
But the scale of debt keeping the industrial machine chugging along far outweighs our energy resource base. At some point, he warned, this unsustainable heyday was bound to grind to a halt.
These dynamics have made the economics of oil particularly unsustainable. In 2005, conventional crude oil entered a long plateau. To meet growing economic demand the industry shifted to more expensive unconventional forms. Since then, US shale supplied some 71.4 percent of global oil supply growth.
In February, as most of the world was sleepwalking into the Covid-19 pandemic, the Geological Survey of Finland — a Finnish government agency overseeing the EU’s mineral resource modelling — published a comprehensive study. It confirmed my earlier warning that this much-lauded expansion was in reality a debt-driven ‘bubble’.
Although there is ‘plenty of oil left,’ it is ‘increasingly expensive to access’, the report warned. Record shale oil production came at higher costs and declining well productivity. Most shale oil companies faced negative cash flow, compensated for by drawing down billions of dollars of unrepayable debt.
The pandemic was a pin that burst this oil bubble. And it may not ever come back.
Part of the reason is that the demand slump will probably last more than a year. The more optimistic anticipate that a vaccine could be developed within around 18 months, but this estimate doesn’t account for the regulatory hurdles that usually make vaccine development a complex 10-15 year process. So a vaccine is most likely several years away — if one is even possible. According to top systems biologist Professor David States, there are many reasons it may not be.
This means that the most likely scenario will see a prolonged economic contraction keeping demand too low for the global oil industry as we know it to survive. Prior to the pandemic, several analysts suspected that the US shale industry’s debt-levels were largely unrepayable — now it seems plausible that the debt can never be repaid.
The conventional view is that we are now drowning in cheap oil. We have so much oil we are running out of storage. While marginally true, this view fails to recognise that the dynamics of the crisis are rooted in the deepening ‘biophysical’ constraints that have emerged from having shifted to forms of fossil fuel energy which are, ultimately, far more expensive and difficult to extract than ever before. And that is why many pundits have not realised that the current ‘oil glut’ is a precursor to an unprecedented supply crunch. Oil companies are now caught between a rock and a hard place.
If they keep pumping, the price will plummet further as demand remains flat and the industry is forced to begin paying more than the market price just to store the oil: a dynamic that could trigger a spate of industry-wide debt defaults and bankruptcies.
Even if they stop pumping, the problem is that you can’t just turn oil wells on and off like a tap. Because these wells are organic deposits needing pressure to extract, a prolonged shut down risks massive damage to reserves that could be too costly to repair.
In either scenario, by the time the world is on the way toward recovering from the Covid-19 crisis, the oil industry would be decimated to an unprecedented degree. And while the immediate losers would be the US shale sector, major producers such as Saudi Arabia and Russia remain well within the firing line — facing the prospect of haemorrhaging state revenues within months.
In such a post-Covid-19 world, the resurgence of economic demand amid a permanently decimated oil industry would likely drive new price hikes. The oil glut is paving way for an era of long-lasting oil scarcity from which there may be no recovery.
It is only a matter of time before the earthquake that has hit Big Oil reverberates out across the global system.
As Abhi Rajendran of Columbia University’s Center on Global Energy Policy has warned, a ‘bailout’ cannot resolve the industry’s problems. Any support to the industry must be to hone it down it to protect immediate supply chains, and rehabilitate it to supply petro-chemicals and other key industrial services in a post-carbon age.
It is only a matter of time, then, before the earthquake that has hit Big Oil reverberates out across the global system. In coming months and years, Big Oil’s breakdown will pose an escalating risk to critical supply chains underpinning the energy flows, transport, manufacturing and food production activities of all societies. Petrol stations are already being forced to close as fuel sales dry up, endangering transport networks and critical supply chains. The global industrial food system, which is fundamentally dependent on oil inputs at every point — fertiliser, pesticides, on-farm machinery, processing, packaging, transport and distribution — would face unprecedented strain. The core mining and manufacturing processes that sustain industry as we know it could hit a wall.
National governments and international institutions are currently unprepared for the potential impacts, because they are not built or designed to anticipate or respond to complex risks.
That is why we urgently need two responses: a ‘life-boat economy’ approach designed to mitigate immediate risks, and a longer-term transition to sustainable and resilient economic foundations based on a fundamentally different energy paradigm.
Amid this unprecedented crisis, we face a unique opportunity to transition to a regenerative civilizational paradigm which no longer breaches environmental boundaries in ways that make pandemics like this inevitable.
This is, potentially, the making of a paradigm shift. But it’s not simply one that could be ‘right’, ‘good’ or even ‘better’ — a paradigm shift that recognises how interconnected and embedded we really are in environmentally-based energy flows is now absolutely critical for the continued survival of human civilization.
Although there remains resistance to this paradigm shift, voices around the world are waking up even in unexpected places. ‘Whichever way we look at it, this pandemic and crisis requires an unprecedented transformation of economics as we know it,’ said Vinod Sekhar, Chairman and Chief Executive of environment and biotechnology conglomerate, The Petra Group. Sekhar, who has made it to Forbes’ Asia rich lists, recently set up the Good Capitalism Forum to promote responsible business. ‘We need a true form of capitalism premised not merely on private profit but dedicated to social purpose and public good,’ he told me.
I asked him whether such a paradigm could still be called ‘capitalism’. Sekhar’s answer was that some of the best innovations are still happening in the private sector — the challenge is to ensure that the benefits accrue to society, rather than being horded by an ever-tightening network of elites. ‘We need an approach which protects planetary boundaries, not one which ignores them to make money. This is now the urgent mission of our times,’ he said. ‘To understand that to create wealth we need to lift society as a whole. All business leaders that want to remain relevant, if not survive, must be attentive to it. The world has changed permanently and the economic order must change with it. This is a fact we must accept.’
To some extent, the ingredients of this paradigm shift are now underway — even in the heartlands of neoliberal capitalism. Despite alarming levels of mendacity and incompetence, we have also seen unprecedented efforts by US and British authorities to safeguard vulnerable people at various levels. But it’s important to remember that we only are at the very early stages of what has to be a wide-ranging process of deep and comprehensive structural transformation.
For the first time in decades, such radical thinking is becoming the mainstay of serious political parties. I spoke to Labour MP Sam Tarry, parliamentary private secretary (PPS) to the shadow secretary of state for business, energy and industrial strategy about his views on the global energy crisis. ‘The oil market crash is perhaps the biggest sign that business-as-usual simply cannot continue,’ he said. ‘It raises the question — what if we had weaned ourselves off fossil fuels much earlier? What if our societies had made much more progress in transitioning to a new renewable energy infrastructure, creating a new clean transport networks, with households and businesses producing and sharing energy? What if we had created new hubs of local, organic agriculture reducing our dependence on traditional supply chain networks? We would have had a country far more resilient to this crisis. If anything, then, this crisis must spur us to move as rapidly as possible to such a more resilient society.’
Tarry is spot on. There is simply no time to lose. We need not only to rapidly shift to a new renewable energy system, we also need to recognise that doing so is going to mean the end of the ‘endless growth’ paradigm that, in many ways, caught us sleepwalking into this pandemic. Despite years of warnings from scientists that industrial expansion was increasing the risk of exotic diseases jumping to humans due to the encroachment of human systems on natural wildlife, we continued with abandon.
This means that global stimulus packages being rolled out to sustain workers, businesses, industries, supply chains and beyond need to go beyond emergency reaction. They need to facilitate a longer-term re-design of our economies so that they function to support life, rather than simply maximise fossil-fuelled material throughput.
This means we need to take seriously the vision of adaptive resilience outlined by Tarry to envision a comprehensive transformation of our social and economic structures. Industrial agriculture and manufacturing will need urgently to become less dependent on oil inputs from production, to transport, to distribution. That means organic ‘agroecological’ methods, as well as ‘circular economy’ recycling of locally-sourced minerals and raw materials.
We also need to consider the need for more immediate mitigation measures. As the traditional petrol supply infrastructure breaks down due to plummeting fuel sales, there are alternative bridge fuels that could be urgently scaled up. One potential source of clean biofuels for this purpose is Malaysia, where the government has created mandatory national regulation to support a transition to 100 percent deforestation-free sustainable palm oil.
It was in November 2018 that a new Malaysian government finally rose to power and made this landmark declaration — and just months after that the EU chose to ban palm oil for biodiesel on environmental grounds in a well-intentioned but misconceived move that undermined Malaysia’s nascent efforts.
To be sure, the initiative still has huge room for progress, but new research proves that bans and boycotts will only displace the deforestation problem onto more land-intensive commodities like soy and rapeseed (which happen to be produced in the West). A new partnership here could offer a bridge for a clean transport revolution, precisely at a time when traditional petrol distribution networks are at growing risk.
It requires dismantling the global structures of debt dominated by Western financial institutions, banks and governments.
This sort of levelling of the playing field between East and West can pave the way for a wider historic partnership between North and South, to finally break the global structural inequalities that define the unjust way in which the global system extracts wealth from the ‘developing’ world. These are the countries most vulnerable to the pandemic — facing a stark and horrific choice between a virus that could kill millions from the uncontrolled spread of disease, and lockdowns that could kill millions by preventing those already poor and food-insecure from accessing work, food and water.
That requires dismantling the global structures of debt dominated by Western financial institutions, banks and governments. And it also means levelling the playing field to open up new opportunities for North and South to work together to tackle the crisis. For instance, instead of allowing millions of garment workers across Asia to languish as Western retailers slash their production chains, Western governments could rapidly solve their domestic shortages by switching to new orders for mass production for PPE from these suppliers, and paying them fair wages.
Read also , “Covid-19: a shock to the system”, Le Monde diplomatique, April 2020.The huge structural changes suggested here are merely the tip of the iceberg. Many of them may seem aspirational. But the current collapse of oil markets is a huge signal that we have reached a new civilizational inflection point, with one core lesson: If we do not shift as rapidly as possible to a new system whose fundamental orientation is about the protection and flourishing of life, human societies face a level of risk that is barely conceivable.
It’s time to face the fact that the Covid-19 pandemic is forcing us to leave the fossil fuel era behind us.
Nafeez Ahmed
Dr Nafeez Ahmed is executive director of the System Shift Lab, a research fellow at the Schumacher Institute for Sustainable Systems and an award-winning investigative journalist and change strategist. His latest book is Failing States, Collapsing Systems: BioPhysical Triggers of Political Violence (Springer).
The Grim New Relevance of Workers Memorial Day
A holiday dedicated to workers injured or killed on the job takes on a darker resonance as work grows more dangerous in a pandemic.
By KIM KELLY April 28, 2020
The United States loves a good holiday, and depending on how detailed a calendar one keeps, there are daily opportunities to celebrate everything from gumdrops to argyle. (I finished writing this on National Spanish Paella Day.) And given our political leaders’ penchant for trumpeting America’s (faltering) manufacturing prowess and undying respect for (some) hard-working families, there are a number of holidays—both informal and federally recognized—dedicated to the struggles of the working class.
Labor Day is the best-known, though it is of course little more than a federal sleight of hand meant to distract the toiling class from the true worker’s holiday, May Day (an international celebration of workers that’s rather gruesomely marked on official U.S. calendars as “Loyalty Day”). This year’s May Day celebrations will most likely be rather muted, given the need for social distancing and impossibility of gathering in the streets. But the revolutionary flame that sparked the first American May Day parade in 1886, when anarchist firebrands Lucy and Albert Parsons led a parade of unemployed workers through the streets of Chicago, still burns; this year, it has been transmuted into a growing call for a large-scale May rent strike.
But even ahead of this year’s May Day festivities there’s another, more somber workers’ holiday worth observing in earnest: April 28 is Workers Memorial Day, an international day of remembrance for workers who have been injured or killed on the job, or after being exposed to hazards at work. It’s a grim holiday in any year, but it has a special resonance now, with so many workers facing the cruel choice of either reporting for work amid a pandemic or struggling to make do as job prospects evaporate and a new recession sets in.
This day holds a personal meaning for me, as it must for many others. Last month, my grandfather died. He was 82 and had been fighting off lung cancer for a while; I didn’t know how bad it had gotten until near the very end, because he did his best to hide the extent of the damage. He was a hard man, an ornery son of a bitch who played his cards close to his chest, loved a gin and tonic, and never took painkillers, even after countless surgical procedures had ravaged his body and left his steel backbone bent. I loved him more than anything, and I was always his favorite; he was the kind of man who was still getting into bar fights in his seventies, but he always saved a wink for me. He was an unschooled farm boy, then a Marine, then split his time between factory jobs and a side gig as a motel janitor. It was the decades he spent working as a millwright in an iron powder factory that broke his body, but I never expected him to die in his bed. It was undignified—too soft for a man like him.
But in the end, he died of mesothelioma, a vicious form of lung cancer caused by exposure to asbestos; it creeps in unannounced and eventually suffocates its victims. Industrial workers like him were four times more likely to contract the disease than members of the general population. Its long dormancy period—sometimes up to 40 years—means that when it rears its ugly head, it does so stealthily, when its prey is already weakened. Now I can’t stop thinking: Did his employer know about the risks of asbestos back then? Would they have cared? Would he? Knowing him, he would’ve waved it off. As a six-foot-four former Marine and avid big game hunter, he by all rights should have been taken down by more than a little prickly insulation. And yet down he went, to join his brethren on the great Workers Memorial in the sky.
What happened to him should never, ever happen to anyone else. Yet even now, as the world grapples with an invisible plague, employers seem hell-bent on flouting safety regulations and cutting corners. On April 23 (which had been known in less socially distant times as Take Our Children to Work Day), the National Council for Occupational Safety and Health, or COSH, released a special edition of its 2020 “Dirty Dozen” study. The report highlights a list of employers the group has cited for endangering workers and their communities with unsafe working conditions, harassment, and racial discrimination during the coronavirus pandemic.
Given the scale of worker displacement and suffering in the coronavirus crisis, it’s especially dispiriting to see trade groups such as the American Hospital Association and the National Restaurant Association actively working against the interests of the workers in their industries. These actions are especially blood-boiling when they’re directed at workers routinely expected to put their lives on the line in service of others—when, that is, they aren’t getting laid off in droves, virtually overnight.
And that only scrapes the surface of this grimy rogue’s gallery. There are a number of other big names on the expanded Dirty Dozen list, including Chipotle, Hard Rock Cafe, Smithfield Foods, Trader Joe’s, Victoria’s Secret, and Amazon. Their alleged offenses run the gamut from skirting labor laws to violating sick leave requirements to skimping on coronavirus protections for their workers to helping deport a witness in a labor dispute. The litany of abuses is shameful but wholly unsurprising.
“The Covid-19 pandemic has demonstrated, more clearly than ever, that worker health cannot be separated from public health,” Marcy Goldstein-Gelb, co-executive director of COSH, said in a press release. “Life-threatening hazards don’t stay put in a single building or worksite, but spread to family members, neighbors, and the public at large. Every worker is essential to their family—and deserves to come home safely at the end of their shift.”
The cognitive dissonance between the ongoing wave of “essential workers are heroes!” rhetoric and the actual way that working people are treated is brutal. The idea of the worker is celebrated while the workers themselves are expected to be happy with a few extra pennies in their paychecks and the admonition to keep washing their hands. It’s a particularly American nightmare, one built on fantasy and a stubborn refusal to accept the human wreckage that capitalism and an oblivious strain of American exceptionalism have wrought. “No one should be sacrificed for profit,” an asthmatic construction electrician told me after he’d quit his job for fear of contracting the virus on-site. “This is all just mind-numbingly idiotic and perverted.”
Even the calendar itself looks like more and more of a grim joke. Employee Appreciation Day happened way back on March 6 (a lifetime ago now), as retail workers strained to keep up with spiraling demand from a panic-buying public and fought to convince their bosses to provide them with hand sanitizer. On March 11, National Funeral Director and Mortician Recognition Day passed by without a whisper, as the bodies began to pile up and death industry workers grappled with the macabre conditions of a corona-fueled speed-up. March 29 saw National Mom and Pop Business Owners Day, even as countless small businesses were forced to lay off their staff and shutter their operations with no clear assurance of when, or whether, they might reopen. National Doctors Day blew past on March 30, as health care professionals across the country begged desperately for personal protection equipment and life-saving ventilators; odds are that when National Nurses Day rolls around on May 6, things won’t look much better.
April 4, National Hug a Newsperson Day, was a nice thought, even as the media industry was roiled by mass layoffs, budget cuts, and an exodus of advertiser money, leaving the fourth estate on even shakier ground than usual. National Library Workers Day passed by on April 21, as actual library workers continued their fight to close the libraries to protect themselves and the communities they serve. Administrative Professionals Day followed on April 22, as public service workers struggle to keep up with the cascading applications for unemployment insurance and are forced to keep coming into the office because crumbling state infrastructure makes telework impossible. It’s anybody’s guess what the world will look like come May 13, National Third Shift Workers Day.
With the arrival of this year’s Workers Memorial Day, there are so many more names to add to that ever-expanding book of the dead. All too many of these fatalities have been needlessly accelerated by both this cruel virus and its willing handmaidens: the profit-hungry bosses keen on extracting every possible pound of flesh from their workforces and the rapacious ghouls on both sides of the mainstream political aisle who enable the slaughter. In reality, those essential workers cheered by the press and in heartwarming viral videos are being treated as disposable beasts of burden. Those making these unwilling human sacrifices do not want your gratitude; they just want to survive this plague, too.
Truly, the best way to honor the workers who keep this country running isn’t to pay tribute after they’re already dead and gone. It’s to take care of them while they’re still here. When Mother Jones said, “’Pray for the dead and fight like hell for the living,” she wasn’t talking about hand claps or simpering news segments—she was talking about solidarity, supporting our fellow workers, beating back the bosses, taking bread and planting roses. That’s the attitude we need to be taking as we head into May Day and as we bow our heads on Workers Memorial Day. The working class needs to seize the future while we still have time to live it.
And if you remember, come September 18, it’ll be my granddad’s birthday. Raise a glass of something strong to him and all those who’ve worked alongside him, because it’ll be National Tradesmen Day—and Lord knows we’ll all need a drink by then.
Kim Kelly is a writer and organizer based in Philadelphia.@grimkim
WORKERS MEMORIAL DAY
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Sold Short, Politics, Coronavirus, Labor, Labor Rights, Worker Rights, May Day, Workers Memorial Day, Health Care Workers, Grocery Workers, Pandemic, Cultures Of Capitalism
Accelerating habitat loss behind Covid-19
The microbes, the animals and us
by Sonia Shah
Repeated close contact makes it easier for animal microbes to cross over to humans
China Photos · Getty
It could have been a pangolin. Or a bat. Or, as one later-debunked theory suggested, a snake. The race is on to identify the animal source of Covid-19, the coronavirus that now holds several hundred million people in quarantines and cordons sanitaires in China and elsewhere. The animal origin of the disease is a critical mystery to solve. But speculation about which wild creature originally harboured the virus obscures a more fundamental source of our growing vulnerability to pandemics: the accelerating pace of habitat loss.
Since 1940, hundreds of microbial pathogens have emerged or re-emerged into territory where they’ve never been seen before. They include HIV, Ebola in West Africa, Zika in the Americas, and many novel coronaviruses. The majority, 60%, originate in the bodies of animals. Some come from pets and livestock. Most, more than two thirds, originate in wildlife.
That’s not the fault of wild animals. Although stories illustrated with pictures of wild animals as ‘the source’ of deadly outbreaks might suggest otherwise (1), wild animals are not especially infested with deadly pathogens poised to infect us. In fact, most of these microbes live harmlessly in animals’ bodies. The problem is that cutting down forests and expanding towns, cities and industrial activities creates pathways for animal microbes to adapt to the human body.
Wild species face extinction
Habitat destruction threatens vast numbers of wild species with extinction (2), including the medicinal plants and animals we’ve historically depended upon for our pharmacopeia. It also forces wild species that hang on to cram into smaller fragments of remaining habitat, increasing the likelihood that they’ll come into repeated, intimate contact with the human settlements expanding into their habitat. It’s this kind of repeated, intimate contact that allows the microbes that live in their bodies to cross over into ours, transforming benign animal microbes into deadly human pathogens.
Cutting down forests forces bats to roost in trees in backyards and farms, increasing the likelihood of a human taking a bite of fruit covered in bat saliva
Consider Ebola. According to a 2017 study, Ebola outbreaks, which have been linked to several species of bat, are more likely to occur in places in Central and West Africa that have experienced recent deforestation. Cutting down forests forces bats to roost in trees in backyards and farms, increasing the likelihood that a human might take a bite of fruit covered in bat saliva, or hunt and slaughter a bat, getting exposed to the microbes sheltering in its tissues. Such encounters allow a host of viruses carried harmlessly by bats, including Ebola, Nipah (notably in Malaysia and Bangladesh) and Marburg, to slip into human populations. When ‘spillover’ events happen frequently enough, animal microbes can adapt to our bodies and evolve into human pathogens.
Mosquito-borne disease outbreaks have similarly been linked to the felling of forests (3), although less because of the loss of habitat than its transformation. As tree leaf litter and roots disappear, water and sediment flow more readily along the barer forest floor, newly open to shafts of sunlight. Malaria-carrying mosquitoes breed in the sunlit puddles. A study in 12 countries found that mosquito species that carry human pathogens are twice as common in deforested areas as in intact forests.
Habitat destruction also scrambles the population sizes of different species in ways that can increase the likelihood that a pathogen will spread. West Nile virus, carried by migratory birds, is one example. Squeezed by habitat loss and other affronts, bird populations in North America have declined by more than 25% over the last 50 years (4). But species don’t decline at a uniform rate. Specialist species, like woodpeckers and rails, have been hit harder than generalists like robins and crows. That increases West Nile virus in bird flocks because, while woodpeckers are poor carriers of the virus, robins and crows are excellent carriers. It gets every more likely that a local mosquito will bite a West-Nile-virus infected bird and then a human (5).
Spread of Lyme disease
The expansion of suburbs into the US northeastern forest increases the risk of tick-borne disease by driving out creatures such as opossums, which help control tick populations, while improving conditions for species like white-footed mice and deer, which don’t. Tick-borne Lyme disease first emerged in the US in 1975; in the past 20 years, seven new tick-borne pathogens have followed (6).
It’s not only habitat destruction that increases the risk of disease emergence; it’s also what we’re replacing wild habitat with. To sate our carnivorous appetites, we’ve razed an area the size of Africa (7) to raise animals to eat. Some of these are delivered through the illicit wildlife trade or sold in ‘wet markets’, where wild species that would rarely if ever encounter each other in nature are caged adjacent, allowing microbes to jump species. This process begot the coronavirus that caused the 2002-03 SARS epidemic and possibly the novel coronavirus stalking us today.
Many more animals are reared in factory farms, where hundreds of thousands await slaughter, packed close, providing microbes with lush opportunities to turn into pathogens. Avian influenza viruses, which originate in the bodies of wild waterfowl, rampage in factory farms packed with captive chickens, mutating and becoming more virulent, a process so reliable it can be replicated in the laboratory. One strain called H5N1, which can affect humans, kills more than half of those infected. Tens of millions of poultry had to be slaughtered to contain another strain, which reached North America in 2014 (8).
The avalanche of excreta produced by our livestock introduces yet more transference opportunities. Because animal waste is far more voluminous than croplands can possibly absorb as fertiliser, it is collected in many places in unlined cesspools called manure lagoons. Shiga-toxin producing Escherichia coli, which lives harmlessly inside the guts of over half of all cattle on American feedlots, lurks in that waste (9). In humans, it causes bloody diarrhoea and fever and can lead to acute kidney failure. Because cattle waste so often sloshes into food and water, 90,000 Americans are infected every year.
This process of transforming animal microbes into human pathogens is accelerated today, but it began with the Neolithic revolution, when humans first cleared wildlife habitat to make way for crops and domesticated wild animals. The ‘deadly gifts’ from our ‘animal friends’, as Jared Diamond put it, include measles and tuberculosis from cows, pertussis(whooping cough)from pigs, and influenza from ducks.
The process continued during the era of colonial expansion. Belgian colonists in Congo built the railways and cities that allowed a lentivirus in local macaques to adapt to the human body; British colonists in Bangladesh cut down the Sundarbans wetlands for rice farms, exposing humans to bacteria from the wetlands’ brackish waters. The pandemics those intrusions created plague us to this day. The macaques’ lentivirus evolved into HIV. The bacteria of the Sundarbans, now known as cholera, have caused seven pandemics so far, the latest in Haiti, just a few hundred miles off the coast of Florida.
What we can do
The good news is that, because we are not passive victims of animal microbes invading our bodies but fully empowered agents who turn harmless microbes into pandemic pathogens, there’s much we can do to reduce the risk that these microbes emerge. We can protect wildlife habitats, so that animal microbes don’t cross over, an approach championed by the One Health movement (10).
Larry Brilliant once said that ‘outbreaks are inevitable, but pandemics are optional.' But they only remain optional if we have the will to disrupt our politics as readily as we disrupt nature and wildlife
We can actively surveil places where animal microbes are most likely to transform, hunting for ones that show signs of adapting to the human body — and squelching them before they cause epidemics. For 10 years, scientists funded by the USAID’s Predict programme did that, pinpointing more than 900 novel viruses that emerged from changed habitats around the world, including new strains of SARS-like coronaviruses (11).
Today, the shadow of the next pandemic looms, and not just because of Covid-19. In the US, Donald Trump’s administration has liberated extractive industries and industrial development from environmental and other regulatory constraints, which will accelerate habitat destruction. In October 2019 the administration ended the Predict programme, reducing the ability to pinpoint the next spillover microbe and contain it when it starts to spread. Officials reportedly felt ‘uncomfortable funding cutting-edge science’. In early February, the US proposed cutting funds to the World Health Organisation too, by 53%.
The epidemiologist Larry Brilliant once said that ‘outbreaks are inevitable, but pandemics are optional.’ But pandemics only remain optional if we have the will to disrupt our politics as readily as we disrupt nature and wildlife. In the end, there is no real mystery about the animal source of pandemics. It’s not some spiky-scaled pangolin or furry flying bat. It’s populations of warm-blooded primates: the true animal source is us.
Sonia Shah
Sonia Shah is a journalist and the author of Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond (Sarah Crichton Books, New York, 2016) and The Next Great Migration: the Beauty and Terror of Life on the Move (Bloomsbury Publishing, London, forthcoming June 2020). This article was first published in The Nation, New York.
Original text in English
Amid the Covid-19 pandemic, which brings into sharp relief the failures of the US health system, Donald Trump has decided to cut funding to the World Health Organisation (WHO)
Thursday 16 April 2020
Trump accused the WHO of being in China’s pocket and of having accepted falsified figures from Beijing, though the biggest donor to the WHO is the US, and not China, as one sometimes hears. The scale of the human tragedy we are living through deserves better than a cold war over health that will deprive the WHO of essential means to act. Richard Horton, editor of the British medical journal The Lancet, has called Trump’s decision ‘a crime against humanity’. That said, in-depth reform of the WHO’s funding and the way programs are developed is essential. Back in 2013, Dominique Kerouedan pointed out the influence of states, laboratories and private foundations on the WHO, and how this affects treatment.
What comes after the millennium goals aren’t reached?
No development without better health
Even though the UN’s millennium development targets won’t be reached by 2015, new goals are being set, especially in health. They may not be the right ones
by Dominique Kerouedan
Back in 2000 the 193 member states of the United Nations and 23 international organisations set eight Millennium Development Goals (MDGs) — minimum levels of progress to be achieved by 2015 in reducing poverty, hunger and inequality, and improving access to healthcare, safe drinking water and education (see Health targets).
Gro Harlem Brundtland, then director of the World Health Organisation, identified funding as a key priority and chose Jeffrey Sachs, special adviser to UN Secretary-General Kofi Annan, to head the Commission on Macroeconomics and Health, responsible for promoting investment with a view to achieving the health goals at an early date (1).
Global funding for developing countries from public-private partnerships, especially vaccine and drug manufacturers, quadrupled between 2000 and 2007; between 2001 and 2010 it tripled, reaching $28.2bn in 2010. Most of the money came from US-based public and private funds. (The Bill and Melinda Gates Foundation contributed nearly $900m in 2012.) Global development aid rose by 61% during this time, reaching $148.4bn in 2010.
Africa is estimated to have received 56% of all funding in 2010 (2), but 2015 is fast approaching and for sub-Saharan Africa the MDGs are still far out of reach. A shortage of funds is not enough to explain this slow progress: other, less visible, factors have played an important role. Studies (3) show that the allocation of global aid is based not only on epidemiological, population or burden of disease criteria, but also on commercial interests and historic and geopolitical relationships. Those involved in drawing up new goals for after 2015 would do well to take these factors into account.
19th-century century concerns
The first international conferences on health, in the 19th century, were motivated less by a desire to prevent the spread of plague, cholera and yellow fever than by the need to minimise quarantine measures, which were impeding trade. Tensions between medicine, health, commercial interests and political power remain inherent to global public health: the problem of ensuring that the poor have access to medicines within the framework of the Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS) is a good example.
The Global Fund to fight AIDS, Tuberculosis and Malaria, and its partners, assume that the strategies for combatting these three diseases are pertinent to every country and that only the money is missing. To understand this finance-led view of health issues and the limits of its effectiveness, it is necessary to return to the context in which the fund was established. In 1996 President Bill Clinton called for a strategy focused on infectious diseases, less from altruism than for reasons of national security; the US government was concerned about disease propagation, its economic consequences, delays in the development of new drugs, resistance to antibiotics, population mobility, the growth of megapolises and the weakness of health systems in poor countries.
In 1997 the Institute of Medicine, the leading scientific authority in the US, published a report that first used the expression “global health”, and said it was of vital interest to the US: “The world’s nations — the United States included — now have too much in common to consider health as merely a national issue. Instead, a new concept of global health is required to deal with health problems that transcend national boundaries, that may be influenced by circumstances or experiences in other countries, and that are best addressed by cooperative actions and solutions” (4). At the same time AIDS was spreading rapidly in southern Africa, and a South African defence ministry report on the high rate of HIV infection among the armed forces of many African countries caused alarm: very soon national defence capabilities would not be enough to deal with internal or external conflict. According to the International Crisis Group, many countries would “soon be unable to participate in peacekeeping operations” (5).
Between 1999 and 2008 the National Intelligence Council, the US intelligence community’s centre for long-term strategic analysis, published six reports on global health. These defined disease as a “non-traditional” threat to the security of the US, which has military bases around the world. This threat even reached the UN. For the first time in its history, the Security Council’s agenda in January 2000 included a topic not linked to a direct risk of conflict: the impact of AIDS on peace and security in Africa. The US delegation chaired the discussions, which produced a number of resolutions. Article 90 of the Declaration of Commitment on HIV/AIDS adopted by the UN General Assembly in 2001 called for the urgent establishment of a global HIV/AIDS and health fund to finance a response to the epidemic based on an integrated approach to prevention, care, support and treatment, and to help governments combat HIV/AIDS, especially in sub-Saharan Africa and the Caribbean.
Kofi Annan’s mobilisation of the G8 resulted in the establishment of the Global Fund, but this is far from being the “AIDS and health” fund called for by the UN: its mandate covers only AIDS, tuberculosis and malaria.
Restoring US leadership
US national security policy is driven by fears of communism, terrorism and disease, and the US does not hesitate to use the UN Security Council to defend its position on global health issues. After the wars in Afghanistan and Iraq, Barack Obama is steering his country towards struggles other than external conflicts. The aim is to restore US leadership abroad, and deal with the control of epidemics, as mentioned in the National Security Strategy in 2010. In July 2012 the US government announced the establishment of an Office of Global Health Diplomacy within the State Department: “We have made a collective recommendation to ... shift our focus from leadership within the US Government to global leadership by the US Government.” According to international relations historian Georges-Henri Soutou, “The US has understood that real power today means being able to operate in both spheres — international and transnational” (6).
Analysis of health policy in recent decades reveals that global health is seen variously as an economic investment, a tool for security and an element of foreign policy. (Charity and public health complete the picture according to David Stuckler and Martin McKee (7).) Security demands quick action, a short-term approach and the control of contagious diseases, rather than the holistic and systematic long-term approach required to strengthen institutional capabilities. This threatens the survival of initiatives in which money has been invested for almost 15 years.
So no matter how much the Global Fund and the US government allocate under the president’s emergency programme for AIDS relief (8), the actual results are disappointing because so little account has been taken of the need for prevention, or of demographic, urban, social, economic and conflict factors, or of national characteristics of disease propagation.
Thirty years into the HIV/AIDS pandemic, little funding is being allocated to local, epidemiological, anthropological and economic research to help decision-making. For every two people treated, five new cases of HIV infection are reported. Despite the many conflicts in Africa, the role of rape in the spread of the virus among women has not been examined. The world is shocked by the embezzlement of Global Fund monies, but ignores the failure of governments to analyse the effectiveness of the strategies adopted in their own countries. The financial choices (influenced by lobbyists) favour cure, to the benefit of the pharmaceutical industry, rather than prevention of the spread of HIV.
Who is accountable?
The growing number of entities in development aid has led to conflicts between decision-makers and partners, and a blurring of responsibilities: who should be accountable for the use of funds allocated through global partnerships or through new mechanisms. Financial issues are the responsibility of the Global Fund’s board, rather than its executive secretariat. Technical and strategic issues are supposed to be handled by individual countries and their partners (UNAIDS, Unicef and the WHO). Where UN agencies have given technical support to member states, have they guided them towards a strategy that heeds national characteristics? If not, then it’s time they did.
Africa (and the EU, including France) face unparalleled challenges. Africa’s population is set to double by 2050, from one billion to two billion, 20% of the global population. The economist François Bourguignon claims poverty, strictly defined, will be an exclusively African problem by 2040 or 2050 (9).
Africa is undergoing major demographic and epidemiological change, with rapid urbanisation and the as yet unquantified spread of chronic diseases — cancer, diabetes, cardiovascular and respiratory disease, mental illness, diseases linked to environmental pollution. These, diagnosed late or not at all and spreading like pandemics, together with more road accidents, add to the burden on healthcare workers, already in very short supply. Economic and social inequalities are creating health inequalities. Health insurance and social protection systems are being put in place too slowly, and unevenly. Universal health coverage would help the poor if it were part of a policy based on national priorities, especially prevention.
Given their historic links and centuries of political, economic and commercial interaction with sub-Saharan Africa, European countries have important contributions to make on the political front, as well as in terms of expertise and funding, and these should not be obscured by US priorities. The situation in central and western francophone Africa calls for large-scale, long-term action.
In equating the MDGs with sustainable development goals for after 2015, we risk focusing only on shared global issues, and neglecting fragile states and the most vulnerable people. The priorities are education for girls, maternal health, unknown tropical diseases and the development of institutional capability to formulate and implement complex policies.
The Indian economist Amartya Sen said: “Those who ask if better health is useful for development are missing the point: health and development are inseparable. You don’t need ... to try to prove that good health stimulates economic growth.” Long-term health for everyone on the planet should be the goal, not just the funding mechanisms that would allow universal health coverage, currently being presented as a sustainable development goal.
Health targets
UN Millennium Development Goals relating to health, to be achieved by 2015:
Goal 4: to reduce mortality among children under 5 by two thirds
Goal 5: to improve maternal health and reduce maternal mortality by three quarters
Goal 6: to combat HIV/AIDS, malaria and other diseases
Goal 8, target E: in cooperation with pharmaceutical companies, to provide access to affordable essential drugs in developing countries
Africa’s 2010 figures
76% of deaths in Africa are from infectious diseases, maternal and neonatal illnesses and nutritional disorders.
Africa accounts for 70% of deaths from HIV/AIDS worldwide.
Africa accounts for 75% of new HIV cases worldwide — of which the majority are among young people, girls and women (60% of all cases).
75% of HIV-positive young people aged 15-24 in Africa are girls. HIV/AIDS is more common in cities, where promiscuity-linked diseases (such as tuberculosis) spread with urbanisation.
Condom use is still infrequent (less than 20% in high-prevalence countries).
75% of HIV-positive men in four high-prevalence African countries admit recently having unprotected sex.
According to a study conducted in Abidjan with the support of Unicef, HIV/AIDS is more prevalent among the best-informed, best-educated and richest young people.
75% of Africans aged 15-44 do not know their HIV status. Among those aged 15-24, only 10% of boys and 15% of girls have taken an HIV test.
Only 25% of eligible patients in central and western Africa take antiretroviral treatments. (20% of HIV-positive pregnant women take them for their own sake, 33% of them to prevent the transmission of the virus to their child.)
Africa accounts for 50% of deaths among pregnant women and deaths due to complications arising from abortion procedures worldwide. Africa has the highest rate of teenage pregnancy (girls aged 15-18) worldwide. 97% of abortions in Africa are carried out under poor conditions.
Africa accounts for 91% of deaths from malaria worldwide (including 87% of deaths among children under 5, according to the World Health Organisation).
Africa is short of healthcare workers: Africa accounts for 25% of the global shortfall, and has only 3% of all healthcare workers worldwide.
Sources: MDG Africa and Global reports; Measuredhs.com; “Financing Global Health 2012: the end of the Golden Age?”, Institute for Health Metrics and Evaluation, University of Washington, Seattle, February 2012
Dominique Kerouedan
Savoirs Contre Pauvreté chair at the Collège de France and author of Géopolitique de la Santé Mondiale (The Geopolitics of World Health), Fayard, Paris, 2013. She also edited Santé Internationale: les Enjeux de Santé au Sud, (International Health: the Health Issues Facing the South), Presses de Sciences Po, Paris, 2011
Translated by Charles Goulden
What comes after the millennium goals aren’t reached?
No development without better health
Even though the UN’s millennium development targets won’t be reached by 2015, new goals are being set, especially in health. They may not be the right ones
by Dominique Kerouedan
Back in 2000 the 193 member states of the United Nations and 23 international organisations set eight Millennium Development Goals (MDGs) — minimum levels of progress to be achieved by 2015 in reducing poverty, hunger and inequality, and improving access to healthcare, safe drinking water and education (see Health targets).
Gro Harlem Brundtland, then director of the World Health Organisation, identified funding as a key priority and chose Jeffrey Sachs, special adviser to UN Secretary-General Kofi Annan, to head the Commission on Macroeconomics and Health, responsible for promoting investment with a view to achieving the health goals at an early date (1).
Global funding for developing countries from public-private partnerships, especially vaccine and drug manufacturers, quadrupled between 2000 and 2007; between 2001 and 2010 it tripled, reaching $28.2bn in 2010. Most of the money came from US-based public and private funds. (The Bill and Melinda Gates Foundation contributed nearly $900m in 2012.) Global development aid rose by 61% during this time, reaching $148.4bn in 2010.
Africa is estimated to have received 56% of all funding in 2010 (2), but 2015 is fast approaching and for sub-Saharan Africa the MDGs are still far out of reach. A shortage of funds is not enough to explain this slow progress: other, less visible, factors have played an important role. Studies (3) show that the allocation of global aid is based not only on epidemiological, population or burden of disease criteria, but also on commercial interests and historic and geopolitical relationships. Those involved in drawing up new goals for after 2015 would do well to take these factors into account.
19th-century century concerns
The first international conferences on health, in the 19th century, were motivated less by a desire to prevent the spread of plague, cholera and yellow fever than by the need to minimise quarantine measures, which were impeding trade. Tensions between medicine, health, commercial interests and political power remain inherent to global public health: the problem of ensuring that the poor have access to medicines within the framework of the Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS) is a good example.
The Global Fund to fight AIDS, Tuberculosis and Malaria, and its partners, assume that the strategies for combatting these three diseases are pertinent to every country and that only the money is missing. To understand this finance-led view of health issues and the limits of its effectiveness, it is necessary to return to the context in which the fund was established. In 1996 President Bill Clinton called for a strategy focused on infectious diseases, less from altruism than for reasons of national security; the US government was concerned about disease propagation, its economic consequences, delays in the development of new drugs, resistance to antibiotics, population mobility, the growth of megapolises and the weakness of health systems in poor countries.
In 1997 the Institute of Medicine, the leading scientific authority in the US, published a report that first used the expression “global health”, and said it was of vital interest to the US: “The world’s nations — the United States included — now have too much in common to consider health as merely a national issue. Instead, a new concept of global health is required to deal with health problems that transcend national boundaries, that may be influenced by circumstances or experiences in other countries, and that are best addressed by cooperative actions and solutions” (4). At the same time AIDS was spreading rapidly in southern Africa, and a South African defence ministry report on the high rate of HIV infection among the armed forces of many African countries caused alarm: very soon national defence capabilities would not be enough to deal with internal or external conflict. According to the International Crisis Group, many countries would “soon be unable to participate in peacekeeping operations” (5).
Between 1999 and 2008 the National Intelligence Council, the US intelligence community’s centre for long-term strategic analysis, published six reports on global health. These defined disease as a “non-traditional” threat to the security of the US, which has military bases around the world. This threat even reached the UN. For the first time in its history, the Security Council’s agenda in January 2000 included a topic not linked to a direct risk of conflict: the impact of AIDS on peace and security in Africa. The US delegation chaired the discussions, which produced a number of resolutions. Article 90 of the Declaration of Commitment on HIV/AIDS adopted by the UN General Assembly in 2001 called for the urgent establishment of a global HIV/AIDS and health fund to finance a response to the epidemic based on an integrated approach to prevention, care, support and treatment, and to help governments combat HIV/AIDS, especially in sub-Saharan Africa and the Caribbean.
Kofi Annan’s mobilisation of the G8 resulted in the establishment of the Global Fund, but this is far from being the “AIDS and health” fund called for by the UN: its mandate covers only AIDS, tuberculosis and malaria.
Restoring US leadership
US national security policy is driven by fears of communism, terrorism and disease, and the US does not hesitate to use the UN Security Council to defend its position on global health issues. After the wars in Afghanistan and Iraq, Barack Obama is steering his country towards struggles other than external conflicts. The aim is to restore US leadership abroad, and deal with the control of epidemics, as mentioned in the National Security Strategy in 2010. In July 2012 the US government announced the establishment of an Office of Global Health Diplomacy within the State Department: “We have made a collective recommendation to ... shift our focus from leadership within the US Government to global leadership by the US Government.” According to international relations historian Georges-Henri Soutou, “The US has understood that real power today means being able to operate in both spheres — international and transnational” (6).
Analysis of health policy in recent decades reveals that global health is seen variously as an economic investment, a tool for security and an element of foreign policy. (Charity and public health complete the picture according to David Stuckler and Martin McKee (7).) Security demands quick action, a short-term approach and the control of contagious diseases, rather than the holistic and systematic long-term approach required to strengthen institutional capabilities. This threatens the survival of initiatives in which money has been invested for almost 15 years.
So no matter how much the Global Fund and the US government allocate under the president’s emergency programme for AIDS relief (8), the actual results are disappointing because so little account has been taken of the need for prevention, or of demographic, urban, social, economic and conflict factors, or of national characteristics of disease propagation.
Thirty years into the HIV/AIDS pandemic, little funding is being allocated to local, epidemiological, anthropological and economic research to help decision-making. For every two people treated, five new cases of HIV infection are reported. Despite the many conflicts in Africa, the role of rape in the spread of the virus among women has not been examined. The world is shocked by the embezzlement of Global Fund monies, but ignores the failure of governments to analyse the effectiveness of the strategies adopted in their own countries. The financial choices (influenced by lobbyists) favour cure, to the benefit of the pharmaceutical industry, rather than prevention of the spread of HIV.
Who is accountable?
The growing number of entities in development aid has led to conflicts between decision-makers and partners, and a blurring of responsibilities: who should be accountable for the use of funds allocated through global partnerships or through new mechanisms. Financial issues are the responsibility of the Global Fund’s board, rather than its executive secretariat. Technical and strategic issues are supposed to be handled by individual countries and their partners (UNAIDS, Unicef and the WHO). Where UN agencies have given technical support to member states, have they guided them towards a strategy that heeds national characteristics? If not, then it’s time they did.
Africa (and the EU, including France) face unparalleled challenges. Africa’s population is set to double by 2050, from one billion to two billion, 20% of the global population. The economist François Bourguignon claims poverty, strictly defined, will be an exclusively African problem by 2040 or 2050 (9).
Africa is undergoing major demographic and epidemiological change, with rapid urbanisation and the as yet unquantified spread of chronic diseases — cancer, diabetes, cardiovascular and respiratory disease, mental illness, diseases linked to environmental pollution. These, diagnosed late or not at all and spreading like pandemics, together with more road accidents, add to the burden on healthcare workers, already in very short supply. Economic and social inequalities are creating health inequalities. Health insurance and social protection systems are being put in place too slowly, and unevenly. Universal health coverage would help the poor if it were part of a policy based on national priorities, especially prevention.
Given their historic links and centuries of political, economic and commercial interaction with sub-Saharan Africa, European countries have important contributions to make on the political front, as well as in terms of expertise and funding, and these should not be obscured by US priorities. The situation in central and western francophone Africa calls for large-scale, long-term action.
In equating the MDGs with sustainable development goals for after 2015, we risk focusing only on shared global issues, and neglecting fragile states and the most vulnerable people. The priorities are education for girls, maternal health, unknown tropical diseases and the development of institutional capability to formulate and implement complex policies.
The Indian economist Amartya Sen said: “Those who ask if better health is useful for development are missing the point: health and development are inseparable. You don’t need ... to try to prove that good health stimulates economic growth.” Long-term health for everyone on the planet should be the goal, not just the funding mechanisms that would allow universal health coverage, currently being presented as a sustainable development goal.
Health targets
UN Millennium Development Goals relating to health, to be achieved by 2015:
Goal 4: to reduce mortality among children under 5 by two thirds
Goal 5: to improve maternal health and reduce maternal mortality by three quarters
Goal 6: to combat HIV/AIDS, malaria and other diseases
Goal 8, target E: in cooperation with pharmaceutical companies, to provide access to affordable essential drugs in developing countries
Africa’s 2010 figures
76% of deaths in Africa are from infectious diseases, maternal and neonatal illnesses and nutritional disorders.
Africa accounts for 70% of deaths from HIV/AIDS worldwide.
Africa accounts for 75% of new HIV cases worldwide — of which the majority are among young people, girls and women (60% of all cases).
75% of HIV-positive young people aged 15-24 in Africa are girls. HIV/AIDS is more common in cities, where promiscuity-linked diseases (such as tuberculosis) spread with urbanisation.
Condom use is still infrequent (less than 20% in high-prevalence countries).
75% of HIV-positive men in four high-prevalence African countries admit recently having unprotected sex.
According to a study conducted in Abidjan with the support of Unicef, HIV/AIDS is more prevalent among the best-informed, best-educated and richest young people.
75% of Africans aged 15-44 do not know their HIV status. Among those aged 15-24, only 10% of boys and 15% of girls have taken an HIV test.
Only 25% of eligible patients in central and western Africa take antiretroviral treatments. (20% of HIV-positive pregnant women take them for their own sake, 33% of them to prevent the transmission of the virus to their child.)
Africa accounts for 50% of deaths among pregnant women and deaths due to complications arising from abortion procedures worldwide. Africa has the highest rate of teenage pregnancy (girls aged 15-18) worldwide. 97% of abortions in Africa are carried out under poor conditions.
Africa accounts for 91% of deaths from malaria worldwide (including 87% of deaths among children under 5, according to the World Health Organisation).
Africa is short of healthcare workers: Africa accounts for 25% of the global shortfall, and has only 3% of all healthcare workers worldwide.
Sources: MDG Africa and Global reports; Measuredhs.com; “Financing Global Health 2012: the end of the Golden Age?”, Institute for Health Metrics and Evaluation, University of Washington, Seattle, February 2012
Dominique Kerouedan
Savoirs Contre Pauvreté chair at the Collège de France and author of Géopolitique de la Santé Mondiale (The Geopolitics of World Health), Fayard, Paris, 2013. She also edited Santé Internationale: les Enjeux de Santé au Sud, (International Health: the Health Issues Facing the South), Presses de Sciences Po, Paris, 2011
Translated by Charles Goulden
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