Crisis
In Search of A New Synthesis
-Ajit Abhyankar
Jean
Paul Sartre a French Existentialist Philosopher and member of militia fighting
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 Corona 19
is undergoing the same experience today. All are facing the house arrest under
lock down facing the same fear, anxiety and mass threat to life although poor
are the most vulnerable sections to suffer the most and the worst. Lenin,
commenting upon the Russian Revolution
had observed “there are decades in human history when nothing happens
and then there are some weeks when decades happen”. These are those weeks under
Covid19 lockdown when the decade full of history is moving fast forward.
The
question before us is are we facing a crisis of mere survival or of
authenticity of human existence as a global community, as was indicated by
Sartre in 1944 ?
But why is Covid19 so
serious ?
Pandemics
are not unknown to mankind. Human history has witnessed serious epidemics such
as Bubonic Plague killing 1/3 of European Population( 1345-1350 ), Spanish Flue
of 1918 -19 killing about 5 crores in the world, of which 1.75 crore were
Indians constituting about 5% of then
Indian Population. AIDS-HIV virus has killed so far 3.20 crores of people since
its major incidence from 1996 averaging about 1,40,000 deaths per year for last
24 years. In 2009 H1N1 swine
flu virus had infected as many as 1.4 billion people and killed more than 1,51,700
people across the globe.
The
Carona death toll at the global level till today is 1,61,784 (19th
April ) which relatively appears to be a very small number in comparison to the
pandemics of Spanish Flu and Bubonic Plague. If so, why has the world become explosively sensitive to this pandemic?
Why this total close down of social life ?
Although
generation of Covid 19 pathogen is an act of nature, the aftermath & trauma
it has caused for human race was more of than avoidable. During Bubonic
Pague(1345), Spanish Flu(1918) pandemics, humanity had no clue of viruses
,their vaccine, medicine or even prevention. Now hospitals can diagnose the new symptoms
and new diseases immediately on their occurrence. The research laboratories can
identify and find the RNA sequence of any virus/ bacteria within a week and can
share the same all over the world in a few hours and the vaccine of medication
can be worked upon in weeks.
Covid19 stuck in spite of astonishing
strides of human knowledge in virology and capability to intervene at a flash
speed; 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)Sept 2019 says “ 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 anti virals 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 !
Five
major policy shifts in last 2 decades are visible across the globe, barring of
course a few countries.
1. Shift from Public
Health To Medical Care. Public Health and
Medical Care are two aspects of health care systems.Medical caere Public health
and its research has a
prime focus on major threats to the health of populations. Its research moves
between laboratory and 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 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
corporate houses. The world finds itself an absolutely helpless situation in
any pandemic as the institutional and policy framework for community health and
preventive health care is conspicuously absent across the globe .For example the
UK spends £97 billion of public money on treating disease, while only £8
billion on preventing it[1].
From the perspective of private sector, the public health issues symbolize the
‘cost’ and medical care becomes an opportunity for profit. Therefore for last
two decades even the public money for health care is spent on funding insurance
premium/subsidizing hospitalization expenses of the poor which ultimately goes
into the kitty of the private sector hospitals and pharmaceutical companies. 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 have
systematically been either hijacked or paralyzed for the want of funding and
policy support by this policy shift mimicking what Covid 19 does to your lungs
inside the body. Consequentially even the international bodies such as WHO were
made toothless and proved to be utter
failure of preventive actions on global scale in spite of the some efforts made
in that direction.
2. Shift Form Innovative
Companies To Big Corporate Giants – Last two decades have seen the fattening of big
Pharmaceutical companies effected through mergers and takeovers. These
takeovers more than often are found to be motivated by suppressing or
preventing the cheaper and better
innovative alternative drugs in the markets. One such take over has been
directly responsible for the non availability of life saving ventilators in
treating Covid cases. Following is the account of how such a takeover
exemplifies this phenomena.
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 onwards, had warned the governments about the requirements
of medical equipments and protective gears. Accordingly US agency Centre for
Disease Control (CDC) in 2008 ,decided to have a stock pile of 70,000 small and
affordable ventilators. After negotiations contract was given to a small
company Newport from California, specializing in ventilators to supply 40,000
ventilators @$ 3000/- per piece. This design was an innovation and was cheaper
than the existing market price of $10,000/- a piece. 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 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 priority list of any of the Government
Agency. Later somehow the contract was given to Phillips. No ventilators necessary
for preparation against a pandemic designed in 2011 could reach US till 2020 in
spite of millions of public funds spent for the same. Ironically after thousands of US citizens lose their
lives for the want of ventilators, first assignment is due in May2020!!![2]
It should be remembered in due
course Covedian was taken over by Medtronics which shifted its corporate office
to Ireland, a tax heaven, to siphon off the profits from USA for a clear motive
of tax avoidance. This itself shows the criminal culpability behind such take
over.
This example of
Covedian killing the innovation and possibility of cheaper ventilators is not
an exception, but a rule in 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 a one-time hemophilia. This treatment was cutting directly
into the Roche’s hemophilia drug
Hemlibra which is required to be administered every four weeks. No wonder the
one time treatment on hemophilia now is put on shelf forever so that Roche
continues to get enormous super profits at the cost of mental and financial
burden on the hemophilia patients!![3]
3.
Shift From Public Medical Care To Private Insurance Based
Medical Care- It is the privatization of health care and its
intellectual framework that has failed humanity and not Covid 19. 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 upon 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, hospital 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 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.
4.
Shift From Global Vision of
UNO To LPG vision of WTO –After the two
devastating World Wars an
international consensus was attempted with the formation of 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, 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 commercialization of all public
spheres of life including the public goods such as health, education, water,
rivers etc. 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 pandemic such as Covid-SARS-MERS-H1N1 in spite of warning bells ringing loud and
clear from 2007.
5.
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 a $ 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 last 20 years. The super profits of these companies have become
major health hazard in itself. 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
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 tax payers. It is
revealed through this letter that the $ 700million. The letter also point out
that unjustifiably high drug prices are one of the most pressing public health
concerns 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.
Conclusion
Unfortunately even bigger crises are waiting next door. The
pandemic of Covid may look dwarf with 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 new vision, new ideas, new synthesis.
Calamities
shape societies because systems are
created and obliterated. The current world order which is based deregulated
markets, 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 human future. As Noval Yuv
Harrari has observed in his book 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 German Ideology
that the ideas when grip the imagination of masses they become a
material force in history.
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 nuclear arms race. Unfortunately Einstein died within one week
of signing the manifesto. The scientists and philosopher thinkers had warned in
the manifesto “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.”
Devastating world crises have always acted as
power houses for new philosophies, ideas for new institutions and ways of life.
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 !
Covid 19 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. 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 round the corner last 3
decades. This reminds us what Victor Hugo, a great writer and social thinker of
18th century has said ‘ No force on earth can stop an idea whose
time has come.’
Covid 19 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 round
the corner for last 3 decades. This reminds us what Victor Hugo a great French
romantic poet and thinker of 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
a telescope in the hands of an intriguing mind targeted at the skies changed
the world history, humanity needs to project its gadgets and powers in the
right direction.
-Ajit Abhyankar
