RECLAIMING A HOLISTIC POLITICAL NARRATIVE FOR THE FUTURE OF GLOBAL HEALTH

Introduction

This paper is written at the invitation of the Society for International Development (SID). For the benefit of general readers, it is important to introduce SID and the reason why I was asked to write this paper, and why I agreed to do it.

SID is “an international network of individuals and organizations founded in 1957 to promote socio-economic justice and foster democratic participation in a development process aimed at inclusiveness, equity and sustainability.”

It is because I share the values and vision of SID that I agreed to accede to their invitation. I was also excited by the title of the paper SID suggested. There is a significant phrase in the title that is challenging – “Holistic Political Narratives”. It says a lot. It is a critique of the dominant partial and factional narrative. So this paper applies the holistic and political to the very important issue of health at the global level – an issue made critical by Corona-19.

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I am not a medical doctor or a health specialist.  I am a teacher from Uganda. Besides teaching, I’ve been involved for nearly fifty years in the struggle for the liberation of my country. While we have gained political independence, we are still owned and controlled by global finance capital and corporations. Liberation is still a long struggle.

SID approached me because of my book titled Trade is War.  In her letter to me Nicoletta Dentico who leads SID’s global health program, said:

More particularly, I would suggest that you might be writing a piece on the pathogenic driver of trade, in relation to health. Your book on trade as a war of the West against the world is not only a powerful metaphor but a compelling representation of trade’s sickening reality on people, governments and societies.

So although I am not a medical person, I took up the challenge. I will develop the argument on why international trade is not what it appears at first sight.  It is not possible to understand trade unless we have a deep understanding of how the global political-economy operates at a systemic level.

This is quite complex. The system appears to be in control of those who hold state power – like Trump, for example. But underlying the state are several layers of financial and technocratic power-holders. For example, Jeff Bezos, the founder of Amazon is worth: $116.9 billion; Bill Gates, Co-Founder of Microsoft is worth $99.9 billion; Warren Buffett is worth $70.5 billion. They – not Trump – are the big players at both the economic and political levels. Admittedly, they give a lot to charity. But charity is not just to placate their “social conscience” – that’s only what meets the eye. Their exploitation of the working classes and the marginalised sections of the population go deeper than the eye level.

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The paper is divided into eight parts:

1. A parallel between Coronavirus and the Black Plague
2. The Dominance of the Global Pharma Industry

III. The “free trade” fiction

1. The Nexus between Capitalism and Coronavirus
2.  A Silver Lining
3. Challenges and Possible Openings

VII. Summing up

VIII. Moving Forward

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I  A parallel between Coronavirus and the Black Plague

Let us not joke about Coronavirus. I say this because people like President Trump (he is not the only one) are not serious. Coronavirus poses an existential threat to the present epoch. Instead of working together, the top political leaders of our world are pointing fingers at one another – playing an idiotic “blame game”.

The closest parallel I can think to Coronavirus is the Black Plague of mid-14th Century. It was a devastating global epidemic of bubonic plague that struck Europe and Asia.  It eventually ended serfdom in Western Europe by 1500.

Is what we are going through now the beginning of the end of our global system? Are we witnessing a tectonic, epochal shift?

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There is a kind of replay of some aspects of the 14th Century black plague and today’s Coronavirus. The Black Plague was aggravated when 12 ships from the Black Sea docked at the Sicilian port of Messina. 700 years later – on 2nd September 2013 – 2,750 tons of ammonium nitrate came by ship and landed at the port of Beirut. The ship was abandoned by its owner, a shady businessman. The Lebanese Government knew nothing about this. On August 4, 2020, an unknown missile exploded at the warehouse holding the dangerous chemical. It caused a total destruction of the port – the nation’s key trade lifeline – as also the main grain silo. Hundreds of people died and thousands were made homeless. At the time of writing, Lebanon had only two weeks food left.

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I don’t want to make too much of the uncanny parallel between the 12 ships from the Black Sea that docked at the port of Messina 700 years ago and the 2,750 tons of ammonium nitrate in a ship that took almost the same route and landed at the port of Beirut in 2013. Seven years later, it exploded. At the cost of repeating let me say that instead of joining hands the world’s leaders are pointing fingers at one another. It is true that France’s Macron went to Lebanon as a gesture of “solidarity”, but we all know that he is in the pay of Rothschild that has its eyes on Lebanon’s trillions of dollars’ worth of real estate.

We’ll come back to this again later. For now, let us move on.

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There are two points I want to make before going to the next section.

1. One cannot fully understand the post-Corona tragedy without putting it in a proper geo-political context. We live in the Capitalist era. The global corporations that rule us put profits before people – People’s Lives Don’t Matter (PLDM). This is a global parallel to Black Lives Don’t Matter (BLDM).
2. In its background paper the Society for International Development (SID) has made some important observations, namely:

• COVID19 has imposed health right at the centre of the international community agenda.
• COVID19 has crossroad with climate, food, finance, gender, racism, trade and global governance.
• A dramatic nexus between viral pandemic and ensuing global effects on broken economic and social structures of inequalities

I agree with these, especially with the second half of the last point. Indeed, the pandemic has “broken economic and social structures of inequalities”.  If I may add, it has also “broken” promises by those who hold state power – in the global South as well as in the North. There are exceptions, of course, like Cuba, Vietnam and Eritrea – but to these we shall come later.

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1. The Dominance of the Global Pharma Industry

I have studied global trade in great detail in Trade is War (2015, 2019). The chapter most relevant to this issue is chapter 4: “Technology and Intellectual Property Wars”. The Chapter starts with:

One lethal weapon in the arsenal of the West’s trade war against the Rest is intellectual property (IP). The common heritage of humanity—including the seeds for food and medical knowledge—is turned into property under capitalism, to be bought and sold as “IP.”

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Here I want to narrate my own experience for over forty years – first in Zimbabwe working with the Zimbabwe National Traditional Healers Association (ZINATHA), and then in Geneva fighting with the World Trade Organisation (WTO), and the World Intellectual Property Organization (WIPO).

In Zimbabwe, I witnessed representatives of pharmaceutical companies (all from the West – such as Novartis, GlaxoSmithKline, and Pfizer) descending on the villages where ZINATHA was active. I discovered that they were working on antiretroviral drugs for HIV/AIDS. They took away herbal samples free and got free advice from the ZINATHA. On top of this they took free blood samples “in the interest of science.”  These were then used to produce medicines (less effective, if I may add, than the natural herbs). These were then sold at exorbitant “monopoly” prices.  This is equivalent to daylight robbery.

I was also involved in a case in South Africa. It was a “war’ (yes, war using economic power) between Novartis – the Swiss multinational pharmaceutical company – and the South African government. Novartis was complaining that South Africa had allowed CIPLA (an Indian pharma company) to market cancer drugs.  CIPLA produced generics (as opposed to drugs protected by the laws of “intellectual property”).  So CIPLA was able to sell the drugs at a fraction of the price charged by Novartis. Access to CIPLA’s antiretroviral medicines was vital for providing life-prolonging treatment to more than 1.5 million patients.

In 2012, taking advantage of South Africa’s adherence to TRIPS, Novartis took the government to court.  The Court ruled in favour of Novartis. The odds were against the government.  What followed then was a lesson in “people power”. The people took to the street in protest against the Court’s verdict. I flew from Harare to Johannesburg to join the protest.  The people won! People DO Matter (PDM)

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In order to get a sense of global corporations’ domination over our lives, I reproduce the concluding section of this Chapter from my book.

1. “Property rights confer control over resources. The owners can then exploit these pretty much as they will. In the present capitalist system, the intellectual property regime has resulted in surrendering people’s knowledge of the world’s seeds and biodiversity (to name only two things), which are part of the “global common,” to the will of mega corporations. The IP system is a relatively new development even within the evolution of capitalism. It violates all principles of natural justice, and it is dangerous for millions of poor people. It must be phased out.
2. The notion that without IP protection, innovation would be stifled is an ideological position created and propagated by those that benefit from the privatisation of knowledge. I came to a diametrically opposite conclusion over two decades of work with farming communities in Tanzania, Zimbabwe, Botswana, and much of eastern and southern Africa. Ordinary peasants and workers are amazingly innovative and productive, until their resources and knowledge are appropriated and corporatized, and the people enslaved to earn profits for corporations.
3. The institutions of global governance, including the WTO and the WIPO, are creations of an asymmetrical world dominated by the early industrializers of the imperial North. They have no interest in helping the South to industrialize and compete against them in the exploitation of the world’s diminishing natural resources. Attempts by the countries of the South to challenge this system have provoked aggressive action by the industrialized West, in ways that can justly be described as acts of war. They use the existing legal order that they created to criminalize those that fight against the unjust system. The examples from the seed and pharmaceutical industries provide ample evidence of this. The North tries to divide and rule the South. When the South, against all odds, manages to unite and fight back (as in the WTO and the WIPO), the West counterattacks using its money and market power, directly or through institutions such as the World Customs Organization, the Global Congress on Counterfeiting and Piracy, SECURE, and several other Western-dominated organizations.
4. International regulatory regimes, such as the Kyoto Protocol and the Biodiversity Protocol, are too weak against the big and powerful players like the US and the EU and their mega-corporations. This is not an argument for not trying to change the trade regime through the WTO—for although the WTO is unreformable, it is politically imperative that it must be constantly challenged—or the IP regime through WIPO, or the climate regime through the United Nations Framework Convention for Climate Change. This is a cautionary note against putting too much faith in these institutions. Developing countries must have faith in themselves. They must harness their own innovative capacity and build alternative models of development, while always trying to abide by their international obligations as interpreted in a fair manner, while working toward a just and humane global society.”

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III. The “free trade” fiction

I will start with a question: where does knowledge come from?

I have taught at various Universities in the West as well as in Africa. In the 1970’s I was teaching at the University of Dar es Salaam. Like most of us, I thought knowledge came from books. Reality soon caught up with me – like a rude awakening. Books on the social sciences are simply a rendition of the authors’ experiences in books and papers, and therefore influenced by their political and ideological orientation. Since 90 percent of the books in the Social Sciences come from Western authors, naturally they become the “custodians” of knowledge. The rest of us are largely marginalised.

What changed my thinking about academia was our struggle against Idi Amin Dada – a petty soldier who rose up to higher ranks and then was put in power in Uganda by collaboration between Britain and Israel.  Amin is known as the “Butcher of Uganda”. In 1979, I joined the struggle against the “Butcher”. I quit the academia.

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We are still struggling for liberation of our country. Uganda has won political independence, but its wealth – including precious metals and pharmacological resources – are owned by global finance capital.

So in writing this paper I draw on my own experience. I don’t write for academia. My books (Trade is War and Common People’s Uganda) are drawn from my own engagements – together with people and NGOs involved in solidarity with our struggles. Academia – especially in the social sciences such as economics and political “science” – are abstractions from reality. These abstractions are an impediment to real battles on the ground.

We in Uganda are still struggling for liberation. Uganda has won political independence, but its wealth – including precious metals and pharmacological resources – are owned by global finance capital.

My research on the WTO and practical experience in the area of trade and trade negotiations has given me interesting insights that might be useful in our search for a “silver lining” to which I come in part V. Here, briefly, are the lessons I learnt while I was heading the South Centre in Geneva for five years.

1. Trade has not always been war; it does not have to be. We need trade.
2. Under capitalism trade has become as destructive as the weapons of mass destruction. Under Capitalism trade has never been free or fair. Free Trade is a fiction.
3. In 1776 after it gained independence the US defied British-imposed “free trade”, and within the next 50 years, it became an industrialised country. In the 1960’s most of Africa became independent. At the time it had some manufacturing capacity. After 50 years of independence Africa got deindustrialised. We were forced under the neo-liberal regime of “globalisation” to lower down tariff and quota protection of our industries.
4. Free trade fiction has destroyed African economics.

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1. The Nexus between Capitalism and Coronavirus

The global political system is close to anarchy

We reasoned earlier that one cannot fully understand a natural catastrophe like the Coronavirus without putting it in a proper geo-political-economic context. We live in the Capitalist era. Before we go to the last section on how we move forward, it is important that we have some understanding of the nexus between these two formidable forces. It is no exaggeration to say that one or the other has to go: Capitalism will either conquer the Coronavirus pandemic, or it will succumb to it. Both are evil. We have to fight both.

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Earlier we saw how the mid-14th Century Black Plague eventually destroyed serfdom by 1500. The question I asked is: Are we going through the beginning of the end of the Capitalist system? Are we witnessing a tectonic, epochal shift?

This is, of course, a complex question. We cannot fathom its complexity in this paper.  We will very briefly explore the link between these, but we assume that both are with us for the foreseeable future.

The pandemic has severely challenged the management of the capitalist system –let alone the global health system which is the theme of SID’s quest for a “Holistic Political Narratives for the Future of Global Health”.  I have given a narrative from my personal experience over the last five decades.

Let us be clear about one thing. The power-holders of the capitalist system – (the United States, Europe, Japan, Russia and China) really have no clue how to manage the global system.  The US and Europe do not know how to manage even their national systems.

I do not wish to go into this in any detail, but we cannot deny the relationship between economics and politics.  In any case, each country is trying to manage its own backyard. The global capitalist system is in a state of disarray. It is in a state of anarchy.

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Marx, Mao, Keynes and the Neoliberals

Marx taught us that the “Base” (the productive forces of science and technology) determines the “Superstructure” (the state and governance). Mao taught us that in the short run it is possible for the Superstructure to shape the Base. Keynes taught us that governments need to increase state expenditures and lower taxes in order to stimulate demand and pull the global economy out of depression. All three had one thing in common: the relationship between economics, politics and the role of the state. This is contrary to the neoliberal economists who advocate that the state must not interfere with the economy: the private sector and free trade will sort out things by a merry-go-round “laissez faire”.

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War of all against all

Let us start with the proposition that the global capitalist system is in a state of disarray, . As the 16th century English philosopher -Thomas Hobbes – in his famous book Leviathan said: “There is war of all against all” (Bellum omnium contra omnes).

This is where we are today.

Instead of co-operating to face the challenge of the Corona crisis and helping the poor and the marginalised sections of our societies, nations are warring against one another. The most coveted site of war is the Corona vaccine. The media has dubbed it as “vaccine nationalism”. What the media does not explain is that this is linked to the battle for the right to “intellectual property” – an issue we covered earlier. Most of the research is done at universities and state-funded research and vaccine testing institutions. But when the product is found the pharma giants rush to “own” it and make huge profits from “IP-patented” vaccines. The tax-payers pay the bills, the corporations collect the profits.

This is one area SID might want to explore further.  Its phrase “The pathogenic driver of trade, in relation to health” is most apt. It is not only pathogenic but also pathetic. This is happening, coincidentally, with the rise of “National Populism” – sadly joined by sections of the political “left”.

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Who manages theWestern so-called “democracies”?

Earlier we saw that the Neoliberals are on a “laissez faire” merry-go-round. The pathetic point about the Neoliberals is that although they want to delink politics from economics, they are hypocritical for their position is politically and ideologically for the benefit of the “private sector”. I must add here that the World Bank and the International Monetary Fund (IMF) are also double-faced. They are just as ideological as the corporate masters they serve.

Let me dwell a bit on what this merry-go-round carousel running into circles amounts to with a few examples of how the capitalist countries are handling this circus.

• Escalating debts (public and private) to “save” the economy
• Downward pressure on workers’ wages.
• Monetary policy and quantitative easing (QE): a sophisticated term to confuse people. What it really means if simply printing money to increase “liquidity”.
• The financial sector is investing in asset markets rather than in productive sectors, risking banking crisis and bubbles – like the 1990’s “housing bubble” in the United States.
• Negative interest rates: banks charge you interest to keep cash with them, rather than paying you interest. On the other hand, low interest rates encourage clever speculators to park their hoarded money into safe tax heavens, and then borrow money from banks at zero interest for further accumulation.  What a world!
• Austerity measures to save the financially -starved state treasuries. This has had disastrous consequences – such as the virtual demise of UK’s National Health Services (NHS)

I can go on and on. The underlying problem is that finance capital manages Western so-called “democracies”. Effective power lies not the people but in

the hands of those who have money for lobbying members of, for example, the British Parliament and those of the US Congress. Western political classes have lost credibility. But the merry-go-round goes on and on.

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1. A Silver Lining

The SID paper has an important working title: “Reclaiming a Holistic Political Narrative for the Future of Global Health”. SID should be commended for taking this positive and creative stand. The Capitalist terrain is nowhere near a “holistic political narrative”. It is all about politics of conflict and power.

SID and the Capitalist system are at opposite ends of the humanitarian divide.

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Learning from Uganda’s experience

Under the “free trade globalisation” policies imposed on Uganda by the World Trade Organisation (WTO) and Western “development” aid donors, the country has been obliged to remove all protection of its industries and now Uganda (like the rest of Africa) is deindustrialised. [1]

Take the textile industry. It was flourishing in the period preceding and following Uganda’s independence. We had 6 textile mills vertically integrated from spinning, weaving, to production of fabric, to clothing.  Then came the WTO and imperial invasion. At its peak in 1972/3 the textile industry consumed approximately 400,000 bales of cotton per year; now it is down to 15,000 bales (barely 3.8%). This has virtually destroyed cotton production and the livelihood of thousands of peasant-farmers. The same misfortune has visited Uganda’s other agricultural products and the farmers producing these.

Enter the post-coronavirus situation – post March 2020. The ground has shifted. The coronavirus is bad for Uganda’s external traders. They cannot import cheap raw materials from Uganda, nor export their industrial products. But for Uganda coronavirus is a blessing in disguise. It is a true “silver lining”.

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Let me relate my experience. I was in Europe from 2005 to 2020 – first in Geneva and then in Oxford, UK. I have come back to my country of birth – Uganda. I am now working with the Government on “Domestic Value Added Import Substitution Industrialisation” to restore our industries.

President Museveni had already seen the silver lining.  On arrival I met him. He gave me two papers he had authored. One is titled the “Real Economy V/S Vulnerable Economy”[2]; and the other “The history of economic thought funny position of pseudo neo-liberals in Uganda and Africa.”[3] In the first paper he takes a regional East African perspective. For example, Uganda’s Iron-ore, he said, should be carried by train to Mombasa to meet imported coal there to make cheaper steel for East Africa. “Patriots and Pan-Africanists”, he said, “should “disregard nonsense touted by neo-colonial agents – the parasitic system.”  [Italics added]. In the second paper, he talked about “Anarchic liberalism” that advances the idea of “micro-economics” and “private profitability” regardless of their “macro-economic distortions.”  On a point relevant to the subject of this paper, he said, “Why should we import even medicine? Why not make it ourselves? ”

I have two reasons for quoting the President.

One: Earlier when talking about where knowledge comes from, I stated that “Since 90 percent of the books in the Social Sciences come from Western authors, naturally they become the “custodians” of knowledge. The rest of us are largely marginalised.”  It is difficult to marginalise a whole President.  Museveni has the authority of state power. But more importantly, he is talking on the basis of the reality on the ground, not from some abstract theory of “pseudo neo-liberals”.

Two: The President is able to talk this language because he can see the silver lining around the dark clouds of the Coronavirus. Coronavirus has weakened the iron fist of the Empire. He is able to tell “Patriots and Pan-Africanists” to “disregard nonsense touted by neo-colonial agents – the parasitic system.”

Both these reasons fit into the theme of the paper: “Reclaiming a Holistic Political Narratives for the Future of Global Health”. Economics cannot be abstracted from politics.

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I am now part of a working committee that is looking into the of local value-added import substitution possibilities. Uganda’s imports and exports are declining. A monthly Bank of Uganda report shows that in March 2020 imports suffered a 10 per cent decline to $492m (Shs1.8 trillion). This was lower than $522m (Shs1.9 trillion) earned in February and $543.7m recorded in January. Exports also declined by 11 per cent to $315.2m (Shs1.1trillion) down from $356.1m (Shs1.3 trillion) recorded in February and the $386m (Shs1.4 trillion) earned in January. A high import bill of Shs28.5 trillion in 2019 according to the finance ministry report, has denied Uganda an opportunity to create more jobs as local firms lose out market to foreign factories and traders.[4]

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1. Challenges and Possible Openings

In the previous section I commended SID for advocating a holistic political alternative narrative to the dominant paradigm on the future of global health. I’ll take one more sentence from their email to me to guide us for this section. It is the need for us “… to repoliticize health to morph towards universal social protection, human dignity and economic development.”

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The Current Situation

Let us start with the World Health Organisation (WHO). It puts out a daily report on how the situation is developing on many fronts. Director-General Dr Tedros gives us an objective and (if I may add) on the television, a passionate analysis of the challenges we face.

On 9 August, for instance, the Situation Report 182 was on the International Day of the World’s Indigenous Peoples. This is an annual event to raise awareness of the needs and rights of the world’s indigenous populations. The Report mentions a recent UN News article which discusses how the COVID-19 pandemic has made indigenous Hawaiians reflect on their heritage.

The next day’s Report (183) cites 20 million COVID-19 cases recorded so far. The comment by Dr Tedros stressed that “…behind these statistics there is a great deal of pain and suffering”. This is very important – to bring out the human dimension, and not treat them as just “cases”.

The following day’s Report (184) talks about 390,000 people killed in the Americas, and how this is threatening regional plans to eliminate and control infectious diseases including tuberculosis, HIV, hepatitis and others. The Report has other news items, including:  “The members of the Diagnostic Consortium – WHO, UNICEF, United Nations Development Programme (UNDP), the Global Fund, the Global Drug Facility and other partners have procured and shipped:18 million polymerase chain reaction (PCR) tests to 83 countries, and 4 million sample collection kits to 78 countries.” This is important and very useful.

Let me repeat: the World Health Organisation is a good and humane sources of information and analysis on the global pandemic.

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Vaccine nationalism

Vaccine nationalism has become a hot issue. We have touched on it briefly in the section on “War of all against all”.

An interesting article by COVAX (COVID-19 Vaccines Global Access) has a sobering introduction:

“Developing a vaccine against COVID-19 is the most pressing challenge of our time – and nobody wins the race until everyone wins.”[5]

Exactly. We should repeat this sentence in our minds until it becomes a cognitive force to reckon.

The article makes a couple of other points:

• “Global equitable access to a vaccine, particularly protecting health care workers and those most-at-risk is the only way to mitigate the public health and economic impact of the pandemic.”
• COVAX  needs $2 billion in donations to pay for the vaccine doses in 90 countries. It is a facility that countries need to sign on.
• Then follows this: It seeks “to entice rich countries to sign on. But it’s unclear how many rich countries will join… money and national interest may win out…The United States and Europe are placing advance orders for hundreds of millions of doses of successful vaccines, potentially leaving little for poorer parts of the world. … (The) rich countries’ biggest concern is to protect their own citizens”.

This should surprise nobody.

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Let me introduce you to another article.

Rebecca Weintraub, Asaf Bitton, and Mark L. Rosenberg’s piece on “The Danger of Vaccine Nationalism”[6] broke my heart.  I agree with everything they say as to what should happen, but I know, alas, that it won’t happen.

Nonetheless I give some excerpts from the article because they deserve serious consideration.

• “This ‘vaccine nationalism” is not only morally reprehensible; it is the wrong way to reduce transmission globally.”
• In the UK AstraZeneca developed a vaccine. On May 21, the US pledged $1.2 billion to have priority access to at least 300 million doses. The pledge is part of the Trump administration’s Operation Warp Speed for securing vaccines for Americans as early as possible.
• In 2009, the H1N1 virus, also known as Swine Flu, killed as many as 284,000 people worldwide. A vaccine was developed within seven months. “High-income countries directly negotiated large advance orders for the vaccine, crowding out poor countries.”

Here are two excellent suggestions with which I agree.

• “Experts in epidemiology, virology, and the social sciences – not politicians – should take the lead in devising and implementing science-based strategies to reduce the risks that Covid-19 poses to the most vulnerable across the globe and to reduce transmission of this novel virus for all of us.”
• “We must leverage our global governance bodies to aid in doing all this and planning and strengthening health systems to operationalize national vaccine campaigns. They include the WHO, the Global Fund, CEPI, and GAVI, and a wide array of country partners within health ministries, regional health systems, and the private sector…”

And so on. It is worth taking the time to download and read the above two articles – by COVAX and Rebecca Weintraub et.al.

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Cuba, Vietnam and Eritrea

In Part I “A parallel between Coronavirus and the Black Plague”, I talked about “broken” promises by those who hold state power – in the global South as well as in the North. However, I mentioned Cuba, Vietnam and Eritrea as exceptions.  I cite these not as “models”. What is so wonderful about their leaders is that they act on humanitarian grounds – not to make profit for their companies or to win kudos for themselves.

Cuba

Cuba is less than half the size of Uganda with less than half of Uganda’s population – 11.1 million to Uganda’s 28.4 million. But the most significant difference is that Cuba has practically no resources. Not even fresh water! It has to desalinate ocean water for domestic consumption. It has no gold or oil like Uganda has. And yet – and this is remarkable – it has been able to perform better than the United States when it comes to tackling Coronavirus, not only within Cuba but also helping other countries.

Cuba sent medicines and medical personnel to, for example, Spain and Italy which were refused help by the United States and the European Union. (Spain and Italy are members of the EU).

Here is a report worth reading in full.[7]

“Neither the northern Italian chill nor the unfamiliar language has deterred a young Cuban doctor who for the past two months has been helping in the fight against coronavirus in Europe, thousands of miles from home.

“Roberto Arias Hernandez, one of Cuba’s so-called “Army of White Coats” sent by his country in March to help Italy battle a spiraling epidemic of COVID-19, said he and his colleagues were “simply doctors.”

“Today it is our turn more than ever to play our role,” the 28-year-old internist told AFP on a recent morning, before starting his shift at the Crema Maggiore Hospital in the heart of Lombardy, the region hardest hit by the virus.

Cuba has invested in the pharmaceutical industry – based on its traditional knowledge and local herbs.  It has free medical service not just for their citizens only. American patients who cannot afford hospital fees in the US travel to Cuba and get free treatment.

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Vietnam

Vietnam has a complex history. During the Cold War the United States attacked Vietnam to try to defeat the Communist regime of Ho Chi Minh. The war lasted for 20 years – from 1955 to 1975 – until the US was defeated.

Coming to our times, it is generally known that Vietnam is very successful in controlling the Corona pandemic.[8]  Geo-politically, Vietnam occupies a strategic position in the region. But let us focus on the issue we are discussing, and what we can learn from the country.

Vietnam with a population of 95 million is tiny compared to China. But it is bigger than Italy which has a population of 60 million, and France 67 million.

• Italy had 253,000 cases; 203,000 recovered; and 35,234 deaths.[9]
• France had 212,000 cases; 83,848 recovered; and 30,234 deaths.[10]
• China had 84,808cases; 79519 recovered and 4,634 deaths[11]
• Vietnam had 930 cases; 471 recovered; and 22 deaths[12]

Let us look at some of the highlights of Vietnam’s strategy.

• Early awareness of the pandemic, appropriate, drastic and people-centric measures.
• Participation of whole political system & community in making pandemic prevention a priority.
• Vietnam developed its own testing kits as early as January 2020 by the Military Medical University and Viet A Co.
• People’s committees in cities and provinces – directing, guiding, inspecting – and preparing for second wave
• Special attention to help vulnerable, young people and patients stranded abroad.
• Revive economy to cut losses. GDP$262 bn; low inflation rate to help businesses, investors & people

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Eritrea

Eritrea is a very small country with an area of 117,598 sq.km and a population of 3.5 million. In 1991, it ended a 30-year war of independence from Ethiopia.

On March 21, Eritrea recorded its first COVID-19 case. To date it has 285 confirmed cases; 248 recovered; and no deaths.[13]  Eritrea has rigorous measures to contain the virus bases on the strategy of “blocking the transmission chain” of the virus rather than “mitigation measures”.

The reason I cite Eritrea’s case is that despite its size and lack of resources, it is self-reliant. Unlike most countries in Africa that have succumbed to the IMF – like South Africa and Zimbabwe that have enormous resources – Eritrea refuses to surrender its sovereignty.  It is a member of the IMF whose economists make annual visits to the country to collect data and willing to give loans to Eritrea. But – and this is significant – Eritrea has refused to be induced by IMF loans.

At least that was the situation until President Afwerki died of stroke on April, 2020. He was defiantly independent and dignified. Whether his successors will follow his path is difficult to say. The country will undoubtedly face increased pressure from the IMF and the West.

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In looking to the days and years ahead we should have at least a ten-year long term strategy and an immediate to one or two year’s short term strategy.

To chart out a long term strategy would require a whole new paper, possibly based on an in-depth discussion between some like-minded organisations and individuals.  So here I focus on the immediate.

Below are the main points from each chapter. Before I come to these chapters, let me give some quotes from Nicoletta Dentico’s email inviting me to join the discussion. It provided me with an important guideline on what is expected of me.

From SID:

• Reclaiming a holistic political narrative for the future of global health (also, therefore, the title of this paper)
• The pathogenic driver of trade in relation to health
• Promotion socio-economic justice and foster democratic participation in a development process aimed at inclusiveness, equity and sustainability
• Repoliticizing the centrality of health as a proven strategy to morph societies according to principles of universal social protection.

To this I added my comment: SID should be commended for taking this positive and creative stand. The Capitalist terrain is nowhere near a “holistic political narrative”. It is all about politics of conflict and power. SID and the Capitalist system are at opposite ends of the humanitarian divide.

Here, then, are the main points from the seven parts.

1. A parallel between Coronavirus and the Black Plague 

• Uncanny parallel between the 12 ships from the Black Sea that docked at the port of Messina 700 years ago and the 2,750 tons of ammonium nitrate in a ship that took almost the same route and landed at the port of Beirut in 2013
• Instead of working together, the top political leaders of our world are pointing fingers at one another – playing an idiotic “blame game”.
• Are we are going through the beginning of the end of our global system? Are we witnessing a tectonic, epochal shift?

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1. The Dominance of the Global Pharma Industry

• One lethal weapon in the arsenal of the West’s trade war against the Rest is intellectual property (IP).
• The common heritage of humanity (including the seeds for food and medical knowledge) is turned into property under capitalism – bought and sold as “IP.”
• IP violates all principles of natural justice, and is dangerous for millions of poor people. It must be phased out.
• Pharmaceutical companies (such as Novartis, GlaxoSmithKline, Pfizer and others) descend into African villages and take away herbal and blood samples “in the interest of science.”  This is daylight robbery.

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III. The “free trade” fiction

• “Free trade” is an ideological fiction. We need trade. But under capitalism it has become as destructive as the weapons of mass destruction.  It has destroyed the economies of the countries of the third world.
• It is not possible to understand trade unless we have a deep understanding of how the global political-economy operates at a systemic level, and who creates knowledge of the system.
• It is a complex subject dominated by those who think they have the monopoly of creating knowledge
• The global corporations that rule us put profits before people – People’s Lives Don’t Matter (PLDM). This is a global parallel to Black Lives Don’t Matter (BLDM)
• But people do matter (PDM). In 2012 the South African government buckled under the might of the giant Novartis pharmaceutical company. The Court decided in favour of Novartis. People took to the streets and got the Court to reverse its decision. The people defeated the Goliath.

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1. The Nexus between Capitalism and Coronavirus

• One cannot fully understand a natural catastrophe without putting it in a proper geo-political context. We live in the Capitalist era.
• The pandemic has severely challenged the management of the capitalist system – let alone the global health system.
• The global political system is close to anarchy – a continuous war of all against all (Thomas Hobbes)
• Marx taught us that the “Base” (the productive forces of science and technology) determines the “Superstructure” (the state and governance).  Mao taught us that in the short run it is possible for the Superstructure to shape the Base. Keynes taught us that governments need to increase state expenditures and lower taxes to stimulate the economy. By contrast, the neo-liberals advocate that the state must not interfere with the economy: the private sector and free trade will sort out things by a merry-go-round “laissez faire”.  The main text has examples of how this laissez faire system affects the workers and the poor, and puts the economy on a speculative spin-off.
• On Coronavirus, the text has analysis of how, instead of co-operating to face the challenge nations are warring against one another – dubbed it as “vaccine nationalism”. This issue is dealt with more thoroughly in Part VI: “Challenges and Possible Openings”.

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1. The Silver Lining

Learning from Uganda’s experience:

• “Free trade” globalisation destroyed Uganda’s industries – e.g. textiles with devastating impact on cotton production and lives of farmers.
• However, Coronavirus has now shifted the ground. It is bad for Uganda’s external traders. They cannot import cheap raw materials from Uganda, nor export their industrial products. But for Uganda coronavirus has been a blessing in disguise. It is a true “silver lining”.
• President Museveni quotes:

*”Patriots and Pan-Africanists should disregard nonsense touted by neo-colonial agents – the parasitic system.”

*”Anarchic liberalism” that advances the idea of “micro-economics” and *”private profitability” regardless their “macro-economic distortions.”

*”Why should we import even medicine? Why not make it ourselves? ”

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1. Challenges and Possible Openings
2. SID on the issue of how to move forward “…to repoliticize health to morph towards universal social protection, human dignity and economic development.”
3. The World Health Organisation (WHO) is a good and humane source of information and analysis on the global pandemic.

• WHO puts out a daily report on how the situation is developing on many fronts. Director-General Dr Tedros gives us an objective and yet passionate analysis of the challenges we face.
• Situation Report 182 – 9 August, 2020 on how the COVID-19 has made indigenous Hawaiians reflect on their heritage.

3. Vaccine nationalism is a hot issue.

• COVAX (COVID-19 Vaccines Global Access: “Developing a vaccine against COVID-19 is the most pressing challenge of our time – and nobody wins the race until everyone wins.”
• COVAX seeks to raise $2 billion. It is unlikely it will succeed. Big countries are concerned only about their interests
• Rebecca Weintraub, Asaf Bitton, and Mark L. Rosenberg’s piece on “The Danger of Vaccine Nationalism” :”This ‘vaccine nationalism” is not only morally reprehensible; it is the wrong way to reduce transmission globally.”
• In 2009, the H1N1 virus, also known as Swine Flu, killed as many as 284,000 people worldwide. A vaccine was developed within seven months. “High-income countries directly negotiated large advance orders for the vaccine, crowding out poor countries.”
• “Experts in epidemiology, virology, and the social sciences – not politicians – should take the lead in devising and implementing science-based strategies to reduce the risks that Covid-19 poses to the most vulnerable across the globe and to reduce transmission of this novel virus for all of us.”

4 Learning from Cuba, Vietnam and Eritrea

   Cuba: helped Italy (and Spain) when the US and the EU did not

• Cuba has practically no resources. Not even fresh water! It has to desalinate ocean water for domestic consumption. And yet it has been able to perform better than the United States when it comes to tackling Coronavirus, not only within Cuba but also helping other countries.
• Roberto Arias Hernandez, one of Cuba’s so-called “Army of White Coats” sent by his country in March 2020 to help Italy battle a spiraling epidemic of COVID-19, said he and his colleagues were “simply doctors.”

Vietnam: Highlights of its strategy

• Early awareness of the pandemic, appropriate, drastic and people-centric measures
• Participation of whole political system & community in making pandemic prevention a priority
• People’s committees in cities and provinces – directing, guiding, inspecting – and preparing for    second wave
• Special attention to help vulnerable, young people and patients stranded abroad.
• Revive economy to cut losses. GDP$262 billion; low inflation rate to help businesses, investors and people.

Eritrea: A self-reliant and dignified nation

• Eritrea’s case is unique. Despite its size and lack of resources, it is self-reliant.
• Unlike most countries in Africa that have succumbed to the IMF – like South Africa and Zimbabwe that have enormous resources – Eritrea refuses to surrender its sovereignty.  It is a member of the IMF, but it has rebuffed IMF’s offer of loans, and has maintained its dignity

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VII Summing up the main points of each section

Society for International Development (SID)

• The pathogenic driver of trade in relation to health
• Promotion socio-economic justice and foster democratic participation in a development process aimed at inclusiveness, equity and sustainability
• Repoliticizing the centrality of health as a proven strategy to morph societies according to principles of universal social protection

Part I. Parallel between Covid-19 and the Black Plague

• Are we witnessing a tectonic, epochal shift –like what happened 700 years ago with the demise of the feudal system in Europe?
• The global political leaders should work together to face the crisis.
• Instead, they are pointing fingers at one another – unlike leaders of small countries like Cuba, Vietnam, and Eritrea

Part II. The Dominance of the Global Pharma Industry  

• The West uses IP as weapon of trade war against the Rest.
• Humanity’s  common heritage of medical knowledge turned into property for profit
• IP violates natural justice. It must be phased out.
• Pharma giants steal African traditional knowledge. It is “daylight robbery”.

Part III. The “free trade” fiction

• We need trade. But under capitalism it is a weapon of mass destruction
• Under free trade people’s Lives Don’t Matter (PLDM).  Like Black Lives Don’t Matter (BLDM)
• But people do matter (PDM).
• The victims of free trade are on the path of systemic resistance.

Part IV. The Nexus between Capitalism and Coronavirus

• One can understand a natural catastrophe like Coronavirus only in a proper geo-political context – the Capitalist era under which we live.
• The pandemic has severely challenged the management of the capitalist system – let alone the world’s global health.
• The global political system is close to anarchy – a continuous war of all against all (Thomas Hobbes)
• Marx, Mao, Keynes and Neoliberals: Neoliberalism is the ideology of free trade warriors against world’s nations and peoples.

Part V. The Silver Lining

• Coronavirus: a blessing in disguise a “silver lining” for nations to reconstruct their industries destroyed by free trade
• Learning from Uganda: Rebuilding the economy through local  value added import substitution industrialisation

Part VI. Challenges and Possible Openings

• Vaccine nationalism is morally repugnant. Behind it lies the hand of big pharma companies fighting for patent right to maximise their proficts
• WHO is a good and humane source of information and analysis on the global pandemic.
• Developing vaccine: biggest challenge. Nobody wins until everyone wins
• Rich countries concerned  only about their interests
• All the above are challenges. The only possible opening is to learn, for example, from small countries such as Cuba, Vietnam and Eritrea.

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Part VII. Moving Forward

I have finished the analysis. Earlier I said that we need to have at least a ten-year long term strategy, but that would require a whole new paper based on an in-depth discussion between some like-minded organisations and individuals.

By way of concluding, I take up the issue of how we might organise an in-depth discussion suggested above. Of course, if my paper is accepted and published, it would get a good audience: SID well known amongst scholars and NGO activists.

Here are some ideas to explore:

1. We might want to reach a broader grassroots readership through the Social Media.  In recent years, it has become a powerful tool for social networking, using interactive computer-mediated technologies.  Indeed, with lockdowns because of Coronavirus the computer-mediated methods such as Zoom are becoming necessary. You read journal articles largely on your own. But Zoom-like methods are highly interactive, even if you sit at home alone with your computer.
2. I am founder of an organisation called Southern and Eastern African Trade Information and Negotiation Institute (SEATINI). It was founded on 1997 following the first WTO Ministerial Conference in Singapore. I am now retired, but the younger people who have taken over – the techno-generation – are very innovative. They talk about “target audience”, “grassroots community platforms”, and so on (all new to me) but they have hooked me up with these “online” networks. It is quite exciting.
3. There are experts who can help design an interactive platform. May be SID has done this already.
4. As I had said earlier, people believe that knowledge comes from books. But in the social sciences books are simply a rendition of the authors’ experiences. What I’ve written above comes largely from my experience. It would be good to have an interactive dialogue with people who have different experience from different environments.
5. A ten-year long term strategy would require an in-depth discussion between some like-minded organisations and individuals.

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Yash Tandon

Kampala

Uganda

[1] I should add that Uganda gets investments and development aid from China too. But China does not impose any IMF-type “conditionalities” on the country. It is true that Uganda’s market is inundated with Chinese goods, but that is because the WTO “free trade” has practically destroyed our protective umbrella even before China joined the WTO. China is reaping the benefits of the destruction caused by the West.

[2] www.google.com/search?q=Museveni+Real+economy+vs+vulnerable-economy

[3] www.yowerikmuseveni.com: history-economic-thought

[4] Ismail Musa Ladu and Dorothy Nakaweesi, “What are the possibilities of import substitution?”  Daily Monitor,  May 12, 2020

[5] https://www.who.int/initiatives/act-accelerator/covax

[6] https://hbr.org/2020/05/the-danger-of-vaccine-nationalism

[7] https://www.france24.com/en/20200517-young-cuban-doctor-helps-with-italy-s-battle-against-covid-19

[8] https://www.aa.com.tr/en/asia-pacific/vietnam-a-success-story-in-fight-against-covid-19

[9] https://www.google.com/search?q=italy+covid+19+cases

[10] https://www.google.com/searchFrance+covid+19

[11] https://www.google.com/search China+covid+19

[12] https://www.google.com/search/Vietnam+covid+19

[13] https://www.google.com/search/Eritrea+covid+19