Valdai Club

The crisis of the coronavirus was dangerous and it will have a serious aftermath.  But it also has a silver lining, at least for those who are willing to open their eyes. This crisis was indeed a moment of truth.

After years or even decades of neoliberal policies, with deregulations, privatisations, private public partnerships and cuts in social expenditures, almost all national governments were unprepared to tackle the pandemic. Even worse: they had no clue on how to do it.
In many countries of Western Europe, one of the richest parts of the world, there were no masks to protect health workers, there were no ventilators to care for the sick, there was no protective clothing for the doctors, many public hospitals lacked beds in their intensive care units while several private hospitals refused to open their doors. 

While clear guidance had been given by the World Health Organisation and several national public health services on how to prepare for and tackle a pandemic – after outbursts of SARS, MERS, Chikungunya…  – Ministers and their staff did not even know about the requirements.

Add to this, in a country like my own, Belgium, health competences are with 7 (seven!) different ministers. If ever evidence of incompetence and ignorance was needed, here it was. 

Capitalism unfit

While the stock markets continued to flourish, the real economy collapsed, because lockdowned people only buy what they really need! 

Informal workers, homeless people, asylum seekers, the poor and vulnerable lost their income and assistance and were left to charity.

Old people living in homes for the elderly were not taken care of. A large proportion of the dead in Western Europe died in places where they paid a high price for getting get help and protection. 

Again, if evidence was needed to show how unfit our economic, social and political systems were to protect people, here it was. Markets were not willing to provide what they promised.

 A common interest, a societal concern

What then is the silver lining?

For those living with their eyes open, it is crystal clear that health is not just an individual concern, but a common interest. Viruses live in society, they do not know borders and they know no classes. They can hit every unprotected person.

Secondly, a profit-seeking market cannot take care of a pandemic. As obviously care should be at the forefront, this is opposite to the profit objective of private health institutions. Once again, the role of the State or public authorities becomes crucial.

Thirdly, the people who sustain societies and take care of the sick, should be central in our social organisation: doctors, nurses, health workers but also drivers of public transport, cashiers in supermarkets, garbage collectors… But precisely these people have wages and working conditions that are among the worst. They deserve better.

Fourthly, if ever a vaccine becomes available, it should be widely available and affordable. In other words, patents should be considered a global public good and should not be appropriated by the private sector.

Interdependence

There are more reasons why health and health care should be considered global public goods. Health care is a common concern, it is in the interest of all, and we are interdependent.

One cannot cure a viral illness for one person or in one country, hoping it will never travel to a neighbouring country. If the pest of the 14th century took several years to travel from Central Asia to China and Southern Europe, today, it is a matter of hours. One cannot stop it. If one country does not do its work, peoples in other countries will be victims. 

The same goes for environmental problems. The destruction of the Amazon forest in particular and deforestation in general has consequences for all peoples all over the world. Forests are a global public good.

Or consider poverty. Even if the poor only rarely belong to the groups of migrants seeking a better life, it is clear that the lack of perspective for a better future is the main reason people leave their homes and villages in order to seek employment in a far off country. Wellbeing is a global public good.

The same interdependence plays between sectors. Still in the context of this health crisis, it becomes clear that housing and water are health concerns. As it becomes clear that the chemical sector can become a problem for the health of people. As agriculture and food are health concerns.

What this means is that as soon as one wants to protect the health of people, working on prevention, one cannot only look at doctors and hospitals. One has to look at the whole economy and one has to look at power relations in society. There is no objective reason why there are so many vulnerable people who are always the first victims of any problem arising in society, whether is a pandemic or whether it is climate change.

All this points to the need for a comprehensive approach that can only come from public authorities. One cannot expect a ‘free market’ to coordinate all activities and even make profit from it.

Health and health care, then, are crucial elements for which a whole range of other policies should be taken care of. In fact, this reasoning is valid for the whole of social protection which can become, within a comprehensive and thoughtful framework, a tool for change. Through its links with the environment and several economic sectors, it can be truly transformative.

What free markets cannot do, coordinate a wide range of sectoral activities, focused as they are on profit-making, public authorities can do. The condition is we consider them indeed as global public goods and are prepared to work in an intersectional way.

The institutional framework

There are other conditions. States can only be the advocates of public goods if they abandon their public management policies of the past decades. They should interiorize their role as protectors of people and of societies, in the same way as international organisations should be more than vehicles for inter-governmental coordination, but should become the heralds of global issues, from health to the environment, from the seas and oceans to the forests and mountains, from water to all natural resources.

What we need then is first, an awareness of the interconnectedness of issues and of our interdependence, an awareness of the need for comprehensive and structural policies and a re-emergence of States and international organisations willing to embody the common interest.

This means an institutional change with decent funding for autonomy, instead of being dependent on philanthropy. It means capacity for monitoring, data collection and preparedness for global health issues, such as pandemics. It means management with a long term vision.

And it means coordination between several institutions, from health to labour to trade and to women and children. They are all interlinked.

Progressive social movements from all over the world should push for these changes by working together and get organized. We can say whatever we want on what needs to be done, but it is urgent now to also show we can do it.