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Capitalism’s New Age of Plagues (Part 3)

Part 3 of a multi-part article on the causes and implications of global capitalism’s descent into an era when infectious diseases are ever more common. My views are subject to continuing debate and testing in practice. I look forward to your comments, criticisms, and corrections.

[Part 1] [Part 2] [Part 4] [Part 5] [Part 6]

“Never before has the world been so clearly forewarned of the dangers of a devastating pandemic.”
—Global Preparedness Monitoring Board, September 20201
Judging by the excuses we hear for governments’ failure to respond effectively to the pandemic, one might think that COVID-19 was an act of God, a natural event that no one could have anticipated. U.S. President Donald Trump said that it “came out of nowhere,” “just surprised the whole world,” and “nobody had ever seen anything like this before.” Because it was unexpected and unpredictable, he could not be blamed for being unprepared.

That is simply not true. As historian Kyle Harper writes,

the pandemic was a perfectly inevitable disaster.

No one could have known that a novel coronavirus would jump from animals to humans in central China late in 2019 and instigate a global pandemic. Yet it was bound to happen that some new pathogen would emerge and evade our collective defense systems. It was a reasonable likelihood that the culprit would be a highly contagious RNA virus of zoonotic origins spread via the respiratory route. In short, a destabilizing pandemic was inescapable, its contours predictable, its details essentially random.2

That expectation was so widely shared by experts on infectious diseases that just two months before the real pandemic began, the Johns Hopkins Center for Health Security hosted a pandemic simulation workshop, attended by government and business executives from around the world, involving “a novel zoonotic coronavirus transmitted from bats to pigs to people that eventually becomes efficiently transmissible from person to person, leading to a severe pandemic.” The fictional disease, which was based on SARS. killed 65 million people.3

COVID-19, which emerged soon after the workshop participants dispersed, is caused by a mutated RNA coronavirus that moved from bats to animals to humans. It is related to SARS but is more infectious. The similarities were so strong that when the real pandemic broke out officials at the Johns Hopkins Center felt compelled to issue a statement insisting that their scenario was fictional, not a prediction.

Zoonotic Acceleration

As we’ve seen, zoonotic diseases–caused by viruses and bacteria that originate in animals–have long affected humans. But something has changed in the Anthropocene–as Sean Creaven argues in Contagion Capitalism, we now face “zoonotic accelerationism … a speeding-up of the manufacture of new zoonotic diseases and the resurgence of older ones, and this therefore spells a corresponding deepening of global pandemic risk.”4 COVID-19 is the most recent manifestation of this deadly threat to human health.

Major zoonotic pandemics of the past five decades have included:

  • 1968, Hong Kong Flu. A new strain of Avian Flu was first detected in Hong Kong, then quickly spread worldwide, carried in part by U.S. troops returning from Vietnam. It killed about 1,000,000 people, mainly elderly. Variants continue to the present.
  • 1981, Acquired Immunodeficiency Syndrome (AIDS). Probably jumped from chimpanzees to hunters in about 1910, but had limited impact until a variant exploded in fast-growing Congo cities in the 1980s. Spreading next to Haiti, the U.S., and then worldwide, it has killed tens of millions of people and remains a major cause of death, especially in southern Africa.
  • 2002, Severe Acute Respiratory Syndrome (SARS). A coronavirus, part of a family of viruses that causes mild cold symptoms, was first detected southern China. It probably jumped from bats to an intermediate animal, then infected some eight thousand people in two dozen countries, killing about 800.
  • 2009, Swine Flu. A new influenza virus that emerged from hog farms in the United States and Mexico, then spread to over 70 countries. Close to one billion people contracted the disease, and between !50,000 and 575,000 people died in the first year. Unlike Hong Kong Flu, it is particularly harmful to children.
  • 2012, Middle East Respiratory Syndrome (MERS). A new coronavirus jumped from bats to camels to humans in Saudi Arabia. It spread to about two dozen countries, notably South Korea. About 2,500 people have been diagnosed, and of those 850 have died–a low contagion rate, combined with a very high fatality rate.
  • 2012, Ebola. Previously rare, a major outbreak of Ebola began in Guinea, Liberia and Sierra Leone, killing half of those infected. Spread to Europe and the U.S., killing over 11,000. Re-emerged in the Democratic Republic of Congo in 2018-2020, infecting 3500, killing two of every three.
  • 2015, Zika. First identified in 1947 in Uganda as a rare condition with mild symptoms: for sixty years there were fewer than 20 human cases. A mutated version emerged in Brazil in 2015, leading to a major pandemic that spread to over sixty countries, causing severe birth defects in babies born to thousands of women who were infected while pregnant.

Between 2011 and 2018, the World Health Organization tracked 1483 epidemic events in 172 countries–on average, one outbreak every two days.5 Most were small and ended quickly, but any of them, given the right combination of gene-copying errors and environmental conditions, could have become a regional or even global pandemic. There is a widespread consensus among epidemiologists, microbiologists and virologists that zoonotic diseases are increasing in frequency and intensity, which means that new epidemics are more probable than ever.

Disease X

In 2016, Dr. Jonathan Quick, chair of the Global Health Council, described the “gigantic threat” that a hitherto unknown pathogen could soon emerge.

Somewhere out there a dangerous virus is boiling up in the bloodstream of a bird, bat, monkey, or pig, preparing to jump to a human being. It’s hard to comprehend the scope of such a threat, for it has the potential to wipe out millions of us, including my family and yours, over a matter of weeks or months…

It could be born in a factory farm in Minnesota, a poultry farm in China, or the bat-inhabited elephant caves of Kenya–any place where infected animals are in contact with humans. It could be a variation of the 1918 Spanish flu, one of hundreds of other known microbial threats, or something entirely new, like the 2003 SARS virus that spread globally from China. Once transmitted to a human, an airborne virus could pass from that one infected individual to 25,000 others within a week, and to more than 700,000 within the first month. Within three months it could spread to every major urban center in the world. And by six months, it could infect more than 300 million people and kill more than 30 million…

Scientists don’t know which microbe it will be, where it will come from, or whether it will be transmitted through the air, by touch, through body fluids, or through a combination of routes, but they do know that epidemics behave a bit like earthquakes. Scientists know that a ‘big one’ is coming because scores of new, smaller earthquakes pop up around the globe every year…

Infectious-disease experts agree that under present conditions the question is not whether a superbug will occur and create a global pandemic. The question is when.6

In 2017, the World Bank warned:

We know that it is only a matter of time before the next pandemic hits us. We also know that there is a good chance that it will be severe. It may mean death on a slow fuse, spreading insidiously through populations, unrecognized for years, like HIV in the 1980s. Or it may strike people down with stark violence and lightning speed, plunging national economies abruptly into chaos, like Ebola in West Africa in 2014-15. Whatever its mode of attack, the next large-scale, lethal pandemic is at most only decades away.7

Also in 2017, the World Health Organization urged its member countries to focus R&D efforts on a short list of known diseases that could become pandemic and for which no vaccines or other countermeasures existed. The 2018 iteration of that list included: Crimean-Congo haemorrhagic fever, Ebola and Marburg viruses, Lassa fever, SARS and MERS, Nipah and henipaviral diseases, Rift Valley fever, and Zika. The list concluded with Disease X, recognizing that “a serious international epidemic could be caused by a pathogen currently unknown to cause human disease.”8

The WHO and the World Bank sponsor an independent Global Preparedness Monitoring Board that assesses and advises on the measures needed to ensure prompt and effective responses to epidemic disease. In their first annual report, issued just two months before COVID-19 emerged in Wuhan, the Board’s co-chairs warned:

There is a very real threat of a rapidly moving, highly lethal pandemic of a respiratory pathogen killing 50 to 80 million people and wiping out nearly 5% of the world’s economy. A global pandemic on that scale would be catastrophic, creating widespread havoc, instability and insecurity.9

As Alex de Waal writes,

Covid-19 was the least unexpected pandemic in history.10

De-prepared

In The Challenge and Burden of Historical Time, Istvan Mėszáros argues that the capitalist system is “incompatible with planning in any other than the myopic sense of the term.” Even when catastrophe looms, “the unrestricted pursuit of capital accumulation, no matter how damaging, and even utterly destructive,” is top priority for corporations and the states that represent their interests. The profit imperative has two inevitable results.

  1. The time-horizon of the system is necessarily short-term. It cannot be other than that in view of the derailing pressures of competition and monopoly and the ensuing ways of imposing domination and subordination, in the interest of immediate gain.
  2. This time-horizon is also post festum [after the fact] in character, capable of adopting corrective measures only after the damage has been done; and even such corrective measures can only be introduced in a most limited form.”11

This was powerfully and tragically demonstrated in the richest countries’ response to the pandemic. Despite overwhelming scientific evidence, despite books and binders filled with detailed plans and strategic guidelines, despite repeated calls for investment in vaccine research and in maintaining stockpiles of essential protective gear, the world’s governments were utterly unprepared for COVID-19 or anything like it.

In May 2021, a panel of independent experts, appointed by the World Health Organization to evaluate the world’s pandemic preparedness, issued a blunt assessment:

It is clear to the Panel that the world was not prepared and had ignored warnings which resulted in a massive failure: an outbreak of SARS-COV-2 became a devastating pandemic….

Despite the consistent messages that significant change was needed to ensure global protection against pandemic threats, the majority of recommendations were never implemented. At best, there has been piecemeal implementation….

COVID-19 exposed a yawning gap between limited, disjointed efforts at pandemic preparedness and the needs and performance of a system when actually confronted by a fast-moving and exponentially growing pandemic.12

Many books and reports document the gross failures of government responses to COVID-19. I won’t repeat that appalling story here. But it is important to note that they were not just unprepared–in the decades before COVID most governments de-prepared.13

In the advanced capitalist countries, public health systems have been starved of funding, privatised and hollowed out over the last forty years to the benefit of private profit and the market. Health spending has not been directed towards prevention or primary care, but mainly to emergency treatment…

As a result, most health systems were already stretched to the limit in dealing with illness and disease before the pandemic broke–indeed, it was regarded as ‘efficient’ to run health capacity at 99 per cent, with no room for major emergencies. Many health systems had no stock of necessary equipment for virus pandemics such as masks, personal protective equipment, ventilators or even medicines to ameliorate the impact of the virus. When the pandemic hit, many health systems in Europe were overwhelmed, forcing ‘triaging’ and ignoring the impact on residential homes. Eventually, governments had to impose drastic lockdowns. Health systems were then forced to concentrate on the Covid-19 patients to the detriment of other seriously ill patients, leading to secondary deaths.14

Neoliberal politicians have slashed funding for research, disbanded scientific advisory groups, and cut public health budgets to the bone. When COVID-19 reached the U.S., “it found a public-health system [that] … could barely cope with sickness as usual, let alone with a new, fast-spreading virus.”15 In most of the global south, conditions are far worse–already weak health care systems have been gutted by austerity programs imposed by the International Monetary Fund.

As the WHO Independent Panel commented, it was not the first body to recommend urgent changes.

The shelves of storage rooms in the United Nations and Member State capitals are full of the reports of previous reviews and evaluations that could have mitigated the global social and economic crisis in which we find ourselves. They have sat ignored for too long.16

Now we have another plan for extensive changes in how governments and institutions should respond to future outbreaks–and it too has been shelved. No one familiar with the capitalist world’s track record will be surprised that the WTO Panel’s plan hasn’t been implemented or even seriously considered.

Even if it had been accepted, the plan once again confirms Mėszáros’s judgment–it is a long list of post festum measures, focusing on reacting to future pandemics, not on preventing them. Benjamin Franklin’s proverb about an ounce of prevention finds no echo in official discussions of pandemic preparedness.

Massive investment in public health care is surely needed, and we are in awe of the dedication of scientists and front-line health care workers who labor to save victims of Ebola, Influenza, SARS-CoV-2 and other emerging viruses, but so long as the the underlying social and ecological causes remain, the new age of plagues will continue, unabated and probably more deadly.

To be continued.


References:

  1. Global Preparedness Monitoring Board, “A World in Disorder: Annual Report 2020” (Geneva, September 2020), 3.
  2. Kyle Harper, Plagues upon the Earth: Disease and the Course of Human History, The Princeton Economic History of the Western World 46 (Princeton: Princeton University Press, 2021), 504.
  3. “Event 201,” accessed March 19, 2024, https://centerforhealthsecurity.org/our-work/tabletop-exercises/event-201-pandemic-tabletop-exercise.
  4. Creaven, Sean, Contagion Capitalism: Pandemics in the Corporate Age (London: Routledge, 2024). viii.
  5. Global Preparedness Monitoring Board, “A World at Risk: Annual Report on Global Preparedness for Health Emergencies” (Geneva: World Health Organization;, 2019), 12.
  6. Jonathan D. Quick and Bronwyn Fryer, The End of Epidemics: The Looming Threat to Humanity and How to Stop It (New York: St. Martin’s Press, 2018), 25.
  7. Global Preparedness Monitoring Board, “World at Risk,” 6.
  8. World  Health Organization, “List of Blueprint Priority Diseases,” March 1, 2020.
  9. Global Preparedness Monitoring Board, “World at Risk,” 6.
  10. Alex De Waal, New Pandemics, Old Politics: Two Hundred Years of War on Disease and Its Alternatives (Medford: Polity Press, 2021), 14.
  11. István Mészáros, The Challenge and Burden of Historical Time: Socialism in the Twenty-First Century (New York: Monthly Review Press, 2008), 383.
  12. Independent Panel for Pandemic Preparedness and Response, “COVID-19: Make It the Last Pandemic” (Geneva, Switzerland, May 2021), 15.
  13. I borrow the word from Alex de Waal, New Pandemics, Old Politics.
  14. Michael Roberts, “Pandemic Economics: The Global Response to Covid-19,” Theory & Struggle 122, no. 1 (June 2021): 32—45.
  15. Ed Yong, “How Public Health Took Part in Its Own Downfall,” The Atlantic (blog), October 23, 2021.
  16. Independent Panel for Pandemic Preparedness and Response, “Make It the Last Pandemic,” 62.