Epidemics as the silent policy maker

Ridwanul Haque | Published: 00:00, May 17,2020 | Updated: 13:54, May 17,2020


Taking past epidemics and pandemics and authorities responses into account, Ridwanul Haque talks about political economy of epidemics

The number of COVID-19 infected reached 4 million last week, among them, more than a quarter-million people passed away and the numbers on both sides are increasing every day. More than a dozen vaccines are going through testing phases and no one knows, exactly which one is going to come out with flying colours, let alone the talks on their probable effectiveness are the ones.

The near future is still gloomy based on those extrapolations. At least the experts are sure that this visitation of the COVID-19 is not its last, it will pay sporadic visitations until any vaccine proves effective. Governments around the world are busy searching for policy alternatives to curb this mayhem.

History witnessed many epidemics. From the bubonic plague to the Ebola, effects of every epidemic acted like policy enforcers making the authorities pursue socio-economic and political transformations, separate wings for public health came into attention, and the urbanisation process got remodeled. Even the modus operandi to tackle healthcare-related problems on a global scale saw radical changes.

The initial stage was tropical medicine which dealt with disease outbreak in the colonies situated in the tropical zones by the colonial authorities. Next came the international health based on bipolar contrasts in opulence and development where the affluent north used to help the poor south. As the cross-border journey of epidemics gradually came into contention, it allowed headway to establish global health measures, which demands co-operation among countries. Besides public health, the last one also includes individual care among its priorities.

In the pre-modern world, government allocation did not use to take disease tackling expenditures into account. The very first aberration of this tradition occurred during the bubonic plague at the very beginning of the last millennia. Governments and city authorities deployed soldiers and volunteers to ensure quarantines in ports and public places, to let not outsiders or foreigners trespass, and to convert public building structures into quarantine centers.

The duties and implications of modern public health structures we see in many developed worlds are mainly nineteenth-century phenomena. The idea of sanitation, mainly — sewerage lines, waste management systems, pure drinking water-facilities — has dominated the idea of setting up the modern public health system.

The pioneer in supporting sanitation, Edwin Chadwick, conducted studies on urban poor working class and saw that those who were living in unhealthy conditions were also the ones suffering from water-borne and air-borne diseases the most. His prescription got approved by the London city council; as per recommendation, the authority started to build up sewerage networks, waste management systems, and secure public water supply from safe water sources.

Previously, the groundwork laid by Leeuwenhoek's invention of the microscope, which pushed visual magnification by 275 fold, helped Edward Jenner and Louis Pasteur make their groundbreaking discoveries in vaccines, thereby blazed the trail towards the germ theory of disease which stated that diseases spread via germs. 

The modern structures of the cities in Europe were shaped by the idea of sanitation. Sewerage line networks, small canals crisscrossing the cities, bigger windows and entrances, less dust absorbing interiors with plain designs, wider roads et cetera are the result of sanitation movement. But there were initiatives to suppress other aspects of life too.

France's capital, Paris, has boulevards that attract people, has a harsh history to recall. When cholera was at its peak in the city, the town planner summoned the authority to drive the poor working-class people out of the center and to settle them to the periphery. As these workers were also the ones who were protesting and calling strikes against sacking and unpaid labour, the boulevard had to be built up for the free movement of the law enforcement agency and the military to counter and disband them.

Napoleon's ambition to conquer Russia with a half-million soldiers went in vain as cholera and typhus ran medieval upon them. Alongside the harsh Siberian winter, these diseases reduced the number to its one-fifth and gifted Napoleon with the drubbing loss he could ever bear under the ambition of his colonial expansion; he ordered retreat.

At the advent of the last century, Italy took different countermeasures. Their premier insisted upon data manipulation. The city authorities were ordered not to reveal the true scenario, to hide the CFR (Case Fertility Rate is counted as the number of death per hundred infected people) and to use euphemism where the scenario is harsh to express as Italy was expecting a large number of tourist influx on the eve of its golden jubilee of unification.

When AIDS turned into a pandemic, and after a long while, some preventive drugs became available, but South Africa's president Jacob Zuma refused to accept these. He said that all of these were western propaganda to reduce the population of African people of colour. He scraped off many policies that were devised to fight AIDS during the Mandela regime. Suddenly, South Africa found itself into deep abyss.

Frank M Snowden, in his book Epidemics and Society: From the Black Death to the Present (2019), cynically put that — disease might have ubiquitous characters irrespective of classes and genders — an equally treating property which he called 'Microbial Marxism'. Plague, tuberculosis, malaria et cetera have such property whereas cholera, typhus et cetera hunt for the poor only.

The late 14th century Europe witnessed a drastic decline in the labor population due to the black death that troubled the feudal lords and the business classes and in turn triggered the peasant revolution, which, after the bloodshed, secured the freedom of choices for the laborers to some extent.

Apart from the history, the present situation evolving around COVID-19 might reach to different height regarding what governments are thinking about to fight the pandemic. Spanish government acquired all the private hospitals and clinics to ensure that its citizens are getting treatment at a subsidised cost. Some governments are insisting upon increasing fiscal expenditure, which, in the upcoming years will surely continue and the health sectors will become the main priority to be modernised and far-reaching. 

The legacy of neoliberalism might come into contention as governments in many countries reduced tax and thereby cut off government expenditures that distorted the accountability mechanism underlying public trust. Neoliberalism's most expedient and treacherous outcome — distancing the state from public welfare-related expenditure — might come to halt.

The system saw escape route in some previous occasions when its biggest preacher — the USA — got to exert its influential position more firmly than ever. The case of Italy under the dictatorial regime of Benito Mussolini had the support and blessings of the USA. While Italy's some areas turned into a malaria-prone netherworld, the preacher gave in. The very initial technological fightback against malaria was the invention of DDT (Dichlorodiphenyltrichloroethane), a proven insecticide used to kill mosquitoes and other insects.

The exclusive right to produce the DDT went to the infamous GMO product company Monsanto. Its share price skyrocketed within days. Meanwhile, the USA made United Nations launch a new wing named United Nations Relief and Rehabilitation Administration (UNRRA) to conduct UN-backed social safety-net to provide foods and shelters to the workers sacked by the declining production due to decreasing demands at a time when the leftist party was becoming demotic for their manifesto of emancipatory proclamation. In the offshoot, the tyranny restored.

2008 global financial crisis was the product of neoliberalism. The system's powerhouses are financial corporations, such ossified was its base that even when the whole world was going down the hill, the Wall Street flourished. High scale deregulation of financial markets brought immoral speculation to the site, and when it collapsed, Kuznets’ ‘rising tide’ saw ‘lifting’ so many ‘boats with leaked bottom’ that all of them suddenly drowned and withered away. Ever increasing inequality did not see its swansong though.

The irony was that the bail-out package was mostly offered to the financial institutions whose avarice feast bamboozled the whole economy, where most of their employees and owners shared the dividends outpoured from the bubble and the money heist. Taking this as a highly referential example — the case of Bangladesh — can be brought-forth for perusing the size and impact of the liquidity government packages are putting into the pockets of the garments industries. More than four million garments workers are working in this industry which brings the most of the foreign currencies. Speculating that if apparel industry can be brought to life, the COVID-19 infected economy will recover and the thought of a trickle-down economy circulating money though different sectors will take the lead in the future as a short term solution.

This is not going to happen, because most of the other sectors are not operational to circulate the trickled-down money. Recalling the words of the USA’s veteran Republican Paul Ryan, who once said ‘let's not focus on redistribution, lets focus on upward mobility’ and again as Republican party’s one of the major donors ‘Google Inc.'s design ethicist Tristan Harris said ‘If you control the menu, you control the choices’, the scenario reads the same in Bangladesh. The garments’ capital owners will be getting more and the representation of the industry as the only staple food on the menu sums up the whole thing. 

Sony Picture’s famous documentary ‘Inside Job’ on 2008 financial crisis also showed that during pre-crisis decades many brilliant minds were pursuing degrees in finance and law. As deregulation came into effect at a time when they were holding jobs in many financial and judicial entities, they misused it with sheer brilliance and operated in tandem.

I was having a look at some front-line websites offering free online courses. Home quarantine can be made effective by attending diverse subjects on the offer by Coursera, edX et cetera. And, here again, I saw the number of students enrolled in finance, law, and game theory related courses are staggeringly high.

Who knows what comes next. But it won't be a hyperbolising to insist that — the governments will step in at least for a long while to reduce the distance beefed up by the specter of neoliberalism. Reforms in health sector might go through unprecedented level of transformation and as an auxiliary support, public education related expenditure also needs to be increased as research shows that literate people lead healthy lifestyle.

There is a crucial thing to consider — vaccine diplomacy— conditions a country might need to fulfill in order to get vaccine related help from abroad. The diplomatic skill needs insights to do this on favorable terms.

Hope for the best.

Ridwanul Haque is interested in political economy and cultural anthropology.

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