SOME of the truths the COVID-19 pandemic is exposing about the United States are its racial disparities in health and access to health care. Black and indigenous people are more likely to be infected with the virus that causes COVID-19 than white people. They are two to three times more likely to be hospitalised and two to two and a half times more likely to die than white people. There are a number of factors that contribute to this.
Another related truth that is being exposed by the pandemic is the relative failure of capitalist countries to contain the virus and limit deaths when compared to socialist countries. Even some relatively poor countries, many of which are targeted by the US’s illegal economic warfare, are outperforming wealthy countries because they have socialised systems.
This shouldn’t be surprising because capitalism as a system is designed to profit from emergencies, not provide for people’s needs. The response, or lack of it, to the winter storms in the south last week was a stark example. Millions of people froze without power and water because Texas failed to invest in its infrastructure to prepare for an emergency and those who had electricity are now facing energy bills of thousands of dollars because the market prices for energy soared.
But all in all, the global south, mainly composed of indigenous, black and other people of colour, is struggling during the pandemic as are their brothers and sisters in the United States. Wealthy western nations are hoarding more supplies than they need. They are protecting the profits of their corporations at a cost of human lives and allowing the pandemic to rage across the planet, mutating into more infectious and deadly strains as it goes.
People are organising to end this medical apartheid. This is an important opportunity to address the longstanding causes of these disparities and build systems that uphold all of our human rights to health. This is a struggle that calls for solidarity from people in the US with the global south.
The COVID-19 pandemic is taking a toll on the overall health of people in the United States, but indigenous, black and latino people are impacted the most. New data from the Centres for Disease Control and Prevention show that life expectancy in the United States fell by a year in the first half of 2020, and it is likely to be a larger decline once the data for the entire year has been analysed. Black people lost almost three years and latino people lost almost two years of life while the decline for white people was less than a year. The CDC did not report on the life expectancy of indigenous people.
There are multiple reasons for the disparity. As the Economic Policy Institute found last year, black workers are suffering more during the pandemic in part because they are less likely to be able to work from home than white workers. Black people are more likely to have lost their job or to be an essential worker where they risk contracting COVID-19 and introducing it to their families and communities.
Prisons, where black people are more likely than white people to be incarcerated, are sites of a high proportion of COVID-19 cases. As Marc Norton writes, prisons are super spreader sites infecting not only inmates but the surrounding community as well. One inmate who was involved in protests over the conditions at the Justice Centre in St Louis, Missouri, explains that inmates are not being tested, are not being given adequate access to what they need to protect themselves and are being housed with infected people. Although it is difficult to find data for prisoners who have COVID-19 categorised by race, the ACLU of West Virginia reports that the percent of black inmates with COVID-19 in a number of states is nearly twice as high as the percentage of them in the prison population. For example, in Missouri, black people are about a third of the prison population but are 58 per cent of the COVID-19 cases.
Racial disparities are present in long-term care facilities too, another site of high numbers of COVID-19 infections. Less than one per cent of the population is in a long-term care facility, but that is where five per cent of the infections are occurring. A study published in the Journal of the American Medical Association found that there were more COVID-19 deaths in nursing homes with a high percentage of non-white residents than in nursing homes with a low percentage of non-white residents.
And rural areas, which in the south and southeast tend to be majority indigenous, black and brown, also contribute to the racial disparities in COVID-19 cases and deaths. For the last decade, rural communities have been losing their hospitals and with that, their health professionals. There is also less access to tele-health services. But cities are problematic too.
An article in the Gothamist explains that, in New York City, ‘Black and latino residents by and large suffer the highest death rates, which are attributable to inequitable access to health care and housing.’ They also find great disparities in vaccination rates. White residents are being vaccinated at three times the rate of black and latino residents.
Disparities in vaccination rates exist elsewhere too. In Philadelphia, 44 per cent of the city residents are black but they make up only 12 per cent of those who have been vaccinated. To change this, the Black Doctors COVID-19 Consortium is taking vaccines directly to black neighbourhoods to immunise people. In Baltimore, while more than 60 per cent of the people living in the city are black, only five per cent of the people who have been vaccinated are black.
In the United States, a big reason for the racial disparities in who is being vaccinated has to do with the lack of a coordinated plan to make sure that those who are most impacted are vaccinated first. The US lacks the public health infrastructure to administer a mass vaccination campaign. There are different guidelines and methods of getting vaccinated in different parts of the country.
If the United States had a universal healthcare system like Medicare for All, then vaccination programmes could be run through primary care practices where the patients and health professionals know each other. Practices would know who in their patient population needs the vaccine most and could contact them. In the current environment, people have to sign up online, which disadvantages those who do not have access to the internet, and in some areas people can only get vaccinated in drive-through centres that exclude people without cars.
Instead of primary care practices doing the vaccinations, vaccines are being distributed through for-profit pharmacy chains. In California, healthcare workers have to go to a pharmacy chain or Costco to get vaccinated instead of getting the vaccine at work. This creates another barrier for workers. In Florida, the governor has politicised the vaccine rollout by prioritising zip codes that are mostly Republican and allowing the grocery chain Publix to be the sole distributor. Publix donated heavily to the governor’s campaign.
As Margaret Kimberley explains, the underlying problem is capitalism. She writes, ‘Donald Trump was blamed for the poor response in 2020 but it is clear that Americans are in trouble regardless of who occupies the White House because profits determine the response to a healthcare crisis.’
Recently, Popular Resistance co-hosted a webinar called ‘COVID-19: How Weaponising Disease and Vaccine Wars Are Failing Us.’ It featured some of the authors and editors of the book, Capitalism on a Ventilator, who gave an update to it. It is clear that countries that treat health care as a public good and that have socialised governments, such as China, Vietnam, Cuba, and Nicaragua, were able to take immediate steps to control the pandemic. They had the healthcare system and infrastructure in place to get information to people about how to protect themselves, to identify people who were infected and to provide what they needed to quarantine or receive medical treatment. They were able to coordinate getting health professionals and supplies to the areas where they were needed. And they are treating immunisation as a public health necessity instead of a profit-making venture.
The situation in the United States has been the opposite. There was no centralised plan. City and state governments scrambled to put in place what was needed and engaged in bidding wars with each other for basic supplies and equipment. Some areas were overwhelmed and could not provide necessary care to everyone. Health professionals and others on the front line worked in hazardous conditions. People who needed care delayed seeking it out of fear of the cost. Hunger and poverty are now growing as the government failed to provide needed support financially and in other ways such as housing, health care and food.
In the United States, immunisations are being treated as a profit centre instead of public goods. The United States government spent $12.4 billion on ‘Operation Warp Speed’ to produce vaccines using private corporations that are now reaping the profits. Spending on the vaccine delivery side was only in the hundreds of millions while the actual cost is billions of dollars. States are struggling to afford their vaccine programmes as they wait for Congress to pass another spending bill. This is likely a factor in driving states to turn to for-profit entities like pharmacy chains to administer the vaccines.
The United States and other wealthy western nations have also been acting on a global scale to thwart the efforts of other countries to handle the pandemic. Early on, as countries worked together by sharing information, supplies and health professionals, the United States withdrew from these efforts and increased its economic warfare in the form of sanctions on countries such as Venezuela and Iran. The results have been devastating.
This week, the United Nations special rapporteur on the impact of unilateral coercive measures on human rights, Alena Douhan, released her preliminary report on the dire situation in Venezuela. In an interview with Anya Parampil, Douhan said that the economic blockade shrunk Venezuela’s government revenue by an astounding 99 per cent. On top of that, the United States, United Kingdom and Portugal are withholding $6 billion of Venezuela’s assets, money that Venezuela had agreed to use to purchase food, medicine and other necessities from the United Nations. The sanctions are also preventing Venezuela from purchasing vaccines through the COVAX programme. Douhan is calling on the US and others to end the sanctions and give Venezuela access to its money, but so far the Biden administration has refused.
When Russia announced its COVID-19 vaccine last August, a vaccine produced by state agencies, the United States quickly moved to impose economic sanctions on those research centres seemingly out of spite. Similar sanctions were forced on China, which has produced five different COVID-19 vaccines and plans to share its vaccines with less developed countries at a low cost to them.
The United States and other wealthy western nations are responsible for the global vaccine apartheid. Instead of putting policies in place to make sure that all people, especially in the vulnerable global south countries, have vaccines, they are buying up the vaccines in quantities greater than they need, causing scarcity and driving up prices.
In These Times reports that ten wealthy countries have administered 75 per cent of the vaccine doses given so far to their people while 130 countries have not given any doses. African countries are struggling to buy vaccines even through the COVAX programme, which is short on supplies. Hadas Thier writes, ‘AstraZeneca, despite claiming a “no-profit” pledge during the pandemic, is charging South Africa $5.25 per dose and Uganda $7 per dose. The European Union, by contrast, has paid just $2.16 per dose.’ Doctors who are on the front lines are dying from COVID-19 because they aren’t protected, leaving African countries that already lack sufficient doctors in a worse situation.
Another issue that is driving the vaccine apartheid as well as limiting access to lifesaving medications is corporate monopolisation of patent information. If other countries had access to that information, they could produce the vaccines and therapeutics themselves. Pressure is being put on the World Trade Organisation by 40 countries and 200 organisations to exempt COVID-19 medications and vaccines from patent restrictions, called a ‘TRIPS waiver,’ at their meeting next month but the US and other wealthy nations are blocking it.
The G7 nations met on Friday and agreed to provide a small portion of their vaccines to developing nations. Global Justice Now, one of the organisations pushing for open access to the patents for medicines and vaccines, says the G7 nations’ offer is a ‘fig leaf’ that is inadequate to address the problem: ‘Promising donations “at some point in the future” fails to tackle the real problem: urgent lack of supply caused by Big Pharma’s patents.’
A stark example of vaccine apartheid is occurring in the occupied Palestinian territory where Israel, which has one of the highest vaccination rates in the world, is refusing to give the vaccine to Palestinians. The United States could use its power to pressure Israel to stop this practice, but it isn’t. The United States has been a strong supporter of Israel’s genocidal actions.
The People’s Vaccine Alliance, a group of organisations pressuring the WTO to lift the patents, states that if the situation doesn’t change, ‘90 per cent of people in poor countries won’t be able to get the vaccine in 2021.’ Some countries in Latin America are taking matters into their own hands. Cuba is developing its own vaccine, the Sovereign 2, and plans to produce 100 million doses this year, far more than it needs, so that it can make it available to other countries at no or low cost. Argentina and Mexico are working with Astra Zeneca to start producing its vaccine together. The manufacturing process will begin in Argentina and be finished in Mexico.
The COVID-19 pandemic and global medical apartheid affect all of us. The more the virus is allowed to proliferate, the more likely there is to be mutations, like the ones in the strains coming from the UK and South Africa. The UK strain is more infectious than the original strain and appears to be more lethal. It is widespread in the US now and may cause another surge of cases in the coming weeks or months. The South African strain is also in the US. It is more infectious and seems able to evade the body’s immune system.
If the world does not get the pandemic under control, all of our lives are at risk. It is in our interest to make sure that enough people are vaccinated quickly to stop the spread before new strains arise that are resistant to the vaccines. It is also critical that people who need medications to treat COVID-19 have access to them no matter where they live.
The Biden administration claims to be concerned about racial inequities. If that is the case, it must address these inequities wherever they occur or be called out for failing to do so. The COVID-19 pandemic is an opportunity to transform the world in a way that ends the great inequities that exist.
Health care must be viewed worldwide as a public good, not a profit-making venture.
Instead of competition, there must be an open sharing of information to tackle the healthcare crises we face.
The global south, which comprises the most vulnerable populations, must be prioritised for access to medications and vaccines so it can resolve the crisis quickly with less impact on its struggling economies.
And, the United States must end its illegal actions around the world including economic sanctions, military interference and support for major human rights abusers such as Israel.
We in the United States can hasten this transformation by putting pressure on our government to change. This is a way to show solidarity with people around the world who, like us, are struggling for the right to a life of dignity and prosperity. What our government does abroad, it also does at home because we all suffer under the capitalist system. Together, we can create a better world.
DissidentVoice.org, February 21. Margaret Flowers is co-director of Popular Resistance, national coordinator of the Health Over Profit for Everyone campaign and co-chair of the Green Party US.
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