Why global solidarity on Covid won’t come from public opinion in the North

This morning, I read an op-ed from a Belgian psychiatrist (Wim Simons) in my newspaper and suddenly, I understood why we haven’t really seen huge pressure from Northern public opinion on Covid vaccine related inequities over the past months and years. In the  piece, Simons argued that our capacity for empathy is determined by several elements: (1) our own assessment of wellbeing, (2) the way in which we know ourselves connected to others, and (3) the meaning we get from life. Right now, after two years of pandemic stress, all of these aspects are under pressure, he claims.    (I would add that even before Covid, many of them were already jeopardized in our neoliberalized economies and societies, for an increasing number of people.) 

Although Simons' piece focused on the (increasing lack of) empathy in Belgium in Covid times, I’m afraid it has implications for the global Covid vaccine equity debate as well. But let me just give you these figures by way of example: a few weeks ago, about 35000 (organizers said, 70000) people, an ideological hotchpotch of people like in other countries in Europe, took to the streets in Brussels to protest against Covid response measures in my country. Some days later, 150 committed activists were protesting the EC TRIPS Waiver stance, also in Brussels.

More in general, even now at the height of the Delta wave in my country, and with Omicron looming on the horizon, global vaccine (and other) Covid inequities don’t really get people on the streets. That doesn’t mean we’re all racist, or selfish. It’s just not ‘top of our priority list’. Yes, many people say, “what a shame this is, this vaccine inequity”. It’s really not for a lack of information at this stage in the pandemic. A bit like on the migrants drowning in the seas at our borders. Many of us know very well the ugly implications of 'Fortress Europe' by now, find it very sad, but few are taking to the streets for it. And our “leaders” know it damned well. Currently, in the Covid era, they feel a lot more pressure from irritated and fatigued citizens, and from interest groups, than they do from people arguing for, say, a TRIPS waiver.

And so they get away with it, and I personally don’t want to blame public opinion for that. Not after 2 years in this pandemic, where many people have been struggling and juggling to get their lives going. No, it’s our so called leaders who need to have a deep look at their track record over the past two years, when it comes to real global solidarity.  At the end of the day, it’s Ursula, Boris, Alexander, Jens, Joe and others. Even more than Albert & Stéphane, I would say. Our political leaders have gone, in spite of lofty rhetoric on ‘global solidarity’ for the strategic choice to stick to the neoliberal IP model we know, in combination with geopolitics  (even trying to use ‘vaccine diplomacy’ for diplomatic gain, perhaps worried that others were doing the same). That was their deliberate choice, and they should be open about it. Covax and, after a while, facilitating tech transfer on Big Pharma terms (in the medium term) were their ‘shield’ for criticism, together with repeating the Pharma mantra that ‘supply won’t be the problem by mid-2022’. 

For the time being, they’re getting away with it – public opinion doesn’t really criticize them for their lack of global solidarity (although I would have liked to see otherwise), no, citizens increasingly criticize our leaders because the ‘Empires of freedom’ they had been promised in their own countries have failed to materialize. That these two are connected, many even know, from good coverage in media for example. But no, it doesn’t tick people’s buttons enough to put pressure on their leaders.

In the process, as it’s all too obvious to citizens that many of our leaders are “in the pocket” of Big Pharma, who earn billions and billions in the pandemic, trust in democracy is going down. I know, it’s just one reason, but it is one. With the results you see on the streets, but not just there I’m afraid. Citizens have become deeply cynical about their leaders (and Bezos and other billionaires flying into space isn’t helping much). The backdrop for Biden's 'Summit for Democracy' this weekend is really quite worrying. 

So it’s not public opinion’s fault, I reckon. Not after 2 years of Covid.  

At this stage, instead I really hope some enlightened leaders will display the guts to understand that this is a pandemic, and so do the necessary, both on dropping the neoliberal IP model and their inclination towards geopolitical brinkmanship. I’m very grateful dedicated activists continue to keep pressure on our leaders to do the right thing.

While not everybody likes using the term, it’s a war. A global one. One that needs global solidarity. Two years ago, in fact.  But it’s not too late for Joe, Ursula and others to change tack. Let’s indeed go for tech transfer and regional manufacturing big time, not on Big Pharma terms this time, and let’s make that a lot easier via a TRIPS waiver, among other measures. Albert & Stéphane (and their companies) have earned more than enough by now. A criminal amount of money, if you ask me.  And enough empty talk about preventing the next pandemic. Time to fix this one.

On providing expert ‘nuance’ in the temporary Trips waiver debate

 

It’s a full blown Framing War now. Perhaps it always was, but after last week’s US shift in position, and the ongoing Covid horror in India and elsewhere, the war has gone into overdrive.

Against that backdrop, it’s perhaps good to again reflect on how experts (scientists & others) can contribute to this debate in, what is arguably and admittedly, a rather difficult “political economy” in the EU. Indeed, let’s face it, with the sheer amount of “liberal” politicians (in the European sense: that means, almost neoliberal on this issue (see von der Leyen, Merkel, Michel, Macron, Rutte, …) at top level in the EU (and a bunch of neo-authoritarians watching from the corridors), it’s obvious that it will be anything but easy to change the position of ‘Team Europe’ on the issue of a Trips waiver. Germany is perhaps the key domino in this fight, but doesn’t really look like falling in the short term, for a number of reasons, see for example Katri Bertram’s blog on the impact of upcoming German elections, or Hyo Yoon Kang 's points on Twitter.

And yes, I know, it’s no silver bullet, the temporary waiver, but that sort of argument is also too easily used for a rather cynical “status quo” position, including among experts, especially in academia, who often like to leave the dirty work to activists on more controversial items (not just because of the typical scientists’ ambition to be seen as a credible, nuanced experts  ( unlike activists and, on the other side, Big Pharma) but also sometimes because there are ‘vested interests’ in the own institution or organization at play).

So perhaps a gentle reminder on how scientist experts can indeed provide ‘nuance’ in this vital global health equity debate.   

Given that this is a ruthless framing war now, perhaps we can borrow a leaf from some of the more outspoken politicians and their ‘debate cards’ when they enter a tv-studio or write an op-ed.   Indeed, there’s absolutely no need at this stage in the pandemic for an expert to sound like a centre “middle of the road” politician, going like, “on the one hand… on the other hand…”.  “The Third Way” might have been popular end of the 90s and early 2000s, these days I would argue it’s only popular in Big Pharma circles (and their supporters).

And so scientists & other experts who believe strongly in global vaccine solidarity, who are asked to weigh in, should ruthless examine arguments from both sides and clearly point out where they have a point, whether it’s a big point or minor point, or where instead these arguments totally suck. Obviously, based on our own values (yes, scientists do have values and even an ideology, the horror! 😊). Unlike the average politician, we don’t have to conveniently ‘forget’ arguments if they don’t fit our values and case. But there’s no need to use woolly language either: if an argument sucks, let’s clearly say so.

And at the end of an op-ed or media intervention, let’s also not shy away from giving a clear advice to public opinion (confused in this framing war, and I don’t blame them), based on this ruthless & systematic exploration of the strengths, merits and flaws of the various arguments in play. While I don’t fully agree with Rachel Silverman (CGD) ’s  presentation from last weekend, I think her meticulous and very analytical approach, not shying away though from taking a clear stance on certain arguments and also going for a clear conclusion, deserves a good following. And yes, experts can and should certainly also weigh in on the difficult political economy in the EU, WTO, … and the higher political and diplomatic interests, but that should not become a pretext for defeatism or weary political realism, sometimes bordering cynicism.

Indeed, these are no times for cynicism, we have seen some remarkable things happening in recent years, including in terms of paradigms shifting. And sometimes you have to help ‘self-fulfilling prophecies’ a bit : )

Final comment: let’s face it, 30 years of neoliberalism have all affected us, deep down, whether we recognize it or not. Sadly, to some extent, we’re all neoliberals now. I don’t think a discourse currently popular in EU power corridors, focused on “protecting innovation and competitivity” would have had it so easy in the 50s and 60s  (the time of Jonas Salk). Conversely, we probably would have been far more open to pope Francis’ discourse from this weekend, when he supported the temporary suspension of intellectual property rights in unequivocal terms “while offering his own classification for  “variants of concern””  (in the words of Peter Singer on Twitter).

When push comes to shove, for pharma companies to share their mRNA technology, even with Russia and China (which some, like BioNtech are already doing anyway), is not like sharing atombomb technology to the nazis…  

In sum: nuance shouldn’t be a pretext for weary political realism and too 'balanced' viewpoints. We can’t afford it.  More, if we do so, the risk is that we become “objective allies” of the ones who want to maintain the status quo.

PS: similarities with the climate emergency crisis are obvious…

On declaring one’s privilege

 This might not be the smartest thing I ever wrote but for some reason I do feel the need to write about this once (and only once 😊).  

Let me just set the scene: I’m a middle aged (European) man, largely in favour of the woke & decolonizing global health agendas (long overdue), I don’t need much convincing that structural/systemic racism remains widespread in pretty much every country in the world, although it’s in some countries worse than in others. I wouldn’t describe myself as “woke” though – some things are beyond me, plus I aimed to be, at a certain point in my life (like many in my generation), J Krishnamurti-style “aware” (instead of “awake” 😊). In case you wonder, that didn’t really happen.   

So, with that out of the way,  I wanted to briefly offer some thoughts on a practice that seems to  become more common (last week, for example, I noticed it at a Decolonize Global Health seminar I attended): to make one’s privilege(s) explicit, before you start talking.

Now,  I certainly get the idea of ‘privilege’: I probably experienced it most during my travelling years (2000-2003) and when teaching English in China. Now in Covid times, very much so as well, obviously. But of course, in many ways, I had been privileged all along, even if I wasn’t fully aware of it at the time (white, male, stable upbringing, safe country, relatively good governance, social security,… you name it).

But although I understand why it can be useful to indicate one’s’ “positionality” in a debate, I don’t really see the point of making one’s privilege explicit before starting to talk in a session. Or rather, if one does so, I would like to see it broader. Let me explain why.

For one, it’s blatantly obvious for most of us in these sessions that many of us are ‘privileged’. I admit, it provides some interesting (and sometimes necessary) info. But check somebody’s social media, and you will know as much (if not more).

Two, it feels a bit like the self-flagellation from the Middle Ages, a sort of purifying ritual (that especially Americans seem fond of). Or if you want a metaphor from another part of the world, it also smacks a bit of “neo-Mao style self-criticizing” (like Jack Ma had to do in recent weeks versus Xi Jinping).

Three, for some reason, it’s always the well-meaning public health students or soft-spoken young social scientists who seem to be willing to declare their privilege, I never see this being done by the posh medical students heading for their first Tesla, let alone by the ‘top dogs’ in the system. I’ll be all for declaring one’s privilege in sessions if  Bill Gates, Seth Berkley, Peter Sands, Albert Bourla, Emmanuel Macron (not to mention Jeff B) do so too, when kicking off their High-Level meetings and replenishments.      

Four: it’s mainly young people who seem bent on declaring their privilege. When you get older, that sort of thing doesn’t come that easily anymore, it appears, perhaps because by then, one day you feel privileged, the next day, nah… not really. Maybe also because you increasingly realize that we human beings are actually a mix: of (1) privilege (and some of us are certainly far more privileged than others), (2) struggle (“life happens to you, your family…”, and you can’t really blame anybody for it … (eg disease, tragical accidents, choices you made that turn out the wrong ones…)) and (3) exploitation by a ruthless capitalist/patriarchal/... economic system  (unless you belong to the 0.00001 % (and even then)). 

My point is: unless you start talking about all these dimensions, your self-introduction – focusing on privilege only - remains a bit fragmentary.  I don’t think that in a scientific session you need to go into the ‘struggle’ dimension, but discussing ‘privilege’ should be complemented by talking about ‘exploitation’, in my opinion.  Even if I’m very well aware that the ‘exploitation’ suffered by participants in most of these sessions doesn’t even come close to the exploitation of the ones “really” hit (and often destroyed) by this economic/patriarchal/… system. But this sort of ‘race to the bottom’ benchmarking is one of the favourite legitimizing mechanisms of our neoliberal global system, and there’s no need to give in to it.

As make no mistake, many of these well-meaning global health students won’t feel as ‘privileged’ when they have to hit the labour market, or more in general, join the rat race where ever more needs to be done with fewer people for reasons of ‘efficiency’. When some of them become Deliveroo or Uber Eat-deliverers, previous talk of ‘privilege’ will feel empty. And I really don’t need to go into the way many public health people in LMICs, even some of the relatively ‘privileged’ ones, are now being hit by budget cuts, often coming from the North.

Also,  I feel “privileged” to have grown up in a time where the massive size of the ecological crisis & planetary emergency wasn’t that obvious yet, I still had a few ‘innocent decades’ in that respect. It’s anything but “a privilege” to have to face the climate & biodiversity crisis, as a young generation, and clean up the mess (if it’s even possible).

Finally, unless I’m mistaken, “global health” & academia have a fair amount of exploitation itself, both being quite neoliberally run “businesses” at times, including towards relatively privileged young people based in the South, so better to also include that in the “picture”.  

So here’s my suggestion: 

Let’s indeed declare one’s privilege at the start of a session or even plenary, but (1) let the bigwigs do so first, and let them also make explicit why they continue to take the decisions they take to sustain a ruthless economic system; (2) when you, as a humble global health student or staff member, do so, make it something “creative” in which you also include the exploitation dimension.

Like: “ ‘I’m privileged in many ways, … but having said that, I’m not as privileged as (and no doubt more exploited than) Bill Gates ( who doesn’t have any ‘deliverables’ or KPIs apart from self-imposed ones, as far as I can tell), I don’t have Seth Berkley’s or Peter Sands’ salary package, neither do I have billion dollar signs in my eyes like Albert “Pfizer” Bourla, “breathe” privilege like Emmanuel Macron …  and I certainly don’t have Jeff Bezos’ privilege to exploit hundreds of thousands of employees, while getting filthy rich with it”.      

For the ones among you who prefer three dimensions (and who doesn’t in academia?  😊) ‘white supremacy’, a term that is used a bit too easily in woke discussions, in my opinion, could be added to the equation.  That is no doubt a continuum as well, not a binary thing.  Let’s call it perhaps ‘supremacist thinking/mindset’ (as obviously, this is not just a white ‘privilege’)

So when we exclude ‘struggle’ from the discussion (even if there are, obviously, links with ‘privilege’ & ‘exploitation’ dimensions, see the whole SDH debate), we could then go for a “3-D declaration”.  

Let’s call it the woke equivalent of the UHC cube. You would make explicit:

-        The amount of privilege (so far in your life)

-        The amount of (capitalist/patriarchal/…) exploitation you suffer in your current job/life

-        The amount of supremacy thinking  (my guess: most of us in global health score very low on this dimension, in the year 2021, but happy to be proven wrong)

That should make for interesting “3-D introductions”, I think. And for the many cube fans among you, you can even visualize it 😊!  

PS: I’m well aware that there are many more dimensions (see also the intersectionality debate), but at my age, I’m not that intellectually flexible anymore : ) 

PS: let me repeat this again, for good order: I know the ‘exploitation’ doesn’t come close to what marginalized people in LMICs (and, increasingly, HICs) suffer. But I don’t believe in this sort of ‘race to the bottom’ benchmarking, which is too often used by “the powers that be” to sustain their system. We shouldn’t let them.  And in Covid times even less.