Connect with us

Politics

COVID-19: Uganda Must Take Robust Measures to Defeat the Coronavirus Pandemic

13 min read.

The coronavirus pandemic will end but without strong public services, Uganda will remain vulnerable to the next epidemic, pandemic or extreme climate event. The health, water and sanitation and all other sectors must be transformed into robust, life-enhancing government services.

Published

on

COVID-19: Uganda Must Take Robust Measures to Defeat the Coronavirus Pandemic
Download PDFPrint Article

The onset of the COVID-19 pandemic has challenged the public service infrastructure as never before. We commend the government for the efforts it has made to limit the contagion. In particular, we commend health service personnel for their tireless round-the-clock monitoring, testing and treatment of those affected by the disease.

I appreciate the 300 water points rolled out by the National Water and Sewerage Corporation and Kampala Capital City Authority on Friday 27 March. NWSC must be funded to enable them to continue to offer handwashing points in urban areas.

It is heartening to observe the positive public response to the Ministry of Health guidance and directives. I join the President of Uganda in emphasising that the contagion can only be stopped if we collectively practice physical distancing, frequent handwashing and avoiding touching our faces. These are the only preventive measures possible. There is no cure available so far.

The Director of the World Health Organisation, which is at the forefront of the fight against the pandemic, has described lockdowns as “extreme social & economic restrictions”.

In Uganda, our first confirmed case of COVID-19 was detected on 21 March 2020. As of Friday 3 April, Uganda had 48 confirmed cases. It is not easy for public servants and it is not easy for the ordinary citizen, but if we continue to cooperate, the pandemic will end. Uganda is among the countries with fewer than 100 cases and we stand a good chance of overcoming this crisis if we make the right policy choices now.

We agree with the WHO that the lockdown provides a window of opportunity to curb and finally defeat the disease but also to prevent a resurgence of infections once the lockdown is lifted. We believe it is necessary to “Refocus the whole of government on suppressing and controlling Covid19”, as Dr Tedros Ghebreyesus, Director-General of the WHO, has advised.

The World Health Organisation, which is at the forefront of the fight against the pandemic, has described lockdowns as “extreme social & economic restrictions”

We agree that “on their own, these measures will not extinguish epidemics”. We adopt the recommendation that, to be effective, the lockdown must be accompanied by measures aimed at strengthening the health service. It is our view that Uganda’s response to this pandemic can lay the foundations for a healthier and better-prepared country.

In everything we do, we must prioritise the safety of the health workers at the frontline. We therefore propose that they are provided with daily transport, risk and other duty-facilitating allowances, as well as personal protective equipment (PPE). In his address to the nation on 31 March, the President reported that health workers in upcountry facilities are avoiding suspected COVID-19 cases because they lack protective gear. This is unfortunate and must be addressed immediately at all Regional Referral Hospitals. It was shocking to hear in the Presidential Address on Friday 3 March that Uganda only has 10 per cent of the PPE required at this time.

We also support the call by some members of Parliament to pay health workers a motivational allowance, on time and during this crisis, not in arrears.

It may not be possible in the short term to expand, train and deploy our healthcare and public health workforce as recommended but the recruitment process can begin. The news that hundreds of healthcare workers are being recruited at all levels is welcome. Hopefully, the majority are clinicians and nurses.

What is possible in Uganda in the short-term is to continue efforts to “find, isolate, test, treat and trace” those who may have been exposed to the virus and who together with their families are at risk. Of the 48 cases, nearly all were incoming travellers and contacts of travellers arriving mostly from Dubai, 15 from the United Kingdom, three from the United States, one from Kenya. By 28 March, only three confirmed cases were not incoming travellers. We wish them all an easy recovery.

Uganda is among the countries with fewer than 100 cases and we stand a good chance of overcoming this crisis if we make the right policy choices now

In the two weeks prior to the airport closure, 2,661 high-risk travellers entered the country. Also, there are others that had not been identified before Dubai emerged as a high-risk country. Less than 1,000 of these people have been quarantined and tested. It would help to offer amnesty to the hundreds remaining to encourage them to come forward. The security services need only be deployed if there is further failure to cooperate after the amnesty is announced. In any event, the forces should endeavour to treat citizens with the respect they deserve. Wanton violence of the type we have seen contributes nothing to disease control and undermines faith in the government to lead us out of this crisis.

As has been noted, the more tests done, the greater the number of positive diagnoses. While we appreciate the donation of testing equipment from the WHO and Jack Ma, we note that we remain vulnerable as long as our capacity to test depends on donations. We recommend that Uganda seeks short-term measures to find funds for test kits. The public needs to be informed whether all the tests being used are WHO-approved. There is some concern about the potential for false negative results and, being a “fragile State” that is receiving multiple donations, we need assurance that all equipment is up to par.

Regional Referral Hospitals, and Naggulu and Mulago Specialised Hospitals, have been tasked with the management of COVID-19 cases. The input of the Uganda Medical Association, whose members are at the frontline of this battle, is required in signing off those entities equipped to take on the task. This will ensure healthcare workers at those designated facilities have adequate equipment, drugs and PPE. It is hoped that funds will be made available to provide testing facilities in hospitals outside Entebbe.

Wanton violence of the type we have seen contributes nothing to disease control and undermines faith in the government to lead us out of this crisis

Biosafety professionals should be involved in setting up any quarantine sites outside hospital settings to avoid healthcare-associated infections after the pandemic passes. The same should apply to General Hospitals and all Health Centre IVs if the need arises. Regional quarantine and treatment centres are needed to ensure everyone has a good chance of survival wherever in the country they may live as transporting patients across the country puts health workers at risk. Moreover, disinfection of markets, taxi parks and, where possible, other public places should take place before the lockdown is lifted.

Funding the fight

To fund the interventions we request that money currently allocated to Ministries, Departments and Agencies for non-essential activities be reallocated to increasing the number of tests carried out per day and providing transport and PPE for health workers. For example, fuel expenditure saved by grounding government vehicles and cancelling bench-marking trips, conferences, and treatment abroad for ailments that are treatable in Uganda, should also be reallocated to the health sector. Above all, we should minimise waste; expenditure on advertising in the media, printing official bulletins and so on, is not a priority. As WHO recommends, the way forward is “find, isolate, test, treat & trace”.

Most challenging, however, is the third recommendation from WHO: “Expand, train & deploy your health care & public health workforce”. Currently, we have five hospital beds per 10,000 people, 200 intensive care units and less than one (0.9) doctor per 10,000 people. To further complicate matters, other affected countries will seek to import our doctors to combat COVID-19 in their countries. The United States has already invited work visa applications from doctors. The US has 25.9 doctors per 100,000 people but 300,000 COVID-19 cases. Robust interventions on our part will serve in the current crisis and during any future health crises.

As WHO recommends, the way forward is “find, isolate, test, treat & trace”

The immediate sizeable source of funds would be the suspension of the Lubowa Specialised Hospital Project targeting health tourists. The total project cost is Sh1.4 trillion ($379 million). After the first payment of Sh327 billion ($87million), there remains a balance of Sh139 billion. These funds are needed to provide primary healthcare, intensive care and emergency care for Ugandans. (The existing budget for the 41 hospitals to be built in 39 districts is Sh1.3 trillion.) The reallocation from Lubowa Hospital should take place as soon as possible and should the lender decline, the rest of the loan should be cancelled.

Easing the Economic Impact of COVID-19

The majority of Ugandans are employed in the informal sector. In fact, 83 per cent of non-agricultural workers are in the informal sector (World Bank Databank). The majority of workers (75.2 per cent) are classified as being in “vulnerable employment” (Human Development Report 2019, UNDP). What this means is they do not have health insurance and are unlikely to have savings or any other form of social safety net. For the fishermen and small traders who pay annual licence fees, Uganda Revenue Authority could consider extending the validity of those licences to take account of trade lost during the pandemic.

Borrowers from the Youth Livelihood Programme and the Women’s Entrepreneurship Programme present a problem. The 83,000 participants in the government-funded loan schemes such as the Youth Livelihood Programme were already having difficulties making repayments and the majority defaulted. During this time we request that the government suspends the pursuing of defaulters and resumes collections when normal work resumes.

Those in debt to micro-finance companies can be assisted by freezing interest accumulation during the lockdown and extending repayment periods once work resumes. Boda boda riders who have bought their motorcycles on credit fall into this category.

Formal Small and Medium Enterprises face similar loan repayment challenges and require similar consideration. The Bank of Uganda has the responsibility to use those mechanisms as are within in its powers to maintain economic stability. It should ensure that SMEs are not forced out of business by enabling banks to extend repayment periods for loans. In this connection, borrowers forced to default should not be penalised and listed by the Credit Rating Bureau.

Both the formal and informal sectors increasingly use digital means to do business. To reduce the use of potentially infectious money, and to make transactions more affordable, we request that the government lift the OTT tax (excise duty on over-the-top services). The government is also urged to reach an agreement with Telcos to further reduce their rates for all telephony.

Mortgages and rent

Without work, the informal sector and struggling SME owners may be unable to pay rent and may face eviction. Bear in mind landlords too may rely on the rent to repay building loans and cater for their families. Therefore, for those in the informal sector we request that the government works out an arrangement with landlords to grant a month’s grace period for those forced to default on rent. The government could take on the debt for the period of the lockdown. For those in the formal sector, the government should consider guaranteeing the rent and mortgage payments and later recover them from salary or from the National Social Security Fund (NSSF) savings of the tenant. Moreover, the NSSF Act needs to be amended to give members access to their savings during emergencies in future.

Utilities

Payment of electricity and water bills will become more difficult in the days ahead. The National Water and Sewerage Corporation has explained that it is unable to waive water charges because it too must meet its obligations to employees and suppliers.

What is needed are subsidies for consumers in difficulty. Two options are possible for a fixed period: a VAT waiver on water and electricity or selective subsidies through Yaka credits and water credits for those most in need. It should be possible to apply online or to regional offices and be granted these credits according to criteria agreed upon between the government and the utilities providers.

Social protection of the most vulnerable

We note the relief being distributed to the vulnerable in Kampala and Wakiso districts. It is true that many urban dwellers have been suddenly deprived of incomes and require support. However, rural people in vulnerable employment are also affected by the lockdown through loss of income. Many depend on roadside markets between towns and cities, traffic which no longer exists.

The elderly are the most vulnerable because globally fatalities have been most prevalent among this demographic and also because their caregivers will be unable to provide for them as before. Yet many of the elderly are themselves caregivers to grandchildren and employers of farm workers. The government has already compiled a list of the aged to which it pays a monthly grant. This Senior Citizens’ Grant is vital in keeping the rural economy afloat and for children being cared for during this time and therefore it must be paid in full and in a timely manner.

The incapacitated and those whose caregivers are themselves incapacitated by illness will need to be added to the list of the vulnerable as will the unemployed who will lose caregiver support. Nearly all Ugandans are at risk of financial disaster if they were to become seriously ill. The Human Development Report states that 75 per cent of Ugandans are at risk of catastrophic expenditure – expenditure which wipes them out financially – were they to require surgery. COVID-19 may not require surgery but in the worst cases (should they appear) it will require intensive care. With a reported 200 ICU beds nationally and most probably all occupied, the situation is dire.

In the absence of public transport, a special public transportation plan for patients and expectant mothers travelling to hospitals and medical centres should be put in place. The beginnings have been difficult as travel passes have not been easy to obtain. We propose hiring and branding vehicles for delivering COVID-19 patients to health facilities. The modalities can be worked out by the Joint Task Force. People Power Co-ordinators will be available to assist in locating those who require transport to health facilities.

The 21 per cent of people living in poverty forms a large part of the vulnerable section of the population. Undernourishment (caloric intake below minimum energy requirements) has been steadily rising for the last 14 years, from 29 per cent to 41 per cent. We have been advised by the Ministry of Health that people have a better chance of surviving COVID-19 infection if they are adequately nourished. To exclude them from the lockdown-affected persons requiring assistance is unfair and counter-productive as they are more likely to succumb to infection.

Disaster preparedness

We cannot afford not to be prepared for other disasters. The shortage in medical masks, respirators, gowns and goggles caught Uganda unprepared yet this was forecast by the World Health Organisation on 27 February.

A resurgence of the desert locust plague in the region was forecast to begin in early May. A swarm entered Amudat district for the second time on 3 April. If it grows, there will be food shortages.

Extreme climate events such as mudslides this rainy season cannot be ruled out either. Our preparedness should reflect the seriousness of the situation and funds set aside to deal with any eventualities. A government statutory contingency fund must be put in place with immediate effect.

On an individual level, to increase food security, owners of uncultivated land are requested to either plant staple foods or allow food to be planted on their land during this rainy season. This arrangement would be limited to this season that is coinciding with the lockdown period.

Funding the safety net

To fund the social safety net, it will be necessary for the government itself to get debt relief on the national debt. Currently over 65 per cent of revenues goes towards debt payment. While we appreciate the World Bank’s call for suspension of debt repayments to development partners and offer of a loan package to finance the campaign against COVID-19, this is not a time to acquire more debt. Lenders are aware that Uganda is a fragile state and, therefore, negotiations for debt cancellation to enable us to provide a social safety net must go ahead and they must succeed. The absence of a social safety net is the direct result of ill-advised development policies.

Long-term interventions: Rehabilitation of the Health Care System

People Power has long argued that the stagnation in health and other services must be addressed as a matter of urgency, not in 2022 or in 2026 but now. This pandemic will end but without strong health and other public services, we shall remain vulnerable to the next epidemic, pandemic or extreme climate event. So we would like all interventions to go beyond the COVID-19 pandemic to cater for future needs.

The health, water and sanitation and all other sectors must be transformed into robust, life-enhancing government services.

Health expenditure

Our expenditure on health decreases nearly every year. That trend must be reversed. We must go from spending 6 per cent of GDP on the health service to spending the 15 per cent we signed up to in the Abuja Declaration.

Not surprisingly, a review of the hospitals around the country reveals that the majority have faulty equipment. To finance a health service that meets national requirements, the health insurance scheme that has been in the pipeline for over a decade needs to be rolled out.

We must go from spending 6 per cent of GDP on the health service to spending the 15 per cent we signed up to in the Abuja Declaration.

We need to develop the capacity to manufacture items for clinical use, e.g. protective gear for health workers. We have the capacity. In 2019 young Ugandans developed life-saving and cost-saving bio-medical equipment. All are important because of the nationwide shortage of medical equipment especially in rural areas. Olivia Koburongo and Brian Turyabagye developed the Mama-Ope smart jacket for digital pneumonia diagnosis. In 2018 Phyllis Kyomuhendo invented M-Scan a portable ante-natal ultrasound device. Brian Gitta and colleagues developed a bloodless malaria test (Winner of the Africa Prize for Engineering Innovation, founded by the Royal Academy of Engineering in the UK); we often cannot afford reagents used to test blood. In 2014 Dr Chris Nsamba developed an incubator for premature babies which he donated to the government. It is in use at Mukono Health Centre IV whereby last year it had saved the lives of 243 critically ill babies. Uganda has one of the highest rates of premature deaths in the world.

In 2019 young Ugandans developed life-saving and cost-saving bio-medical equipment

However, Dr Nsamba failed to get any government funding although a government agency later claimed to have sponsored the development. The government should make a firm commitment to support local innovators by buying their products while following procurement rules to give all innovators a competitive chance.

Water and Sanitation

Only 18 per cent of the population has access to basic sanitation services with which to keep themselves and their homes healthy. Of every 100,000 deaths, 31 are related to unsafe water and poor sanitation and hygiene services. Of every 100,000 deaths, 159 are caused by household and air pollution (Human Development Report 2019, UNDP).

In the long term, there needs to be an investment in the water sector that meets the needs of the 82 per cent without access to basic sanitation services.

We are grateful for the government’s transparency in admitting that the limited water supply to homes has been caused by “poor planning and implementation of programmes over the years”. As a result, the water and environment sector now needs at least nine times the present level of funding every year for the next 12 years to meet national development targets (Budget Monitoring and Accountability Unit Briefing Paper 30/19, Ministry of Finance, June 2019).

Environment

During the lockdown many will struggle to get fuel for cooking. Under normal circumstances, less than 1 per cent of Ugandans has access to clean fuels and technologies for cooking. Apart from being unsustainable environmentally, the daily search for firewood, like the daily trip for water, takes away time children would otherwise have spent in school, acquiring skills to innovate for our survival as a people.

Human Development

We have an opportunity to reflect on the type of nation we want to be. Are we willing to invest in our human development and well-being or will we forever belong to WHO’s category of “the most fragile and vulnerable countries”?

Human development costs money. We will only see a change if we manage our resources better, this goes both to government and to the population. We must eliminate non-essential expenditure; expenditure on salaries of political appointees and on electioneering – cash handouts in return for votes. We must eradicate waste; last year vehicles were bought at a cost of $5.5 million for the Commonwealth Parliamentarians Conference. It was said that they would thereafter be used for government work but they have not been surrendered to the pool for use in fighting COVID-19. The recent budget proposals for the desert locust emergency, especially by the ICT ministry, show that we have not learned this yet.

As a Nation, we need to reflect on the wisdom of splintering the country into tiny entities paying salaries for MPs, and public service but remaining financially unable to maintain decent health centres, hospitals or roads, or to deliver quality education in most local government institutions.

As individuals, each one of us must have as much integrity as we expect from our leaders. In the last four years, Uganda lost Sh28 billion in the Youth Livelihood Programme. An audit of a sampling of Youth Livelihood Project groups which received loans found that 64 per cent were non-existent (representing 71 per cent of the value of the loans). Another 25 per cent had embezzled the funds. This means that repayments were not available for re-lending to new Youth Interest Groups.

We must never again be found without sufficient medical facilities. We must never again find ourselves lacking water with which to wash our hands and prevent disease.

The physical environment in which we live and work can and must be transformed. Unsanitary working conditions in markets and other public places must be addressed beginning with the NWSC/KCCA handwashing points which we expect will become a permanent feature.

We must never again find ourselves lacking water with which to wash our hands and prevent disease.

A durable solution to the broken public transport system is needed, especially in cities and towns. This pandemic has taught us that public transport is a public good that must be supplied, regulated, maintained and sanitised by the government. Supplementary systems are well and good, but the primary responsibility for public transport lies with the government.

On behalf of the millions of People Power foot soldiers across the country, I call upon the government of Uganda and all Ugandans to reflect and consider the proposals I have laid out here.

For God and My Country.

Avatar
By

Robert Kyagulanyi Sentamu, AKA Bobi Wine, is the Member of Parliament for Kyadondo East and leader of Uganda’s People Power Movement.

Politics

A Problem of Denial: Why Tanzania Could Lose the War Against COVID-19

President Magufuli’s response to the current coronavirus crisis has been far from exemplary. Some of his actions, like urging pubs to throw post-coronavirus parties and firing those who question his bizarre remedies for COVID-19, could actually put the lives of thousands of Tanzanians at risk.

Published

on

A Problem of Denial: Why Tanzania Could Lose the War Against COVID-19
Download PDFPrint Article

Authorities in the East African nation of Tanzania have started a process to reopen the country, claiming that the number of people testing positive for the coronavirus disease (COVID-19) has dropped significantly, with numerous cases of recoveries reported. However, given the state’s laxity in containing the pandemic since it was first reported in the country, plus its obsession with excessive secrecy in its approach to dealing with this new virus, makes many Tanzanians suspicious of the state’s claims and intentions – and for good reason.

Tanzania’s handling of COVID-19 remains a divisive and controversial subject that is passionately debated both within the East African nation and beyond. As nations across the world grapple with the deadly virus, which continues to indiscriminately claim the lives of thousands of people, and wrecks the economies of many countries, opinion here is sharply divided between those who are convinced that this novel coronavirus situation in the country is not so worrying as to warrant interventions seen in other countries, such as lockdowns, and those who accuse the government of underestimating the magnitude of the pandemic, thereby putting the economy above public health, and thus risking the lives of hundreds of citizens. No compromise seems to be on the horizon between these two warring factions.

The ongoing debate, which feeds into the political polarisation already prevalent in Tanzania, has been made more acute by the government’s own approach to fighting the COVID-19 pandemic, which to this day remains opaque and unknown to the general public. The government’s approach seems to be informed by partial denial, inordinate secrecy, sheer incompetence, and ancient superstitions and prejudices.

So confusing is the government’s response to COVID-19 that after almost three months since the crisis was first reported, people’s anger and apprehension have subsided to ridicule and mockery as President John Magufuli’s administration continues to expose deep and terrible contradictions in its strategy and style to deal with the pandemic. Annoyance, therefore, seems to have subsided into derision. (If one would expect a different reaction then it means that one is not well-versed in Tanzania’s political culture. The long-reigning years of the ruling CCM have reduced the population to apathy and conformism, all in exchange for “peace and development” as defined by the party’s own ideologues and propagandists.)

Corona parties

The sheer absence of organised protest and pushback on the part of the citizenry, the press, religious institutions, and civil society organizations (CSOs) against the government’s handling of the COVID-19 pandemic means that the minimalists (those who advocate for less restrictive measures lest the economy is hurt and interpret the news that portrays Tanzania in a gloomy picture as fear-mongering and hysterical) secure an ostentatious victory and hence wield a significant influence in the government’s latest measures aimed at bringing the country back to normalcy.

The government’s approach seems to be informed by partial denial, inordinate secrecy, sheer incompetence, and ancient superstitions and prejudices.

On May 21, for example, while addressing the nation from the capital Dodoma, President Magufuli announced that schools, colleges, and universities will be reopened on June 1 and called for the resumption of suspended football activities, citing physical exercise as one of the best ways to avoid contracting the virus. A day earlier, the cocky regional commissioner of Tanzania’s commercial capital Dar es Salaam, Paul Makonda, urged hoteliers and restaurant owners in the city to reopen their businesses, and claimed that COVID-19 was now over and that the city should go back to work. He even urged pub owners to throw a party on Sunday, May 24, to celebrate the end of COVID-19 in the country.

These measures follow the ones taken earlier, including the opening of the country to tourists and the lifting of a restriction that required tourists to undergo the mandatory 14-day quarantine when they visit the country. In the same vein, churches and mosques that were closed due to the pandemic have been ordered to reopen. The Evangelical Lutheran Church in Tanzania (ELCT) bishop of Karagwe Diocese, Dr Benson Bagonza, subsequently announced that church services would resume on May 31.

The government’s claim is that these and other measures aimed at returning the country back to normal are thanks to the “tremendous drop” in the number of people contracting COVID-29 in Tanzania and the increasing number of COVID-19 recoveries across the country. For instance, during a church service in his hometown of Chato, a town in Geita region of northwestern Tanzania where President Magufuli has been self-isolating since the pandemic arrived in the country, the head of state told his fellow congregants that, thanks to what he termed as divine intervention, the number of COVID-19 cases in different hospitals across the country have gone down and the number of recoveries have increased. It was in this address that Mr Magufuli talked about his daughter who contracted the virus but who was able to recover, thanks to steam therapy and the consumption of lemons, things that he and his government have been pushing people to use to “stay safe” against the pandemic for a while now.

President Magufuli’s assurance notwithstanding, not many people seem to buy into his government’s claims that Tanzania is safe now and people can go back to doing their business. People’s doubts have been intensified by many factors, the most important factor being the lack of transparency. The claim about the sharp drop in COVID-19 cases reported in the country are being made at a time when the government does not share COVID-19 updates with the public and other national and regional public health stakeholders. This follows the temporary closure of the national health laboratory to pave way for an investigation into the allegations made by President Magufuli that the lab officials were “conspiring with imperialists” to portray Tanzania in a negative light by releasing more positive cases, an allegation which eventually led to the sacking of the lab’s director, Dr Nyambura Moremi.

It was in this address that Mr Magufuli talked about his daughter who contracted the virus but who was able to recover, thanks to steam therapy and the consumption of lemons…

These misgivings are made more relevant by reports from neighbouring Kenya where the increasing number of truck drivers from Tanzania test positive for COVID-19 when they cross the border into Kenya, something which led to the Kenyan authorities to not only close all their borders with Tanzania but also deport 182 people who tested positive for COVID-19 back to Tanzania in an effort to protect Kenyans from the pandemic. Another reason why people doubt the government’s claims of the “divine defeat” of COVID-19 is the feeling that the government is not there to serve their interests in the first place but that of President Magufuli and his administration.

Attacking political opponents, not the virus

Mr Magufuli’s actions portray him as a person who is more interested in himself than he is in the people. One of these actions includes getting rid of people from his administration who are thought to be realists and replacing them with sycophants who are willing to go the extra mile in their attempts to please the president, even if is at the expense of people’s lives.

For instance, President Magufuli swore in Mr Mwigulu Nchemba, a man who just before his appointment as the new constitutional and legal affairs minister to replace Mr Augustine Mahiga, who died after a short illness, had suggested that the government announce only the number of people who recover from COVID-19 and leave out the numbers of those who died of the pandemic.

If that was not enough, President Magufuli fired Dr Faustine Ndungulile as the deputy health minister – a man who once contradicted the president’s steam therapy as a cure for coronavirus and pointed out its associated health risks – and replaced him with Dr Godwin Mollel, who had once advised against mass testing, a practice emphasised by the World Health Organization (WHO) if the war against the coronavirus is to be won, saying it was too expensive for people to afford. According to this lawmaker, who defected from the opposition Chadema to the ruling CCM, “to support President Magufuli’s efforts to bring development to the people” the government’s complete abandonment of mass testing made more sense to him as a people’s representative than asking the government to make the testing free of charge!

Tanzania seeks to reopen at a time when its laxness in its efforts to contain the pandemic has triggered a diplomatic crisis with neighbouring Kenya following the latter’s decision to close all its borders with Tanzania, allowing only cargo to pass through, something which so infuriated the Magufuli administration that regional commissioners with the regions that border Kenya (Arusha, Mara, Kilimanjaro and Tanga) retaliated against Kenyan truck drivers, banning even cargo trucks to pass through. The border crisis, now settled, led to the sacking of Tanzania’s High Commissioner to Kenya, Pindi Chana, presumably because she was not as aggressive as her Kenyan counterpart in Tanzania, Dan Kazungu, in finding a solution to the problem.

The inward-looking approach of Tanzania made it skip two important COVID-19-related consultative meetings organised by the East African Community (EAC) and the Southern African Development Community (SADC). While opening the SADC meeting, South African president Mr Cyril Ramaphosa is quoted to have said that he talked to President Magufuli, the sitting chairperson of the block, of the need to organise the meeting but the Tanzanian leader asked for the member states to just send their opinions to him, a charge that Tanzania denies. These and other steps taken during the pandemic had some analysts worried that Tanzania risked losing its historical and strategic allies in the region.

It is this same megalomaniacal type of thinking that has made President Magufuli not listen to, and work on, the advice offered by other stakeholders of Tanzania’s development, such as opposition parties (see here and here) and CSOs, which on more than one occasion have outlined some of the necessary measures to be taken to help the country combat the pandemic and save lives.

Election-related measures

The measures to reopen the country are being taken when Tanzania is just a few months away from a general election in October 2020. The measures are being viewed as preparatory work towards the elections that President Magufuli’s party, CCM, is projected to win in a landslide largely due to a disorganised opposition and years of deliberate efforts to shrink Tanzania’s political and civic space. The measures come against the backdrop of debates among Tanzania’s lawyers and intellectuals on whether or not Tanzania should go ahead with the general elections given the presence of the public health emergency. However, the latest steps that the government has taken to reopen the country seem to have brought this debate to an end.

Efforts to reopen the country go hand in hand with steps to further shrink the available civic space in the country. For example, COVID-19 has not stopped the Magufuli administration from detaining a comedian who laughed at the president’s old photos, arresting journalists, local and foreign, who interviewed people on their experience with the pandemic, as well as restricting NGOs working in the country. On May 22, for example, a coalition of Tanzanian NGOs planned to organise a TV programme with a local television station, ITV, to talk about NGOs’ role in the fight against COVID-19 pandemic only to have the network postpone it at the last minute without giving a rational or understandable reason.

It was against this troubling background then that after being tired of government lies and prevarications, and having lost her close relative to COVID-19, gender and human rights activist Mwanahamisi Singano was forced to write an open letter to President Magufuli, reminding him that fear is not fought with threats, torture, or shackles (or lies if I could add), but with “sincere and intentional government actions in the fight against [COVID-19] scourge”.

The measures to reopen the country are being taken when Tanzania is just a few months away from a general election in October 2020. The measures are being viewed as preparatory work towards the elections that President Magufuli’s party, CCM, is projected to win in a landslide largely due to a disorganised opposition and years of deliberate efforts to shrink Tanzania’s political and civic space.

Sincerity is what is missing in the government’s entire strategy in the fight against the pandemic and thus explains to a great extent why most people are suspicious of its assurances that the pandemic has been contained and that people are free to go about their business as they did during the pre-COVID-19 period.

How, for instance, can a sane person trust a government claiming that the number of COVID-19 cases have dropped yet it declines to share those very statistics with anyone, not even its own citizens or at least with the Africa Disease Control and Prevention? How can we trust an administration that tries to lull us to sleep with sweet songs that the pandemic is over when it has treated the pandemic more as a national security issue than as a public health crisis? (The president’s second address on COVID-19 was to the heads of Tanzania’s security organs, not with public health experts.)

If the government is being genuine that coronavirus has been contained in the country to the extent that studies and sports should resume, why did it find it necessary to ask Kenya in making public the data on the COVID-19 status of truck drivers, not to mention the nationality of those who test positive?

If we cut through the propaganda barrage, we find that Tanzania is not as safe as the ruling elites and their apologists want people to believe. People who heed the call to go about their business believing that the pandemic is over will be doing so at their own risk.

Continue Reading

Politics

A Very Political Virus: Trumpism’s Ridiculous Response to COVID-19

Trumpism in the age of coronavirus may be gasoline poured onto the fire of a worldwide catastrophe in bizarre ways that are only beginning to be spelled out now, but which could have dire ramifications globally, including in East Africa.

Published

on

A Very Political Virus: Trumpism’s Ridiculous Response to COVID-19
Download PDFPrint Article

I can’t tell for certain, but the ambulance sirens seem to keep increasing, not with the incessant wails reported in New York, but a creeping feeling that something is on the rise.

Here, in the state of Wisconsin, on April 6th, the Democratic Governor, Tony Evers, fearing the worst in light of the COVID-19 crisis, passed an executive order to postpone the primary election, which took place on April 7th. Republicans had immediately taken the order to the state Supreme Court, and over turned it, forcing people to go to the polls.

Why? To align with Trump’s political desires. With thousands of absentee ballots already thrown out, the primary election (which includes a key state Supreme Court seat) is one that could be decisive in what is sure to be a controversial, close and unprecedented presidential election in the fall. President Donald Trump had backed the Republican candidate publicly, and called for the people of Wisconsin to turn out to vote for him, despite COVID-19.

In a state with controversial voter ID laws (which disproportionately affect people of colour), this has made a stark choice all the more vivid – come vote if you dare tempt coronavirus or stay home and be disenfranchised.

That’s where the screw really turns here: Donald Trump didn’t just learn from the example of Kenyan election farces; he studied and plagiarised them. (It makes sense that in this context, both the Kenyan ruling political elite and the Trump campaign were clients of Cambridge Analytica, the controversial firm whose use of unethical data mining tactics during elections have been exposed by the international media.)

Shown through the lens of an increasingly horrific pandemic, such election rigging is all the more grotesque. But it will soon be swept aside as another story of power grabbing, political manoeuvring over human life and bullshit grandstanding over the public good will utterly mar the last two months of the descent into the Age of the Coronavirus. An entire state just got thrown into an accelerated timeline of potentially being a horrific hotspot for the virus; the fates of potentially thousands of lives now sealed, there will be a push to promote a political agenda.

Donald Trump didn’t just learn from the example of Kenyan election farces; he studied and plagiarised them.

The political leadership of East Africa could truly stand in awe at the utter Machiavellian dumbness of this narcissistic manoeuvre – as it is truly a Stalinesque effort. The problem inherent right now in the world’s “best economy” is that politics has crept into the pandemic; the divisive nature of the discourse is such that it has spiraled downwards over the last five years. The election debacle in Wisconsin perfectly encapsulates the state of things right now in the US. In the year of a presidential election, pandemic tumult and constant political punching dominate.

All things are on equal footing, all things are intertwined, as Trump has made them to be. And as anyone with eyes or outside the administration can tell, it is going terribly. By the third week of May, the US had more than 1.5 million COVID-19 cases; of these, nearly 94,000 had died from the disease. Because the country is woefully inept at testing, more than a dozen states seem to be on the upward curve.

Where to start?

Even attempting to encapsulate the last several weeks in a sprawling critique seems to point in a million directions, so let’s focus and dissect three key aspects of the response to coronavirus in the US more in depth:

The Trump administration playing dumb while being dumber

First, Trump and his cohort have seemingly deliberately made a once distant threat of disease exponentially worse through denial, deceit, malice and twists so moronic they mystify the mind. (You can’t expect a climate denier to have the brains to handle a scientific crisis). Trump’s positions, like a fish left on the counter, grow in their stench as the days continue bloodily onward. His latest in a long string of travesties find him stumbling into the idea of injecting disinfectant into the human body to “clean it” of the virus. This latest gaffe, at least, was rooted more in idiocy than in cruelty, and was almost a welcome change towards comic relief after previous actions he’s undertaken. Even so, despite what he and the American far right-wing culture say, the fact is that the White House is listened to by the public, and so poison control cases went up across several US states after Trump made this ridiculous claim.

Trump and his cohort have seemingly deliberately made a once distant threat of disease exponentially worse through denial, deceit, malice and twists so moronic they mystify the mind.

The most important aspect to emphasise here is the outright denial that carried over for approximately six weeks (and, according to some reports that leaked memos to the White House regarding the COVID-19 threat, possibly even longer). Trump’s denial of the crisis was astounding, and to be frank, is still ongoing. Often, even in the days leading into May of 2020, the stance of the White House has been to express how things are improving, although they are clearly markedly getting worse for all to see. The optics hit the American public in the same vein as the Westgate mall terror attack crisis hit Kenya’s. (The fires in the mall couldn’t possibly be merely burning mattresses.)

Trump’s reaction to the crisis helped spur what must be statistically the worst outbreak globally. As far as optics are concerned, his reaction can only be put alongside Bolsanaro’s in Brazil and the Iranian regime’s in terms of terminal dumbness, obtuse means-spiritedness and ineptitude. It is a denial of a natural disaster that I haven’t seen at a leadership level since perhaps the 2011 drought ravaging northern Kenya; while the Kibaki administration and Kenya’s Parliament seemed largely to sit and twiddle their thumbs, occasionally making a statement expressing their condolences, they promptly went back to bitching at one another.

On a daily basis, Trump lumbers out (despite constant efforts by Republican lawmakers to stop him), shouts mixed messages to a confused press corps, then screams at them for asking what he’s talking about. The paranoia has reached levels of Daniel arap Moi in the 1980s; there are enemies within all corners, closing in, making the virus worse just to hurt him, the mounting deaths swept aside in importance so that the name of his brand not be tarnished by “haters”.

Such a tone is a tonic for no one, least of all medical staff, who, despite all outward claims made by the administration, are in dire need of absolutely everything, with no end in sight. Random people are scrambling to adjust – there are weird stories of desperation and plugging in holes wherever the government fell abysmally flat. People sew masks and stockpile if they can afford to. There is mounting concern that the hospitals are so overwhelmed that people with other conditions are going ignored or skipping vital visits.

It is simply proving to be more than anyone bargained for, even for those who officially became doctors and nurses by taking the Hippocratic Oath. As an old friend, a resident nurse at a prominent Michigan hospital, told me in early March, “We’re going to lose many doctors, nurses…people we already have a national shortage of. There are already conversations amongst healthcare providers, nurses, staff about what’s worth the risk. None of us signed up to work in unprotected conditions. It is like walking onto a battlefield without anything, anything at all needed for the specific fight.”

In the US, nurses, doctors and emergency medical technicians talk openly about going on strike, citing lack of protection – a move almost reminiscent of the series of strikes undertaken by medical workers in Kenya over employment conditions across the last several years. Even now, after months of the obvious from a multitude of voices, the Trump administration comes out and yells about its successes in the very areas that are the depths of its failure.

Think about this: over the last several weeks, Trump has ignored the virus, then fought to reopen the economy; he has blamed Democrats, yelled at the media on a daily basis, and called the virus a conspiracy to get him out of office; he has supported rebellion in several US states, encouraged primary elections to go forward and given his son-in-law (who has been cited by multiple researchers as an utter failure) a more prominent role in the COVID-19 response than any scientific expert.

All this while the high-ranking members of his party and surrounding hangers-on float ideas, such as the federal US government not owing states supplies (although states make up the US) and for states themselves to go bankrupt.

It has, for all intents and purposes, been a showing so abysmal and wrong-headed at every conceivable level that there is already talk that the last two months may have permanently crippled the GOP and will push them out of political relevance permanently as the US becomes a more diverse and younger country moving into the middle decades of the 21st century.

Trump and his administration, in their desperate flailing about in the dark for someone to blame, have made this crisis entirely about themselves and their own inherent “victimisation” – a strategy which, as deaths mount steadily and the economy finds new cliffs to dive from, looks increasingly foolhardy.

It is now growing harder to see how the current administration will get its collective act together (even though it urgently needs to do so) as the virus continues to pound the US in the coming months.

Clear cracks in the US system

Over the years, many friends have told me that they have wanted to go to the United States – to study, to work, to whatever. Universally, I’ve told them all to look elsewhere. All the flaws in the American Death Star have been highlighted by the Trump administration, including inherent societal problems, susceptibility to totalitarian blowhards, racial inequity, horrific economic disparity, capitalism’s exploitative nature, and the fundamental flaws in the US system of governance itself.

Trump and his administration, in their desperate flailing about in the dark for someone to blame, have made this crisis entirely about themselves and their own inherent “victimisation” – a strategy which, as deaths mount steadily and the economy finds new cliffs to dive from, looks increasingly foolhardy.

The last several weeks have proven the “far left types” (myself included) correct – although few of us could have imagined such a rapid descent. America, “the most powerful nation on Earth”, is inherently unequal, terminally flawed and fetishises money to a disgusting level. There are rampant stories of businesses closing, predatory loans, and debt claims coming out of life-saving stimulus money.

The very governmental system has shown itself to be labyrinthine, a truth only accelerated by capitalism, Trumpism and, let’s face it, the modern Republican Party.

Take medical care, where is an ugly Catch-22 at play. People are broke, and the American medical system is the most expensive in the world. People need healthcare and tests, but the fear of the cost often outweighs the fear of a deadly virus. The one thing that could correct the economy (testing) is avoided because of the state of the economy (both before the crisis and into it).

States compete against each other to get supplies while the government sells off its supplies to companies in order for the companies to sell them back to the government for distribution to the states. All this is happening while the government is questioning whether the states really need the supplies, and possibly favouring some states that favour Trump and his cronies politically. It is the kind of nightmarish inaction that would even make Kafka stir in his grave.

The medical system itself has been brought to its knees. Walking around a few weeks ago, I saw two ambulance crews going into houses, all wearing masks, every one of them looking well beyond their breaking points.

All this is happening while the government is questioning whether the states really need the supplies, and possibly favouring some states that favour Trump and his cronies politically. It is the kind of nightmarish inaction that would even make Kafka stir in his grave.

This, in a well-to-do city with several prominent functioning hospitals run by competent individuals. This is not the case in all US states and cities, but the most glaringly obtuse responses are coming from Republican-held legislatures.

An inherent problem in the US is that smaller states skew Republican votes, hold equal power in the Senate, and elect increasingly bigger idiots and inept climate sceptics while carving up districts to benefit their own hold on power. This has proven true in South Dakota, where the Republican Governor, resistant to social distancing, has seen an outbreak of more than 500 cases in a single pork processing plant.

It has also rung true in Florida, where Governor Ron DeSantis, himself a loyal Trumpian, resisted calls within his state to close down because the state with the high geriatric population could be hit catastrophically. Instead he waited for Trump’s go ahead, even as White House press conferences repeatedly turned into unbalanced, unhinged name-calling sessions while Trump himself denied the true impact of the virus and prematurely called for the economy to reopen. DeSantis has since given a “stay-at-home” order and ordered that World Wrestling Entertainment be continued as an essential service, alongside grocery stores, banks, hospitals, and the fire department.

It inherently means that while some states (such as California, Ohio and Washington) reacted with preemptive speed and some (like Maryland, New York and New Jersey) have risen to the challenge admirably after it began to spiral, other states may keep up the perpetual game of whack-a-mole indefinitely through their own failings.

In many of these states, particularly those with large black communities (New York, New Jersey, Michigan), the disparities have grown even more stark. It is a discrepancy in standards that can almost be compared to the lack of resources afforded to Western Kenya; there are some areas of focus, but if you’re not of a certain set, a constant less will be your systemic truth.

This has become all the more clear in the American situation. Ugly reports have seeped out about black and minority individuals being less likely to receive coronavirus testing, care or access to the same medical treatment as whites. In turn, this has led to minority and lower class communities being slammed by this virus disproportionately, sometimes at shocking rates. In hardest hit New York City, some reports show people of colour dying at double the rate of white people.

It has also shown the true insidious nature of the political divide under the Trump administration. From powerful corners on the right, there have been ideas floated to defund Democratic states for reasons that are still unclear beyond the spectrum of unbelievable political pettiness. Take Trump’s Twitter gem on April 27th: “Why should the people and taxpayers of America be bailing out poorly run states (like Illinois, as example) and cities, in all cases Democrat run and managed, when most of the other states are not looking for bailout help? I am open to discussing anything, but just asking?” The irony that states like Illinois are also American is an irony that may or may not be lost upon the Republican Party.

Economically, the capital of capitalism has shown its true colours; and they break badly along generational lines. People post long screeds about suddenly being thrown out of work, with the government arguing bitterly about any support for citizens while simultaneously sending trillions to large corporations.

There seems to be something tectonic happening, although it is yet to be seen if it will prove to be beneficial or harmful to the public good after the scourge of COVID finally recedes.

Trump sinks the world

The final key takeaway: that in this globalised world, Trumpism in the Age of Coronavirus may be gasoline poured onto the fire of a worldwide catastrophe in bizarre ways that are only beginning to be spelled out now, but which could have dire ramifications globally, including in East Africa.

The virus has already shifted from the West down and into the Southern hemisphere, with the level of consequence yet to be seen. While some credit must be given to the swift action taken in many African countries (such as closing borders and reinstating Ebola protocols), the reaction of some governments has taken on a definitively Western tint: doing what works for them while simultaneously ignoring the economic realities in their own backyards.

Economically, the capital of capitalism has shown its true colours; and they break badly along generational lines. People post long screeds about suddenly being thrown out of work, with the government arguing bitterly about any support for citizens while simultaneously sending trillions to large corporations.

China, of course, has borne the brunt of the blame, and perhaps in the long term, ensured the nation’s dominance over global influence (especially in sub-Saharan Africa, a focus of Beijing).

Given this, the failings of countries such as the US should be looked at as a warning. Where society fails to protect, advantage shall be taken, and swiftly. Just this month, the US cut off funding to the World Health Organization (WHO), a UN body where US contributions constitute approximately 20 per cent of the budget. Make no mistake about Trump and his ilk – he abandoned us Americans, and, as his recent cut in funding to WHO showed, he won’t think twice about abandoning the rest of the world too. There will be no gestures of international goodwill coming from the Trump administration, something that is leading to feelings of unease within spheres of the diplomatic community. It can be seen already, with valuable protective equipment being intercepted from going abroad; those ugly protectionist and isolationist instincts are taking over.

This move just proves that the ugliness of Trumpism is, unfortunately, not localised within US borders; there is no quarantining this administration. Such isolationism and xenophobia will get downright dangerous when (for instance) a global pandemic, a historic economic crisis and a once-in-a-century locust swarm hits the East African region simultaneously with full force in the coming months.

On top of this, the Trump administration’s policies have helped to undercut the already stretched-thin medical systems of the developing world. In Kenya, for instance, a major pillar of funding for blood donations and subsequent transfusions has already been cut. It is unlikely to be restored under a Republican White House.

In times of crisis, the failings of this White House will become starker. In the years to come, it may come to light that the mishandling of this crisis by the Trump administration accelerated the economic and health ramifications of COVID-19 and spiraled the global system further on its downward trajectory. If the West has been brought to its knees, the United States seems hell-bent on sinking itself lower, swamping the world as well.

Once the US industrial machine finds footing and produces the needed testing, masks, ventilators and medication (it will, despite the Trump administration, not because of it), the White House will surely rapidly pivot to “these must be kept to protect us”, the same shortsighted dumbness that will both kill people by the tens of thousands in the developing world, and serve to perpetuate the virus once it circulates around the global channels again, inevitably circling back into America, which, when led by such an inept head of the federal government, will be “totally unaware, because it is your fault anyway” and the cycle will continue until a vaccine is developed or Trump is finally cast out of the White House.

The latter option, while knocking on every piece of wood within reach, is becoming increasingly viable. In that same bastardisation of an election in Wisconsin – the one that was blatantly rigged and dangerous – Jill Karofsky, the Democratic candidate for the Supreme Court, landed an improbable victory, and a massive one. Winning by more than 150,000 votes and a margin of more than 10 per cent (which is much higher due to factors such as voter suppression and the throwing out of ballots) in the swing state of Wisconsin, which narrowly went for Trump in 2016, gives hope that a rational person can get back behind the wheel of the White House as early as January of next year. It may be an early indication that Trumpism has overstayed its welcome in the time of corona, and that a more sensible America may emerge again.

Even so, while there may be some glimmer of better heads coming to the table in the US, this is far from certain. The fear is that the damage to the world from a single man with bad hair may be irreparable.

This is the truest shame of the US side of this initial chapter of coronavirus: that it has truly shown the goodness of the people of the country who as individual citizens and communities have largely reacted admirably, at times even heroically, to meet the challenge head on. Their efforts couldn’t have been wasted on a worse leader. What progress they make locally gets undercut nationally.

Even so, while there may be some glimmer of better heads coming to the table in the US, this is far from certain. The fear is that the damage to the world from a single man with bad hair may be irreparable.

As Trump and his cronies continue to cast blame, ban immigrants and defund international health organisations, there may be a truly long fight ahead. It may become a situation akin to an unruly drunk desperately trying to break everything just to ruin the vibe of a party as he is forced out of the gathering.

If nothing else, this crisis proves that the American model is an utter failure. Anyone who wishes to emulate its foray into neoliberalism will wind up in a similar ruin.

And the ambulances will continue coming.

Continue Reading

Politics

Responding to COVID-19: Should Science Alone Determine Policy?

The advantages of governments pursuing policies that are based on scientific evidence cannot be disputed. However, listening to the science does not automatically mean shutting down society and the economy.

Published

on

Responding to COVID-19: Should Science Alone Determine Policy?
Download PDFPrint Article

As I was starting to write this article, the British Prime Minister, Boris Johnson, a victim of the coronavirus pandemic that is sweeping the globe, had just left the intensive care unit of a London hospital after fighting for his life. Just a few weeks earlier, he had been gleefully shaking hands at events, including one at a hospital treating coronavirus patients. That may seem, in hindsight, to be incredibly reckless behaviour on his part, which ignored the scientific advice we were all getting about the need for social distancing. Similarly, many may see the sluggish UK response to the threat posed by the virus as flying in the face of science.

However, a Reuters investigation suggests the opposite. In fact, Johnson may have been guilty of too uncritically following the advice of scientists. It suggests that when future historians look back at his handling of the crisis, “the criticism levelled at the prime minister may be that, rather than ignoring the advice of his scientific advisers, he failed to question their assumptions”.

Should we be listening to the doctors? It may seem like a foolish question to ask in the midst of a deadly global pandemic that had infected over 3 million people and killed more than 200,000 by the end of April. In such circumstances, heeding the advice of the medical establishment seems to be the most sensible thing to do.

However, as the disruption of national and global commerce and travel demonstrates, the coronavirus does not just attack individuals; it poses a threat to entire social and economic systems built around mass personal interactions, be they markets or transport systems. And though medics may be adept at safeguarding and even curing our bodies, they are perhaps less so when it comes to societies. As Kenyan economist and outspoken public intellectual, Dr David Ndii, pointed out on Twitter, “Our medical/epidemic experts seem to understand pathogens/disease spread but they don’t seem to understand people/society. And that’s a problem.”

However, this has not stopped governments around the world from rolling out the high priests of science (medical doctors and epidemiology specialists) to lend legitimacy and credibility to the measures they are taking, in some cases reluctantly, to combat the virus. It is, after all, difficult for the ordinary citizen to argue with inevitability as presented by knowledgeable people who have spent their lives drinking from the fountain of wisdom and who now come armed with charts and graphs and statistics predicting a terrifying apocalypse if we do not obey.

Yet the question still should be asked whether it is desirable that science and scientists should be dictating government policy responses. One thing to keep in mind is that despite the appeals to it, science doesn’t actually tell us what to do; rather, scientists attempt to explain the linkages between variables, to predict what might happen if we decided on a particular course of action. As Therese Raphael explains, “The world of scientific modelers looks so neat — pristine sloping lines on two-dimensional axes that tickle our love of pattern recognition and cause-effect. Only, that’s deceptive; it simply masks all the uncertainty.”

Models are simplified representations of reality, and inasmuch as scientists may recommend a particular path, this recommendation is based on their interpretation of what the science is telling them about the options they have looked at, the assumptions they have made, and the variables they have decided to consider. As Dr Mark Nanyingi, an infectious diseases epidemiologist explains, “Models can help in forecasting where and when the diseases are likely to occur and what measures are needed to slow down the spread. This can guide future government policies for better preparedness and response to pandemics.”

One thing to keep in mind is that despite the appeals to it, science doesn’t actually tell us what to do. Rather, scientists attempt to explain the linkages between variables, to predict what might happen if we decided on a particular course of action.

Further, as the saying goes, to a man with a hammer, every problem looks like a nail. So different scientists will bring their various biases to their assessment of problems. While medics may privilege the need to do whatever it takes to arrest the disease, economists, on the other hand, may point out that harming the economy could create worse problems.

Even within the medical fraternity, one might be likely to find people who think that focusing on coronavirus while ignoring other diseases that kill many more people may be a mistake. As Tom Angier of the University of St Andrews points out, “There are significant disagreements between experts even within limited domains of expertise, and these disagreements are often themselves fundamentally political.” He adds that it would be naïve to expect politically neutral results. “The rule of experts would generate not expert rule, but a cacophony of conflicting views and interests.”

Asking whether we should listen to our doctors is not about questioning their capabilities and knowledge; it is about querying the role of science and scientists in democratic governance and decision-making. Few would argue that they have no role. But it is another thing altogether to claim that theirs are the only considerations. For one, when scientists speak, it is not just the science talking; they bring with them their biases, even prejudices, as exemplified by the recent suggestion by two French doctors that a potential coronavirus vaccine should be first tried out on Africans. As Prof W. Henry Lambright notes, “When scientists leave their labs to advocate position they may be behaving much like other interest groups, trying to influence public policy.”

More importantly, technocracy (rule by unelected skilled experts) or its cousin, epistocracy (rule by the knowledgeable) may not be a good idea. As David Runciman explained two years ago in an intriguing article for the Guardian, “Even qualified economists often haven’t a clue what’s best to do. What they know is how to operate a complex system that they have been instrumental in building – so long as it behaves the way it is meant to. Technocrats are the people who understand what’s best for the machine. But keeping the machine running might be the worst thing we could do. Technocrats won’t help with that question.” Substitute medics for economists and you begin to see the conundrum.

Asking whether we should listen to our doctors is not about questioning their capabilities and knowledge; it is about querying the role of science and scientists in democratic governance and decision-making.

The British response provides a telling example. In explaining why the UK government did not join the rush to impose a lockdown, Graham Medley of the London School of Hygiene and Tropical Medicine, who chairs a group of scientists advising the government on pandemic responses, told The Atlantic’s Ed Yong: “My problem with many countries’ strategies is that they haven’t thought beyond the next month. The U.K. is different.” The country would not be panicked into taking rash measures, such as closing down schools, “in a way that feels good but isn’t necessarily evidence-based”.

Waiting for the evidence to come in before making a decision may sound like a good plan in the academy, but in the real world, decisions often need to be taken in the absence of full information, and waiting can have catastrophic consequences, as was the case in Italy.

Who decides?

So who should determine what the best course of action is? In a democracy, this function is left to elected public officials who then answer to the electorate. But are politicians any better placed to make wiser decisions? Not necessarily. However, as Runciman argues, the advantage of democracy is assuming that no one has a monopoly on wisdom; it “protects us against getting stuck with truly bad ideas”, even when these are promoted by the most knowledgeable people on the planet.

Democracy is better thought of as system for limiting the harm that governments can do than as a route to generating the best possible decisions. “Rather than thinking of democracy as the least worst form of politics, we could think of it as the best when at its worst.” And such damage limitation is undoubtedly a virtue when poor decisions – such as choosing to wait – could lead to people dying in the streets. As Prof Rupert Read writes regarding the situation in the UK, “Make no mistake, it is government policy that has led to the dire situation we are now in.”

But democracy cannot function in the absence of information and transparency about the basis on which governments are making their decisions. In the case of the UK, Yong pointed out that the models and data that had influenced the government’s initial strategy hadn’t been published, much to the chagrin of many scientists. “If your models are not ready for public scrutiny, they shouldn’t be the basis of public policy,” one scientist told him. The same could be said of other countries, including Kenya, where Dr Nanyingi has decried the government’s reluctance to publish the information on which it is basing its directives. “The disease belongs to the people but data belongs to the government,” he wryly observed.

However, as Runciman argues, the advantage of democracy is assuming that no one has a monopoly on wisdom; it “protects us against getting stuck with truly bad ideas”, even when these are promoted by the most knowledgeable people on the planet.

Obviously, science and the advice of scientists matters. The advantages of governments pursuing policies that are based on evidence and the best and most accurate information available cannot be disputed. And listening to the science does not automatically mean shutting down society and the economy, as countries like Sweden and South Korea may be proving. Requiring politicians to reveal the data underlying their decisions can inoculate against the tendency of politicians to play to the gallery, taking actions that may be popular or make them look decisive but that may have little actual utility. However, it must be emphasised that this is not the same as saying that it is the scientists who should be setting public policy.

In the end, querying the role of science is not really about the competence of modern day medicine-men, but rather the accountability of politicians and public officials. The decisions that need to be taken must consider the scenarios presented by different cadres of scientists, as well as the various uncertainties in their models. They will need to take into account not just consequences but also values and the aspirations of society. They will inevitably involve painful trade-offs and compromises.

In short, these are political, not technical, decisions and will require human beings prepared to make them and to be accountable for them. They are not abstract science.

Continue Reading

Trending