The crisis of Covid-19 has exposed the myth of “global health.” There is no global public health system, and there never was. The pandemic has stripped the mask of multilateralism from the pharmaceutical-philanthropic complex, revealing a system that serves rich countries before the rest, and puts private profits before public health. We should not celebrate the anniversary of the pandemic by reviving the myth of “global health.” We should build a system that actually delivers it.
The foundations of this powerful myth were crushed at the very outset of the pandemic. The Trump administration walked out of the World Health Organization, and its allies stirred racist, orientalist, and xenophobic sentiment instead of prepraing for the spread of the virus. Within months, a handful of rich countries had stockpiled every existing vaccine candidate, hoarding more than half the world’s supply. Meanwhile, they voted to uphold intellectual property rules that would deny them to the rest.
The institutional architecture of the so-called global health system caved immediately to these nationalist interests, from global health organizations — two-thirds of which are headquartered in the US, UK, and Switzerland — to international financial institutions, mobilized to protect creditors’ right to collect interest over debtors’ right to survival.
Even the philanthropists — who have worked assiduously to construct the myth of global health — played their part in this process, urging the privatization of vaccine technology instead of sharing it with the world.
Now, these institutions mark the anniversary of pandemic declaration with debates about the future of global health — finance reforms, governance mechanisms, innovation costs, and so on. But we cannot save a system that does not exist.
Instead, we must revisit the question at the very heart of the health debate: How can we protect human life? How can we resist a health apartheid that protects the lives of the rich and discards those of the poor? How can we build a system that prioritizes the love and care that we need to keep each other alive?
Convening scholars, activists, and practitioners from around the world, the Covid-19 Response group of the Progressive International has proposed some principles in a new ‘Manifesto for Life.’
First, a People’s Vaccine for Covid-19.
As long as the virus spreads, it can mutate and move. No one country can end the pandemic alone; Covid-19 anywhere is a threat to public health everywhere. A system truly premised on global health would guarantee open access to all know-how for the COVID-19 vaccine and the creation of production facilities across the globe.
Second, a World Health Organization that can work for world health.
The interests of its rich countries, private funders, and bad ideas of big financial institutions hinder the World Health Oorganisation. It is time to free the WHO from these constraints. This does not mean building a supranational authority unaccountable to the governments it serves; on the contrary, it means delivering on the WHO’s core promise of multilateral governance. A WHO focused on world health would focus on building the regional and national public health systems that enhance the principle of self-determination, rather than riding roughshod over it.
Third, private capital must be made to submit to public health.
The plain objective of “Big Pharma” is to profit from people falling ill. The right to life is made into a commodity and sold as a luxury to a limited few. To enshrine a global right to life, we must begin from the principle of free and universal healthcare, shifting from a private locus of provision over to a public.
Fourth, human life is not a bargaining chip.
We are asked to believe in a “global health” system that considers public health a source of geopolitical leverage. The pandemic has made clear that seeing health through the lens of “national security” leads to policing over provision, aggression over cooperation. A true global health system will end medical sanctions and the deployment of security forces in response to public health emergencies.
Finally, pride of place for our carers.
‘Essential’ workers have been hailed as heroes but dehumanized in practice: underpaid and overworked, often without any rights as workers or recourse to social support. Carer unions will be key to any public health policies. Workers must be trained, protected, paid, and their right to provide or withdraw labour respected.
One year into the pandemic, it is easy to feel that everything has changed. But it hasn’t, and it must. We continue to live by the laws of a “global health” system that does not exist, preventing us from building one that does.
There are only two choices. One path leads us backwards to a planet of neglect, where the rich shield themselves with the bodies of the poor. This is a familiar story. The other leads to life. On the anniversary of Covid-19, this is the path that we choose.
Áurea Carolina de Freitas e Silva
Elizabeth Victoria Gomez Alcorta