Rise in tuberculosis in Peru: A byproduct of the COVID-19 pandemic

Angelo Perera

In an article titled, “An Unexpected Pandemic Side Effect in Peru: A Comeback For TB,” NPR (National Public Radio) gives a sobering account of the rise of tuberculosis (TB) in Peru and much of the developing world because of the COVID-19 pandemic.

In Peru, in 2019, the nonprofit health care organization Partners in Health (PIH) began a screening program called TB Móvil, which brings TB testing to the community via two vans equipped with X-ray machines that use Artificial Intelligence (AI) software to diagnose TB quickly and accurately. The vans are operational in the three northernmost districts of Peru’s capital, Lima.

Carabayllo hillside slum north of Lima Peru work done by Partners in Health on treatment of MDR-TB. Photo courtesy of Partners in Health

Martin Valencia Garcia, a community agent of TB Móvil, noticed that after the onset of COVID-19, patients likely stopped seeking further tests and treatment. Speaking of a 52-year-old patient who was in his care before COVID-19 but has since lost touch with him, Garcia remarked, “He could not do the exams, and since he couldn’t do the exams, he couldn’t be diagnosed, and he couldn’t receive treatment.”

Under disruptions caused by COVID-19, Luz Villa-Castillo, a study coordinator at Cayetano Heredia University in Lima, pointed to the masking of a rising tuberculosis caseload as fewer patients sought diagnostic testing and received inconsistent treatment. Villa-Castillo suspects many milder strains of TB may “have likely become resistant.”

At the onset of the coronavirus pandemic in March 2020, Peru, like most countries across the globe, went into partial lockdown with restrictions on movement and commerce. While lives were certainly saved, job losses were extensive, leading to more than six million people left unemployed by the second quarter of 2020, with many jobs permanently destroyed. With public transportation capacity cut by 50 percent, many younger workers who depended on these modes of commuting were unable to go to work and lost their jobs.

The stresses of economic devastation coupled with a lack of transportation also meant that many patients with multiple drug-resistant tuberculosis (MDR-TB) most likely stopped seeking treatment and were lost to followup evaluation and care.

Worldwide, TB is one of the top 10 causes of death and the leading cause from a single infectious agent. The World Health Organization (WHO) states that a total of 1.4 million people died from TB in 2019 (including 208,000 people who also had HIV).

The infectious disease is caused by the bacterium Mycobacterium tuberculosis, which usually affects the lungs, causing the signature bloody coughs. Most infections, however, are described as latent TB, producing no symptoms, and the person is considered not contagious.

The primary risk is that about 10 percent of these individuals will go on to develop the active disease. The risk is as high as 5 percent in the first two years, climbing at a rate of 0.1 percent per year afterwards. The elderly or those with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a higher risk of falling ill with active TB.

TB is considered a poor man’s disease, with 95 percent of cases and deaths appearing in developing countries. In 2019, out of the estimated 10 million people who fell ill with TB worldwide, 2.2 million cases were attributed to undernutrition. Another 1.4 million cases were attributable to alcohol use disorder and smoking, practices that continue to exist disproportionately in poorer sections of global communities.

Yet the disease is both preventable and curable. The WHO stated that, since 2000, an estimated 63 million lives were saved through early diagnosis and treatment of TB. For most who have access to treatment, a rigorous six-month course of four antimicrobial drugs, which need to be taken daily, can be curative. But without the support of health care workers and health infrastructure, patients may not be able to complete the full course, which can lead to the development of drug-resistant strains.

Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the two most effective first-line anti-TB drugs. Extensively drug-resistant TB (XDR-TB) is also resistant to second-line medications, which are much more toxic and less effective than the first-line medications. Treatment schedules for MDR-TB are arduous, possibly lasting up to two years, with medicines that are both expensive and difficult to take due to their side effects. MDR-TB remains a public health crisis and a health security threat.

A global total of 206,030 people with multidrug- or rifampicin-resistant TB (MDR/RR-TB) were detected and notified in 2019, a 10 percent increase from 186,883 in 2018. Globally, only 57 percent of patients with MDR-TB have been successfully treated. About 3 percent of new cases and 18 percent of existing ones are drug-resistant.

Around the world, TB health care facilities and personnel have been diverted to handle the COVID-19 pandemic. A survey by the Stop TB Partnership, an international organization fighting to eradicate TB, noted that of the top 20 high-burden TB countries, which represent 54 percent of all TB cases in the world, staff, isolation wards, and specialists had frequently been redirected to provide COVID-19 care, with many TB laboratories and research teams essentially shut down. TB diagnostic supplies and drug shipments have been drastically disrupted, leaving infected patients without medical recourse.

To place the impact of the pandemic on the burden of drug-resistant TB into its dire context, as the NPR report stated, even before COVID-19, in 2018, of the nearly 500,000 new MDR-TB cases, only a third were given an effective treatment. Peru has the highest estimated RR/MDR-TB burden of the Americas, with 9 percent of TB cases being drug-resistant, according to 2017 data.

A Stop TB Partnership study conducted in India, Kenya and Ukraine estimated that second-line treatments for drug-resistant TB will drop to as low as 25 percent in those countries due to coronavirus-related disruptions.

In October 2020, the WHO warned that the pandemic is threatening to reverse the global progress against TB. TB notifications in three of the highest-burden countries—India, Indonesia and the Philippines—fell by 25 to 30 percent from January to June of 2020, compared with the same period in 2019. The agency estimated that roughly 85 percent of people who are diagnosed with TB and notified could be successfully treated. However, according to their modeling estimates, if the number of TB patients detected and notified globally falls by 25 to 50 percent over a three-month period due to disruptions in TB services, deaths related to the disease could reach as high as 400,000 just for 2020.

A 2015 report published by Oxfam titled, “Inequality in Peru: Reality and Risks,” paints a devastating portrait of the deplorable conditions caused by extreme poverty and substandard infrastructure in the country. The report found that more than half a million households had no electricity. An estimated 1 million households are not connected to the public water network, 2.5 million lack sewage, 7 million do not yet have access to safe drinking water, and in rural areas, less than 5 percent of households drink chlorinated water. The pandemic has only exacerbated these grim statistics.

Peru’s ruling class has for decades conducted a concerted assault on the working class. Perhaps this has been best personified by the “Wall of Shame” that separates the slum dwellers of Lima from the wealthier neighborhood called Casuarinas.

Korey Finn of Lehigh University depicts in his paper, “The Informal Economy in Peru: a blueprint for systemic reform,” a deplorable picture of misery sustained by an informal economy that collapsed under the pressures of COVID-19. Finn describes the shantytown in the outskirts of Lima in the following passage. “The Peruvians here are seldom able to travel into the city for income opportunities, finding whatever work they can within their neighborhoods to provide for themselves and their families. One woman described making a living by selling milk, bread, and other essentials in the neighborhood mini mart, earning less than $2 a day. These Peruvians have one thing in common—they operate in the pervasive informal economy, which disproportionately affects Peruvian workers.”

Where an informal Peruvian worker could make as little as $2 a day, Wikipedia lists seven billionaires in the country who collectively hold $11.9 billion. This level of inequality is not sustainable, and Peru, having gone through three presidents in a week last November, is poised for a social explosion. The health care crisis exemplified by the resurgence of TB under these squalid conditions ripe for the spread of the bacterium only confirms the complete indifference of the ruling class towards much of the population.

Chinese defense minister visits Sri Lanka amid rising geopolitical tension

Rohantha De Silva

Chinese Defense Minister General Wei Fenghe visited Sri Lanka for two days last week as part of Beijing’s efforts to strengthen its influence in the region under conditions of deepening geopolitical tensions and US-led military preparations against China.

Wei briefly visited Bangladesh on his way to Colombo, telling President Abdul Hamid that China and Bangladesh “should make joint efforts against powers outside the region setting up a military alliance in South Asia and practicing hegemonism.”

Sri Lankan Prime Minister Mahinda Rajapaksa, right, and Chinese Defence Minister Wei Fenghe fist bump as they avoid traditional hand shake as a precaution against the coronavirus during their meeting in Colombo, Sri Lanka, Wednesday, April 28, 2021. (AP Photo/Eranga Jayawardena)

Although Wei did not specifically name any country, he was clearly referring to the de facto Quadrilateral (Quad) alliance led by the United States and involving Japan, Australia and India. On March 11, US President Biden held an online meeting with Quad leaders, making clear that his administration would be strengthening military and strategic ties to confront China.

Wei’s trip to Colombo is the second visit by a high-level Chinese official in the past nine months. Last October, former Chinese foreign minister and Political Bureau member Yang Jiechi came to Sri Lanka. According to media reports, Chinese Foreign Minister Wang Yi will be arriving in Colombo next month.

Wei held bilateral talks last week with Sri Lankan President Gotabhaya Rajapakse and Prime Minister Mahinda Rajapakse. He also met with Defence Secretary Kamal Gunaratne, a retired major general, in the presence of three Sri Lankan armed forces commanders. Both sides said the discussions were “extremely fruitful” but provided few details.

The Xinhua news agency reported that President Rajapakse told Defense Minister Wei that Sri Lanka “has been pursuing an independent foreign policy and will never bend to pressure from major powers outside the region, as well as never forge an alliance with any country.” While the report did not indicate which “major powers” the president was referring to, Washington and New Delhi are openly hostile to Sri Lanka’s growing relations with Beijing.

Colombo’s connections with Beijing are extremely important for two main reasons. Firstly, the Rajapakse government confronts a deepening economic crisis and growing foreign debt, which has been exacerbated by the COVID-19 pandemic. Exports have sharply declined, tourist revenues have all but collapsed and the country is required to pay $US4.5 billion annually in foreign loan and debt repayments until 2025. In order to avoid default, Colombo has turned to Beijing for financial assistance.

In March, China’s People’s Bank signed a three-year $1.5 billion currency swap deal with Sri Lanka’s Central Bank, and on April 12 Colombo obtained a $500 million loan from the China Development Bank. Even before the latest financial arrangement, Sri Lanka owed Beijing over $5 billion in loan repayments.

Secondly, the Rajapakse government is counting on Chinese support to counteract political pressure from the US and other western countries over Colombo’s human rights violations.

In March, the US co-sponsored a resolution presented to the UN Human Rights Council (UNHRC) by a “Core Group on Sri Lanka,” whose members include the UK and Germany.

The resolution, which was passed in a majority vote, called for an investigation into war crimes committed during the final months of Colombo’s communal war against the separatist Liberation Tigers of Tamil Eelam. At least 40,000 Tamil civilians were killed and numerous other human right violations committed during this time. It also requested the collection and preservation of evidence that could be used in a future prosecution of Sri Lankan military leaders.

The US and its allies are not concerned in the slightest about the violation of democratic rights or war crimes committed in Sri Lanka or anywhere else. The UNHRC resolution is in order to pressure Colombo to distance itself from China. Although New Delhi, for tactical reasons, abstained on the UNHRC vote, it expressed support for the resolution. China and Russia voted against the resolution.

The government of former President Mahinda Rajapakse faced similar US-led resolutions at the UNHRC in 2011, after it turned to China for financial support. While Beijing campaigned heavily on behalf of Colombo in the UNHRC at that time, Mahinda Rajapakse’s government was ousted in 2015, following a US-sponsored regime-change operation.

Four years later in 2019, the pro-China Maldives President Abdulla Yameen was forced from office in an Indian-backed and Washington-sponsored removal.

Defence Secretary Gunaratne last week thanked Wei for China’s support in the UNHRC. Wei said Beijing was looking forward to working with Colombo “to enhance practical cooperation and to promote bilateral relations to a greater extent.” He promised a $7.73 million grant for military assistance.

Wei’s visit coincided with agitation against the Colombo Port City Economic Commission Bill by Sri Lankan opposition parties and other groups. The $1.4 billion Port City was built by the China Communications Construction Company with a loan from Beijing.

The Samagi Jana Balawegaya, the Janatha Vimukthi Peramuna (JVP) and several other formations have mounted a virulent anti-China campaign against the project, alleging that Port City will become a “Chinese colony.” The racist agitation lines up with the US-led opposition to Port City and other Chinese investments in Sri Lanka.

Washington and New Delhi claim that Chinese investments in Sri Lanka, and other poor countries, are “debt traps” used by Beijing to further its “hegemonic” ambitions. Last October, former US Secretary of State Mike Pompeo visited Sri Lanka, openly denouncing China as a “predator” and demanding that Colombo line up against Beijing.

China regards Sri Lanka as vital to its efforts to retain a foothold in the Indian Ocean, secure its crucial energy supplies and counteract aggressive US military preparations. The Chinese-funded Port City in Colombo and Hambantota Port are crucial links in its strategic Belt and Road Initiative.

To boost its influence in the region, Beijing also held a six-country South Asia dialogue on April 27 on COVID-19 and economic cooperation. Foreign ministers from Afghanistan, Bangladesh, Nepal, Pakistan and Sri Lanka participated in the meeting. India was not invited.

The Sri Lankan government, like a number of its counterparts in the region, is attempting a desperate balancing act. Washington has made clear many times, however, that it will not brook any wavering as it seeks to ensure American imperialism’s hegemony in the Indo-Pacific, including, if necessary, through war.

New estimates claim COVID-19 death toll is twice as high as reported

Bryan Dyne

A new global “excess mortality” estimate of deaths caused by the coronavirus paints a truly harrowing portrait of the real state of the ongoing pandemic. While official counts of the pandemic place the current global death toll at more than 3.26 million, the study calculates the dead at 6.93 million.

The study was conducted by the Institute for Health Metrics and Evaluation (IHME), a research center at the University of Washington. Throughout the pandemic, Dr. Chris Murray and his team have sought to use numerical methods to track and predict the cases and deaths caused by the pandemic, and are cited often by various agencies and departments of the United States government.

People watch burning funeral pyres of their relatives who died of COVID-19 in a ground that has been converted into a crematorium in New Delhi, India, Thursday, May 6, 2021. (AP Photo/Ishant Chauhan)

As the authors note, however, such reports, based on officially recorded statistics, are inherently underestimations. The amount of testing and reporting of deaths in countries, and in states and provinces within those countries, changes over time and varies greatly across national lines. Reported cases are also subject to manipulation for political reasons.

By estimating the excess mortality of a given region—the deaths in excess of previously calculated averages for a defined period—researchers at the IHME were able to get a more robust picture of the disastrous state of the spread of the disease in each country studied, as deaths as a whole are generally recorded with some degree of accuracy. Importantly, for the first time since the beginning of the pandemic, this analysis looks at excess deaths across the entire planet.

“Once we completed this analysis,” Murray said in an interview accompanying the data release, “our understanding of the magnitude of COVID to date has been much worse than what we have been thinking so far. We have estimated to date that 6.9 million people have died from COVID globally already.”

In terms of absolute number of deaths, the United States, India, Mexico, Brazil and Russia have the most fatalities caused by COVID-19. In the US, more than 905,000 people have died, 58 percent more than records indicate. In India and Mexico, deaths stand at 654,000 and 617,000, respectively, nearly triple officially acknowledged deaths. The adjusted number of dead in Brazil stands at nearly 596,000, about 46 percent above official counts. And Russia has an excess death count about that of Brazil, 593,000, indicating the tally of the dead in that country has been undercounted by at least a factor of five, around double previous excess mortality estimates.

Other countries had even higher ratios of excess mortality to reported mortality. Japan’s death toll was estimated to be more than 10 times higher. In Egypt, under the yoke of a blood-soaked military dictatorship backed by the imperialist powers, the IHME reports that the pandemic has claimed more than 12 times the lives reported by that regime. And in Kazakhstan, the total COVID-19 deaths are at least 14 times more than government tallies.

Notably, these adjusted death counts reveal high death counts in whole regions that to date have reported relatively low numbers of COVID-19 deaths. In sub-Saharan Africa, for example, the ratio of actual cases to reported cases ranges from 1.6 to 4.1, suggesting many tens of thousands more human lives have been lost in those countries that previously thought. A similar situation exists across the Indian subcontinent and in numerous countries in Southeast Asia and the Pacific.

The COVID-19 fatality rates, deaths per 100,000 people, reveal equally stark disasters in other parts of the world, particularly eastern Europe, the Balkans and Latin America—not coincidentally regions that have suffered drastic declines in their living standards in the past three decades as a result of the restoration of capitalism after the dissolution of the USSR and imperialist intrigue and war. In Azerbaijan, for example, the official pandemic death rate is 44.6, whereas excess mortality figures estimate a death rate of 648.8, a more than 14-fold increase. In Belarus, the estimated actual death rate is nearly 17 times the official numbers, nearly 460 dead for every 100,000 people.

Officially reported and estimated global daily death counts. Credit: IHME

Moreover, unlike previous excess mortality studies, the current IHME model was careful to as much as possible not include deaths not directly caused by the virus itself. They analyzed six “drivers of all-cause mortality” related to the pandemic, broad categories that make up the excess death counts. These include COVID-19 itself, deaths caused by delayed or deferred health care, deaths from increased mental disorders and drug use, a reduction in deaths from injuries because of lockdowns and social distancing mandates, fewer deaths from other diseases, including the flu, and measles, and reduced deaths from heart or lung conditions because many of those individuals instead died prematurely from the coronavirus.

The predictions also used weekly and monthly all-mortality data, rather than yearly, to get a very granular view of how the death rates in different countries changed over time.

This approach allowed the IHME team to accurately calculate deaths caused by the coronavirus even in places where excess deaths actually went down for the above reasons, as well as to differentiate between deaths caused by the virus itself and those caused by the pandemic’s impact on society. In total, the scientists were able to exclude 615,000 deaths that occurred from March 2020 onward, providing a very clear picture of the colossal death toll of the pandemic.

The data also suggest many areas for further study on the indirect human cost of the coronavirus. They show that, for example, opioid deaths in the US increased by about 15,000 last year, likely a result of increased anxiety and depression brought on by the immense social crisis.

In addition, the study makes clear the even its immensely high excess mortality calculations are likely an underestimation. In Europe, they excluded data during five weeks of late summer when a heat wave made accurately estimated COVID-19 deaths much more difficult. They were also not able to use the reported all-cause deaths data from Brazil, which has been plagued by an incomplete registration of deaths since near the beginning of the pandemic and was forced to use a secondary record instead.

The authors further note that “As the evidence is strengthened in the coming months and years, it is likely that we will revise our estimates of the total COVID-19 death rate upward in future iterations of this work.” This will no doubt especially hold true for areas like sub-Saharan Africa where even reported deaths, the yardstick of this method, are difficult to get with any specificity and are generally undercounts.

Facebook Community Accelerator Programme 2021

Application Deadline: 31st May 2021 by 11:59 PM (PDT)

About the Award: Facebook’s mission is to give people the power to build community and bring the world closer together. An important part of this is supporting the leaders who foster community—people who offer encouragement, build bridges and drive change. We invest in and empower these leaders to start, grow and sustain meaningful communities that positively impact people’s lives.

Type: Entrepreneurship

Eligibility: If you run an impactful, established community, are ready to grow using Facebook’s family of apps and have the time and energy to invest in this program – we encourage you to apply!

Eligible Countries: All

To be Taken at (Country): Online

Number of Awards: Not specified

Value of Award:

• Growth Focused Training: Participants will be immersed in an intensive training program to create a growth plan for their community through Facebook’s family of apps.
• Mentorship & Partnerships: Facebook team members and experts in product and community growth offer each participant hands-on mentorship and connections to local funders and partners.
• Funding to Grow: Facebook will work with GlobalGiving to fund participants’ approved growth plans.

How to Apply: Apply here

• It is important to go through all application requirements in the Award Webpage (see Link below) before applying.

Visit Award Webpage for Details

AT&T’s “Harvesting” Scam

David Rosen

If you live in California and still use legacy Plain Old Telephone Service (“POTS”) from AT&T, you are likely getting ripped-off big time. And if you are an AT&T POTS customer anywhere in the U.S., you are also likely getting ripped-off.

In April 2019, the California Public Utilities Commission (CPUC) undertook an exhaustive examination of the policies and practices of Pacific Bell Telephone Company (dba AT&T California [AT&T]) and Verizon California Inc. (dba Frontier California) and found they ”consistently failed to meet existing service quality metrics.”

“AT&T appears to have adopted a ‘harvesting strategy’ for its legacy POTS services,” the CPUC noted. It added, “the company has ceased active marketing of POTS, has degraded POTS service quality, and instead relies upon successive price increases and customer inertia to maintain its declining POTS revenue stream. [CPUC/17-18] Ars Technica reports that the study was “written in April 2019 but kept private because data submitted by the carriers was deemed confidential and proprietary.” When it was finally released, it was heavily redacted.

The CPUC’s assessment is a straight forward indictment:

AT&T’s overarching approach to its stewardship of the California ILEC [Incumbent Local Exchange Carrier] infrastructure has been a “harvesting strategy” that relies upon customer captivity and inertia, rather than providing good quality service.

It goes on to declare, “’Harvesting’ of this legacy service customer base allows AT&T to maintain revenue levels and to extract the maximum amount of capital from the California ILEC entity in order to support the parent company’s wireless, video distribution, video content, and other business initiatives – activities that have captured the overwhelming bulk of management’s attention.

The state oversite agency goes further, noting that “to support its ‘harvesting’ strategy and maintain revenues despite a massive drop-off in demand, AT&T California has raised its rates for legacy flat-rate residential service by [blacked out]% since the service was de-tariffed by the CPUC in 2009.”

In the telecommunications world, “harvesting” as a number of very different meanings. The most well-known is data aggregation, the collecting of user or customer information (e.g., location data) and selling it to third parties. A second takes place when a telecom company (e.g., AT&T) decided to upgrade or replace an older network (e.g., 2G) and convert users to a new frequency (e.g., 3G). A third and more pernicious form of harvesting is exemplified by how AT&T treats POTS customers.

Two examples of the overcharging that characterize AT&T’s harvesting campaign are illustrative. The fee for “Local Service” (i.e., basic service) for 2004 was $10.69 and for 2021 was $27.00 – an increase of 153 percent; the fee for “Call Waiting” in 2004 was $3.23 but by 2021 it was $11.99, a 271 percent increase. (The inflation rate for the 2004-2021 period was 40.2 percent.)

Compounding the issue of overcharging, the CPUC reports that, since 2010, AT&T failed to meet the state “requirement to clear a minimum 90% of out-of-service reports within 24 hours has never been met …. Verizon/Frontier met the OOS standard in only two of the 96 months covered by this study.”

Why, one might ask, did AT&T fail to deal with service problems? The California agency does not pull any punches: “Whether deliberate or not, AT&T’s investment policies have tended to favor higher-income communities, and have thus had a disproportionate impact upon the state’s lowest income areas.” It then notes, “Wire Centers serving areas with the lowest household incomes tend to have the highest trouble report rates, the longest out-of-service durations, the lowest percentages of outages cleared within 24 hours, and the longest times required to clear 90% of service outages. The opposite is the case for the highest income communities.”

And it adds:

AT&T’s record on service outages has deteriorated over the 2010-2017 period (the subject of this study). AT&T’s overarching approach to its stewardship of the California ILEC infrastructure has been a “harvesting strategy” that relies upon customer captivity and inertia, rather than providing good quality service.

Unfortunately, the AT&T’s harvesting scheme is likely being played out across the country. The Irregulators, a group of independent telecom experts that includes former FCC officials, estimated that AT&T’s California harvesting campaign for the five-year period ending in 2019 could range from a low estimate of $2.3 billion to as high as $10.3 billion.

There are an estimated 22 million wireline (DSL or other) telephone users in the U.S. as of 2020. One can only wonder how many are being harvested by AT&T and other providers.

Comprehensive Health Reform Program Will Benefit All Developing Countries

Bharat Dogra

While so many differences have emerged in the context of the recent response to COVID-19 in various countries, one point on which it should be possible to establish wider agreement is that this response would have been much better if a robust, strong, well-rooted, trustworthy and trust-creating, community-based , well-resourced health system was in place in all rural as well as urban settlements. Another point on which it should be possible to have wide agreement is that  any health system would work much better if it functioned on the  basis of need and not  on the basis of narrow profit considerations and if its policy  decisions were not influenced by narrow profit considerations.

This is an important time to consider need for comprehensive reforms in health sector. While these will be useful for all countries, in the case of developing and poorer countries this need is even more compelling as here  essential, life-saving interventions still have to reach many people and the problems arising from hunger and malnutrition as well as low resource base also exist in a big way. So developing and poorer countries also have to find ways and means of reducing all misuse, profiteering and wastage of resources while meeting essential needs. They cannot afford to spend their scarce budget on inputs or options which are not useful, wasteful or even hazardous. Hence the availability of more resources has to be accompanied by  more caution and firmness in avoiding waste and improper use of resources.

While social, economic and technological progress has made possible significant improvements in health to a certain extent and within certain limits, at the same time it cannot and should not be ignored that several regressive factors have also been  at work and in some contexts these have been becoming more dangerous in recent times. An even greater threat is posed by wider changes in environment ( such as those relating to climate change, deforestation and animal-human inter-actions) and human society ( such as those relating to increasing inequalities, high levels of substance abuse and high level of violence of various kinds) which can bring extremely difficult challenges for the health sector to cope with some of which it may be quite helpless despite all the technological advances. For example if and when weapons of mass destruction are used, a very advanced and dedicated health system can also find itself quite helpless in providing much relief to victims despite the best intentions and high levels of commitment.

Keeping in view these and other important factors a comprehensive program of health reform is presented here–

* Creating Health Systems Which Meet the Essential Needs of All People—It is extremely important to create a health system which is able to meet the needs of all people, including the poorest. This means having primary health centers which meet all basic health  needs, including immunization, maternity, preventive aspects, essential health-hygiene-nutrition messages for people and care of diseases and injuries which do not involve too many complications and do not require  very specialized equipments and expertise. This should be entirely the responsibility of the government with the involvement of decentralized units of governance and people, with special emphasis on women. This should be free for all, although those who can afford to pay can be encouraged to make modest contributions as well as donations, the principle being that no one is denied the needed care for lack of money. These primary health centers should have adequate staff and funds to carry out all their duties. There can be one primary health centre for a population of around 10000, supported by sub-centers where needed, in rural as well as urban areas. There can be regional variations depending on special needs and features.  Health workers, more female than males, will be based in all hamlets. Ambulances should be available in all such centers. Cooperation of people to meet health needs should be encouraged at all levels. All primary hospitals should be linked to bigger and specialized hospitals of the government, with adequate staff and funds, operating on the same principles, with compulsory acceptance of all complicated cases referred to by primary health centers. In addition private doctors, hospitals and health institutions are to be allowed, but will be regulated as per ethical norms. Philanthropic institutions functioning with a spirit of service are to be welcomed and encouraged but still subject to regulations, and requested to fill gaps rather than  duplicate. All government doctors and health staff will be assured good salaries and satisfactory housing near workplace.

* Curbing/ousting forces of profiteering and control—It is important to keep away those forces which seek to turn health sector into a source of high profiteering, domination and control. Health sector will not be able to serve people and meet their needs in a satisfactory way as long as these forces are not checked. At present these forces are extremely powerful. Billions of  people of entire world should unite to give these forces a big kick, which is overdue.

*Responding Well to Climate Change , Environmental Threats, Deforestation and Changing Human-Animal Interactions –It is by now widely agreed that climate change is likely to bring extremely difficult health challenges for which humanity is not at all well prepared in many parts of world.  What is more climate change cannot be seen in isolation. A number of other critical environmental problems are linked to very serious harm to health. These include air pollution, water crisis ,natural forest depletion and other related changes whose combined impact will pose extremely difficult challenges. Inequalities in health are likely to be accentuated as the poor are affected more by climate change and at the same time have less access to health care. It is important to understand health problems related to deforestation , loss of species and their habitats, cruelty to animals and unhygienic, healthy congested conditions of keeping, feeding and slaughtering animals. Health sector should help to increase awareness of essential reforms and push for this. The health sector should give much more importance to climate change related emerging challenges in region specific situations. This should include timely warnings about new emerging problems and situations in various regions. *Reducing Exposure to Hazardous Substances–Due to a complex of factors the chances of excessive and prolonged exposure to a  range of hazardous and toxic substances, chemicals and radiation are increasing, particularly for children, leading to increase in a host of physical and mental disabilities and serious diseases, including occupational diseases and various cancers. As scientific research in several such contexts has not been adequate or is biased, the chances of remedial action in time are reduced. Health sector personnel and researchers should watch out more carefully for these linkages so that people have timely warning and public regulation and policy are better informed.

*Improving Access to Adequate, Safe and Nutritious Food –While inequalities and poverty remain a major reason for denial of nutritious food to millions of people, other factors are fast emerging which may deny safe and nutritious food to an even larger number of people. Powerful multinational companies strive to control the world food and farming system in unprecedented ways, spreading genetically modified (GM) crops which have a range of adverse health impacts. The same trends make way for food to be contaminated by more and more dangerous agri-chemicals and food additives and preservatives. Availability of fresh safe food from nearby areas seems likely to diminish, according to recent trends and forecasts.  Health researchers and personnel should re-emphasize the important role of safe food from a health perspective, as also how access to safe food is likely to become more and more difficult given the recent trends in world food system, so that people and public policy are better informed on this issue of critical importance.

* Curbing Proliferation of Highly Destructive Weapons and Reducing Possibilities of War-In recent times countries like Iraq and Syria have witnessed the horror of how reasonably well-developed health systems can be destroyed by a few days of bombing, also leaving behind a legacy of longer-term health impacts, such as persistent adverse impacts (including cancer) of depleted uranium and disease outbreaks caused by the destruction of sanitation systems. Yet this is nothing compared to what may be unleashed by an exchange of nuclear weapons. Medical science, with all its technological advances, will appear quite helpless in coping with the impacts of any significant exchange (or one-sided use) of nuclear weapons. Yet the possibility of actual use of nuclear weapons are increasing in some significant contexts and new very dangerous weapons, such as robot (or AI or autonomous weapons) are fast emerging. The possibilities of very destructive wars are also increasing, with escalating tensions among the most powerful countries and the breaking down (or non-renewal) of existing nuclear arms control agreements. The health sector should more clearly extend its support to the world peace movement and to the various peace efforts, while also giving adequate and timely warning about the much increased and unacceptably high price of  conflict and war in present-day world.

*Helping to Reduce Disaster-Related Threats– Both as a result of and independent of climate change, disasters are increasing and have adverse impacts on the health of people in a number of direct and indirect ways , for example resulting in denial of safe water and food while at the same time the threats of disease and injury increase. High intensity cyclones have in recent times caused great destruction and created huge challenges for the health sector but this is only the more visible aspect of disasters as the harm done by less visible but prolonged , more frequent droughts is also enormous in terms of increasing hunger, under-nutrition and malnutrition as well as other health implications. High intensity earthquake risks are high in some densely populated regions which are ill-prepared to meet the threat. The health sector must be better prepared to respond to higher frequency and intensity of disasters.

*Reducing Risks From Accidents- Despite the better availability of technology, due to a number of factors the risks of a wide range of accidents (not just road accidents) is increasing in many parts of the world. Occupational accidents of some kinds can be very high without attracting much public attention. Higher possibility of accidents is troubling anywhere but is likely to have more dangerous consequences in more densely occupied areas. The health sector must not only make better preparation for timely, early treatment of accident victims, but on the basis of its experience and research should contribute more to understanding and reducing causes of high incidence of various kinds of accidents,  accident injuries and deaths. Most accidents and accident deaths can be prevented, and the harm done by accidents can be reduced greatly by the availability of prompt medical care.

* Reducing Risks of Violence , Violent Behavior and Self-Harm– Due to a complex of factors everyday life is become more violent in many parts of world and the risk of injury and deaths from violence, including self-harm, is increasing. On the basis of its careful observations and research, the health sector should contribute not just to better care and cure but also to better understanding and reduction of violence, including various kinds of self-harm and suicides.

* Reducing Mental Health related Problems– Several prevailing and accentuating trends can be seen in increased individualism, loneliness, a culture of instant gratification and much reduced stability / commitment in social relationships at various levels. There are also higher levels of aggressiveness in pursuit of increasingly narrow and self-centered goals. Pandemic related issues have further increased the risks of mental health problems. Wider social links of mental health are likely to get much more attention if warnings come from health personnel, doctors and researchers. Hence beyond better treatment the health sector can contribute much more to proper understanding and prevention of mental health problems.

* Reducing Substance Abuse - More and better efforts to check the consumption of and addiction to tobacco, alcohol and all intoxicants are needed. There are indications of overall higher substance abuse, including in new forms. This has implications for increase of a wide range of health problems. The health sector should play a more active role in spreading awareness of health impacts of substance abuse and helping society to reduce substance abuse very significantly.

*Improving Access to Safe Drinking Water—Due to a number of reasons, despite more pipelines and hand pumps being installed, the number of people not having easy access to clean and safe water for drinking, cooking and hygiene is likely to increase. By drawing attention to emerging trends in problem areas and by giving timely  warnings about health impacts of this, the health sector can contribute to timely increased attention being given to this important aspect of health.

* Increasing Concern for Poor and Vulnerable People–While the number of people living in poverty has been reported to be decreasing, there are reasons to suspect that some of these achievements may be over-reported and/or the problem may be defined in such a way as to under-report or hide some disturbing trends. For example people reporting more assets than before may yet may be facing more problems in terms of sustainability of their livelihoods or access to basic needs like safe drinking water and safe food, or also may face the wrath of worse disasters in future. Overall the number of vulnerable people may be increasing, particularly in terms of risks to their health and wellness. The health sector can help by providing a more balanced and nuanced understanding of poverty and health.

* Contribution to decrease of inequalities– At world level inequalities are increasing sharply. This has an adverse impact on health in various ways, for example in terms of access to nutrition, medicines and health care. By drawing attention to adverse impact of inequalities on disease and health problems, the health sector can strengthen the case for policy reform for reducing inequalities. If inequalities continue to increase this can lead to much worse implications in a situation of climate change , and this is another aspect that demands attention.

* Reducing Social discrimination– Social discriminations existing at various levels in various societies such as gender, sexual orientation, caste, ethnicity, race, color etc. also get reflected often in access to health care and education and at some places, in some contexts such concerns may even be increasing .The health sector should be better prepared for this challenge and must contribute to reducing this discrimination, more particularly the prevalence of any such discrimination in accessing health care.

* Ensuring Access to Medicines–Low cost, rational and good quality medicines should be available to all those who need them. No person, no matter how poor, should be denied medicines essential for him or her. This responsibility should be accepted by the public sector to provide all essential good quality medicines at low cost and very low profit margins. International and national philanthropic organizations should help in this Essential and rational medicines should be identified clearly, including essential medicines needed by relatively smaller number of people. The existing patent laws need to be challenged to the extent that these conflict with this objective. The existing serious distortions in the medicines sector should also be challenged in this context and strong efforts made to restructure the medicines industry in keeping with the real needs of people.

* Ensuring real need-based, rational vaccines–Profit-driven distortions have increased even more in the vaccine industry. Control over vaccines is likely to be increasingly used by powerful  organizations and forces to not only push for distorted, high-profit orientation of the vaccine sector but to also use vaccine sector as an entry point for growing dominance and control of health systems. In the process irrational decisions may be taken ignoring real need as well as serious side-effects, all this posing serious problems for health sector and its limited budget. Gates of developing countries may be opened for bills of billions of dollars, that too for products of dubious merit. These problems are already arising in a big way in the context of the controversies relating to COVID-19 vaccine. Decisions regarding vaccines should be taken very carefully  on rational, ethical and unbiased basis. All irrational vaccines or those of dubious safety and suspect need should be avoided. As far as possible, manufacture of all vaccines should be with the public sector.

* Preventive Aspects Should Get More Attention–Preventive aspects of health care at the grassroots level should get much more attention. Preventive health covering all aspects – from sanitation to checking substance abuse, from non-violence to accident prevention – should be a very important aspect of primary health care and should be well supported. Sanitation and public hygiene should get high priority.

* Adequate Funds and Their Careful Use Should Be Ensured–Adequate budget should be made available for public health and medicine, but at the same time equal care should be taken to ensure that it is used carefully for real needs. If higher budgets are sucked up by high profiteering then the purpose will not be achieved. Use of public funds for enriching private insurance companies should be stopped.

* Areas of Special Needs Should Get Adequate attention–International organizations helped by professional bodies of health personnel everywhere should draw up special plans to meet the special requirements of most needy areas of world for medicines and medical personnel. These include areas of extreme poverty or those affected by disasters and epidemics, or conflict zones. Within various nations rural and remote areas with a shortage of medical personnel should get special attention.

* Medical Education Should Be Reformed–Medical education should be linked from the outset with real needs and priority concerns, linking high standards of education and expertise with critical concerns of  needs of people and medical ethics. Along with treatment prevention of disease and injury should get higher attention.

* Holistic Approach Is Needed– An approach which integrates modern medicare very well with preventive aspects, social concerns and alternative therapies (which have given good results in particular contexts), an approach that integrates physical, mental and spiritual health, an approach that links professional high attainments with medical ethics, which can integrate present day needs with a futuristic vision, will be most useful.

* Improvements in International Cooperation and Regulation Needed–This is needed badly to ensure better observance of medical ethics all over the world and ensure availability of low-cost, good quality rational medicines, medical devices and vaccines all over the world. This is necessary also for developing wider acceptance of a holistic vision. Genuinely philanthropic organizations can contribute much to this effort.

Right-wing extremist Hans-Georg Maassen runs for the Christian Democrats in German general election

Johannes Stern

Former President of the Office for the Protection of the Constitution, as Germany’s secret service is called, Hans-Georg Maassen will run for the Christian Democratic Union (CDU) in the upcoming federal elections. He was selected at the end of April by the four CDU district associations of Schmalkalden-Meiningen, Hildburghausen, Sonneberg and Suhl in Thuringia as a direct candidate for the Bundestag (federal parliament) with 37 out of 43 votes cast.

Hans-Georg Maaßen in the Bundestag (German Parliament) on Oct. 5, 2017 (AP Photo/Michael Sohn)

The selection of Maassen, which CDU chancellor candidate Armin Laschet defended at a press conference on Monday, shows the extent to which the ruling class in Germany is once again relying on fascist forces 75 years after the fall of Hitler’s Third Reich. Maassen, more than anyone else, is the face of the far-right conspiracy inside the state apparatus, whose political representation in parliament takes the form of the Alternative for Germany (AfD).

In his role as head of the domestic intelligence service between 2012 and 2018, Maassen played a key role in covering up and strengthening far-right terrorist networks in the police, military and intelligence agencies, and advancing the agenda of the extreme right.

As president of the Verfassungsschutz (BfV) at the time, Maassen was responsible for the Sozialistische Gleichheitspartei (Socialist Equality Party, SGP) being included in the agency’s 2017 annual report as a “left-wing extremist party” and “object of surveillance.” This was because, as the report states, the SGP stands for a “democratic, egalitarian and socialist society.” The report, which the federal government still adheres to today, bears the signature of the AfD and criminalises any left-wing criticism of capitalism and the right-wing policies of all the establishment parties as “left-wing extremist” and “anti-constitutional.”

When a far-right mob marched through Chemnitz in August 2018, hunting down foreigners, immigrants and Jews, Maassen described reports about this as “fiction.” He called videos documenting the violence “disinformation” and “misinformation,” to applause from AfD honorary leader Alexander Gauland. When the grand coalition federal government of the Christian Democrats and Social Democrats (SPD) then felt compelled to make Maassen retire early due to massive popular opposition, he ranted in the style of the extreme right about a conspiracy of “radical left-wing forces.”

Since then, Maassen has openly acted as a far-right politician. He incites anti-refugee sentiments, trivialises and justifies right-wing extremist terrorist attacks and promotes the building of a fascist movement in right-wing magazines like the Swiss Weltwoche. With the onset of the COVID-19 pandemic, Maassen positioned himself as one of the country’s leading coronavirus deniers. He declared on Twitter that the “novel virus” was “comparable in danger to a flu virus” and called for an immediate end to all protective measures in the interests of business and the corporations.

Representatives of the SPD, Left Party and Greens reacted to Maassen’s candidacy with feigned indignation. “Mr Maassen’s nomination is certainly a bad day for the CDU, but unfortunately also for all of us,” said Olaf Scholz, the SPD chancellor candidate and current finance minister. The CDU had “difficulties with people who move away from what we need for cohesion in Germany,” he added.

Maassen has always held extreme right-wing positions and owes his career in the state apparatus in particular to the social democrats. His rise in the Interior Ministry coincides with the term of Otto Schily (SPD), who headed the department from 1998 to 2005. During this time, Maassen prevented the return of Murat Kurnaz, a native of Bremen, to Germany and ensured that he languished in the notorious US Guantánamo Bay prison camp for five years while innocent.

He held his post as head of the BfV largely under the aegis of the grand coalition. During his watch, the investigation into the series of immigrants murdered by the neo-Nazi National Socialist Underground (NSU) was torpedoed, and right-wing extremist structures within the state apparatus were strengthened. In the process, he established close ties with Scholz. When Scholz ran for SPD chair in 2019, Maassen demonstratively backed him. On Twitter, he described Scholz as a “good man” whom he had “first met at the Visa-UA [Visa Investigative Committee],” declaring, “Olaf Scholz enjoys my trust!”

The Greens’ “criticism” is no less mendacious. They call Maassen a “door opener to the extreme right” (Federal Executive Director Michael Kellner), but at the same time hold on to possibly forming the next federal government with his party.

“Any parliamentary group can put up with one right-wing CDU MP and a handful more,” said Green Party Co-Chair Robert Habeck cynically. He clearly also had in mind the right-wing extremist “door openers” in his own party, such as the mayor of Tübingen, Boris Palmer. In the past, Palmer had repeatedly outed himself as a staunch supporter of Maassen. Among other things, he defended Maassen’s denial of right-wing extremist violence in Chemnitz with the sentence: “Who do I believe more now, antifascist insects or the president of the Office for the Protection of the Constitution?”

Most repulsive, however, is the hypocrisy of the Left Party. Maassen’s candidacy was “a red line,” declared Susanne Hennig-Wellsow, party chair together with Janine Wissler since the end of February. “The firewall to the right is gone.” Adding that “Maassen is Höcke in a three-piece suit,” referring to Björn Höcke, leader of the now-disbanded ultra-right “Der Flügel” (“Wing”) inside the AfD. In southern Thuringia, she said, “there will now be a race on the right.” The fact is, the Left Party is not only involved in this “race” but is actively driving it forward.

In Thuringia, where Maassen is now a candidate, the Left Party state prime minister Bodo Ramelow cooperates with the fascists in the state parliament committees and hoists them into important offices. Last February, Ramelow helped AfD deputy Michael Kaufmann to the vice presidency in the Thuringia state parliament with his own vote.

The Left Party’s support for the extreme right in Thuringia is no exception; there is an entire wing around former parliamentary group leader Sahra Wagenknecht that openly spreads nationalism, rails against immigrants, and demands an immediate end to all protective measures in the pandemic.

This course is supported by the vast majority of the Left Party and the party leadership. Wagenknecht will “always play a prominent role in this party,” Hennig-Wellsow and Wissler declared at their first joint press conference. Last month, Wagenknecht was then elected by a large majority as the Left Party lead candidate in Germany’s most populous state, North Rhine-Westphalia, even though she had just published her book Die Selbstgerechten (The Self-Righteous), which was hailed by the AfD.

The Left Party has also long since made its real position clear concerning Maassen and the BfV. As recently as March 2013, it had invited Maassen to a public meeting and practised direct solidarity with the domestic intelligence service. Wherever it is in government at state level, it supports increasing the powers of the police and intelligence apparatus, which is permeated by right-wing extremist structures. Its current “criticism” also serves to cover its own tracks.

Maassen’s candidacy for the CDU must be understood as a warning. Faced with the deepest crisis of capitalism since the 1930s, the ruling class is closing ranks based on an extreme-right programme.

G7 foreign minister discuss anti-Russia and China agenda amid global pandemic

Thomas Scripps

Foreign ministers from the G7 nations—the United States, the UK, France, Germany, Italy, Japan and Canada—met in London this week ahead of the full G7 summit this June. The event made clear that the meeting next month will be used to strengthen an anti-Russia and anti-China axis, led by the US.

Britain is using its position as host this year to confirm its wholehearted commitment to President Joe Biden’s aggressive foreign policy and push other nations, especially the European powers, to adopt the same stance.

On Monday, US Secretary of State Antony Blinken and UK Foreign Secretary Dominic Raab held a joint press conference. Raab declared that the two countries stand “shoulder to shoulder” and Blinken hailed their “special relationship”, saying the US had “no closer ally, no closer partner”. Blinken met with Prime Minister Boris Johnson Tuesday and discussed “the close alignment between UK and US foreign policy,” according to a Downing Street spokesperson.

UK Foreign Secretary Dominic Raab poses for a photo alongside G7 Foreign Ministers in Lancaster House, London, United Kingdom. May 5, 2021 (Picture by Simon Dawson / No 10 Downing Street-FlickR)

In a statement ahead of the talks, Raab said, “The UK’s presidency of the G7 is an opportunity to bring together open, democratic societies and demonstrate unity at a time when it is much needed to tackle shared challenges and rising threats.” At his press conference with Blinken, he called for “agile clusters of like-minded countries that share the same values and want to protect the multilateral system” and the “international rules-based order”—that is, based on US hegemony.

UK Prime Minister Boris Johnson chairs a bilateral meeting with the US Secretary of State Antony Blinken in 10 Downing Street. May 4, 2021, London, United Kingdom. (Picture by Simon Dawson / No 10 Downing Street-FlickR)

Both emphasised that the purpose of such an alliance would be a confrontation with Russia and China. Raab demanded Russian President Vladimir Putin end his “brinkmanship sabre-rattling on the border of Ukraine, the cyber-attacks and misinformation and the poisoning of Alexei Navalny, that was not just a human rights abuse but a use of chemical weapons on Russian soil”. Blinken warned that “if Russia chooses to act recklessly or aggressively, we’ll respond,” while claiming the US was “not looking to escalate”.

It is the US orchestrating provocations against Russia through NATO and the right-wing, nationalist government in Ukraine, which has endorsed a strategy to “recover” Crimea—territory now held by Russia. Blinken travelled to Ukraine from the UK yesterday to “reaffirm” America’s “unwavering support for the independence, sovereignty and territorial integrity of Ukraine.”

The G7 communique accuses Russia of “irresponsible and destabilising behaviour”, including “the large build-up of Russian military forces on Ukraine’s borders and in illegally-annexed Crimea, its malign activities aimed at undermining other countries’ democratic systems, its malicious cyber activity, and use of disinformation.” It states threateningly, with reference to allegedly poisoned Putin critic and imperialist stooge Alexei Navalny, “There must be accountability for those that use chemical weapons.”

To help counter popular opposition to the imperialist powers’ warmongering, Raab encouraged the G7 to “come together with a rapid rebuttal mechanism” to shut down media coverage and discussion which cuts across the group’s objectives, labelled “lies and propaganda or fake news”. The communique commits to deterring “those who target our democratic institutions and processes, seek to undermine public confidence in the integrity of our democracies, and attempt to interfere in the information space.”

China was the main focus of the foreign ministers’ meeting, allotted a two-hour slot for discussion, versus 90 minutes for Russia and 30 minutes for Myanmar and Syria, according to the South China Morning Post. A working dinner was held on the Indo-Pacific region.

Blinken claimed, “It is not our purpose to try to contain China or to hold China down. What we are trying to do is to uphold the international rules-based order… And when any country—China or otherwise—takes actions that challenge or undermine or seek to erode that rules-based order and not make good on the commitments that they’ve made to that order, we will stand up and defend the order.”

The “order” referred to by Blinken is one in which the US and its allies seek to isolate China internationally and stage repeated provocations in the South China Sea and Taiwan, while deploying ever larger military forces to the region. The US is moving forward with plans to deploy missiles previously banned by the Intermediate Range Nuclear Forces (INF) Treaty in Japan, Taiwan and the Philippines. The UK is increasing its number of nuclear warheads and sending a strike group, including an aircraft carrier and nuclear submarine, to the South China Sea.

Both countries had the gall to sign a communique which claims, “We are committed to the ultimate goal of a world without nuclear weapons” and lauds the Nuclear Non-Proliferation Treaty.

According to a European Union statement, EU foreign policy chief Josep Borrell held a private meeting with Blinken during the week to discuss relations with China. Key European powers, notably Germany and France, have been reluctant to fully embrace Biden’s hardline anti-China strategy, which would mean sacrificing significant economic interests. On Tuesday, in an indication of the ongoing dispute in Europe over this issue and a clear concession to the US, the EU announced that it had halted progress on an investment deal with China. The deal was pushed by Germany, which has substantial commercial interests in China, but faced opposition from the European nations most closely aligned with the US.

German Foreign Minister Heiko Mass alluded to these divisions in a statement before the meeting, saying it was “high time” for the G7 to “counter authoritarian states trying to play us off against each other and breaching the rules is becoming the norm”.

The G7 communique struck a less belligerent tone than against Russia, but still registered “concern” over “human rights violations and abuses in Xinjiang and in Tibet”, “China’s decision fundamentally to erode democratic elements of the electoral system in Hong Kong” and “practices that undermine such free and fair economic systems, including on trade, investment and development finance.” It called on China “to uphold its commitments to act responsibly in cyber space, including refraining from conducting or supporting cyber-enabled intellectual property theft.”

To broaden the anti-China axis, the UK invited the foreign ministers of Australia, India, South Africa and South Korea to the talks, along with the chair of the Association of Southeast Asian Nations. Raab explained the invitation reflected “the growing significance of the Indo-Pacific region for the G7.” The expanded list of foreign ministers included all four members of the “Quad”, an alliance of the US, Japan, Australia and India, directed against China.

The invitation of the Indian foreign minister underscored the utter disregard for the effects of the pandemic shared by the G7 powers. Representing close to half the world economy, with a combined GDP of around $40 trillion, their representatives barely even mentioned the coronavirus and offered only empty words when they did, under conditions in which at least 13,000 are being killed by the virus every day. India, the epicentre of this global humanitarian catastrophe, was not invited to discuss emergency measures to save millions of lives, but war plans threatening countless millions more.

The G7’s commitment to the murderous policy of “herd immunity”, or “learning to live with the virus”, was highlighted by the intervention of UK Transport Secretary Grant Shapps. The government minister chaired a meeting of his G7 counterparts and the EU Commission to organise the reopening of international travel. Just a few hours before, the entire Indian delegation to the UK had been forced to self-isolate after several tested positive for Covid-19.

As for the economic catastrophe looming over billions of people across the world, the sum total of the G7’s new commitments towards a “sustainable recovery” was a $15 billion fund “to provide women in developing countries… with improved economic opportunities” and to agree to a target of getting 40 million more girls into school by 2026. In a year when trillions have been looted from the working class and handed over to the corporations and the super-rich, this barely qualifies as window dressing.