Consuming Stuff: The Polluting World of Fashion

Graham Peebles

The interconnected environmental catastrophe is the result of a particular lifestyle; a materialistic way of life relentlessly promoted by mass media and governments throughout the industrialized world and beyond. Consuming stuff, most of which is unnecessary, is the key ingredient; excess is championed, sufficiency scoffed at. Far from addressing need, satisfying desire is the driving impulse; the object of desire changes with every new fad of course, discontent is thereby ensured, unlimited consumerism maintained.

This pattern of insatiable shopping is evident within the polluting world of fashion perhaps more than any other sector; when we should be buying less, more clothes are produced and sold year on year. Worldwide, almost 100 billion items of clothing are made annually (400% more than twenty years ago), a third of which end up in landfill, increasing at a rate of 7% a year.

The global fashion industry is a major source of environmental contamination, as well as human exploitation. Every item of clothing that is produced carries with it an environmental cost in terms of energy, water, chemicals and land use. The choice of fabrics – natural or man-made – production methods, transportation, dyeing and printing, customer care, all are areas that cause pollution.

According to the United Nations Climate Change, “around 10% of global greenhouse gas emissions (GGE’s) are churned out by the fashion industry, due to its long supply chains and energy intensive production.” The industry consumes more energy than aviation and shipping combined. In search of greater profits most manufacturing is now undertaken in China and India, where labor costs are lower, coal-fired power plants predominate, GGEs are highest and, in many cases, employee rights are non-existent. By moving production to developing nations, western companies outsourced, jobs, as well as the pollution and environmental impacts, threatening the health of local people.

The Natural Resources Defense Council (NRDC) relates that textile factories in China, where “over 50%” of the worlds clothing is now made” spew out around three billion tons of soot every year burning coal, contaminating the air leading to respiratory and heart disease. Textile mills are estimated to generate 20% of the world’s industrial water pollution and use 20,000 chemicals, many of them carcinogenic. Textiles are the largest source of synthetic fibers in the oceans, micro-plastics get into the water system every time garments are washed; the UK House of Commons Environmental Audit Committee on fashion reports that “a single 6kg domestic wash has the potential to release as many as 700,000 fibers.”

As well as textile production, the manufacture of leather goods has also largely been shipped to China – where most items are made – and India. Leather production is an intensely cruel and poisonous process. The animal welfare charity, PetaUK, reports that globally more than 1 billion animals are killed every year – cows, calves, water buffalo, horses, lambs, goats and pigs –and, in China, dogs and cats. Huge amounts of water are used in highly polluting tanneries; most wastewater and solid waste (hides and skins etc.) are dumped into rivers, riverbeds or farmland, causing contamination of the water and land. In Kanpur India e.g., everyday 50 million liters of highly toxic water is produced, 80% released untreated; the River Ganges receives most of it: holy it may be, clean it is not. The impact on human health is often fatal; chronic conditions such as heart disease, tuberculosis, asthma, mental disabilities, skin discolouration are widespread among people living near leather factories, which are shipping almost all their production to industrialized countries.

Polluting and poorly made

Different fabrics have different levels and types of environmental impact; synthetic fibers like polyester are made from crude oil (fossil fuel), producing much higher levels of GGEs compared with natural materials: Nature Magazine state that “A single polyester t-shirt has emissions of 5.5 kg CO2, compared with 2.1 kg CO2 for one made from cotton.” But polyester can be recycled, although not indefinitely, is more stain-resistant, can be washed in cold water and dries quickly. Conventional cotton (non-organic), which is used to make almost half of all clothing, has its own environmental consequences; cotton farming uses 3% of the world’s arable land, causing deforestation and loss of biodiversity, and is responsible for 18% of all pesticides, 25% of insecticides. Some of these are highly toxic and dangerous to human health, e.g. Endosulfan, banned in many countries but widely used in India, is linked to several thousand deaths of cotton farmers and their families. Cotton is also a very thirsty crop: the World Wildlife Fund (WWF) estimates that 2,700 liters (715 gallons) of water – on average the amount one person drinks in two and a half years – is used to make a single cotton t-shirt.

In regions where water is scarce, cotton production has an intensely damaging effect: in Kazakhstan, the Aral Sea, which was the fourth largest lake in the world, has all but dried up because the rivers which fed the lake, were diverted by irrigation projects to supply cotton farmers. The disappearance of the great lake is a man-made environmental tragedy.

Huge amounts of water are also used in the dyeing process, the World Resources Institute states that globally 5 trillion liters (1.3 trillion gallons) of water are used each year for fabric dyeing, enough they say to “fill 2 million Olympic-sized swimming pools.”

The most polluting area of the apparel industry is ‘fast fashion’. Like all businesses, fashion is about profit: more profit is generated when people buy more clothing, more often. In the 1980s, when any remaining constraints on Neo-liberalism were removed, ‘fast fashion’ was introduced as a way of increasing the profits for clothing companies by making people buy more; the practice is now widespread among high street brands and has been picked up by designer labels.

Under the fast fashion umbrella up to 50 ‘cycles’ are produced every year; prices are lower, turnarounds quick, and overproduction common. Items are poorly made and so cheap they are sometimes not even worn before being discarded, at best lasting a matter of weeks before being dumped in landfill. The fast fashion fad has increased consumerism, contributed to a ‘throw away’ mentality, leading to huge amounts of waste; it has done enormous environmental damage and should be stopped as a matter of urgency. If companies will not voluntarily halt fast fashion practices governments should force them to do so. The global need is not for the corporate profit, the behavior to be cultivated is not more consumerism, it is saving the planet and encouraging drastic reductions in consumerism.

The Fashion Industry Charter

Aware of the widespread and varied environmental destruction that fashion is causing voices within the industry and beyond have been calling for action to change destructive practices for some time. Last year a group of organizations came together, and under the umbrella of the United Nations Climate Change, created the Fashion Industry Charter for Climate Action (FICCA), launched at COP24 in Katowice, Poland, in December.

The FICCA commits signatories to reducing greenhouse gas emissions by 30% by 2030 and achieving zero emissions by 2050, to phasing out coal-fired boilers, using ‘climate friendly’, sustainable materials and low carbon transport among other measures. The list of 43 founding companies includes Adidas, Burberry, Esprit, Guess, Gap, H&M, Kering, Levis, Puma, PVH and Target; associated NGOs have also pledged to support the initiative and encourage sustainable practices.

Creating sustainable fashion is a core theme of those working to reduce the catastrophic impact on the environment. This entails looking at production methods and water use, curtailing demand, moving from conventional to organic cotton and from virgin polyester to recycled polyethylene terephthalate (PET), collecting and recycling unwanted garments. ‘Sustainable fashion’ needs to be seen as part of sustainable lifestyles, this requires the promotion and adoption of what we might call Sustainable Values, principles that encourage expressions of social/environmental responsibility and cooperation, ideals that promote simpler lifestyles – we must consume less, shop based on need only and, when we do shop or buy services, ensure we do so in an environmentally responsible manner; repair clothes, buy good quality items that last longer and recycle.

Governments need to introduce public information policies aimed at making people aware of the environmental impact of living a certain way and introduce maintenance classes in schools; all product-based companies should be required to make easily accessible the full environmental impact of their products and methods, as well as the human cost, so people can make well-informed choices. Advertising has an important role to play in this, it needs to be closely regulated and reformed so that it gives out facts about products not propaganda.

All aspects of life are interconnected; the environmental catastrophe cannot be faced without the socio-economic mayhem being addressed, social justice created and ways of living inculcated that tend towards unity in all areas of life. Competition and conformity need to be expunged from society, particularly within institutionalized education, the focus on image challenged and rejected, the tendency to imitation curtailed.

If we are to collectively overcome the greatest challenge humanity has ever faced, environmental considerations need to be at the forefront of our daily lives. A shift in living is required, a movement away from lives based on desire and the pursuit of pleasure to simpler lives based on meeting need, cultivating right relationships with others and the natural world and living harmlessly. The responsibility rests with all of us to live well and to pressurize our governments to act to halt the environmental catastrophe before it’s too late.

The Coming Ebola Epidemic

William Minter

The Ebola epidemic in West Africa from 2013 to 2016  left more than 11,000 dead and panicked the American public when a few isolated cases turned up on U.S. soil. By the time the outbreak was contained, the international community had learned valuable lessons about how to combat the virus.

Now, a new outbreak in the Democratic Republic of the Congo (DRC) is testing that knowledge — and the political will of the global community to mount a robust response.

With more than 830 deaths since August 2018, the epidemic in northeastern DRC is the second-largest recorded, behind the multi-country epidemic in West Africa. The DRC outbreak has not yet crossed international borders. Moreover, responders are applying new solutions, including a vaccine that has proved effective.

But many health experts argue that the threat is underestimated, leading to a dangerously inadequate global response.

As of late March, the World Health Organization (WHO) had received less than half of its $148 million funding request for Ebola over the next six months. The WHO bureaucracy, moreover, appears hesitant. On April 12, the agency again declined to declare the epidemic a “public health emergency of international concern” — a designation that could unlock critical resources needed to bring the outbreak under control.

One reason for the tepid response may be the remote location. The DRC epidemic is centered more than 1,000 miles from the capital, Kinshasa. In West Africa, by contrast, three coastal countries were affected, including capital cities with direct air links to Europe and North America.

Nonetheless, the threat of spread beyond the DRC worries health experts. Tens of thousands of people a day cross the borders from the area into Rwanda, Uganda, and South Sudan. Indeed, WHO’s statement expressed “deep concern” about the “potential risk of spread to neighboring countries.”

The response to the epidemic does show that important lessons have been learned from West Africa and from other previous outbreaks. The DRC Health Ministry has gained experience from nine outbreaks in that country since 1976, all of which were contained relatively quickly.

There is also new leadership at WHO: Dr. Tedros Ghebreyesus, the agency’s first African director, took office in 2017. Researchers, notably at the U.S. Centers for Disease Control and Prevention (CDC), have honed containment procedures and developed a new vaccine that is being used in the DRC. The CDC has worked with other international agencies and with national health ministries in training and preparing for a rapid response.

At a March 14 hearing of the Senate Appropriations Subcommittee, CDC director Dr. Robert Redfield laid out the measures being taken. Essential steps to contain further spread include tracing the personal contacts of Ebola cases and checking the health of border crossers. Multiple actors are collaborating, including local health workers, WHO and CDC personnel, and nongovernmental organizations such as the Red Cross and Doctors without Borders. Nonetheless, the outbreak has not yet been contained.

One obstacle, which also existed in West Africa, is lack of trust by local people whose cooperation is essential for timely identification of victims and their contacts. Medical procedures required to treat those infected with Ebola, and for handling the dead, frighten and alienate many people.

In West Africa, health workers and community mobilizers gradually won people’s confidence. The situation in eastern Congo is more difficult, in part because of ongoing conflict that’s displaced almost 1.5 million people from their homes. Health teams face the threat of attack by multiple armed groups and by local people who fear outsiders.

Doctors without Borders (MSF), which saw one of its health centers destroyed in February, has criticized WHO’s failure to declare a global health emergency. In an April 12 press release, an MSF spokesperson emphasized that “the outbreak is not under control.” The group called for a change of strategy: “We need to adapt our intervention to the needs and expectations of the population, to integrate Ebola activities in the local healthcare system, [and] to engage effectively with the communities.”

The other major obstacle is inadequate funding—for national health systems in the most vulnerable countries, but also for the global institutions that provide technical support and resources.

Although this underfunding is longstanding, the Trump administration’s policies are making it worse. If Trump’s budget proposal for the 2020 fiscal year were to be enacted, global health funding would be slashed. That budget zeroes out U.S. funding for UNICEF, cuts U.S. contributions to WHO by 47 percent, and proposes a $1.3 billion (20 percent) cut from the $6.6 billion current budget of the CDC.

Fortunately, there’s bipartisan support in Congress for sustaining, and even increasing, funding for global health. “I consider this every bit as much of a defense budget as anything at [the U.S. Department of Defense],” said Rep. Tom Cole of Oklahoma, ranking Republican on the Labor and Health Subcommittee of the House Appropriations Committee. “We’re much more likely to die in pandemics than in terrorist attacks.”

As in the case of climate change, action on global health is increasingly recognized not just as a moral obligation, but as a matter of national self-interest. The scientific and public consensus is illustrated by a March 4 letter from 225 professional organizations endorsing a $1.2 billion increase over current funding levels for the CDC.

On this front, at least, Congress seems inclined to heed science rather than the administration’s indifference.

Are we on track to #endmalaria?

Shobha Shukla & Bobby Ramakant

This year’s World Malaria Day theme, “Zero Malaria Starts With Me” re-energizes the fight to eliminate malaria which, despite being preventable and treatable, still kills over half a million people every year. While incredible progress has been made in the past 15 years (with over 7 million malaria deaths averted and about 40% reduction in malaria globally), the fight against the disease is now inching towards a tipping point – progress has slowed down in some parts of the world and reversed in a few.

Is drug resistance a threat?

A major challenge confronting malaria elimination is the emergence of drug-resistant malaria in the Greater Mekong Subregion (GMS), including countries like Thailand, Cambodia, Myanmar, Laos and Vietnam. Thailand’s Minister of Public Health, Professor Piyasakol Sakolsatayadorn said to CNS (Citizen News Service): “Drug-resistant malaria is a threat to Thailand and the Greater Mekong Subregion (GMS). This area is the epicentre of drug-resistant malaria. Drug-resistant malaria can become a global health threat if we cannot manage and eliminate drug-resistant malaria in Thailand and the GMS.”

Historically, the GMS region has long been an epicentre of antimalarial drug resistance. In fact, 40-45 years ago, chloroquine resistance had spread throughout the world from this region. So, there are fears about risk of re-emergence of malaria because of anti-artemisinin resistance.

“If drug resistance from Greater Mekong Subregion (GMS) spreads beyond this region, it will have a devastating impact on countries with high burden of malaria” cautioned Alistair Shaw, Senior Program Officer, Raks Thai Foundation.

But science at best is inconclusive, if the spread of drug resistance is a risk. “It is mostly the asymptomatic patients that carry gametocytes and transmit Plasmodium Falciparum. In Thailand, less than 5% patients have gametocytes that can transmit to next mosquito cycle. There is no strong evidence so far if a person who has drug-resistant malaria can transmit it to the mosquito and mosquito carrying that phenotype, transmits it to another person,” says Professor Jetsumon Sattabongkot Prachumsri, who is the Director of Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University in Thailand.

Agrees Dr Tim France, a noted global health expert, who also leads Inis Communication: “At present you can say largely that there is more that we do not understand about malarial drug resistance and we do know we are at a very active learning period. But at the end of the day whether drug resistance is spreading or occurring de novo, the conclusions and essential actions remain the same.”

Governments promised to end malaria

Thai health minister Professor Piyasakol Sakolsatayadorn reaffirmed the country’s target date for ending local transmission nationally: “Thailand is committed to the regional effort, and to eliminate malaria by 2024.”

It is noteworthy to mention that in 2014, 23 Asia Pacific heads of governments had committed to eliminate malaria in this region by 2030, which is in line with the UN Sustainable Development Goals (SDGs).

Thailand’s National Malaria Elimination Strategy was endorsed in 2016 with the elimination goal of 2024. Since then, malaria cases have continued to decline: from 2012 to 2017, the number of malaria cases in Thailand fell by 67%, with a 39% drop between 2016 and 2017. In 2017-2018, malaria cases in Thailand further dropped by 51% (from 14,684 to 7,153).

Challenges confronting the fight to eliminate malaria

Prof Sakolsatayadorn underlined, combating drug resistant malaria with limited pipeline of new drugs as one of the challenges.

Chief Scientific Officer of the World Health Organization (WHO) Dr Soumya Swaminathan agreed: “While there are tools available to deal with malaria, but modelling studies show that to achieve elimination we will need new and better tools by way of better diagnostics, better treatment strategies and also an effective vaccine.”

“Thailand is not only moving towards malaria elimination by 2024 but also making progress towards sub-regional elimination targets within Thailand” said Shreehari Acharya, Project Manager, Regional Malaria CSO Platform. Last year on World Malaria Day 2018, Thailand declared 35 provinces (out of a total of 76) malaria-free. But malaria is concentrating towards Thai borders making the fight to end the disease even more complex. “As we slowly move towards elimination of malaria in Thailand, the cases continue to shift closer to borders and more hard-to-reach mobile migrant populations” says Alistair Shaw of Raks Thai Foundation.

To fortify Thailand response to eliminate malaria from within its border and from the Greater Mekong Subregion, the Global Fund to fight AIDS, Tuberculosis and Malaria (The Global Fund) pumped in the largest multi-country regional grant of US$243 million (2018-2020) to accelerate elimination of drug-resistant malaria.

“Our role has been to create malaria resilient communities who can identify themselves when they suspect malaria cases and can respond to it through all the different mechanisms that have been set up and the links that have been made to health services. We have also made strong relationships with the local government officers to conduct mobile testing and prevention education in vulnerable populations which include mobile migrant populations from Cambodia, Vietnam, Laos and Myanmar, as well as mobile Thai ethnic minority communities traveling through forests or across borders for various activities. Our work is to extend the reach of the government services to communities that are located very far from local government health services and do not feel comfortable, or are unable, to access a conventional health service,” says Alistair Shaw of Raks Thai Foundation which is one of the recipients of this Global Fund grant.

Malaria testing and treatment is free for all the people in Thailand including those who are not Thai nationals. Migrant workers that come to Thailand, are normally covered by Thailand’s disease control programme and they get access to malaria clinics. But Shreehari Acharya, Project Manager, Regional Malaria CSO Platform sees the difficulty about access because, “Although the services are free, all mobile migrant populations may not necessarily be able to access them.”

Acharya added “In some malaria high risk border areas there is no internet access, no mobile network, and/or no public transport, making access to health services more difficult. Another barrier to healthcare is faced by those mobile migrant populations who have a language barrier and/or do not have legal documents. They are still not comfortable to go alone to a health facility. They need someone whom they can trust, and who speaks their language, to accompany them. Government health facilities are, at times, understaffed. Hence government staff may not be available to accompany civil society to go to the forests or farms and provide health services to high risk populations.”

However, as Thailand moves towards malaria elimination, Professor Jetsumon Sattabongkot Prachumsri, said: “As malaria cases decline, people’s awareness also declines, especially in areas that were malaria endemic in the past. For example, Kanchanaburi province, used to be malaria endemic with malaria in every district, but now it has very few (less than 30-40) cases and that too not in every district. Youngsters born in a district that now has no more malaria cases do not know about malaria. But the older people might still carry the malaria parasite asymptomatically inside them and be the reservoir of malaria transmission. We cannot let down our guards, otherwise re-emergence could happen.”

“We need to see greater collaboration to improve surveillance, especially along the border sites. As countries are implementing malaria programme with an elimination approach, surveillance becomes more important to prevent re-emergence. We also need more clarity on roles civil society can play in malaria surveillance” added Shreehari Acharya.

Messages on #WorldMalariaDay 2019

Professor Jetsumon Sattabongkot Prachumsri said: “Malaria elimination is possible, if we raise awareness of all the people. Everyone needs to understand that malaria is transmitted by the vector and that some of the people may not have any external symptoms but can still harbour the parasite in their bodies and can transmit malaria. Everyone, especially those living in malaria endemic areas, must be aware and protect themselves from mosquito bite.”

Shreehari Acharya said: “We need to make all malaria and other essential services available as near as possible to the community. Also I think community at the village level is best placed to effectively provide these services, as civil society volunteers or someone trained in the community shuld be able to test and treat malaria unless medical attention is indicated (like malaria in pregnancy or other severe cases require medical care). Government needs to acknowledge the role of civil society in efforts to eliminate malaria. If we look across the region, civil society is playing a pivotal role in partnering with the government in malaria control. We will like to ensure that civil society/ community volunteers are well equipped, trained and have sufficient incentives.”

Mali government falls amid protests against Franco-German occupation

Stéphane Hugues & Alex Lantier

On April 18, the Malian government collapsed as Prime Minister Soumeylou Boubèye Maïga submitted the resignation of his government to President Ibrahim Boubacar Keïta (IBK). This followed weeks of protests against the Franco-German occupation of Mali in the aftermath of the horrific ethnic massacre of 170 Peuls on March 23 in the village of Ogossagou.

The French puppet regime in Mali, one of the world’s poorest countries, also faces growing strikes by workers. Anger is mounting among workers against the plunder of state finances organized under the auspices of Paris and Berlin. Strikes have been ongoing for months among public school teachers, who are demanding payment of housing bonuses and back wages, and by rail workers mounting strikes and hunger strikes to demand back wages.

On April 5, 50,000 people (30,000 according to Malian police) marched on Independence Avenue in the capital, Bamako, to denounce the Franco-German occupation of the country, launched in 2013, and the corruption of the French puppet regime led by Keïta, known as IBK. The protest was called by representatives of the Peul ethnicity targeted by the Ogossagou massacre, civil society organizations and Islamic preachers, including the former president of the Islamic High Commission of Mali (HCIM), Imam Mahmoud Dicko.

In Bamako, protesters held aloft handmade signs proclaiming, “France is a terrorist state with mercenaries and drones,” “No to France’s genocide in Mali” and “Go home, don’t plunder our natural resources.” They chanted, “Down with IBK.” There were calls for the implementation of Muslim sharia law and also for Russian assistance against the French and German troops occupying Mali.

“We are sick and tired of this regime. Our children, husbands, and our parents are dying due to the misgovernment of the country by IBK and his clan,” Mariam Fomba told AFP. Fomba, whose husband was killed in the war in Mali, said she wanted to “throw out IBK.”

Before that, on March 30, hundreds of people had attended a protest outside Montparnasse train station in Paris, marching to the Malian embassy to denounce the massacre. Mimo Dia, the organizer of the Paris protest, criticized the complicity of the French puppet regime with the ethnic-Dogon Dan Nan Ambassagou militia that is widely suspected to have carried out the Ogossagou massacre.

Dia said, “Dogons and Peuls have always existed. Even today, amid the massacre, Peul and Dogon villages coexist and don’t care about the conflict. So, it’s not a problem with the Dogons. It’s a political problem. The Malian army has outsourced Malian security to the Dogons. That has to stop. It’s why we want one very simple thing: to disband all the militias in Mali … including Dan Nan Ambassagou, and the Malian authorities complicit with them. They should all be caught and tried decently, so that justice can be done.”

These protests fuelled growing discussion of a possible vote of a motion of censure targeting the Maïga government by the Malian National Assembly, which was ultimately submitted on April 17 by parliamentarians of opposition parties and of IBK’s Rally for Mali (RPM).

On the morning of April 18, Maïga was engaged in desperate, back-channel talks with the RPM and opposition parties in an attempt to assemble a majority to oppose the censure motion. A few hours before debate on the motion of censure was about to begin, however, Maïga threw in the towel and handed in his letter of resignation to the Malian president’s office.

Maïga’s resignation offers nothing to workers and oppressed toilers in Mali, however, and will only intensify the class struggle in Mali and across the region. President Keïta’s choice of Boubou Cissé to replace Maïga on April 22 points to his role as a lackey of imperialism and finance capital. Cissé, an unelected economist and political independent, had just been overseeing as finance minister the non-payment of wages to public sector workers. Trained in Germany, the Persian Gulf and France, Cissé worked at the World Bank before returning to Mali amid the French invasion to take ministerial portfolios in mining and then in finance.

Growing anti-war protests and class struggles in Mali are part of a broad upsurge of mass political opposition and class struggles around the world. From militant strikes among American teachers and Mexican maquiladora workers, to the “yellow vest” protests in France and civil servants and plantation workers strikes in the Indian subcontinent, a mood of intransigent opposition to the ruling elites is growing. In Africa, mass protests demanding the fall of dictatorships in Algeria and Sudan are unfolding among waves of teachers strikes across the continent.

In France’s former colonial empire, including Mali, this brings workers into confrontation with the eruption of European militarism since the last great class struggles in the region: the revolutionary uprisings that toppled imperialist-backed dictators in Tunisia and Egypt in 2011.

After the uprising in Egypt began, the NATO powers went to war in Libya and destroyed Colonel Muammar Gaddafi’s regime, which Paris saw as a longstanding obstacle. Gaddafi’s overthrow and murder plunged not only Libya but the entire Sahel into civil war. Militias fleeing Libya arrived in Mali and chased the Malian army out of the north of the country—the pretext Paris seized upon to invade the country in January 2013. With the complicity of regimes in the region, including Algiers, which opened its airspace to French bombers, a war began that has now lasted six years.

In addition to France, the United States, Canada and—since 2015—Germany have sent troops to Mali. With over 1,000 troops, the Mali war is Berlin’s largest overseas deployment since it ended the demilitarization of its foreign policy that followed the fall of the Nazi regime. Events have put paid to imperialist claims that these deployments aim to protect the Malian population from Islamist militias.

The war has displaced hundreds of thousands of people and cost thousands of lives. Bamako receives $1 billion per year in aid funds but—concentrated on helping NATO troops fight its own population—has overseen a collapse in living standards and public services, to the point that now teachers’ and rail workers’ salaries are not even paid.

Despite this expenditure on war, French-led occupation forces have not succeeded in crushing military opposition to their presence and the puppet regime in Bamako. Eleven Malian soldiers were killed in an attack at 5 a.m. April 21 at a military station in Guiré, near Mali’s border with Mauritania. The attacking militia left behind 15 dead, according to the Malian government.

One French military doctor died in Mali in a bomb attack on his vehicle, AFP reported.

Severe police-state measures come into force in Sri Lanka

Pani Wijesiriwardena & K. Ratnayake

Following Sunday’s terrorist bombings in Sri Lanka, a nationwide state of emergency was imposed yesterday, giving the military, as well as the police, sweeping, anti-democratic powers.

Under the pretext of fighting terrorism, the Colombo government, like its counterparts around the world, is strengthening its police-state apparatus, which will be used to suppress a resurgence of working-class struggles.

The emergency regulations allow the security forces to take measures for the “suppression of mutiny, riot or civil commotion, or for the maintenance of supplies and services essential to the life of the community.” The essential services clause has in the past been used to ban strikes and other industrial action.

Under the state of emergency, the military is granted police powers, including the “detention of persons; the taking of possession or control of any property or undertaking without warrant.” The regulations allow for the lengthy detention of so-called terrorist suspects without charge or trial.

The state of emergency reactivates sections of the draconian Prevention of Terrorism Act (PTA) that was extensively used by the security forces during the island’s three-decade communal war against the separatist Liberation Tigers of Tamil Eelam (LTTE) to suppress Tamils and working people as a whole.

The PTA was used to arbitrarily detain thousands of men and women, extract confessions by torture and use those confessions to secure convictions. Using the cloak of a state of emergency, the security forces went far further—carrying out hundreds of abductions and extra-judicial killings, not only of “LTTE suspects” but government opponents and critics.

The government is now extending these measures. An unprecedented nationwide ban has been imposed on social media, including Facebook and YouTube, censoring what is a widely-used and popular form of communication. As of last October, Sri Lanka had 23 million mobile phone users, 6.4 million internet users and five million on Facebook.

The across-the-board crackdown reflects deep fears in ruling circles in Sri Lanka and internationally that social media is a powerful tool not only for disseminating ideas but for organising collective action. In the context of a rising tide of strikes and protests, the government is imposing blanket censorship on the pretext of blocking “false news.”

Speaking yesterday in parliament, Prime Minister Ranil Wickremesinghe noted that world leaders had expressed their support for Sri Lanka. “We should seize this opportunity to use their assistance to eradicate terrorism,” he said, adding, without elaborating, that structural changes needed “to face this terror situation.” Inevitably this will mean a further bolstering of the police-state apparatus.

The death toll in Sunday’s barbaric attack has risen to 321 men, women and children, with more than 500 injured, many seriously. Among the dead are 45 children and 48 foreigners, including some Indian workers, as well as American, European, Chinese and Japanese tourists.

Few details of the bombings have been released. According to the government, seven suicide bombers were involved in the attacks on churches and expensive hotels. The police have said 40 people have been arrested, including suspected members of the Islamist group—National Thowheeth Jamma’ath (NJT).

The Islamic State of Iraq and Syria (ISIS) yesterday claimed responsibility for the bombings, saying they were carried out by “Islamic State fighters.” Many commentators have cast doubt on the statement, noting that ISIS has previously claimed responsibility for attacks it did not carry out, in order to boost its reputation.

Whether or not ISIS was in some way connected to the attack, serious questions remain. The government is yet to offer a credible explanation as to why no action was taken following a specific warning—10 days before the attack—that NJT was planning to bomb Christian churches.

Defence Secretary Hemasiri Fernando attempted to justify the inaction by declaring that the government did not expect an attack of “such magnitude” and “so soon,” adding: “It was quite impossible to protect a large number of churches last Sunday.”

These remarks are at the same time cynical and absurd. The Sri Lankan security forces are among the largest per capita in the world and have waged a brutal war to suppress so-called LTTE terrorists. Yet it appears that no action was taken to investigate NJT nor protect any, let alone all, churches. If the government was not expecting an attack of “such magnitude,” what did it expect? And again, why was no action taken?

The entire political establishment and the security forces are mired in Sinhala Buddhist chauvinism and have connections to Buddhist extremist groups that have attacked Christians and Muslims in the past—with the police turning a blind eye.

Did the Sri Lankan government and state also turn a blind eye to the impending bombings on Sunday, calculating that a tragedy could be exploited for political ends and to justify a security crackdown?

In the wake of the bombings, all the rival political factions, as well as the military, are seeking to exploit the tragedy to advance their own interests.

Tuesday, Army Commander Mahesh Senanayake declared: “An emergency should be declared at least for a short period so that the army is given these powers to enable us to bring this situation under control.” What exactly the military is seeking to bring under control is not clear.

Colombo has been embroiled in bitter political infighting since Maithripala Sirisena ousted Mahinda Rajapakse as president in the 2015 election via a US-backed regime change operation. Now, amid a worsening economic crisis and growing class struggles, Sirisena has come to blows with Wickremesinghe, the man he installed as prime minister.

Wickremesinghe has all but blamed Sirisena, who has control of the police and defence ministries, for not taking action to prevent the bombings. At the same time, the government is clearly intending to whip up anti-Muslim chauvinism, with ministers openly discussing a ban on Muslim women wearing the burqa.

Speaking in parliament, opposition leader Rajapakse accused the government of being responsible for the terrorist attacks, saying it had harassed military officers and his brother, former Defence Secretary Gotabhaya Rajapakse, over their role in the war. In reality, the government has taken virtually no action over the war crimes, for which the entire Colombo establishment is responsible.

The US is also seeking to use the bombings to enhance its position in Colombo and undermine China’s influence. Washington’s hostility to Mahinda Rajapakse stemmed from his close ties to Beijing. Under Wickremesinghe, Sri Lanka has strengthened its diplomatic and military ties with the US, at China’s expense.

Both US President Donald Trump and Secretary of State Mike Pompeo have phoned Wickremesinghe and offered assistance. FBI officials are already on the ground in Colombo and involved in the investigations.

Workers should oppose the state of emergency and reject the reactionary intrigues and manipulations of all factions of the ruling class. All of them are moving to establish dictatorial forms of rule and to whip up anti-Muslim chauvinism to divide the working class. The fight for democratic rights can go forward only through a unified struggle of the working class across ethnic and religious lines on the basis of a socialist and internationalist perspective.

Major Indian airline grounded, threatening 23,000 jobs

Deepal Jayasekera

Jet Airways, until recently India’s largest private airline, has been forced to ground all its aircraft since last Wednesday, threatening the jobs of its more than 23,000 employees. The airline announced the grounding of all flights with immediate effect after it failed to secure funding from investors to pay for fuel and other bills.

With around $1.2 billion in bank debt, the country’s oldest private airline was desperate to secure a stopgap loan of about $217 million from its lenders as part of a rescue deal that had been agreed to in late March. But the lenders balked at advancing the funding. As the airline said in an April 17 statement, “Since no emergency funding from the lenders or any other sources is forthcoming, the airline will not be able to pay for fuel or other critical services to keep the operations going.”

The grounding of Jet Airways poses the immediate danger of massive job losses and demonstrates how the company, its shareholders, and lenders are determined to place the burden of the airline’s crisis on its workforce. All Jet Airways employees have yet to receive their March salary, and its pilots, engineers and senior staff have not been paid since January.

Desperate Jet Airways employees demonstrated in New Delhi and Mumbai last Thursday, calling for government intervention to bail out the airline. They displayed placards saying, “Save Jet Airways, Save our family”.

The collapse of Jet Airways has taken place in the midst of campaigning for India’s general election and presents the government of Prime Minister Narendra Modi with yet another crisis. Modi and his Hindu supremacist Bharatiya Janata Party (BJP) have boasted about India’s “world-beating” economic growth. But numerous reports, including from government agencies, have pointed to a sharp rise in unemployment among all sections of the population, from rural women to university graduates.

In a desperate attempt to derail mounting popular opposition from working people and rural toilers over mass unemployment and under-employment, social inequality and poverty, Modi and his BJP have been whipping up communal animosity against Muslims and tensions with Pakistan.

Jet Airways officials and lenders are searching for an investor willing to acquire a majority stake in the airline. Naresh Goyal, the founder of Jet Airways, is reportedly working with Future Trend Capital, headquartered in Delaware, and London-based Adi Partners to put together such a deal. Jet Airways’s lenders, for their part, are endeavouring to secure bids from US private equity firm TPG Capital and Indigo Partners, which owns a controlling interest in the ultra-low cost US carrier American Frontier Airlines.

India’s government-backed wealth fund, the National Investment and Infrastructure Fund or NIIF, and Abu Dhabi-based Etihad Airways, which already owns a 24 percent share in the grounded airline, are also being tapped as potential takeover candidates.

The airline’s lenders, including the State Bank of India (SBI) and other Indian government-owned banks, have issued a May 10 deadline for potential buyers to submit their binding bids. According to Ashish Nainan, aviation analyst at Care Ratings, “Even if a deal is reached it will take considerable time to get Jet back in the air.” This means that Jet employees, who have not received salaries for one or two months, will be left waiting weeks and months more without pay.

Any “rescue” plan for Jet Airways will be implemented at the expense of the jobs, wages and working conditions of the airline’s 23,000 strong workforce, who will bear the brunt of the “restructuring” measures needed to boost the company’s profitability. Jet Airways Chief Executive Vinay Dube admitted in a communication to employees: “We don’t have an answer today to the very important question of what happens to employees during the sale.”

Jet Airways, which was India’s second-biggest airline by market share until last November, operated more than 120 planes and well over 600 flights daily at its peak. In recent weeks, being unable to pay its staff and for fuel and other critical services, the airline was forced to cancel hundreds of flights and halt all international flights.

The grounding of Jet Airways is part of a global aviation industry crisis. Confronting rising fuel prices, airlines are engaged in cut-throat competition with each other for market share. Airline workers’ wages, jobs and working conditions and passenger safety have all become casualties of their desperate attempts to cut costs so as to keep their companies operating, and ensure the continued flow of dividends to their shareholders.

Last September, Ryanair workers across Europe took strike action to demand higher wages and better conditions. Ryanair became Europe’s largest budget airline through poor pay and working conditions, high levels of exploitation, and the widespread use of contract labour.

The airline crisis has severely affected most Indian airlines. Kingfisher, a major private carrier founded by beer tycoon Vijay Mallya, was grounded in 2012 at the cost of thousands of jobs after failing to make payments to bank lenders, staff, and airports. Spicejet, another low-budget private airline, was saved from collapsing at the last minute in 2014.

Air India, the country’s state-owned carrier, is heavily indebted, with its short and long-term debt totaling $10.3 billion as of March 31, 2017. It is surviving thanks to bailouts totalling billions of dollars. Modi’s BJP government sought to privatise the airline last year, but had to abandon the attempt after failing to secure a single bid by its May 31 deadline. The airline’s crisis continues to be borne by its workforce, which routinely waits weeks and even months for their pay, and by the working class more broadly, which is funding the bailouts through increased taxation and austerity.

The Jet Airways’ crisis has been exacerbated by the growth of low-cost competition in India’s domestic market since the mid-2000s, rising fuel prices, and the depreciation of the Indian rupee. As a result, the airline owes large sums to its suppliers, pilots and other staff, and oil companies. The airline has made a loss in all but two of the past 11 years, and defaulted on loans due to be paid by December 31, 2018.

Last year, the Modi government approached Tata Group to ask for its assistance in rescuing Jet Airways. The crisis deepened still further when companies that were leasing planes to Jet Airways refused to continue doing so as the airline’s imminent collapse became increasingly apparent.

Following its grounding, Jet Airways’ share price plummeted 34 percent Thursday, reaching its lowest level since April 2009. This underscores investors’ scepticism over prospects for the airline’s revival. Moreover, it confirms that in exchange for any “rescue,” investors will demand a savage cost-cutting programme at the expense of workers’ jobs, wages and workplace conditions.

The grounded airline’s rivals have rushed to take advantage of Jet Airways’ withdrawal from operations. Spice Jet said it would add 27 planes over the next two weeks, and saw its shares surge by 15 percent on Thursday. IndiGo, now the country’s biggest private carrier, is also adding new planes.

OECD report: Growth of social inequality fuels global political and economic crisis

Jessica Goldstein

The Organization for Economic Co-operation and Development (OECD) released an annual report, Under Pressure: The Squeezed Middle Class on April 10. The 178-page report paints a glaring picture of the social polarization that has occurred over the past three decades among all OECD countries.

The OECD defines the “middle class” as households earning between 75 percent and 200 percent of the national median income in each country. In the United States, the middle-income threshold for a single person household ranges from $23,416 to $62,442 per year; in contrast, the poverty threshold for a single person in the US is $12,490.

In reality, the vast majority of those households in the middle-income strata would be defined as working class, not middle class—those working for a wage or salary and whose labor is exploited for profit. The findings of the report further underscore this point.

The report shows that among OECD countries, a growing number of middle-income earners perceive “that the current socioeconomic system is unfair.” This is attributed to the fact that in many OECD countries, working households have faced “dismal income growth or stagnation” and in some cases, decline. Middle incomes increased at a rate of one-third less than the top 10 percent over the past 30 years. Broken down by decade, income growth for middle-income households was 1.0 percent from the mid-1980s to the mid-1990s; 1.6 percent from the mid-1990s to the mid-2000s; and 0.3 percent from 2007 to 2016.

The alarming rate of social polarization and growth of income inequality is a main feature of the report. It found that the top 10 percent of households, across all OECD countries, own nearly half of all wealth, while the bottom forty percent own only three percent. In the US, the wealth held by the top one percent of households surged from 11 percent to 20 percent, nearly doubling over the past three decades.

At the same time, the share of middle-income earners in the total population fell from 64 percent to 61 percent, and the proportion of low-income households in OECD has expanded.

The OECD refers to this decline in the middle-income category and expansion of high-income and low-income categories as a “shift in center of gravity of economy.” In the US, earnings have increased faster at the top than in the middle since the 1980s. Among all OECD countries, while the high-income population increased from 11 percent to 14 percent, its share of wealth increased disproportionately from 26 percent to 35 percent.

No longer does a two-income household guarantee middle-income status, the report found. Also, the number of families with children in the middle-income category has fallen over the past three decades, which it attributes to the exorbitant costs of education, healthcare and housing needed to raise a family in most OECD countries.

For middle-income households, the report found that the slide into lower-income status is a real threat, and especially pronounced in the US, Latvia, Estonia, Portugal, Spain and Greece, where middle-income households are at the greatest risk of falling into the lower income category over a four-year period. The immediate reasons for this are varied.

For middle-income earners, one in six jobs are at risk for automation. This number is one in five for low-income earners and one in ten for high-income earners. Housing prices have grown three times faster than the median income over the past two decades, and the cost of education and healthcare have also increased well above the rate of inflation in OECD countries.

This has caused over-indebtedness to be a major problem for middle-income households, with one in five finding that they have to spend more than they earn to make ends meet. In European countries, half of middle-income households say they have difficulty making ends meet.

The report also found that 60 percent of OECD parents surveyed believe that future generations will not reach the same income level as their parents and grandparents. Younger generations of workers have less stable jobs than baby boomers, or those born from 1943–1964. The sharpest decline in the middle-income population was among 18–44-year-olds, with the greatest decline over 30 years being those aged 30–44.

In the US, the share of adults in the middle-income range either fell or remained the same over 30 years. In all OECD countries, an increasing number of elderly people fall into the middle-income elderly, in large part due to the growth in those working past retirement age in order to afford necessities.

Middle-income households do not receive as much in social benefits as they pay in taxes. Meanwhile, since 1981, corporate and personal income tax for top earners has been cut, with corporate taxes down from 47 percent to 25 percent and personal income tax on the wealthy down from 66 percent to 43 percent. The supposed lack of money for social benefits is exacerbated by the fact the wealthy are more likely to hoard income in offshore accounts.

Jobs requiring a high skill level make up one fifth of high-income earners today, as opposed to one-fourth in the mid-1990s. Jobs requiring a medium skill level are mostly found in the middle-income households, but the likelihood that they are now lower income has increased in 14 countries. Medium skilled occupations, according to the OECD, are those in such positions as clerks, craft workers, plant and machine operators and assemblers.

An increasing number of higher skilled and professional occupations are now found in middle-income households as opposed to high-income households. These positions include managerial, professional, and technical occupations, such as teachers, lawyers, health professionals, engineers and social workers. This points to the proletarianization of large sections of the labor force.

More workers than ever in the middle-income bracket are engaged in non-standard work, increasing the perception of instability, insecurity and anxiety. Non-standard work is defined as temporary, part-time and self-employed work arrangements. These jobs have fewer job protections, social rights and job training opportunities.

The OECD report expresses the nervousness within the ruling class over the consequences of these transformations. It states that “a rising sense of vulnerability, uncertainty and anxiety has translated into increasing distrust towards global integration and public institutions” and attributes social inequality to the rise of politicians who promote nationalism, isolationism, populism and protectionism.

Such political tendencies, however, do not actually express the genuine sentiments of the working class, whose strivings are toward social equality and international cooperation. They represent sections of the ruling class that aim to suppress any movement of the working class towards socialism and internationalism through the use of national chauvinism and demagogy.

The report offers desperate proposals for limited reforms to address the crisis. Among these reforms are relaxation on regulations on construction and introduction of rent controls, publicly subsidized childcare or cash reimbursement for parents, universal healthcare coverage or “means-tested” assistance, vocational training programs and adult education, and tuition fee loans and school-to-work programs.

But why have these limited reforms not been enacted already as the world economic system faces its next great financial crisis? The OECD report fails to address the fundamental cause of the crisis: the capitalist system itself.

Money abounds in the banks and stock markets, as the report itself details. The massive transfer of wealth from the working class to the ruling class over the past three decades has created the conditions of social crisis, and yet this same ruling class offers no answers.

Bayer cuts 4,500 jobs in Germany

Dietmar Gaisenkersting

In a deep cost-cutting move, chemical giant Bayer AG is eliminating 4,500 jobs in Germany or almost one in seven of its 32,000 positions in the country. According to the Bayer works council, most of the jobs will be cut at its corporate headquarters in Leverkusen, just north of Cologne in west central Germany.

Last November, Bayer announced 12,000 job cuts in its worldwide workforce, or one in ten jobs. This includes 5,500 administrative positions, 4,100 jobs at Bayer’s agricultural chemicals subsidiary Crop Science as a result of its merger with US-based Monsanto, and 2,350 in the company’s pharmaceutical and consumer health divisions.

These job cuts do not include another 10,000 being eliminated through spinoffs of brands and divisions. The company is selling off its veterinary medicine division, the health product brands Coppertone (sunscreen) and Dr. Scholl’s (foot care), and its 60 percent share of a joint venture called Currenta Solutions. The latter is a business service provider that employs 5,000 workers in Germany who provide waste management, infrastructure, utilities and other services.

A deal reached by the works council will delay the winding down of Currenta until three years after its sale, meaning, at best, that workers will keep their jobs for a maximum of three years.

On Tuesday, all Bayer employees received a “Dear Employees” letter from Bayer CEO Werner Baumann, which said, “We will reduce the annual costs of our platform functions (corporate functions, business services and regional platforms) by 1.4 billion euros.” These moves, the millionaire Bauman wrote, were necessary “to ensure our competitiveness.”

Last year, it was announced that 750 out of 3,400 jobs would be cut at the Wuppertal plant, just east of Düsseldorf, due to the closure of the brand-new factory for blood clotting medicine, costing 350 jobs and another 400 in pharmaceutical research. In Berlin, 650 of the 5,000 jobs in research are being wiped out by 2022, and several hundred jobs will be cut in the agricultural chemicals division in Monheim.

Under Germany’s “co-determination” scheme, half of the seats on Bayer’s supervisory board are filled with members of the works council and the trade union IGBCE (Mining, Chemicals, Energy). While management and the works council are still negotiating the details of the job losses, the works council is already preparing the workforce for deep cuts. The Rheinische Post quoted from an internal letter from the Central Works Council to the workforce, which states, “The company’s plans go to the foundations. The concern is great everywhere in the company with the headquarters in Leverkusen expected to be hit hardest.”

Far from opposing this attack, Heinz Georg Webers of the IGBCE and Deputy Chairman of the Central Works Council announced that the bodies he oversees would help the company shape the reductions. “We insist on keeping the promises in the ‘Joint Statement’ for all colleagues affected by the drastic cuts project,” Webers said.

In November 2018, in the “Joint Declaration” of the Works Council and the Executive Board, titled “Securing Bayer’s Future 2025,” the works councils had unanimously approved the company’s job-cutting plan. As usual, the jobs are to be destroyed in a “socially acceptable way”—i.e., without compulsory redundancies. Instead, with the blessing of the unions, management will get rid of workers by the end of 2025 through offering severance pay and early retirement packages.

The conditions under which workers can leave the company have been fixed since January. Older workers may receive so-called flexi-termination contracts that run for six years and allow them to retire early at age 57, with a maximum 7.2 percent reduction of their statutory pension. For younger Bayer workers, the company will provide severance payments.

As a result of the restructuring, Bayer aims to save €2.6 billion per year from 2022 onwards. The one-time costs—for example, for severance payments—amount to €4.4 billion. Bayer CEO Baumann had already announced to stockholders last year that all of Bayer’s businesses should contribute to “improving the company’s performance” by 2022 and beyond. The profit margin, the corporate executive said, should rise from approximately 26 percent last year to about 27 percent this year and to more than 30 percent in 2022.

Many workers will accept the offer to “voluntarily” give up their jobs because they know the union will do nothing and fear that the Monsanto takeover can only make things worse.

The shareholder’s constant demands for higher yields prompted Bayer to acquire Monsanto in June last year for US$63 billion (€56 billion). While Baumann denies that the Monsanto acquisition has anything to do with the current cuts, in reality the financial markets are demanding the jobs massacre to cover the huge legal costs, stemming from Monsanto’s Roundup weed killer.

There are now at least 11,200 US plaintiffs who blame the glyphosate-based weed killer for their cancer. In two judgements, the courts awarded plaintiffs damages running into millions. Bayer has appealed against the lower court’s judgements.

A US judge, who has already tried Bayer once before, and has brought together hundreds of complaints from farmers, gardeners and consumers, has called on Bayer to engage a mediator and negotiate with the plaintiffs on a settlement.

Business daily Handelsblatt quoted the analyst Richard Vosser of the US bank JPMorgan, who assumes that the number of plaintiffs will rise to at least 15,000. “He expects Bayer to face costs of 5 billion euros.”

These billions, too, will be squeezed out of the workforce through a rigorous austerity programme.

Jobs and working conditions can only be defended by waging a fight in opposition to the works councils and the IGBCE. This means organising rank-and-file factory and workplace committees independent of the union and its local representatives.

In a statement on the redundancies at Bayer last year, the Sozialistische Gleichheitspartei (Socialist Equality Party, SGP) explained that these committees would be “responsible for bringing together all Bayer employees who reject job losses at all locations and planning and preparing joint resistance.” This applied to all Bayer employees worldwide and to all workers—far beyond Bayer.

“This is necessarily a political struggle that is not only directed against individual employers, but against the entire capitalist system and the grand coalition government in Germany,” the SGP writes. “The Socialist Equality Party and the World Socialist Web Site are fighting to develop the growing opposition to redundancies and welfare cuts into a powerful counter-offensive by workers. This requires an international socialist strategy aimed at breaking the stranglehold of the banks and large corporations and transforming the world economy to meet the needs of the population, not private profit. Multinational corporations such as Bayer must be expropriated and transformed into public enterprises under the democratic control of workers.”

Privatisation of UK’s National Health Service escalates

Ben Trent

Starting this month, general practitioners in the National Health Service (NHS) have been banned from advertising private services. The ban is being implemented through a new contract agreed by NHS England, the umbrella organisation for NHS trusts.

The contract stipulates that “from 2019 it will no longer be possible for any GP provider either directly or via proxy to advertise or host private, paid-for GP services that fall within the scope of NHS-funded primary medical services.”

NHS England ratified the contract with the British Medical Association (BMA), one of the biggest associations for healthcare workers, which hailed it as the “biggest overhaul of services for 15 years” and one that would stop the “increasing blurring in recent years between NHS and private GP services offered to patients.”

The reality is the contract doesn’t offer anything to bridge the increasing gulf between the resources allocated to services and the resources required to provide adequate care. GPOnline points out that the deal “could strip hundreds of thousands of pounds in funding from some GP practices that operate private patient lists alongside their standard NHS list.”

The paltry £20 million set aside for three years to offset this income loss is hardly sufficient.

The ban does nothing to stem the growth of private healthcare providers in direct competition with the NHS. An internet search for private GP services finds that Spire Healthcare advertises GP appointments for 30 minutes at £90, with 39 hospitals providing appointments nationwide. If a patient wishes to book an appointment in Oxford, he or she can easily spend £70 for 15 minutes at a BUPA hospital.

In a telling article entitled “Should I go private, doctor?” which was published last month in the medical journal The BMJ, GP Helen Salisbury relates discussions with patients who are interested in “going private.” Patients are compelled to seek private treatment because the NHS Clinical Commissioning Groups (CCGs) “no longer funds—surgical treatment of troublesome varicose veins, removal of unsightly but non-malignant skin lesions, or other ‘low priority’ complaints.”

Another factor pushing patients to private treatment, Salisbury reports, is that the “NHS—which is meant to provide timely investigation, treatment, and relief of suffering—is failing patients as waiting times increase.” She explains that most of her patients support the NHS and don’t want to be “queue jumpers,” but that the conundrum faced by such patients is, “How bad will these symptoms get if I hang on for NHS treatment?” She makes clear, however, that this quandary is faced by only a handful of patients. As for the general populace, there is no spare money for private healthcare.

There remain an increasing number of avenues that can lead to GP privatisations. GPOnline reported the intended move of “at least five” practices in the borough of Tower Hamlets looking to leave their GMS (General Medical Services) contracts to ICP (Integrated Care Providers) contracts.

ICPs, still in a consultative stage, were developed by NHS England to allow NHS trusts a chance to better integrate with private care providers, offering “greater flexibility to achieve full integration of care.”

Dr. Richard Vautrey, General Practitioners Committee chair, described moves by GPs to enter ICPs as a “one-way street to loss of independence, direct management control and potential wholesale privatisation.”

NHS FightBack warned in our February article, “NHS 10-year plan: Recipe for further attacks on services and privatisation in UK”:

“[N]othing is more destructive in the LTP [Long Term Plan] than its commitment to continue privatization with vigour. The current network of 44 Sustainability and Transformation Partnerships (STPs) are to be turned into more centralized “Integrated Care Systems (ICSs) by April 2019. Every ICS will work towards an “Integrated Provider Contract” and these contracts will no doubt be awarded to or sub-contracted to the private sector.”

We noted that NHS England head “Simon Stevens has already written to the government suggesting legislative repeal of significant key sections of the Health and Social Care Act 2012 that he deems as barriers to wholesale privatization and NHS provider mergers.” The LTP wants to “remove the counterproductive effect that general competition rules and powers can have on the integration of NHS care” and “cut delays and costs of the NHS automatically having to go through procurement processes” and to give powers for the ICS commissioners to decide what is “best value” and to award contracts.”

The Long Term Plan is the latest cornerstone in the systematic assault on nationally provided healthcare services.

An investigation last year by the Pulse website found that over a million patients were forced to move surgeries in the preceding five years, due to the closure of nearly 450 GP surgeries. Of these, 134 closed in 2017, displacing 450,000 patients. This was in contrast to the closure of 18 surgeries in 2013, impacting 37,000 patients.

In 2016, NHS FightBack noted the contents of a leaked letter in which a senior official in NHS England official stated that “vulnerable [general] practices must either transform and deliver a quality service or be allowed to fail and wither by the system.” In conclusion, we warned, “The central aim of the policy that GP practices “be allowed to fail and wither” is nothing but creating the most favourable conditions for … private companies to profit from patient care services.” This is the situation three years hence.

The fact that overall NHS privatisation continues unabated puts paid that the shift to for-profit healthcare is being curtailed. Vast portions of the NHS are already in the hands of private sector profiteers. In 2017–18, £8.8 billion of the health service budget went to “independent sector” providers—a 50 percent increase compared with 2009-10.

According to a House of Commons Library analysis undertaken for the Labour Party, 21 NHS contracts worth £127 million are currently out to tender. One of these contracts is worth £91 million and will result in a private firm running an NHS 111/Clinical Assessment Service in the south east of England. Some £36 million worth of NHS contracts were put out to tender in just the last six weeks.

The ban on mixing of paid for and free services at GP surgeries is a calculated manoeuvre. Cognisant of the anger among broad sections of the population at the unabated attacks on the NHS—coupled with the increasing militancy of health workers in Britain and internationally—the government is seeking to find ways of rebranding their attacks and heading off opposition.

In this they are relying on the BMA and other unions to sell the new GP contract as a great barrier in stopping the privatisation of the NHS, whilst using the new lever—the LTP—to integrate private and public healthcare providers.

It was only three years ago that the BMA, via its Junior Doctors Committee, carried out a despicable sellout of the national strike by 40,000 junior doctors. This led to the imposition of a contract that was even inferior to one previously overwhelmingly rejected by its membership.

The only way to prevent the complete breakup of the NHS into private healthcare units is by the building of rank-and-file committees, independent of the trade union bureaucracy, in unity with all public and private sector workers to defend jobs, wages and essential services.