Cuba’s COVID-19 Vaccines Serve the People, Not Profits

W.T. Whitney Jr.

Cuba’s socialist approach to developing vaccines against COVID-19 differs strikingly from that of capitalist nations of the world. Cuba’s production of four vaccines is grounded in science and dedicated to saving the lives of all Cubans, and to international solidarity.

The New York Times’s running report on the world’s vaccine programs shows 67 vaccines having advanced to human trials; 20 of them are in the final phase of trials or have completed them. The United States, China, Canada, the United Kingdom, Germany, South Korea, and India have each produced many vaccines; most vaccine-manufacturing countries are offering one or two vaccines.

Cuba is the only vaccine manufacturer in Latin America; there are none in Africa. The only state-owned entities producing the leading vaccines are those of Cuba and Russia.

Cuba’s Finlay Vaccine Institute has produced two COVID-19 vaccines. Trials for one of them, called Sovereign I, focus on protecting people previously infected with COVID-19. The antibody levels of some of them turned out to be low, and the vaccine might provide a boost.

The other vaccine, Sovereign II, is about to enter final human trials. For verifying protection, these trials require tens of thousands of subjects, one half receiving the vaccine and the other half, a placebo vaccine. Cuba’s population is relatively small, 11 million people, too small to yield enough infected people in the short time required to test the vaccine’s protective effect. That’s why Sovereign II will be tested in Iran.

100 million doses of Sovereign II are being prepared, enough to immunize all 11 million Cubans, beginning in March or April. The 70 million remaining doses will go to Vietnam, Iran, Pakistan, India, Venezuela, Bolivia, and Nicaragua. Sovereign II “will be the vaccine of ALBA,” explained Venezuelan Vice President Delcy Rodríguez, referring to the solidarity alliance established in 2004 by Venezuelan President Hugo Chavez and Cuba’s Fidel Castro.

“Cuba’s strategy in commercializing the vaccine represents a combination of what’s good for humankind and the impact on world health. We are not a multinational where a financial objective comes first,” says Vicente Vérez Bencomo, director of Cuba’s Finlay Vaccine Institute. Income generated by vaccine sales abroad will pay for health care, education, and pensions in Cuba just as happens with exports of medical services and medicines.

Cuba’s Center for Genetic and Biotechnological Engineering is developing two other COVID-19 vaccines; One, named “Mambisa” (signifying a female combatant in wars of liberation from Spain), is administered via the nasal route, just as is Cuba’s hepatitis B vaccine. The other vaccine, named “Abdala” (a character in a Jose Marti poem) is administered intramuscularly. The two vaccines are involved in early trials.

Cuba was ready

Cuban education emphasizes science and technology. In the 1990s, Cuba accounted for 11% of doctorate-level Latin American scientists. Cuban scientists work in the 50 or so biomedical research and production facilities which together make up Cuba’s state-owned BioCubaFarma Corporation, and which produces vaccines, drugs, medical tests, and medical equipment. It makes 60% of medicines used in Cuba, and 8 of 12 vaccines.

Cuba previously produced a pioneering vaccine that prevents life-threatening infection caused by type B meningococcus. Cuba developed a genetically-engineered hepatitis B vaccine and a vaccine offering palliative treatment for lung cancer. A Cuba-developed vaccine offers protection against infection, particularly childhood meningitis, caused by the Hemophilus Influenza type B bacterium.

In fashioning vaccines, Cuban scientists relied on familiar technology.

To provide an immunological extra, the antigen of Cuba’s Sovereign II vaccine is mixed with tetanus toxoid, as was done with Cuba’s Hemophilus influenza vaccine. As with other vaccines, scientists used a segment of the virus’s protein – here the COVID-19 virus – to form an antigen to stimulate protective antibodies. By contrast, the U. S. Pfizer and Moderna vaccines contain the whole viral protein, not a segment. That protein contains “genetic instructions” which enter human cells, causing them “to make spike proteins, which then get released into the body” where they trigger antibodies.

Observers suggest that this innovative U.S. technology may be less safe than the one used in Cuban vaccines. Not requiring extremely cold storage, as do the U.S. vaccines, the Cuban vaccines are suited for areas without adequate refrigeration capabilities.

Cuba’s bio-medical production sector has also created drugs for treating Covid-19 infection. Interferon, an antiviral agent developed in Cuba, produced in China, and used throughout the world, prevents many Covid – infected patients from becoming critically ill. The Cuban anti-inflammatory drug Jusvinza, used for treating auto-immune diseases, and Cuba’s monoclonal antibody Itolizumab, which moderates exaggerated immune responses, are both effective in reducing Covid-19 deaths.

The other way

The U. S. approach to producing and distributing COVID-19 vaccines is based on private enterprise, although the U. S. government did deliver billions of dollars to pharmaceutical companies to produce vaccines free of charge to recipients. The companies have contracted with purchasers abroad.

According to forbes.com in November, 2020, ‘If Moderna’s [vaccine] can get FDA approval and can make enough doses, its top line could be nearly $35 billion higher … than … in the last 12 months.” Another report suggests that, “The companies (Pfizer and Moderna) stand to earn billions of dollars in profits from their COVID vaccines this year [and] there will be more profits in later years.” The companies “claim the rights to vast amounts of intellectual property.”

With corporations in charge, distribution of COVID-19 vaccines is skewed. As of Jan. 27, “some 66.83 million doses have been sent out, of which 93 percent were supplied to only 15 countries.” In Latin America, only Brazil, Argentina, Mexico, and Chile have secured purchase contracts adequate for immunizing entire populations. The companies’ contracts with African nations allow for immunization of only 30 percent of Africans in 2021. Meaningful immunization has yet to begin there.

The wealth divide determines distribution. Epidemiologists at Duke University report that, “While high-income countries represent only 16% of the world’s population, they currently hold 60% of the vaccines for COVID-19 that have been purchased so far.” Cuban journalist Randy Alonso reports that only “27 percent of the total population of low and middle income countries can be vaccinated this year.”

“The world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries,” declared Dr. Tedros Adhanom Ghebreyesus, director of the World Health Organization, on January 18. He warned that, “some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue.”

The WHO initiated the global vaccine collaboration COVAX to assure access by poor nations to COVID-19 vaccines. The 190 nations that are enrolled agreed to obtain vaccines through COVAX. Rich nations would supply COVAX with funds to enable 90 poor nations to receive no-charge vaccines. COVAX anticipates distributing two billion doses, enough to immunize only 25 % of the populations of poor nations during 2021.

Problems include: wealthy nations order vaccines independent of COVAX; they buy more vaccine than they need; manufacturers set prices; and prices are secret, variable, and very high.

Most other countries producing COVID-19 vaccines are at variance with Cuba through their profiteering and because they are complicit with the U.S. economic blockade of Cuba. Pursuing routine overseas commercial affairs, they all too easily adjust to U.S. regulations by means of which that cruel policy is enforced. More to the point, the U.S. blockade hinders Cuba’s vaccine efforts, and they are silent.

“We don’t have in Cuba all the raw materials and supplies we’ll need for the unprecedented scale of production that vaccinating our whole population requires,” Dagmar García-Rivera, Director of Research at Cuba’s Finlay Vaccine Institute, explained. “They have to be purchased and for this, we need financing. This is made infinitely more difficult by the US embargo … Procuring the necessary reagents for research and the raw materials for production is a challenge we face daily.”

In confronting the pandemic, Cuba exhibits attention to detail suggestive of a level of caring and concern not readily matched elsewhere. For example, Cuba’s government-friendly cubadebate.cu website provides a daily, detailed update of the infection’s impact. Its report on Jan. 27 presents data relating to cities, provinces, the nation, and the world – and the nation’s intensive care units. Readers learn that of 43 patients in intensive care that day, 16 were in critical condition, stable or unstable, and 27 were in “grave” condition.

All 43 cases are reviewed, beginning with: “Cuban citizen, 75 years old, from Alquízar, in Artemisa, already suffering from arterial hypertension and ischemic cardiopathy who is afebrile, on mechanical ventilation, is hemodynamically stable… with acceptable blood gases (oxygen and CO2), is improving radiologically with inflammatory lesions in the right [lung] base – reported as critical but stable.” The cases of four Cubans who died that day are also presented.

Fighting a pandemic in Cuba, it’s understood, is no casual matter. Nor is the health of Cuba’s people.

Alexei Navalny And The Politics Of Vladimir Putin

Zeenat Khan & Ferdous Khan

Last Tuesday (February 2) Russian activist Alexei A. Navalny, the loudest critic of Vladimir Putin was sentenced to 2 plus years in prison for violating the terms of his 2014 conviction. The prison service claimed Navalny had violated the terms of his parole by not checking in with his case workers. Some of the violations are from the time when he was undergoing treatment for being poisoned with Novichok, a highly lethal nerve agent that was placed on the inside of his under pants before a flight. The directive supposedly came from the Kremlin, if not from Putin himself. Navalny’s wife approached Putin for permission to go abroad with a comatose Alexei for treatment which Putin says he had granted without hesitation. After Navalny came back to Moscow he was arrested. In the recent weeks, Navalny had irked Putin by posting a video where he accused the president of building a luxurious mansion worth over a $billon on the Black Sea. The palace is replete with all the modern amenities that money can buy including an Ice Hockey rink. That video has been watched by millions of people on YouTube. Russians are simply outraged by the reports of corruption by Putin and his associates. For two consecutive weekends prior to Navalny’s sentencing, millions across Russia took to the streets to protest ignoring the frigid temperature. All of those people are not necessarily Navalny’s supporters – they include people with liberal, conservative ideas to people without strong political views. Women who generally view Navlany as sexist after Navlany once called his wife, Yulia Navalnaya “my little chic” also joined in solidarity. The world saw in disbelief how protesters in Russia were restrained by excessive force by riot police. In Moscow more than 1,950 people were arrested for protesting. More than 5,600 people were detained in 90 cities during protests on past Sunday, according to the monitoring group OVD-Info, which tracks political persecution in Russia. Until the sentencing, Navalny’s supporters were growing in numbers and that had frightened the Kremlin. They most certainly do not want Navalny to be marked as a “political martyr” in history books. That explains the jail term. For two plus years whether Navalny will be sent to a penal colony is anyone’s guess. Will he stay alive in the prison to guide his followers against the anti-Putin movement? Putin’s spokesman, Dimitry Peskov, said, “That Navalny’s case is exclusively a domestic matter and that Russia will not take instructions from foreign governments. The Kremlin has suggested that Navalny works for U.S. intelligence and has branded the Anti-Corruption Foundation a “foreign agent.” Meanwhile, Vladimir Putin can continue on with his agenda of staying in power by crushing his rivals and political dissidents for the foreseeable future. His current term ends in 2024. Putin is trying to kill two birds with one stone – 1) He took a calculating risk that being in jail might diminish Navalny’s popularity as he will be out of the limelight, 2) He is sending out a clear message that he is not going to be swayed by public pressure and will remain steadfast at the face of angry protests after the Navalny sentencing. However, the opposition leader’s incantation of “Do not be afraid!” does not mean there is nothing to fear. With Navalny stashed away in prison, Putin will continue to have a tight grip on all of Russia to carry out his master plan of rebranding Russia. In reality it turns out to be nothing but a classic case of autocratic rule.

Ever since coming to power in 2000, Putin has defined himself as the creator of modern Russia. Russia is a huge and diverse country, and the people have become hostage to Putin’s embryonic ideology, ego, and misguided persona. What may be useful in understanding the crisis in Russia today is to go back in Russian history to the origin of Slavophiles in the nineteenth century as a reaction to modernizations introduced by Peter the Great (1682 – 1725), and Catherine the Great (1762 – 1796). The Slavophiles of the 1830s, such as Aleksey S. Khomyakov, the Aksakov brothers, others were reacting to what they saw as the onslaught of Western ideas of Enlightenment, nationalism and rationalist thought that was eroding the heart of what they had characterized as Slavophilism. To them, it was the soul sustaining idea that salvation of the Russian empire, and that of all Slavs lay in Christian Orthodoxy (though many, including the Poles were Roman Catholics), autocracy i.e., worshipping the Tsar, and adherence to the soil (through peasants’ communes). The Westernizers, such as Herzen, Belinksy and Bakunin opposed these ideas vehemently, and declared that salvation of Russia lay in the adoption of Western ideas of Enlightenment, very much in the tradition introduced by Peter (the Great), then Catherine (the Great.)

Putin, in spite of his KGB roots, and Marxist-Leninist indoctrination while growing up was following many of the anti-western policies that a Slavophile would advocate and cherish. The harsh treatment meted out to political opponent Alexei Navalny is a case in point. In fact, one can show that the sum total of Putin’s actions since he came to power reveal the desire of an earlier day Slavophile to stand up to the (Latin) West and nurture the Eastern (Orthodox) polity.

The Berlin wall came crashing down in 1989. As a KGB officer stationed in East Germany, Putin was shocked; this was too much for a Cold War warrior trained with the very elite cadres of the Soviet state apparatus. He drew several lessons. First, the West was out to crush the Soviet Socialist Republic (USSR) of their dreams. Second, party bureaucrats such as Gorbachev were too soft, and accommodating in their acceptance of the West. Third, the correct response should have been one of strength, and not the one demonstrated by party top brass, including Gorbachev. The disintegration of the USSR and its satellite (east European) states that took place, accompanied by social turmoil, coups and counter coups in Moscow and other centers of powers must have been disorienting to an ordinary Russian.

To Putin, and his comrades, these events helped solidify their resolve to stand up to the encroachment of the West on their borders, as well as within Russia itself. In many ways then, this is reminiscent of the Slavophiles of 1830s and 1840s, Khomyakov and others, in their determination to preserve, and enhance the unique characteristics of the Russian society /soul – Eastern Orthodox Christianity, the autocratic Tsar, and the Russian peasants against the Latin West. Thus, since his KGB days in East Germany, Putin has been someone who plays with danger. He remembers the confusion for those fighting on the wrong side of history and learnt its lessons. It is only logical to expect that he will use these lessons to his own advantage, by holding onto power for as long as he can.

Since Putin came into power in 2000, much has happened in Russia, beginning with the Gorbachev, followed by the Yeltsin years. For the past twenty years (2000 – 2020), the former KGB officer has managed to solidify his hold on power through various manipulations, chicanery, and often brute force. The persecution of Alexei Navalny is a strong reminder of how far Putin and his erstwhile comrades will stoop to in order to maintain their grip. And certainly, this is not the first instance of such attitude towards dissidents.

In recent years, there has been a worrisome trend in Russia – that of the glorification of the cruel dictator, Josef Stalin. Putin has welcomed this trend with open arms. The collective memory in the Soviet Union is replete with instances of brutal persecution by Stalin and his secret police; hardly any family exists that have not been impacted. Yet there is a whitewashing going on of Stalin’s image, at least a forgetfulness of his sins has been underway for quite some time.

This is in line with Putin’s vision of a strong Russia that can stand up to its western foes, much as Stalin had vanquished Hitler in the Second World War. The Slavophiles of the 1870s had predicted the oncoming conflict between the Slavs, and the Teutons (Germans). Stalin’s victory over Hitler was a confirmation of this, and to Putin, it showed that his vision of a strong Russia victorious was possible when a Stalin-like figure took over power in Russia. This of course necessitated the fading from memory of Stalin’s atrocities, the repression that is now known all too well in the west.

Russia has emerged as the largest and the single most powerful state after the former Soviet Union dissolved in 1991. Even before that, they were mighty powerful with the Russian Tsars, and later the Bolsheviks who came to power after the 1917 Russian Revolution. It is well known that “Ukraine and Russia share much of their history… From the mid-17th century Ukraine was gradually absorbed into the Russian Empire, which was completed in the late 18th century with the Partitions of Poland… After the end of World War I, Ukraine became a battleground in the Russian Civil War and both Russians and Ukrainians fought in nearly all armies based on their political belief… In 1922, Ukraine and Russia were two of the founding members of the Union of Soviet Socialist Republics and were the signatories of the treaty that terminated the union in December 1991.”

Since then, “several acute disputes have formed between the two countries… Ukraine’s attempts to join the EU and NATO in 2015 were seen as a change of course to only a pro-Western, anti-Russian orientation of Ukraine and thus as a sign of hostility… In February 2008 Russia unilaterally withdrew from the Ukrainian-Russian intergovernmental agreement signed in 1997 while the US supported Ukraine’s bid to join NATO; the latter launched in January 2008 as an effort to obtain the NATO Membership.” Russia strongly opposed any prospect of Ukraine and Georgia becoming NATO members. The current crisis began when Ukraine decided not to sign a political and trade agreement with the European Union in the fall of 2013. The demonstrations began soon thereafter, led by students and workers fighting corruption aimed at toppling the regime of pro-Russian Viktor Yanukovych, which succeeded three months later. The so-called Euromaidan revolution was strongly backed and financed by western NGOs, and US Assistant Secretary of State Victoria Nuland (married to influential neoconservative historian Robert Kagan, Yale ’80) encouraged the leaders of the protest movement in no uncertain terms. On 17 December 2013 Putin agreed to lend Ukraine 15 billion dollars in financial aid, and a treaty was signed amid massive, ongoing protests by Ukrainians for closer ties between Ukraine and the European Union.

With Putin holding the reins, Russia continues to have a history of imperialist policies in the surrounding countries of Eastern Europe. It is said that if Russia sneezes, any of these nations can catch a major cold. Such was the case in Ukraine in 2013 – 2014 that includes a much-condemned military annexation of Crimea in 2014, and not so subtle interference in southeastern Ukraine for a while.

According to Harvard historian Lubmyr Hajda, there are three basic regions in Ukraine. The center, including Kiev, is what most considers the heart of Ukraine. Influenced by Byzantine Christianity, and proud of the development of Slavic alphabet, this region was ruled by Cossacks, only to be conquered by Russia by the late 18th century. The Byzantine Christianity later became Orthodox Christianity after the Roman and Byzantine churches split over various doctrinal polemics.

The western Ukraine, although like the center, was ruled by Poland with Roman Catholic influence, and was later part of the Austrian empire. This is the ‘European’ Ukraine if you will. Finally, the Southeast was settled by the nomads from central Asian steppes, then the Slavs and the Russians. It was heavily industrialized. Call this the ‘Russian’ Ukraine. There are two regions, Donetsk, and Luhansk (Lugansk in Russian), that are de facto Russian enclaves, and the focus of Putin’s efforts at destabilizing Ukraine should Kiev (alternately spelled as Kyiv) lean heavily towards Europe and the USA. About an equal number of residents in each city identify as Russian or Ukrainian, although the majority speak Russian.

Russia was profoundly upset by these developments in Ukraine. As a response, Russia occupied Crimea, and encouraged an active rebellion in eastern Ukraine to split from Kiev. The United States imposed heavy economic sanctions on Russia as a punishment. The Cold War policy of containment promulgated by George Kennan has come back to rule the US-Russia relations again after many years. The ceasefires that were signed, only to be broken did not stop the violence in the conflicted zone. According to an U.N. estimate, “More than 6,500 people have been killed since fighting between Ukrainian troops and pro-Russian rebels,” the latter in search of independence from Kiev.

Currently in its seventh year, “this complex international campaign of destabilization features everything from traditional military components to economic, informational, religious, and cyber dimensions. It has already brought the world to the brink of a new Cold War, and there is currently no end in sight to the conflict.” “Ever since 2014, international efforts have concentrated on ending the shooting war in eastern Ukraine. This has proven only partially successful. The latest in a long line of ceasefires came into effect in late July, offering cause for renewed optimism. However, even if this ceasefire proves more durable than the many previous failed attempts, large swathes of eastern Ukraine will remain under Russian occupation. Furthermore, over the past year, the Kremlin has moved to cement its hold over these occupied regions via the mass distribution of Russian passports.”

The question that is on everyone’s mind is this: What did Putin want in Ukraine, and more broadly in Eastern Europe? The answer varies from the simple to complex. In the simplest scenario, Putin’s intervention in Ukraine through the Russian separatists was an attempt by the former KGB spymaster (Putin) at tweaking the regional power balance between NATO, bent on bringing Ukraine into its orbit of influence, and Russia. If Kiev leans pro-western, the Russian sympathizers in eastern Ukraine start agitating heavily, destroy Ukrainian property, and cause major mayhem. This kept Kiev governments of Poroshenko and Zelensky on its toes. This is the so called ‘managed instability’ theory. There was speculation that Putin wanted to encourage the agitations, with the eventual goal of taking over the port city of Mariupol, still in Ukrainian hands, on the Sea of Azov.

There are various speculations about what Putin wants. He knows the entire world is watching him and much depends on him, and what he wants not only in Ukraine, but in its orbit of influence in Eastern Europe. Given the serious strains on the economy, ultimately, he may have no choice but to decide in favor of peace. He will then have to rein in the separatists in eastern Ukraine, and give up on the idea of recapturing Mariupol, opening a land corridor to the Crimean Peninsula.

On the domestic front Russia itself has been reeling under heavy western economic sanctions, and the falling oil prices are not helping either. The Covid-19 situation is affecting Russian economy as it is facing deep recession. In 2020 Russia’s GDP growth was an eleven year low because of the pandemic, oil crisis and rise in unemployment, according to the World Bank’s latest Russia Economic Report. It is in no position to undertake another war/annexation, some argue. The most complex scenario, however, is that of a few who argue that Putin is bent on exporting instability to all of eastern Europe, beginning with Estonia, a NATO member with 25 percent ethnic Russian population. Should Estonia succumb to unrest by the Russian sympathizers/agitators, NATO will have to defend it by invoking article V of the NATO charter. This is a major escalation of the conflict between Putin and the West and will surely lead to unintended consequences.

Alternately, should the Russian economy improve, Putin may decide to escalate, and pursue the dream of a bigger conflagration, beginning with Estonia. There are many options in between. It is noteworthy to mention that he is playing a very dangerous game to expand Russian power by using covert actions to destabilize the region. It is only logical to expect that he will use these lessons to his own advantage, by holding onto power for as long as he can. The only fear for Europe, NATO, and the USA is that Vladimir Putin may drag down many nations in his orbit of influence through the process.

Three European diplomats have been expelled by the Russian Foreign Ministry for joining the anti- Putin protests in recent weeks. What stands out from this case is that Russia does not care what the Europeans think. It is considered an ‘internal matter’, as Dmitry Peskov had said.

Sending Navalny to prison is a striking blow to the anti-Putin movement. Does the Navalny camp have a plan B? Will Yulia be persuaded to take up the cause while her husband serves his term in prison? Yulia has been described as highly intelligent, with a good stage presence. She had dealt with Navalny’s multiple detentions and fits the definition of a political prisoner’s wife the way Winnie Mandela of South Africa or Svetlana Tikhanovskaya of Belarus did while their husbands had been jailed. Or will Russia’s anti-Putin demonstrations simply end with the jailing of Alexei Navalny?

HIV science has advanced but policies-programmes have been slow to #endAIDS

Shobha Shukla

HIV science has advanced but policies and programmes have been slow to respond towards ending AIDS, said Mitchell Warren, co-chair of the global conference on HIV Research for Prevention (HIVR4P) and Executive Director of AVAC (Global Advocacy for HIV Prevention).

Scientific advances have seen huge gains on HIV prevention and treatment fronts. Sadly, what has not changed is the lack of equity in the response. Those who are the most marginalized, most stigmatised and most criminalized continue to remain so. No wonder, the number of new HIV infections has almost plateaued at 1.7 million per year, he said.

With only 118 months left to keep the promise of ending AIDS, it is vital to accelerate stronger action towards keeping these goals and targets. Mitchell Warren was in conversation with CNS (Citizen News Service) around the HIVR4P.

2021 marks the 40th year since the first case of AIDS was reported. While a lot has been achieved in this period, the fight against HIV is far from over. Despite having more tools than ever before to control the HIV epidemic, we still saw 690,000 persons dying of AIDS related causes in 2019. Speaking in a plenary at the virtual 4th HIVR4P conference, Winnie Byanyima, Executive Director of UNAIDS said that this is not progress enough as each one of those AIDS related deaths was preventable.

“Today, science has provided us with more potent prevention technologies. But prevention technology means little if people cannot access it. The gaps in HIV prevention continue to be driven by profound inequalities that leave the most vulnerable behind. While new HIV infections fell globally by 23% between 2010 and 2019, they barely changed among people who inject drugs, female sex workers and transgender women. This alarming epidemic is fuelled by gender inequalities, and social norms and structures that magnify risk to HIV”, she said.

Although there is yet no cure or vaccine for HIV, science is making great strides in the field of HIV treatment and prevention- more user-friendly antiretroviral therapy, pre-exposure prophylaxis (oral PrEP), dapivirine vaginal ring, long acting injectables- and many others (like multipurpose prevention technologies (MPTs) to prevent HIV, STIs and unintended pregnancies) are in the offing. But translating scientific research into public health impact has been an Achilles heel.

Mitchell Warren rightly points out that, “Safe and and efficacious products, developed through years of research and clinical studies, are neither safe nor efficacious if they simply sit on the shelves and are not in the hands of people who need them. Sadly, very often in research and development, there is a disproportionate focus on the product and we tend to forget about the people.”

The long journey of product development and delivery

The first step is, of course, development of new safe and effective products through years of clinical research. Then comes the delivery phase – getting WHO pre-qualification, regulatory approvals, marketing and demand creation for potential users of these products and training of healthcare workers to provide these options as viable choices without stigma and prejudice. If we only do research and development and forget about the second ‘d’ of delivery, these products will be of no good. Also, the people who are going to use the HIV prevention products, must be part of this journey from the very beginning and not just be the recipients of someone else’s journey, says Mitchell.

He firmly believes that it is not just about developing the product, but also about the programmes and policies that need to put them in the hands of those who want them.

“Oral PrEP does not magically appear in people’s mouths nor does the vaginal ring magically appear in women’s vagina just because they were found to be safe and effective in clinical studies. It is the programmes that need to deliver them and create demand and awareness about them. There are still communities who do not know that oral PrEP even exists- in the same way that decades later after its inception, women still did not know about the existence of the female condom. It really speaks of the need to focus more on the recipients, and not just on the product.”

UNAIDS and WHO have recently updated their clinical studies’ ethics guidelines that were first launched in 2007. The updated guidelines re-assert the importance of good participatory practice in the clinical studies’ design and conduct. They also re-assert good participatory practice in the sharing of not only data from the study but also the products (if found to be safe and effective), with the study participants.

Only a treatment and prevention combo will work

While an increasing number of people living with HIV are now accessing antiretroviral treatment and getting virologic suppression, we seem to be failing on the front of primary prevention. Mitchell rightly emphasises that it is only through a combination of treatment and prevention that the HIV/AIDS pandemic can be controlled. HIV requires an integrated and comprehensive response- treatment for those who are infected, and prevention options for people who are uninfected. We need to help people access an array of options at their disposal. Until we move from options to choices, we are not likely to reduce the number of new infections, he said.

Agreed Winnie that we must respond with science and with rights to secure for the rest what has been possible for the few, because we cannot succeed unless the most vulnerable communities are at the centre of the HIV/AIDS response.

She informed that to make HIV prevention an urgent priority, the new more ambitious overarching UNAIDS target – defined with detailed thresholds for each vulnerable population group to identify and close the inequalities- is that 95% of the people at risk of HIV infection use combination prevention by 2025. Also, for the first time, UNAIDS has proposed targets for establishing supportive legal and policy environments with access to justice, gender equality and freedom from stigma and discrimination. If targets promoting favourable societal environments are met 440,000 AIDS related deaths would be averted and 2.6 million additional new infections would be prevented, said Winnie who leads UNAIDS.

In the words of Mitchell Warren: “We stand at one of the most precarious moments in public health. We have not succeeded but we have made progress. Science moves quickly and we have the responsibility as advocates and as a global community, to take the fruits of science to the people. The task is huge, the opportunity though, to do the right thing and to meet people where they are and to improve global public health, has never been more opportune. We have more tools to end AIDS and we have to learn to use them faster, better and more equitably.”

Nigerian farmers win hollow legal victory against Shell for oil spillages

Jean Shaoul

In a case that has taken 13 years to reach a conclusion, the Dutch Court of Appeal has ruled that the Nigerian subsidiary of Royal Dutch Shell—the Anglo-Dutch oil giant is headquartered in the Netherlands—is liable for oil spills in the Niger Delta in Nigeria between 2004 and 2007.

While Shell had argued that saboteurs were responsible for leaks in underground oil pipes that have polluted the delta, the court ruled that while sabotage was the most likely cause in two of the villages, this had not been established beyond reasonable doubt. By allowing the leaks to occur and failing to clean up the contaminated area, Shell’s Nigerian subsidiary had acted unlawfully and was liable for the damage.

The court ordered Shell Nigeria to pay compensation for the massive oil spills that have caused widespread pollution and ruined Nigerian farms, with the amount of compensation to be decided later. It ordered the company to start purifying the contaminated water within weeks and to install a leak detection system to a pipeline that caused one of the spills. Shell may yet appeal to the Dutch Supreme Court.

Protest outside a US court where Shell was on trial (AP Photo/Bebeto Matthews)

Environmental and human rights activists have hailed the decision as ground-breaking, enabling cases to be brought against transnational corporations in the country where they are headquartered and making it harder for the parent company to “walk away from trouble” caused by overseas subsidiaries.

Such optimism is belied both by Shell and other oil corporations’ record in Nigeria and the outcome of previous court rulings that, without any mechanisms to enforce their decisions, have achieved little in practice.

Shell, with its deep pockets, have long sought to evade responsibility via lengthy legal proceedings, many of them in UK courts, for their part in regular oil spills on the Niger Delta that have ruined the livelihoods of local people. Even when courts find against Shell, the oil giant manages to manoeuvre its way out of its obligations.

In 2015, Shell accepted responsibility for the oil spills of Bodo, Ogoniland, in 2008 and 2009 and agreed to pay the people of Bodo $83.4 million, far less than their original demand of $454.9 million, but the oil spills have yet to be cleaned.

Just last month, the Nigerian authorities moved to seize $479 million worth of assets belonging to the country’s third largest bank that had acted as Shell’s guarantor after a judge in 2010 ordered the company to pay damages to the Ejama-Ebubu community for polluting its land, as Shell had failed to pay up.

This latest case was initiated in 2008 by four farmers from the villages of Oruma, Goi and Ikot Ada Udo and the environmental campaign group Friends of the Earth to obtain reparations for their loss of income due the contamination of the land and waterways by oil spillages.

Now, 13 years later, any compensation, when or if it comes, will be too late for some of the plaintiffs. Two had died while a third, Fidelis Oguru, an 80-year-old farmer from Oruma, is now blind. Oguru told Al Jazeera that oil leaks from pipelines had devastated farmland and waterways in the region, poisoning their crops of cassava and plantain and eroding their livelihoods. All their appeals to the Shell Petroleum Development Company (SPDC), Royal Dutch Shell’s Nigerian subsidiary, for compensation and environmental clean-up had fallen on deaf ears.

Shell first discovered oil in the delta in 1956, some 20 years after being granted a licence while Nigeria was still a British colony, and started exporting in 1958, two years before independence. The largest oil company in Nigeria, it accounts for more than 21 percent of the country’s oil production with dozens of oilfields, over 6,000 km of pipelines, 87 flow stations, eight gas plants and more than 1,000 wells in the region. More recent entrants, such as Chevron, ExxonMobil, Total and Italy’s ENI, have many of their installations located offshore in the Gulf of Guinea.

Nigeria is Africa’s largest oil producer, producing 101.4 million metric tons in 2019—generating the overwhelming majority of the government’s revenue and almost all its foreign exchange—making the country’s politicians dependent on the oil companies and their imperialist backers in Washington and London, as the release of a cache of secret diplomatic cables by WikiLeaks in 2010 revealed.

The impact of the oil corporations, their imperialist sponsors and successive generations of Nigeria’s venal elite that rule over the country on their behalf has been devastating, producing civil wars and conflicts, brutal military dictatorships and grinding poverty.

Most of the oil reserves lay in the eastern region that secessionists claimed for themselves when they declared the Republic of Biafra in 1967 as rival ethnic groups vied for power. Some 100,000 people died in the two and a half years of war that ensued, while between 500,000 and 2 million Biafran civilians died of starvation, due to the blockade imposed by Nigeria’s federal government.

As oil prices rose tenfold following two oil shocks in the 1970s and early 1980s, the naira, Nigeria’s currency rose in value, making imports cheaper relative to locally produced goods, undercutting domestic industries and businesses. Nigeria once had a thriving textile industry in the northern part of the country, with around 175 mills. Now there are just 25, operating at 40 percent capacity, and half a million farmers who used to grow cotton for the mills no longer do so.

According to the International Monetary Fund, between the late 1960s and the late 1990s, oil generated about $350 billion for Nigeria, making the oil companies and Nigeria’s kleptocrats phenomenally rich, while the number living in poverty—on less than a dollar a day—rose from 36 percent to 70 percent and GDP per capita fell from $1,113 to $1,084. According to a recent Oxfam report, lifting all those living below the extreme poverty line for one year would cost about $24 billion, an amount just lower than the $29.9 billion owned by the five richest Nigerians in 2016.

From the earliest days, Shell’s impact on the local environment caused deep concern and resentment. There have been numerous oil spills and gas flares which emit a deadly poison burning 24 hours a day, some of them for the last 30 years.

In the 1990s, as the protests grew against pollution, Shell called on Nigeria’s venal military government to provide “security protection” for its operations. It supplied the security forces with the cash, transportation and even weapons to carry out a brutal crackdown that raided about 27 Ogoni villages, causing the deaths of 2,000 people, the forced displacement of 80,000 and the use of rape and torture to intimidate the population.

This reign of terror culminated in the execution of writer and activist Ken Saro-Wiwa and eight other men, known as the Ogoni Nine. A report by Amnesty International in 2017 that reviewed internal Shell documents, government reports, witness statements, archival material and other evidence accused the company of complicity in murder, rape and torture committed by the Nigerian government.

Gas flares pollute the atmosphere resulting in acid rain and respiratory problems in the surrounding community, which in 2005, in Bayelsa state alone, caused 5,000 cases of respiratory diseases and 120,000 asthma attacks and forced thousands to escape the pollution by heading for the ghettoes of Port Harcourt and Lagos. The villagers live with the constant noise of the flare, and the area is covered in thick soot, which contaminates water supplies when it rains.

Shell’s pipelines pass above ground through villages and over what was once agricultural land. According to a US diplomatic cable released by WikiLeaks, three-quarters of pipelines in 2008 were more than a decade overdue for replacement, with some that had a 15-year life expectancy still operating after 30 years. There have been numerous pipeline explosions that have killed thousands of people, none of which have led to any sanctions against the company.

Nigeria’s entire history since independence from Britain in 1960, no less than other countries in Asia and Africa, makes clear that the Nigerian ruling elite serve as little more than security agents for the transnational corporations that loot and plunder the country’s rich resources. Only the working class, based on a socialist and internationalist perspective, can lead the fight to ensure that society is reorganised to serve social need not private profit.

Recent developments in Manaus, Brazil raise many issues about the future course of the COVID-19 pandemic

Benjamin Mateus

The health care system in the Brazilian city of Manaus, capital of Amazonas state, has been in a state of collapse for several weeks as a second wave of coronavirus has devastated the region. The onslaught began in late December and had been overtaxing the limited resources of the sprawling urban industrialized center, situated in the middle of the Amazon rainforest.

On January 8, the city declared a state of emergency in the face of the rapidly mounting cases. Refrigerated containers were returned to the hospitals to assist in storing bodies. Local officials informed the health ministry, warning that oxygen supplies would run out in a week, to no avail.

In a video published online, describing the asphyxiation of patients from lack of medicinal oxygen, Mario Vianna, the president of the Doctors Trade Unions of Amazonas, said, “patients are staying alive due to the efforts of medical professionals, nurses and technicians. … this is a terrible situation which we have feared would happen and denounced. At this moment, I appeal to all of the authorities so that they can unite so that we can urgently find a solution.”

The Port of Manaus (Wikimedia Commons)

Only neighboring Venezuela immediately responded to the crisis, offering the governor of Amazonas, Wilson Lima, a stooge of the fascist President Jair Bolsonaro, “all the necessary oxygen to attend the public health crisis in Manaus.”

According to the daily newspaper, Folha de S. Paulo, as of February 4, 366 of the 379 public ICU beds in Manaus were occupied. The adult ICU bed occupancy rate is at 101 percent, with 285 beds available and 288 patients being treated. Though the recent oxygen crisis has been temporarily stabilized, there is limited capacity to generate more. The city’s death rate of 190 per 100,000 is the highest in all of Brazil. The cumulative toll for the state of Amazonas is more than 280,000 cases and more than 8,800 deaths.

With Manaus’s health system inundated with patients, remote towns upriver in the rural Amazon region cannot refer critically ill patients to the metropolis and must fend for themselves. According to Doctors Without Borders, this is “creating a devastating knock-on effect in these communities.”

Last week, the transfer list of patients waiting for a bed had grown to 568 people, of whom 120 of them were waiting for a place in the ICU. Additionally, the Ministry of Health is looking to transfer approximately 1,500 patients to Manaus to alleviate units in neighboring Brazilian states that are even less developed, such as Rondônia.

Amazon Rainforest (Wikimedia Commons)

In a report published on January 22 in Globo, the government of Amazonas predicted that the burden on the health system would grow even more dire this month. They estimated that the demand for medicinal oxygen would rise at least 70 percent higher than on January 14, when hospitals in Manaus ran out of oxygen, leading to dozens of patient deaths. With the beginning of the rainy season, other respiratory diseases are expected to aggravate matters.

Some families that can afford to buy the necessary oxygen tanks and supplies have made makeshift ICU rooms in their homes, hiring caregivers to assist in nursing their loved ones. The chaos surrounding the hospitals has left the population mistrustful. Many protested Bolsonaro and his government’s lack of any appreciable response by banging pans and pots from their balconies.

Much attention has recently been focused on this region by scientists and epidemiologists. An oft-cited seroprevalence study, carried out in Manaus was first presented in a preprint in September, followed by minor revisions, and then published in the journal Science in mid-December, had calculated the COVID-19 attack rate for the metropolitan city at three-quarters of the population.

The study estimated that 76 percent of the population had developed immunity to the COVID-19 coronavirus in the months since the pandemic first hit the region in March, leading to claims that Manaus had passed the theoretical herd immunity threshold of 65 percent, and was therefore safe from future surges. When the second wave slammed into the community after Christmas, it came as a complete and devastating shock, especially to the scientists who carried out the investigation.

The confluence of the Negro and Solimoes Rivers (Wikimedia Commons)

Manaus, the seventh-largest city in Brazil, is home to more than 2.2 million people. It sits at the confluence of the Negro and Solimões rivers, where they form the Amazon River proper. It is a manufacturing base for motorcycles, electronics, chemical products and soap, with a free port and international airport. Agricultural products include exports of Brazil nuts, rubber, jute and rosewood oil.

The Amazon River and its multitude of tributaries are essential for South America’s life, sustaining some 30 million people, mainly in Brazil but including parts of a half dozen neighboring countries. Ferries and various ships navigate through these channels for hundreds of miles, connecting communities by moving goods and supplies into forested regions impossible to traverse overland. Passengers packed in these ships, asleep in hammocks, side by side for days before they reach their destinations, have been critical factors in spreading the coronavirus.

The pandemic reached Manaus in early March, reportedly via a 49-year-old woman who had flown back from London. Within six weeks, the toll on the city reached horrific proportions. The incidence of cases reached its peak in early May and then tapered off throughout most of the year.

In an attempt to calculate the impact of the first wave on the region, Dr. Lewis Buss and Dr. Ester Sabino, colleagues from the University of Sao Paulo, in conjunction with international collaborators, conducted a seroprevalence study using serum from blood donors in Manaus from February to October to determine the percentage of the population who had developed antibodies to the virus.

The provocative title to their study, which caught the attention of the media, was “Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic.”

The authors wrote, “Although the ideal design to determine the prevalence of SARS-CoV-2 infection is a population-based sample, this approach is time-consuming and expensive.” Instead of a random sample, they used blood donors who had been encouraged to give blood with the promise of a COVID-19 test. The inevitable result of such a procedure was to find an extremely high “attack rate,” i.e., to find that many, if not most people in Manaus had developed antibodies to the coronavirus.

Earliest detection of P.1 lineage (Credit:The Lancet)

The study, based on nearly 1,000 new samples each month, found that the incidence of COVID-19 was only 5 percent in April but had climbed steeply by May to 40 percent. By June, the attack rate had reached 66 percent, and in October, it had reached 76 percent.

Critics faulted the study for using a sample of blood donors motivated by the promise of free COVID-19 tests. They argued that infected patients might prefer to donate blood to know their status. In contrast, those who know they are not infected may potentially not expose themselves. Therefore, the study results are skewed toward those with infections, and would overestimate the actual attack rate.

University of Sao Paulo epidemiologist Paulo Lotufo said it most succinctly, “There is a single research carried out on blood donors with several assumptions, which leads to several limitations in the generalization of the findings … reading that article does not allow reaching the conclusion already exposed in the title.” He warned that ignorance “or bad faith” characterized those who were using the study to argue that herd immunity had been reached in Manaus.

During the same time, another less-mentioned study conducting a nationwide serologic household survey found that by June, only 14 percent of Manaus’s population had been infected. Though this study has its methodological concerns, the divergence in results should have led to a scientific debate because the conclusions raised significant public health concerns.

Underscoring the critical concerns raised by these scientists, the virus has taken a savage new turn in Manaus. In December, Sao Paulo’s Institute of Tropical Medicine and Department of Infectious Diseases, in collaboration with Imperial College, London, detected a new variant circulating in the population.

They named the new lineage, P.1, which possesses several mutations found in the UK and South African variants. However, they acknowledged that P.1 developed independently of the other two. They found the P.1 variant in 13 out of 31 (42 percent) of PCR-positive samples collected between December 15 and 23. When they updated their results two weeks later, the P.1 mutation frequency between December 15 and 31 had risen to 52.2 percent. They detected the P.1 lineage in 41 out of 48 samples, or 85.4 percent, for January.

The same group that had conducted the seroprevalence study issued an urgent comment on their findings on the new lineage in the Lancet on January 27, 2021. As their figure shows, the increase in excess deaths and hospitalizations appeared to follow the P.1 lineage rise.

While they offer no less than four possible alternative explanations for the sudden increase in cases of COVID-19 in a city that presumably had achieved herd immunity, the simplest explanation is that the earlier study was highly problematic and its figures were seized on for reasons of political expediency, to justify the lifting of procedures which restricted economic activity in order to contain the pandemic.

There nonetheless remains the possibility that the new P.1 lineage is more dangerous and more infectious. The most recent study urges: “the genetic, immunological, clinical, and epidemiological characteristics of these SARS-CoV-2 variants need to be quickly investigated.” That is no doubt an urgent necessity.

The issues raised by this focus on Manaus highlights the importance that the science behind the pandemic needs to be evaluated thoroughly and afforded a proper critique within the scientific communities and not cherry-picked based on political expediency.

The UK’s experience with the B.1.1.7 variant demonstrated that the lockdowns and stringent contact restrictions and social distancing efforts that drove the first wave of infections down have entirely failed this time around as incidence rates had tripled.

In the US, the Democratic Party and the Biden administration are eager to force schools to open and stay open. The recent drop in cases is being used as a pretext to begin opening small businesses and venues as well. Dr. Michael Osterholm has warned that with the UK variant becoming dominant in the US, conditions are ripe for a massive spring resurgence of the virus. However, the corporate media is seeking to lull the population into complacency in order to promote the herd immunity policy.

The events in Manaus have significance for the rest of the world as the working class is in an existential struggle with the ruling class against the drive to return to economic normalcy at any cost. No nation is even close to herd immunity to risk the safety and well-being of their population. It is high time that the virus is afforded the appropriate concerns as a threat to humanity. Swift and deliberate measures must be taken to contain the pandemic and initiate an international coordinated vaccine initiative unparalleled in human history to end this pandemic.

Czech Republic clinics collapse as pandemic rages

Markus Salzmann

The coronavirus pandemic is assuming increasingly dramatic forms in the Czech Republic. Across the country an average of 9,000 new infections are being reported daily and around 400 people admitted to hospitals due to COVID-19. Clinics in the west of the country are hopelessly overrun and, in some regions, no intensive care beds remain available.

In the region around Karlovy Vary and Pilsen, intensive care treatment capacity has been exhausted. Every day, patients are transferred by helicopter from the municipal hospital in Cheb to other parts of the country where treatment is still possible.

Residents of the border region have launched an online petition titled, “Open the borders for ambulances,” which received over 3,000 signatures in a very short period of time. The Czech health minister, Jan Blatny, has rejected any transfer of patients to German hospitals only a few kilometres away, as long as intensive care beds are free in other parts of the country. The transport to such facilities, sometimes hundreds of kilometres away, is an enormous burden for seriously ill patients.

Healthcare workers move a COVID-19 patient to the Motol hospital in Prague, Czech Republic. (AP Photo/Petr David Josek, FILE)

In the capital city of Prague, the seven-day incidence (infections per 100,000 inhabitants) is over 310 and even exceeds 1,000 in Cheb and in Trutnov to the north. On the German side of the border, high numbers of infections have also been reported in the border region. According to the Robert Koch Institute (RKI), the districts of Hof and Tirschenreuth have the highest number of COVID-19 infections in Germany, with a seven-day incidence of 379 and 351 respectively.

Last Wednesday, the number of infected people in the Czech Republic exceeded 1 million. On the same day, the country, with about 10.7 million inhabitants, recorded 16,545 deaths. Mortality rose by 15 percent last year, the highest rate since World War II. Around 129,100 people died in the country in 2020, an increase of 17,000 compared to 2019, according to the Czech Statistical Office (ČSÚ). More than 11,000 of this increase in deaths were connected to coronavirus infection, according to health authorities.

The situation in the country’s clinics and health facilities can only be described as catastrophic. Up until last week, more than 4,050 clinic workers had been infected. The remaining doctors and nurses have been working to the point of exhaustion for months, and clinics are only able to stay operative due to support from volunteers. A field hospital built specifically to treat 500 coronavirus patients is currently being dismantled. Deputy Health Minister Vladimir Cerny admitted that the hospital could not be put into operation due to a lack of staff.

The consequences for the population are also far-reaching in economic and social terms. Unemployment has risen by around 2 percent since 2019 and a record number of bankruptcies are forecast for this year. In 2020, the Czech Republic experienced its weakest economic performance since it split from Slovakia in 1993, with gross domestic product falling by 5.6 percent.

In the border regions with Germany and Austria, thousands of commuters are affected by the border closures. Those who test positive are often unable to carry out their work in the neighbouring country and may lose their jobs as a result. Entry into the Czech Republic is now only possible for non-Czech citizens in exceptional cases.

The extreme intensification of the situation was foreseeable months ago and is entirely due to the policy of the government in Prague. The ruling minority coalition of the neo-liberal ANO and Social Democrats (CSSD) relies on the support of the Communist Party (KSCM). After a brief lockdown last spring the coalition reopened businesses and schools and withdrew all previous health and safety measures.

Only after the situation escalated dramatically did the government decide to introduce a few half-hearted measures in December. Prime Minister Andrej Babis, himself a major entrepreneur and multimillionaire, stated unequivocally that there would be no lockdown of businesses and industries comparable to that imposed in the spring.

Even the measures due to come into force on Friday are insufficient to improve the situation. Although non-essential shops, restaurants and hairdressers are to be closed down, businesses and industries will remain open and in-person instruction will be allowed in some schools. The obligation to wear FFP2 face masks, which is mandatory in neighbouring countries, remains a mere recommendation in the Czech Republic.

It is evident that the entire political elite of the country is pursuing a policy of herd immunity. Right-wing parties and movements are able to hold demonstrations with several thousand participants opposing lockdown and safety measures. In January, ex-President Vaclav Klaus appeared at a demonstration of ultra-right forces demanding an end to all measures to curtail the pandemic under the slogan “Let’s open up the Czech Republic.”

Conflicts over the coronavirus countermeasures are also brewing within the government. The Stalinist KSCM has adopted the policy of the ultra-right and fascists and is threatening to withdraw its support for the minority government if the measures taken to contain the pandemic are extended beyond February 14.

KSCM leader Vojtěch Filip pointed out that his party had only voted in December for an extension of the current state of emergency with reservations. Among other issues, the KSCM had demanded a return to in-person teaching and the opening up of ski resorts. The ruling parties depend on the support of the KSCM to pass the budget and have agreed to hold further talks.

Popular opposition to the criminal policies of the established parties has been expressed in a wave of resignations. The Social Democrats, which, like the KSCM, emerged from the former ruling Stalinist party of Czechoslovakia, are losing members in droves. Last year alone, 2,000 members left the party. Currently party membership is just over 11,000, less than half the total from 10 years ago.

The ANO, which was founded with extensive funding from the current head of government Babis, is also in deep crisis. Several hundred members and an entire regional grouping have quit the party. The official membership of the leading government party is currently 2,800. According to its own figures, the KSCM lost around 2,000 members last year.

British Medical Journal calls pandemic response “social murder”

Andre Damon

On Thursday, the BMJ (formerly, British Medical Journal ) published an editorial accusing the world’s governments of “social murder” in their collective response to the pandemic.

The BMJ is one of the world’s oldest and most prestigious medical periodicals, with a publication history going back to 1840. Its editorial, “Covid-19: Social murder, they wrote—elected, unaccountable, and unrepentant,” is signed by executive editor Kamran Abbasi. It is a devastating indictment of policies implemented over the past year that have led to the deaths of more than two million of people.

Mortician Triston McAuliff works in a cooler holding deceased people Thursday, Jan. 28, 2021, in Springfield, Mo. (AP Photo/Charlie Riedel)

“Murder,” the editorial begins, “is an emotive word. In law, it requires premeditation. Death must be deemed to be unlawful. How could ‘murder’ apply to failures of a pandemic response?” The BMJ then goes on to argue that the term is entirely appropriate:

When politicians and experts say that they are willing to allow tens of thousands of premature deaths for the sake of population immunity or in the hope of propping up the economy, is that not premeditated and reckless indifference to human life? If policy failures lead to recurrent and mistimed lockdowns, who is responsible for the resulting non-covid excess deaths? When politicians willfully neglect scientific advice, international and historical experience, and their own alarming statistics and modelling because to act goes against their political strategy, is that lawful? Is inaction, action?

“At the very least,” the BMJ writes, “covid-19 might be classified as ‘social murder,’” pointing to the use of the term by the socialist leader Friedrich Engels in “describing the political and social power held by the ruling elite over the working classes in 19th century England.”

The editorial savages the lying justifications of capitalist politicians, who “say they have done all they can or that the pandemic was uncharted territory; there was no playbook. None of these are true. They are self-serving political lies from the ‘gaslighters in chief’ around the globe.”

The characterization by the BMJ of the response to the pandemic is entirely accurate. Around the world, politicians deliberately and knowingly handicapped government responses to the pandemic, often claiming that the mass infection of the population was desirable—in a policy dubbed “herd immunity.”

“It’s not possible to stop everyone getting it, and it’s also not desirable because you want some immunity in the population,” declared Sir Patrick Vallance, the chief scientific adviser to the Boris Johnson government in the UK. In Sweden, state epidemiologist Anders Tegnell demanded that schools remain open to further spread the disease, declaring, “One point might speak for keeping schools open in order to reach herd immunity more quickly.”

In the United States, US President Donald Trump demanded that his government “slow the testing down,” in order to conceal the scale of the disease from the population throughout 2020. “I wanted to always play it down,” Trump told journalist Bob Woodward in March.

Not only Trump, but members of Congress in both political parties were fully briefed on the massive threat posed by the COVID-19 pandemic, but they refused to alert the public, encouraging the population to travel, go to restaurants, and send their children to school.

The policies of governments have been dictated by one overriding priority: No measures could be taken to stop the spread of the virus that impinged on the interests of the financial oligarchy. The slogan, “the cure can’t be worse than the disease,” first coined by New York Times columnist Thomas Friedman, meant in practice that the necessary measures to stop the virus—including the shutdown of non-essential production, with full income to all workers—were unacceptable to the ruling class.

These social interests dictated not only the initial cover-up of the pandemic, but also the premature reopening of schools and workplaces, which helped fuel a massive resurgence that has taken the lives of hundreds of thousands of people since the lifting of partial lockdowns in the spring.

In its most damning passage, the BMJ concludes, “The ‘social murder’ of populations is more than a relic of a bygone age. It is very real today, exposed and magnified by covid-19. It cannot be ignored or spun away. Politicians must be held to account by legal and electoral means, indeed by any national and international constitutional means necessary.”

What conclusions follow from the sober assessment provided by the BMJ? The journal argues forcefully for accountability, but how is this accountability to be achieved? The editorial calls for the public to “vote out elected leaders and governments that avoid accountability and remain unrepentant,” adding that “the US showed that a political reckoning is possible.”

This is a reference to the 2020 US political election, in which voters overwhelmingly rejected Donald Trump, the world’s leading advocate of “herd immunity,” handing the Democratic Party not only the White House, but control of both houses of Congress.

But more than two weeks since Inauguration Day, Biden has made clear that his administration will continue the policies of its predecessor. Since Inauguration Day, Michigan, Illinois and New York have all lifted restrictions on indoor dining, and schools are rushing to reopen in every state where they remain remote. The centerpiece of this policy is the drive to force 23,000 Chicago educators back on the job, which is supported by all sections of the political establishment.

The effort by millions of people to repudiate the policy of “social murder” through the ballot box has been a failure. As for the courts, to which the BMJ also appeals, they have repeatedly struck down the most rudimentary measures to contain the pandemic. In other words, none of the institutions of the capitalist state are capable of changing a pandemic policy rooted in the most fundamental social interests of the capitalist class.

Just as the policies of “herd immunity” or, as the BMJ puts it, “social murder,” are rooted in the class interests of the financial elite, so, too, the opposition to these policies must express the interests of another social force, the working class.

As the BMJ notes, the term “social murder” was coined by Engels in his 1845 masterpiece, The Conditions of the Working Class in England, one of the early works of Marx and Engels as they formulated the theory of scientific socialism. Engels wrote:

When society places hundreds of proletarians in such a position that they inevitably meet a too early and unnatural death, one which is quite as much a death by violence as that by the sword or bullet; when it deprives thousands of the necessaries of life, places them under conditions in which they cannot live – forces them, through the strong arm of the law, to remain in such conditions until that death ensues which is the inevitable consequence – knows that these thousands of victims must perish, and yet permits these conditions to remain, its deed is murder just as surely as the deed of the single individual; disguised, malicious murder, murder against which none can defend himself, which does not seem what it is, because no man sees the murderer, because the death of the victim seems a natural one, since the offence is more one of omission than of commission. But murder it remains.

Three years later, Marx and Engels published the Communist Manifesto, which formulated the definitive response to the ruling class’s acts of “social murder”: “The proletarian movement is the self-conscious, independent movement of the immense majority, in the interests of the immense majority.” The aim of this movement, they wrote, must be the overthrow of capitalist property relations and the expropriation of the ruling class through socialist revolution.

What was true then is even more true now. The interests of all society—expressed in the demand for emergency measures to contain the pandemic through lockdowns with full economic compensation—are represented nowhere but in the movement of the working class.

The social interests of the working class and the interests of human society as a whole are expressed in the worldwide struggle for socialism. This movement will not only take the necessary measures to save human lives and finally tame the pandemic, but see to it that the politicians and corporate executives guilty of social murder are brought to justice.