Inflation sets off gyrations in global bond markets

Nick Beams

It has been a turbulent week for bond markets. The inherent fragilities of the global financial system are being exposed by the rise of inflation, the continuing and deepening COVID-19 pandemic and a resurgence of working-class struggles.

The week began with the Reserve Bank of Australia (RBA) being forced to abandon its targeting of the yield on an April 2024 bond at 0.1 percent. This was because of a sell-off that saw the yield rise to 0.8 percent, meaning the central bank would have had to buy up all the available bonds in order to maintain its objective.

Faced with a rush for the exits, which sent the bond price down and its yield up, the RBA decided to scrap the policy it had put in place in response to the financial crisis that accompanied the start of the pandemic in March 2020.

The RBA decision attracted world-wide attention because it pointed to developments in global markets. Investors, who had acted on assurances by central banks that inflation is “transitory,” were hit with losses, sometimes significant, because short-term bond prices fell in response to fears price rises were becoming entrenched.

Attention then shifted on Wednesday to the US Federal Reserve. As expected, it announced the tapering of its asset purchases by $15 billion per month until next June when they will cease altogether.

Financial markets, which had priced in tapering, responded positively to the Fed’s decision—with Wall Street continuing its surge to new record highs. This was largely because of Fed chair Jerome Powell’s insistence that the central bank’s base interest rate of virtually zero was not going to be lifted in the immediate future.

Powell did not sound any alarms as one of his central objectives is to ensure the stability and continued rise of the stock market. But his remarks indicated that the Fed, like other central banks, is being buffeted by forces it does not fully comprehend much less know how to control.

For example, Powell said that while economic activity had expanded at the rate of 6.5 percent in the first half of the year, in the third quarter “real GDP growth slowed notably from this rapid pace.” This was because the Delta variant had held back the recovery and activity had been restricted by supply constraints and bottlenecks in the motor vehicle industry.

However, he had no answer to meet this problem, noting that “our tools cannot ease our supply constraints” before offering a profession of faith.

“Like most forecasters, we continue to believe that our dynamic economy will adjust to the supply and demand imbalances, and that as it does, inflation will decline to levels much closer to our 2 percent longer-run goal,” he said.

But as to how long it might take for inflation to come down from its present headline rate of 5 percent Powell had no idea. It is “very difficult to predict the persistence of supply constraints or their effects on inflation,” he said.

While there was broad support for the Fed’s latest decision, there are concerns it is responding too slowly to the rise in prices and it may have to make a rapid adjustment.

Paul Jackson, head of asset research allocation at Invesco, told the Financial Times: “If the Fed ends up behind the curve, then they could end up raising rates very quickly and in big amounts.”

Such a move would have a major impact on Wall Street because its rise to record highs has been built on a mountain of debt that has only been sustained by ultra-low interest rates.

On Thursday the Bank of England (BoE) was in the spotlight as its Monetary Policy Committee (MPC) handed down its latest decisions.

Bank of England, Threadneedle Street, London, England [Credit: Flickr, Hongchou's Photography]

In the period leading up to the MPC meeting, financial markets in Britain and around the world had largely priced in that there would be an increase in the central bank base interest rate from its present record low of 0.1 percent. As a result, the BoE would be the first major central bank to lift rates since the start of the pandemic.

This assessment was based on remarks by its governor Andrew Bailey last month that the central bank “will have to act” if inflation proved to be stubbornly high.

UK inflation has shown no sign of slowing with predictions that it will rise from its present level of 3.1 percent to as much as 5 percent in coming months. So it appeared all but certain the base rate would be lifted.

It was not to be. The BoE’s MPC voted seven to two to maintain its present rate.

This set off a series of swings in UK and global markets in the opposite direction to that earlier in the week.

The yield on one-year government bonds almost halved within hours, falling by 0.22 percentage points in the biggest move since 2009 in the wake of the global financial crisis.

These falls were reflected in other markets with yields on the US two-year Treasury bonds falling. The yield on German one-year government bonds, already in negative territory, dropped by 0.08 percentage points, the largest one-day fall since the crisis of March 2020.

While these bond market movements are small in absolute terms, they can have major effects because they impact on large amounts of money—hundreds of billions of dollars—that surge through financial markets every day. This takes place as investors make bets, often involving complex operations, on which way interest rates and other variables, such as currencies, will move.

At his press conference following the decision, Bailey pushed back against assertions by journalists that he had sent a message to markets, insisting “none of us” said rates would go up in November.

“It was a very close call,” he said. “We are in a situation where the calls are close, they’re quite hard.”

He was also questioned on an assertion in his prepared remarks that “monetary policy can do little to affect inflation in the near term.”

The present inflation, he said, was not being caused by excess demand in the economy pushing up against supply as in the past. Rather it was the result of a “supply side shock” and monetary policy could not increase the supply of computer chips or gas.

Asked why central banks did not see this shock resulting from the pandemic, he provided no answer.

It recalled the famous “Queen’s question” in 2008 when the British monarch asked a group of learned economists why none of them had seen the financial crisis coming.

Bailey warned that if monetary policy was used in the wrong context to try to combat inflation this could make things worse for households.

However, his real concern, like that of his counterparts, is not the millions of workers struggling to make ends meet as the prices of necessities escalates. His worry is the stability of financial markets where a rise in rates could precipitate a collapse in the debt-based house of cards.

The overriding concern as regards inflation is its effect on the development of class struggle. This was made clear at the conclusion of his prepared remarks when he said the “short-term evolution of the labour market will be crucial in determining the scale and pace of the response” by the BoE to inflation.

If inflation becomes what central banks term “anchored,” that is if workers begin to press for higher wages, then the BoE will move to lift rates, inducing a contraction in the economy, to suppress those demands.

There is a broader conclusion to be drawn from a viewing of the press conference. The BoE governor, together with other central bank chiefs, find themselves in an entirely new situation. They have no real idea about the trend of global growth, the direction of inflation, when and how global supply chains will operate, and what is developing in the labour market.

For the past three decades and more, they have been able to operate under conditions where inflation has been kept at low levels. Cheaper goods have resulted from the globalisation of production and the suppression of the struggles of the working class which has led to a persistent downward trend in real wages.

Now that situation has changed dramatically, triggered by the pandemic. Global production has been thrown into disarray and the working class is moving back into struggle, not only against the effects of the pandemic but in response to the impact of the policies leading up to it.

Whatever confusion the central bankers may have, they are guided by a sure class instinct, honed by the experience of centuries of rule: that the future course of the profit system over which they preside depends on the defeat of the growing movement of the working class by whatever means necessary, including authoritarian forms of rule.

For the working class, the crucial issue is the fight for an internationalist and socialist perspective aimed directly at the conquest of political power.

This week’s gyrations in financial markets, together with the deepening of the murderous policies of the ruling class on the pandemic, indicate this confrontation is coming increasingly to the fore.

New study in the BMJ provides damning testimony of the impact the pandemic has had on life expectancy

Benjamin Mateus

The actual toll of the COVID pandemic has been assessed in several recent studies and analyses, which have highlighted in detail both the deadliness of the virus and its extensive reach across the globe. Despite these repeated confirmations, high-income nations and the financial oligarchs continue to insist that the cure in the form of elimination of the disease globally remains far worse than the disease, which allows the virus a free rein to upend livelihoods and kill millions so that financial institutions are unfettered by the demands placed on their craving for ever more enrichment.

A nurse holds a phone while a patient affected with COVID-19 speaks with his family from the intensive care unit [Credit: AP/Daniel Cole]

On November 3, 2021, BMJ (formerly the British Medical Journal) published a probing investigation on “the effects of COVID-19 pandemic on life expectancy and premature mortality in 2020” across 37 high-income and upper-middle-income nations. The study is a continuation of previous work done by the same group on estimating excess deaths during the pandemic in 2020. The findings corroborate previous reports and stand as testimony to the malign policies of the ruling elites which can only be construed as deliberate and intentional social murder.

By including in their analysis countries that employed more comprehensive pandemic-fighting measures, the BMJ study provides a stark contrast to the policies followed by the US and Europe. It provides irrefutable evidence against the ignorant mantra of Thomas Friedman of the New York Times, and other apologists for mass death, who put forward the slogan, “The cure can’t be worse than the disease.” From the standpoint of science and public health, the cure has always been better than the devastation wrought by allowing the virus to rip through communities across the globe.

Rather than using excess deaths, the BMJ study employed data on all-cause mortality, which stands as a more reliable measure of the pandemic’s impact, allowing comparisons between countries. The authors explained, “Although using excess deaths has been considered the ideal method for measuring the impact of the pandemic, this metric does not take into account age at death. When people die at an older age, they lose fewer years of remaining life. Analysis of life expectancy and years of life lost (YLL) provides a more nuanced estimation of premature mortality at a population level.”

Figure 1: Changes in life expectancy at birth associated with COVID-19 pandemic in 2020.

Life expectancy is a measure of how long a population can expect to survive if the factors that contribute to deaths for various ages remain constant for the remainder of their lives. Years of life lost utilizes age distributions for these deaths, giving greater weight to deaths at younger ages. It is calculated using the number of deaths observed rather than “hypothetical life tables.” The study notes, “Life expectancy depends solely on mortality, and YLL depends on both the mortality and the age structure of the population.”

The study found that in the 15 years before 2020, all 37 countries studied showed a rising trend in life expectancy at birth for both men and women. However, for 2020, the first year of the pandemic, this trend dropped precipitously. The reduction in life expectancy was most significant in Russia, with 2.32 years, followed by the United States with almost two years. Bulgaria, Lithuania, and Poland were next in descending order.

However, the authors found that life expectancy was not impacted for South Korea, Norway, and Denmark, where strict mitigation measures remained the norm. In Taiwan and New Zealand, life expectancy actually climbed, highlighting the beneficial impact that measures eliminating the virus from their borders had on maintaining access to healthcare and population-based interventions that protected citizens from the hazards posed by day-to-day life.

Regarding Years of Life Lost (YLL) in 2020, only Taiwan and New Zealand had a decline (an improvement) in this category. Iceland, South Korea, Denmark, and Norway had no demonstrable change in the expected years of life lost, corroborating the life expectancy data.

However, in the remaining 31 countries, the 222 million years of life were lost in 2020 (130 million in men and 92.6 million in women), were 28.1 million higher than expected, showing the impact of the pandemic. Men accounted for 17.3 million of these excess years of life lost, while women lost 10.8 million.

When age categories were evaluated in the 31 worst-hit countries, excess YLL increased with age in both genders, showing the disproportionate impact of COVID-19 on older populations. However, Finland, Iceland, New Zealand, South Korea, and Taiwan saw excess YLL for the elderly decline, meaning the intensive mitigation measures employed against the virus benefited the elderly the most.

The findings on life expectancy were especially remarkable for younger populations in the US, especially in men. When the US was compared to Lithuania, Poland, and Spain, “between the observed and expected age-specific death rates by age intervals,” those under the age of 65 in the US and Lithuania were “responsible for a high proportion of the total losses in life expectancy.” By comparison, in Poland and Spain, older age groups drove the loss of life expectancy.

Figure 2: Age group components of difference between observed and expected life expectancy in 2020 among the US and three comparator countries

This is damning testimony demonstrating that the working class in the US, in particular male workers, have been impacted disproportionately. However, the impact of COVID on younger people has been much more severe in 2021, meaning the figures cited in the study will be far more horrific in the pandemic’s second year. In 2020, more than 70,000 people between 25 and 65 died due to COVID. In 2021, over 111,500 in this age bracket have been killed, despite access to COVID vaccines.

The authors found “[that] with a similar burden of excess deaths per 100 000 in Spain and the US (161 and 160, respectively), excess YLL (per 100 000) was substantially higher in the US (3400) than in Spain (1900), indicating higher numbers of deaths at younger ages in the US compared with Spain. Indeed, the ratio of YLL rate in people aged under 65 and 65 years or older at death was 0.29 in the US, whereas it was only 0.07 in Spain. Despite a lower excess death rate than Lithuania, Poland, and Spain, the reduction in life expectancy in the US was higher than in these three countries.”

The death toll in the second year of the pandemic has outpaced the first year of the pandemic. Approximately 2.35 million died in the first 12 months since the World Health Organization declared a Public Health Emergency of International Concern on January 30, 2020. With three months left to the second anniversary of this declaration, another 2.64 million have already died as the world enters the sixth wave of the pandemic.

Indeed, with the introduction of the COVID vaccines, there has been a push by governments of high-income countries to completely force open every economic avenue that remains closed regardless of its devastating impact on the working people of the planet upon whose back the financial oligarchs have enriched themselves.

This critical study published in theBMJ by these courageous researchers should be applauded and studied. It carefully demonstrates that the virus can be eliminated and lives can be protected. The policies that have promoted “let the bodies pile high”, “let it rip”, and “learn to live with the virus”, are fraudulent and criminal. In fact, their findings provide irrefutable evidence to indict these ruling criminals responsible for the massive loss of life and livelihood.

However, these same principled scientists who have been decrying the dangers posed by the ruling elite’s criminal policies must engage with the working class, the only progressive force for whom the issue of eliminating the pandemic is most urgent. It is the turn to the working class that will generate the necessary response to their analysis.

Combatting Global Warming: The Solution to China’s Demographic “Crisis”

Dean Baker

There have been numerous news articles in recent years telling us that China faces a demographic crisis. The basic story is that the market reforms put in place in the late 1970s, together with country’s one-child policy, led to many fewer children being born in the last four decades. As a result, the number of current workers entering retirement, exceeds the size of the cohorts entering the workforce, leading to a stagnant or declining workforce. This is supposed to be a crisis.

I used the word “supposed” because it is not in any way obvious that a declining workforce is any sort of crisis. We see shifts of population all the time, which can lead many cities or regions to have a decline in their population or workforce, even if the country as whole does not. That doesn’t necessarily mean a crisis for the areas losing population, unless of course the population decline is due to the loss of a major employer.

A drop in the growth rate of the workforce, or an actual decline, will likely mean slower GDP growth, but so what? A country’s standard of living is determined by its income per capita (along with many other factors), not its absolute level of GDP. India’s GDP is almost eight times Denmark’s, but Denmark is the far richer country. The reason is that India has more than two hundred times as many people.

If a country’s growth rate is slower because the growth rate of its workforce slows, that is hardly a disaster. People can still be seeing improvements in their standard of living, and in the case of China, these improvements would still be quite rapid even if its annual growth rate slowed by 2-3 percentage points from its recent pace of more than 6.0 percent annually.

There is a common argument that countries with aging populations, like China, will suffer because each worker will have to support a larger number of retirees. It is easy to show that this view is silly. Even a modest rate of productivity growth will swamp the impact of a declining ratio of workers to retirees. With output per worker increasing, both workers and retirees can enjoy rising living standards even as the ratio of workers to retirees fall.

That should not sound surprising. The ratio of workers to retirees has been falling in the United States for the last two decades, yet we have seen substantial increases in living standards, even if the wealthy have gotten the bulk of these gains. The idea that China’s declining ratio of workers to retirees poses a supply side problem, where it cannot produce enough goods and services to support its population is absurd on its face.

The Problem of Secular Stagnation

It turns out that the major problem of an aging population is not too much demand, but rather too little. Older people tend to spend less money than people in their working years. Also, when a country’s workforce is not growing, companies need to spent less money on investment. Employers need more capital when they hire more workers, this could mean desks and computers, or it could be machinery in a factory, or a truck on the road. The more workers companies hire, the more capital they need, which means more investment.

But if the workforce stagnates, then companies need to spend less on investment. They will still modernize their equipment and replace worn out items, but they don’t have to invest to accommodate the needs of a larger workforce.

With both consumption and investment falling relative to GDP, economies will face the problem of inadequate demand. In principle, the economy is capable of producing more goods and services than households and businesses are prepared to buy. This is the situation that we faced in the Great Depression, and again, on a smaller scale, in the Great Recession. It means mass unemployment. In the Great Depression unemployment peaked at 25 percent of the workforce.

It is ironic that the economists warning about the implications of an aging population not only got the magnitude of the problem wrong, they even got the direction wrong. With our aging population, we don’t have to worry about too much demand, we have to worry about too little. This is yet another example of the old saying that economists are not very good at economics.

 

Spending Money: The Cure for Secular Stagnation

We discovered the cure for secular stagnation in the 1930s, the government has to spend money to make up for the failure to spend by the private sector. President Roosevelt embraced this strategy to a limited extent with his New Deal programs. These put millions of people back to work, while modernizing our housing and infrastructure.

Of course, the government spending program that really got the economy back to full employment was World War II. With the country united behind the need to defeat Germany and Japan, budget deficits ceased being an issue. We saw record low unemployment rates in the war years as tens of million of workers were either serving in the military or producing the food, clothes, and weapons needed by the military.

The war provided the political support for massive spending (and budget deficits), but it was the spending that got the economy to full employment. Money spent on civilian uses will create jobs every bit as well as money spent on the military.

This brings us back to China’s demographic crisis and global warming. As Paul Krugman wrote in a recent column, China is going to have to make a massive adjustment in its economy in the years ahead. It has been spending an incredible 43 percent of its GDP on capital formation, either investment goods purchased by businesses, or residential housing. By comparison, the figure for Japan is 24 percent and for the United States less than 22 percent.

This massive spending on capital formation made sense when China was seeing rapid growth in its labor force and also a huge shift in its population from rural to urban. But this process is now reaching an end point, both with a decline in its working age population and the rural to urban shift largely completed.

Currently, over 62 percent of China’s population lives in urban areas. The figure for most wealthy countries is close to 80 percent, but the pace of shift for China will be much slower going forward than in the past. In 1980, less than 20 percent of its population was urban.

This means that China’s big problem going forward is to find a way to spend a very large amount of money. For simplicity, let’s say that their needed spending on capital formation falls to 23 percent of GDP, roughly splitting the difference between Japan and the United States. This would mean that China’s government has to figure out what to do with 20 percent of its GDP.

This is an incredible amount of money. In 2021, 20 percent of China’s GDP would be $5.4 trillion. According to the I.M.F.’s projections, the annual amount would be almost $8 trillion in 2026. Over the next decade, it would be more than $80 trillion, that’s more than 20 times the original $3.5 trillion Build Back Better plan. In short, it’s real money.

It is also important to note that China is already heavily invested in clean energy. China is by far the world leader in solar energy, with more than twice as much as the United States, the second largest user of solar power. It is also by far the world leader in wind energy, again with more than twice as much installed wind power as the United States.  And, China also has more than twice as many electric cars on the road as any other country.

This means that China has a large domestic clean energy sector which can stand to gain by further spending on reducing greenhouse gas emissions. Of course, no one expects that the country will spend anything like $80 trillion over the next decade reducing greenhouse gas emissions, but it certainly can commit considerable resource to this effort. In addition to the benefits to the environment, this spending will help China’s economy grow and keep its workforce employed.

This is one of the opportunities created by China’s supposed demographic crisis. The issue is that because of the aging of the population it faces the prospect of a huge shortfall of demand in the economy. This is a good problem for a country to have, if its leadership is adept in managing its resources.

There are many grounds on which to criticize China’s government. It severely represses minority populations, most extremely the Uighurs, many of whom have been imprisoned for months or even years. It also does not respect freedom of speech, freedom of the press, or basic labor rights. But there is no doubt that it has done an outstanding job in managing its economy over the last four decades in a way that has led to an enormous improvement in living standards for the overwhelming majority of its population.

If China wants a path through its “demographic crisis,” or, in other words, coping with secular stagnation, devoting substantial resources towards greening its economy would be a great path forward. In the process, they can also give a big hand to the rest of the world, both by sharing the technology and showing how it can be done, as well as reducing the damage they are doing to the planet themselves.

Ukraine’s complicated path to NATO membership

Slavisha Batko Milacic

Amid numerous discussions about the future of Ukraine – a country that has been unable to form a single nation in 30 years of independence, and is torn apart by interethnic, linguistic and economic contradictions, Europe should ask itself just what Ukraine really means to it. And the answer will be the same – a buffer zone, because this clearly reflects Ukraine’s geopolitical role in relations with NATO and the EU. The Alliance needs Ukraine as a buffer zone, and even not all of it at that.

During the early 1990s, when Ukraine was not yet torn apart by civil war, NATO was seriously eyeing this former Soviet republic. As for Russian president Boris Yeltsin, he was not ruling out joining the Alliance himself. In 1994, NATO signed a framework agreement with Kiev as part of the Partnership for Peace initiative.

Five years later, Ukraine demonstrated its “pro-Atlantic” slant by supporting NATO’s operation in the Balkans. On June 12, 1999, Kiev even closed the country’s airspace for Russian planes flying to Pristina for several hours. That move caused an angry backlash from many Ukrainians, who consider themselves a part of the Orthodox Slavic world. And still, the first small step towards Euro-Atlantic integration seemed to have been made.

There is no place for failed states in the Alliance

Twenty-seven years on, Ukraine is a fragmented country, with a crumbling economy, a corrupt government and a vague foreign policy. Its biggest foreign policy breakthrough was gaining a “visa-free” status, which gives Ukrainian citizens a chance to look for illegal jobs in prosperous European countries without the need to apply for entry visas. That said, all the assistance Ukraine got from the United States and Europe did not help it to bring back Crimea or gain victory over its own citizens in Donbass. Moreover, Brussels and Washington have strong doubts about the country’s defense capability. The fact is that of all the post-Soviet countries NATO was smart enough to accept only the former Soviet Baltic republics, which spent 2 percent of their GDP on defense – a great deal of money considering their small budgets (for comparison, Belgium spends 0.9 percent and Hungary -1.27 percent).

With Ukraine’s official defense outlays of at least 5.93 percent of GDP (2021) the country should be a mighty military power not afraid of anyone and a welcome new member for NATO. However, military supplies have long become a source of easy money for the country’s political elites, and the change of presidential teams did not change this a tiny bit. Ukraine keeps getting all imaginable foreign assistance, which is written off, disappears on the front line of a smoldering war and is resold to third countries. Meanwhile, despite its wealth of unresolved problems, Kiev keeps knocking on NATO’s door, apparently hoping that Brussels will help sort them out.

Ukraine’s main role is that of a buffer zone

In fact, the only role Ukraine can hope for is that of a buffer zone. In the European geopolitical model, the conflict with Ukraine is forcing Russia to put on hold its aggressive intensions in Europe, and having snatched yet another chunk of Ukrainian territory, the Russians will take some time to digest it. Kiev is certainly not happy about such a scenario and in June, President Volodymyr Zelenskyy appealed to NATO with a demand to immediately accept the country into the alliance. He emphasized that NATO membership will be the only way to end the conflict in Donbass. NATO Secretary General Jens Stoltenberg promised that someday Ukraine will become a member of the alliance, but this will not happen overnight. Naturally enough, Ukraine’s pro-presidential media ignored that latter part of Stoltenberg’s message and started describing in glowing terms the joys of an early entry into the Alliance. And this despite Russia’s firm opposition to NATO’s expansion, which means that Ukraine’s entry into the Alliance will automatically entail active measures by Russia to ensure its own security.

Realizing full well that neither NATO nor the EU are eager to take in Ukraine any time soon, President Zelensky and his administration started portraying Ukraine as a “Shield of Europe”. Well, this propaganda ploy, intended for foreign and domestic consumption, might work for some time for some EU countries, which remain jittery about the imaginary picture of Putin’s tanks racing down Europe’s highways. And again, the Ukrainian right-wingers will have a new reason to pride themselves on their role as “defenders of Europeans” against the “Russian hordes”. But why on earth should Putin want to seize Europe? Who would he be selling gas to? What kind of a threat is Moscow posing to Brussels then?

Gas blackmail? But this is “just business,” and there are other gas suppliers out there. Meanwhile, the “Shield” is costing Europe a great deal and the price tag keeps going up. Kiev demands to preserve gas transit for itself, wants gas supplies at preferential prices and new sanctions against Moscow. At the same time, Ukrainian politicians insult their neighbors, make no attempts whatsoever to rein in the domestic ultra-right, who pose a threat to the whole of Europe, and are mired in corruption. So whether NATO and the Russian Federation really need a buffer zone is a big question. What we certainly do not need, however, is a “Shield” that we pay for from our own pockets…

Fourth coronavirus wave leads to massive outbreaks at German schools and universities

Tamino Dreisam

Within a week, the seven-day incidence rate of the coronavirus in Germany has risen by more than 40, to a level of 155 per 100,000. It is almost as high as it was at the peak of the deadly third wave. The increase cuts across all age groups and is significantly higher than at the same time last year.

The number of new infections reported daily in Germany has reached a new high. The Robert Koch Institute (RKI) reported 33,949 new coronavirus infections within one day on Thursday. This is 172 more than on December 18, 2020, the day with the highest number of confirmed infections so far.

Along with this, the number of coronavirus patients in intensive care units is also rising sharply in all age groups. Within the last day, more than 600 infected patients have been hospitalized. The hospitalization incidence is currently 3.29, with 2,058 ill patients in the ICU—an increase of 74 from the previous day.

People line up for vaccination injections in front of at the vaccination center of the Malteser relief service on the fair grounds in Berlin, Germany, Wednesday, Nov. 3, 2021. (AP Photo/Markus Schreiber)

“We are in a critical situation of the pandemic,” the chief executive of the German Hospital Association, Gerald Gass, told Redaktionsnetzwerk Deutschland. “If this trend continues, we will have 3,000 patients in intensive care units again in just two weeks,” he warned.

As with previous waves, the number of outbreaks is increasing in nursing homes and hospitals. Last week, there were 78 outbreaks in medical facilities (an increase of 23 from the previous week) and 122 outbreaks in nursing homes and homes for the elderly (an increase of 44 from the previous week). In total, there were nearly 2,000 new cases.

It is not uncommon for these outbreaks to be fatal. In a nursing home in Brandenburg last week, the number of residents who died increased to eleven. In a nursing facility in Mecklenburg-Western Pomerania, an outbreak resulted in 17 deaths.

The latest rise in infections is a direct result of the criminal policy of reopening the economy and dismantling protective measures in all areas. The recklessness of all state governments is particularly evident in schools. Among 5-to-19-year-olds, the seven-day incidence level is now over 180, and among 10-to-14-year-olds, it is even over 330.

In the last four weeks, there have been 190 coronavirus outbreaks at kindergartens and 768 at schools. In both cases, however, the last two weeks cannot yet be conclusively assessed, due to late reports. The number of school outbreaks has been increasing significantly since the beginning of August. These numbers can clearly be attributed to the reopening of schools and the dismantling of protective measures.

Despite this, all state governments are sticking to their unsafe school policies. Since the start of school after the end of the summer vacations, they are trying to outdo each other in who is the fastest to abolish protective measures such as distancing regulations or mandatory mask-wearing. On November 2, the mask-wearing requirement for nearly 2.5 million students was dropped in the most populous state, North Rhine-Westphalia. School administrators were expressly prohibited by the state Education Ministry from opposing these dangerous regulations.

In Schleswig-Holstein and Saxony, too, the mask-wearing requirement is to be lifted again after the autumn vacations—contrary to the wishes of many students. “In the student body, we are largely in agreement: we would rather put on masks in class and be safe from coronavirus than be taught at home,” explained Oliver Sachsze, deputy chairman of the state student council, for example.

Thuringia is particularly clear in its pursuit of deliberate mass infection. Although the incidence level among 15-to-34-year-olds is 273 and among 5-to-14-year-olds 527, the Left Party-led state government is continuing to maintain unsafe classroom teaching. The requirement to wear a mask still does not apply to elementary school students. Testing is back, but untested students are allowed to continue coming to school in separate learning groups.

Infections are also on the rise at universities, which recently began their winter semesters again with in-person classes. In mid-October, the nearly three million students at German universities were sent back under unsafe conditions. Now the first consequences of this policy are beginning to show.

In Göttingen, the Faculty of Economics had to cancel its orientation weeks due to the increase in coronavirus infections. City spokesman Dominik Kimyon said it was difficult to determine exactly where the infections were coming from.

Seven infections also occurred during the orientation weeks at Leuphana University in Lüneburg, which can be attributed primarily to three study groups. At Leibnitz University in Hannover, there were two confirmed infections related to the orientation period.

At Freie Universität Berlin, the Korea Institute had to switch to online formats again just one week after resuming face-to-face teaching. Infections were also reported at the History and Cultural Studies department, including several cases of vaccine breakthroughs. Previously, the university president’s office had stated that it did not expect any serious outbreaks, due to the high vaccination rate.

Resistance is growing to this policy of deliberate infection at universities. At the last meeting of the Humboldt University student parliament (StuPa), the International Youth and Students for Social Equality (IYSSE) campus club introduced a resolution opposing face-to-face teaching and calling for “an immediate return to online teaching.” After an amendment, the following text was passed:

The StuPa criticizes the current course of the presidium to hold as many courses as possible in person without creating effective protective measures at the same time. Due to this short-term and chaotic decision, students are being exposed to health hazards and risk groups are being denied participation in courses. Students who have left Berlin due to the pandemic are now also faced with the task of finding an apartment in Berlin from one second to the next.

We call on the university management to oblige lecturers to create real options and to allow students to decide whether they want to participate in the courses in person or digitally. This should not put students who attend digitally at a disadvantage.

Outside of nurseries, schools, and universities, coronavirus outbreaks are occurring in numerous other places where workers must assemble without adequate safety measures. Last week, the Robert Koch Institute (RKI) attributed 643 infections to outbreaks at workplaces, 1,075 at educational institutions and 71 at refugee shelters. But because the origin of the vast majority of infections cannot be identified, the number of unreported cases is much higher.

Sudan’s military seek to crush opposition demanding civilian rule

Jean Shaoul

Sudan’s security forces killed at least three and wounded 100 people taking part in Saturday’s mass demonstrations in the capital Khartoum against the seizure of power by General Abdel Fattah al-Burhan.

It brings the total number killed in recent days to at least 12, according to the Central Committee of Sudan’s Doctors, although a senior US official believed the death toll had reached at least 20-30 people, and the number injured 170, even before Saturday’s protests.

There have been days of protests and strikes calling for a return to civilian rule, including of many federal and state government workers and bank workers, leading to a severe cash shortage in a country without an ATM infrastructure.

Demonstration against the coup in Khartoum (Twitter)

Demonstrators chanted, “The people are stronger and the revolution will continue” and carried banners reading, “No to military rule.” They demanded the release of all civilian leaders, including Prime Minister Abdalla Hamdok. Many schools and shops remain closed. The strikes are set to continue this week, with another rally due in Khartoum on November 6.

Defying arrests and beatings at the hands of the security forces, tens of thousands have taken to the streets in days of nation-wide protests since al-Burhan, who headed the joint civilian-military Sovereign Council that has led the country since August 2019, seized power. The Sudanese diaspora has mounted demonstrations in cities in Australia, Indonesia, Italy, Lebanon, Norway, the United States and the United Kingdom, calling for their governments to oppose the coup.

Al-Burhan dissolved the Sovereign Council on October 25, weeks before he was due to hand over his position to a civilian. He dismissed Hamdok’s civilian “technocratic” government, arrested Hamdok and several members of his cabinet and declared a state of emergency, shutting down the internet and closing the capital’s main bridges. He has sacked the Chief Justice presiding over crucial reforms to the judicial system and released key figures in and around former dictator Omar al-Bashir’s ruling National Congress Party, which was outlawed after his ouster in 2019.

The general said the coup was necessary to avert a “civil war” and that the military would establish a new government, promising elections in July 2023. While Hamdok and his ministers have been released, they remain under house arrest, even though al-Burhan has publicly offered Hamdok his job back. Al-Burhan has been unable to find any credible civilian figures willing to join a new government.

The strikes, rallies and demonstrations are the largest since the mass protests that precipitated the April 2019 pre-emptive military coup, led by al-Burhan with the support of the United Arab Emirates (UAE) and Saudi Arabia, that ousted President Omar al-Bashir and his Muslim Brotherhood-affiliated military dictatorship, which had ruled since 1989. Al-Burhan and the military had sought to prevent the overthrow of the entire state apparatus in which he was a leading light.

After seizing power two years ago, he opened negotiations with the Forces of Freedom and Change (FFC) that had led the protests—an umbrella group of 22 bourgeois and petty bourgeois opposition groups and political parties, including the trade unions and the Sudanese Communist Party. Just weeks later, soldiers and paramilitaries massacred more than 1,000 unarmed protesters, chasing them through Khartoum, tying concrete blocks to their feet and throwing them into the River Nile.

Despite this, the FFC signed a treacherous deal with the military, agreeing to serve in a transitional “technocratic” government, headed by Hamdok, a former economist at the African Development Bank and later the United Nations Economic Commission for Africa. The government operated under the control of the Sovereign Council, in effect a joint military-civilian presidency headed by al-Burhan.

The political and economic path followed by the Hamdok government brought it into conflict with the economic, social and political interests of Sudan’s military, which controls much of the economy.

Hamdok sought to end Sudan’s pariah status by aligning the country with US imperialism and its regional allies, including Israel, in an anti-Iran block. He handed al-Bashir to the International Criminal Court for war crimes in Darfur, where 300,000 people were killed and millions displaced in fighting between 2003 and 2008. His government investigated and sanctioned military and security officials involved in human rights abuses, rooted out corruption and privatized hundreds of Sudan’s state-owned corporations. This was the political price for economic aid, loans and investment needed to shore up the country’s economy that has all but collapsed following the secession of South Sudan in 2011 and the loss of oil revenues upon which the government depended.

The conflict that had been brewing for months burst into the open in September. The army, seeking to capitalize on social discontent generated by increasing poverty and social inequality, mounted an abortive putsch, widely viewed as a dress rehearsal for last month’s coup, and organized mass demonstrations in support of the generals.

The coup has attracted almost unanimous condemnation from the major imperialist powers. The US is determined to prevent Sudan’s social tensions, replicated across the region, spreading to their allies Saudi Arabia, the United Arab Emirates and Egypt. The Biden administration has demanded the Sudanese military restore the civilian government, suspended its $700 million aid programme in the country and sent its fixer for the Horn of Africa, Jeffrey Feltman, back to Khartoum to try and impose a civilian fig-leaf for the military. The World Bank has suspended $2 billion in aid and debt relief packages.

The European powers are also anxious to avoid any instability in Sudan, strategically located in the Horn of Africa alongside the Red Sea and the entrance to the Suez Canal, that might disrupt oil supplies or generate a new wave of refugees. It takes place as Ethiopia, Africa’s second-most populous country and the Horn’s powerhouse, has descended into a civil war that threatens to break the state apart. It is expected that the European Union and the Paris Club of creditors will follow Washington’s lead in suspending funding.

While al-Burhan believed he could count on Egypt, Saudi Arabia and the UAE, Riyadh and Abu Dhabi have joined the US in calling for a return to civilian rule while Cairo has not openly backed him.

To form the now overthrown civilian-military transitional government, the FFC and the Sudanese Professionals Association, under the influence of the Sudanese Communist Party, built a broad alliance subordinating workers to the political parties and armed groups that had dominated Sudan since independence. The claim that such a government would be capable of resolving the enormous social and economic problems confronting Sudanese workers was a dangerous trap. But these liberal and pseudo-left forces in the middle class will stop at nothing to block a social revolution, as their record throughout the Middle East and Africa has shown.

US-trained Afghan intelligence agents, elite troops reported joining ISIS

Bill Van Auken

Intelligence agents and elite counterinsurgency troops trained by the CIA and the Pentagon during the 20-year US occupation of Afghanistan are reportedly joining the Islamic State-Khorsan (ISIS-K).

The Wall Street Journal this week reported on the influx of these US-trained forces into ISIS-K, citing unnamed Taliban leaders, officials of the ousted US puppet regime and people who knew agents and soldiers who had joined the group.

In a November 1 interview with Foreign Policy, Rahmatullah Nabil, former chief of the US-backed Afghan regime’s intelligence agency, the National Directorate of Security (NDS), reported the same phenomenon: “Of the ANDSF [Afghan National Defense and Security Forces] who were left behind, I am receiving reports from different areas that, in order to have some protection, they see the Islamic State as a better platform for themselves. And I think the Islamic State is accepting them.”

Former National Military Academy of Afghanistan (NATO)

In its report, the Journal noted that “Importantly, these new recruits bring to Islamic State critical expertise in intelligence-gathering and warfare techniques, potentially strengthening the extremist organization's ability to contest Taliban supremacy.”

ISIS-K is engaged in a brutal campaign of terrorist bombings against civilian targets aimed at destabilizing the Taliban government. On Tuesday, it claimed responsibility for an attack on the Sardar Mohammad Daud Khan hospital, the largest hospital in Afghanistan’s capital, Kabul, which killed 25 people and wounded more than a dozen others. The attack included a suicide bombing and an invasion of the hospital by gunmen, who shot a number of wounded Taliban fighters in their hospital beds.

This latest attack follows suicide bombings in Kandahar in the south and Kunduz in the north, which claimed well over 100 lives. In both cities, the targets were prayer services at Shiite mosques. ISIS-K identified the attacker in Kunduz as ethnic Uyghur, the largest population in China’s western Xinjiang province, which borders Afghanistan.

Given US imperialism’s record in Afghanistan and the CIA’s intimate connections to the emergence of ISIS, there is every reason to ask whether this bloody campaign is backed by Washington with the aim of destabilizing Afghanistan and preventing the emergence of any regime not under its thumb.

The US armed intervention in Afghanistan began more than 40 years ago with “Operation Cyclone,” in which Washington—together with its allies Saudi Arabia and Pakistan—armed and funded Islamist mujahedeen fighters in a war against the Soviet-backed government in Kabul. The largest operation ever mounted by the CIA, it provoked a civil war that ultimately claimed the lives of millions. It also gave rise to both Al Qaeda, which was allied with the CIA, and the Taliban, which Washington initially supported when it took power in 1996.

In October 2001, the US invaded Afghanistan on the pretext of retaliating for the 9/11 attacks on New York City and Washington, which were blamed on Al Qaeda. It was the start of a two-decade occupation in which some 800,000 US troops participated under four presidencies, cost over $2 trillion and led to the deaths and maiming of thousands of Americans and hundreds of thousands of Afghans.

A decade into the “global war on terror,” which was also the pretext for the even bloodier 2003 invasion and occupation of Iraq, the Obama administration launched a pair of new wars, in Libya and Syria. In both of these wars, Washington shifted from its supposed global crusade against Al Qaeda into supporting, financing and arming Al Qaeda-linked Islamist militias in the toppling of the Libyan government of Muammar Gaddafi and the attempt to bring down that of Syria’s Bashar al-Assad.

In 2014, investigative journalist Seymour Hersh exposed the existence of a CIA “rat line” running from Libya’s eastern port city of Benghazi through southern Turkey and into Syria, which was used to smuggle in weapons and foreign fighters to wage the US-backed war for regime change.

There are strong indications that a similar “rat line” into Afghanistan was created following the rollback of ISIS by the US military along with Iraqi Shia militias, Syrian government forces and US-backed Kurdish militias.

A report issued in June by the United Nations cites information that the Eastern Turkistan Islamic Movement (ETIM), an Islamist separatist group dedicated to carving out a Uyghur state in Xinjiang, China had “established corridors for moving fighters between the Syrian Arab Republic, where the group exists in far larger numbers, and Afghanistan, to reinforce its combat strength” and “facilitate the movement of fighters from Afghanistan to China.” The ETIM has aligned itself with ISIS-K against the Taliban government.

How ETIM and other “foreign fighters” could “establish corridors” into an Afghanistan occupied by the US and NATO, the UN report does not explain.

Among those charging that ISIS-K is a creature of the US is Washington’s longtime puppet Hamid Karzai, who was president in the Kabul regime from 2001 until 2014. In 2017, he told Al Jazeera, “In my view, under the full [US] presence, surveillance, military, political, intelligence, Daesh [the Arabic acronym for ISIS] has emerged. And for two years, the Afghan people came, cried loud about their suffering, of violations. Nothing was done.”

In the same period, Karzai told Voice of America: “I consider Daesh [the US’] tool.” He added, “I do not differentiate at all between Daesh and America.”

There were numerous reports from Afghanistan of unmarked helicopters flying weapons and supplies into areas occupied by ISIS-K. At the time, the US and NATO were in full control of Afghanistan’s airspace.

For its part, the Taliban has alleged a “foreign hand” in the recent terrorist bombings and has rejected US proposals for cooperation in fighting ISIS, charging that the group had grown with US support.

In addition to the former intelligence agents and special forces troops that have joined ISIS, the US evacuated from Afghanistan thousands of commandos of the so-called Zero units that operated under the supervision of the CIA, carrying out night raids, assassinations and other war crimes. This provides the US intelligence agency with a pool of recruits for an intervention aimed at provoking a new civil war in Afghanistan.

Washington is pursuing a policy designed to provoke maximum instability and upheaval in the country that it occupied for 20 years. It has refused to allow access by the Taliban government to close to $10 billion held by US financial institutions, and has cut off all aid, which previously accounted for 80 percent of the Afghan government’s budget. The result has been an economic meltdown and the paralyzing of the country’s health care system as well as foreign aid groups on the ground. This, as the World Bank reports that 14 million people—one out of three Afghans—are on the brink of starvation, and winter is approaching with the threat of even worse conditions of famine.

US imperialism views Afghanistan through the prism of its declared military strategy centered on “great power” confrontation with China and Russia. Just as US national security adviser Zbigniew Brzezinski promoted the CIA-orchestrated mujahedeen war of the 1970s and 1980s as a means of giving the Soviet Union its “own Vietnam,” today Washington sees an Afghanistan in chaos undermining Chinese and Russian interests in Central Asia and potentially provoking terrorist campaigns against both countries.

The Ahmadi family home in Kabul, Afghanistan, after a U.S. drone strike on August 29, 2021. (AP Photo/Khwaja Tawfiq Sediqi)

Meanwhile, the Pentagon issued a report Wednesday exonerating the US military for the August 29 airstrike in Kabul that killed 10 innocent Afghans, including an employee of a Western humanitarian organization and seven children. The US military initially claimed that it had killed four ISIS-K bombers.

The report found no “violations of law or of the law of war,” but rather “an aggregate process breakdown, in which many people are involved.” It insisted that the drone missile massacre had to be seen in the context of the attack at the Hamid Karzai International Airport that killed 13 US service members and resulted in the deaths of scores of Afghan civilians. In the wake of this attack, there was a US drive to exact revenge.

This Pentagon report constitutes a deadly warning that such massacres will continue under the mantle of the US military’s so-called “over the horizon” operations against alleged “terrorists” in Afghanistan.

After more than four decades, it is apparent that the tragic encounter of the Afghan people with US imperialism is far from over.

CDC approval of COVID-19 vaccines for children is portrayed as the last threshold to “normalcy”

Benjamin Mateus

On November 2, 2021, the Centers for Disease Control and Prevention (CDC) released a media statement acknowledging Director Rochelle Walensky’s endorsement of their Advisory Committee on Immunization Practices’ (ACIP) recommendation that children 5 to 11 should receive Pfizer’s pediatric COVID-19 vaccine. The approval means that clinics, schools and pharmacies across the country can begin offering the 28 million children in this age group immediate vaccination.

The pediatric COVID-19 vaccine has only one-third of the adult dosing, or 10 micrograms. However, according to Pfizer’s phase 2/3 trial in children of this age, immune titers were as high as young adults receiving the adult dosing a month after their second dose. Additionally, as with adults, vaccine effectiveness was nearly 91 percent among those aged 5 to 11 years.

Kindergarten students at the Milton Elementary School in Rye, New York on May 18, 2021. (AP Photo/Mary Altaffer)

In making the recommendation for vaccinating children, the CDC also had to admit that COVID-19 does take a significant toll on children. They wrote in their statement, “COVID-19 cases in children can result in hospitalizations, deaths, MIS-C (inflammatory syndromes) and long-term complications, such as ‘long COVID,’ in which symptoms can linger for months. The spread of the Delta variant resulted in a surge of COVID-19 cases in children throughout the summer. During six weeks in late June to mid-August, COVID-19 hospitalizations among children and adolescents increased fivefold.” They go on to assert a critical point, “Vaccination, along with other preventative measures, can protect children from COVID-19 using the safe and effective vaccines already recommended for use in adolescents and adults in the United States” (Emphasis added).

The admission is in passing, and none of the bourgeois press reporting these developments will bother to absorb the significance or entertain the statement’s implication. On the contrary, the pediatric vaccine initiative, though necessary, “will be used to overcome all resistance by parents to sending their children into social settings rather than protecting them at home,” as the WSWS observed this week. Even as the Food and Drug Administration (FDA) was announcing its near-unanimous approval of Pfizer’s pediatric COVID-19 vaccine, on the same day the New York Times was sowing the seeds for ending facemask mandates by publishing a lengthy opinion piece titled, “We need to talk about an off-ramp for masking at school,” by Jessica Grose.

With the CDC’s approval, the offensive to undo all previous restrictions is being accelerated, regardless of worrisome trends in various regions of the US and the world. Despite high levels of natural or vaccine-induced immunity, a surge in cases has led to a rise in hospitalizations and deaths.

Dr. Monica Gandhi, who has been outspoken for school reopening, in promoting her new article in The Atlantic, tweeted, “I recommend, with this [vaccinating children] threshold in the US … and rising immunity, let’s think about when we can downgrade from 2020 crisis mode.” She has brazenly declared the July Delta wave the last wave and children’s vaccination “the last threshold before a return to greater normalcy,” abandoning the most important precautionary principle in her field.

On Wednesday, President Joe Biden said, “For parents all over this country, this is a day of relief and celebration. … My administration is ready, we have been ready from day one, today, organized, and have a plan for this vaccination’s launch. … As soon as next week, we will have enough vaccines and enough places, and parents will be able to schedule appointments to get their kids their first shot. We’ve also been working with governors, mayors, and local school leaders to bring vaccines to schools. As of today, more than 6,000 school clinics have already been planned in school districts around the country. These efforts will also ensure equity at the center of our children’s vaccination program as it has been for adults.”

There is no such thing as equity in the United States, and the attempts to interpret the pandemic through the prisms of identity politics and racial categories are politically reactionary. In their latest update on COVID-19 vaccination, Kaiser Family Foundation found that though the proportion of black people receiving vaccinations has risen and closed the gap with white people, they remain below all other racial categories.

Vaccine distribution and boosters between high and low-income nations. (Financial Times)

However, no mention is made on the socioeconomic indices that demonstrate that poverty and social class, not race, are the fundamental bases of vaccine disparities. This data, however, is collected by the CDC. Between December 2020 and May 2021, it found that disparities in vaccination coverage increased with an increasing social vulnerability index (SVI). They wrote, “By May 1, 2021, vaccination coverage was lower among adults living in counties with the higher overall SVI [poorest and most vulnerable]. … Vaccination coverage disparities were largest for two SVI themes: socioeconomic status (Q4=44.3 percent versus Q1= 61.0 percent) and household composition and disability (Q4=42 percent versus Q1=60 percent).” There is no indication that such disparities will not impact children also.

They concluded by stating, “disparities in vaccination coverage by SVI have increased over time, especially in large fringe metropolitan and nonmetropolitan counties. Disparities were associated with county-level differences in socioeconomic status and household composition, and disability. Although disparities were not associated with county-level differences related to racial and ethnic minority residents and housing types, individual SVI components suggested disparities among adults living in counties with particular housing characteristics (e.g., lower coverage in counties with a higher percentage of mobile homes).” Indeed, these disparities will translate through the same socioeconomic conditions that affect the working class predominantly.

Vaccine inequity within the United States is combined with the broader issue of global vaccine inequity as high-income nations are moving, through the aegis of vaccine nationalism, to curtail worldwide distribution to ensure boosters and now pediatric vaccines are available to their own population. The global supply of vaccines is being limited by profit considerations of the manufacturers and their adamant refusal to waive patents and allow massive production of generic versions of the vaccines that would make it possible to flood the world with tens of billions of cheap and effective life-saving treatments.

This is leading to the continued disparity in the distribution of vaccines, specifically in low-income nations. An interim report by the World Health Organization (WHO) dated October 4, 2021, makes the following recommendations: “In the context of ongoing global vaccine supply constraints, broad-based administration of booster doses risks exacerbating inequities in vaccine access by driving up demand and diverting supply while priority populations in some countries, or in subnational settings, have not yet received a primary vaccination series. The focus remains on urgently increasing global vaccination coverage with the primary series driven by the objective to protect against severe disease.”

The international distribution facility COVAX, which had been conceived to ensure fair and equitable access to COVID-19 vaccines, is facing a significant shortfall on its targets due to hoarding of these treatments and supply-chain issues that have plagued the world economy, as well as a grossly insufficient budget and lack of any meaningful authority to force manufacturers to honor their agreements.

The coordination of the program has been thrown into utter chaos as nations have turned to making lateral agreements between countries or purchasing the vaccines directly from the pharmaceutical companies due to delays and shortages. With more than 7.15 billion doses administered, COVAX has delivered only 400 million vaccines out of a projected 1.4 billion.

In the attempt by high-income nations to vaccinate their way out of the pandemic, they have already given more booster doses than low-income countries have given in total doses all year, according to Dr. Tom Frieden, former Commissioner of Health of the City of New York. He tweeted, “These graphs from the Financial Times (FT ) show just how shockingly unfair vaccine rollout has been. We can potentially prevent millions of deaths from COVID and reduce the risk of new dangerous variants by increasing vaccine supply and improving equity.”

As the US and the rest of the world prepare for winter, the drive to vaccinate children takes on a more urgent character implying that wealthier nations are buying up all the supply that exists. According to the FT, richer countries have received over 16 times more COVID-19 vaccines per person than poorer nations that rely on COVAX. Speaking with FT , Kate Elder, a senior vaccines policy adviser at the Doctors Without Borders access campaign in New York, said, “You’ve really got to look hard at the model. We need structural change if we’re going to avoid repeating this disaster in the future.”