This is an edited version of a talk given at a PSL San Francisco Bay Area meeting on May 8.
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According to the World Health Organization, as of May 7, 24 countries had reported 2,371 cases and 44 deaths. Eight-five percent of people reported infected with H1N1 live in Mexico and the United States, totaling 1,112 and 896 cases, respectively. Of the 44 deaths reported, 42 were in Mexico and two were in the United States.
In the current human epoch, the vast majority of humanity lives in societies divided by class and in nations that are either imperialist or oppressed nations. All human interactions and events have to be seen through this prism of human social relations. Natural and human-made disasters reveal omnipresent class antagonisms that often go unnoticed because they are the normal conditions of existence. The outbreak of H1N1 is such an example.
As the outbreak developed, it appeared the bulk of cases and the most deadly consequences of infection were occurring in Mexico. The initial response to the crisis from other countries was to issue travel bans and warnings to Mexico. There can be a public health basis for taking such measures. In the initial stages of an outbreak many countries issued warnings, including Cuba.
Mexico’s economy has been ravaged by the neoliberal economic policies imposed by imperialist nations. Now Mexico must struggle not only with a health crisis but also with the problem of minimizing the crisis’s impact on tourism—an industry critical to the country’s economy. At a time of global economic crisis and when scarce resources must be used to deal with the H1N1 outbreak, Mexico is seeing its tourist dollars disappear. The Mexican government has had to work on two tracks: one, minimize the outbreak; and two, restore international confidence that it was safe to travel to Mexico.
On May 2, Mexican Tourism Minister Rodolfo Elizondo was quoted as saying Mexico’s tourism revenue may fall 43 percent to $7.58 billion this year, as “almost zero” international tourists visit the country after the swine flu outbreak. Tourism, Mexico’s third-largest source of foreign currency, brought in $13.3 billion in 2008.
The H1N1 outbreak has also highlighted the extent to which racism permeates capitalist society. There have been reports in the United States of Mexican school children being ostracized and taunted by other classmates because of their nationality. The Department of Homeland Security raised the idea of closing the Mexican-U.S. border, only serving to feed racist hysteria. This would not be the first time that a discriminated against or marginalized group would be blamed for a medical crisis. We only have to look back at the AIDS epidemic.
Commonsense prevention out of reach for the poor
Why is there such a concern about this particular influenza strain? Over 36,000 people die from the flu each year in the United States alone. Why the global public health alert?
The flu can be a devastating killer. At the turn of the 19th century, the Asiatic Flu may have killed as many as 1 million from 1889 to 1890; the Spanish Flu of 1918 to 1920 had a death toll of 20 to 100 million; the Asian Flu killed 1 to 1.5 million between 1957 and 1958; and the Hong Kong Flu of 1968 to 1969 took as many as a million lives.
According to the Centers for Disease Control and Prevention, it has been estimated that in the absence of any control measures such as vaccination and drugs, a “medium-level” influenza pandemic in the United States could kill 89,000 to 207,000 people, affect from 15 to 35 percent of the U.S. population, and generate associated costs ranging from $71 billion to $167 billion.
Normally, the very young and the very old, in addition to the immune-compromised, are the ones who die from the flu. This current strain of the flu, however, disproportionately afflicts the young, mostly teenagers. Like most flu viruses, it spreads “via droplets that are expelled by speaking, sneezing or coughing,” according to the WHO. As with many infectious diseases, poverty is a risk factor for illness. The poorer you are, the more likely you are to be exposed to the flu and the less likely you are going to be able to take the precautions to avoid getting sick.
Access to clean water and soap are not a given in many parts of the world. For poor people, the recommendation “to reduce the time spent in crowded settings if possible” is easier said than done if your living situation is an overcrowded one. “Practicing good health habits including adequate sleep, eating nutritious food, and keeping physically active” is unattainable for hundreds of millions of people on the planet. Knowledge of how to prevent and minimize transmission exists, but the means to act on it is often not available.
The disease of neoliberalism
The H1N1 virus was originally called swine flu because it is believed to have been transmitted from a pig farm in Mexico to a four-year-old boy in the village of La Gloria in the state of Veracruz in the eastern part of the country. According to Mexican health officials, 1,800 of the village’s 3,000 residents, or 60 percent of the population, succumbed to a severe cold. Four hundred people required treatment for high fever, pains in the muscles and joints, terrible headaches, vomiting and diarrhea.
Evidence ties the outbreak to the operation of the Granjas Carroll pig slaughterhouse about 12 miles from the village. The company that owns the plant is a subsidiary of Smithfield Farms, the world’s largest pork producer and processor, based in Virginia.
Mexican health officials point to clouds of flies that come out of the hog barns and waste pools that contain tons of hog excrement as the vehicle of transmission. In October 2000, the U.S. Supreme Court upheld a $12 million fine by the EPA against Smithfield for environmental damage due to illegal dumping into the Pagan River of Virginia, which runs into the Chesapeake Bay. The company had been accused of dumping fecal matter and slaughtered pigs’ waste into the Pagan since the 1970s.
Smithfield established the first of 16 pig-processing farms near La Gloria at the time of the implementation of the NAFTA agreement in 1994.
What is the relationship between the imperialist globalization drive and the outbreak of this latest influenza strain? Robert Wallace, an academic and researcher has dubbed the H1N1 virus the NAFTA flu, arguing that the huge size of the pig processing plants that destroyed the local Mexican pig farming industry may have facilitated the development of more virulent strains of influenza.
In his article “The Agro-Industrial Roots of Swine Flu H1N1,” Wallace writes: “Pathogens must avoid evolving the capacity to incur such damage to their hosts that they are unable to transmit themselves. If a pathogen kills its host before it infects the next host it destroys its own chain of transmission. But what happens when the pathogen ‘knows’ that the next host is coming along much sooner? The pathogen can get away with being virulent because it can successfully infect the next susceptible in the chain before it kills its host.”
Wallace describes the conditions in these large meat processing plants that lay the basis for this process: “Larger population sizes and densities facilitate greater rates of transmission. Such crowded conditions depress immune response. High turnover, a part of any industrial production, provides a continually renewed supply of susceptibles, the fuel for the evolution of virulence.”
Marxist socialists are not opposed to large-scale mass production. There is great efficiency in mass production. There is, however, an effective point of concentration of production at which adverse consequences outweigh the benefits.
The capitalist drive for profits increases the potential danger to human existence. That is what NAFTA is all about: removing the barriers to foreign domination so that profits can be maximized through an increase in the exploitation of labor.
NAFTA is only one manifestation of the impact of neoliberalism in facilitating pandemics. The 1980s saw U.S.-dominated global financial institutions impose structural adjustments on oppressed countries around the world, forcing major cuts in government spending that often impacted vital programs and services. During that period, the Mexican government cut back on its meat inspection infrastructure.
It appears from all the information available that this outbreak is slowing. However, the fight against this new strain is not over. Historically, influenza outbreaks during this time of year come back with a vengeance in six months or so during the traditional flu seasons. What is now underway is a global effort to develop and manufacture the vaccinations necessary to prevent an even greater and more deadly epidemic.
The most knowledgeable experts, nations and people on infectious disease are in the developing and underdeveloped world. There is great knowledge, experience and practical know-how about combating the spread of infectious disease amongst the public health institutions and its health workers in the countries that routinely deal with malaria, diarrhea, tuberculosis and other infectious diseases.
Private wealth versus public health
The challenge faced in the developing and underdeveloped world is the inequitable distribution of wealth, which is an obstacle to preventing and eliminating a number of diseases.
For example, over 90 percent of all influenza vaccines are produced in the United States and Europe. Only in the last five years have six other regions of the world begun to manufacture flu vaccines. Those include China, India and South Africa.
On May 3, the Pan American Health Organization issued a press release entitled “PAHO Urges Equitable Access to Influenza Vaccines.” Showing how private property rights stand in the way of health care, the press release states, “As it stands, several manufacturers have preproduction contracts with some countries, which could impose some barriers to vaccine access for the poorest of the poor.” In other words, the price agreed to for the production of the vaccine may be unaffordable to those who are sick.
It is estimated that 1 to 2 billion doses of H1N1 vaccine will be needed globally. Presently, Oseltamivir is one of the medicines to be taken either as a prophylactic or as a treatment for H1N1. Commercially known as Tamiflu, the prescription is for 10 pills at a cost of about $85. The potential profits to be made from a global order for 1 to 2 billion vaccinations must not prevent humanity from having access to treatment and care. It will take a struggle to put what should be a guaranteed right to every human being ahead of the fortunes that pharmaceuticals stand to pocket by selling flu medication as a commodity.
In the United States, the CDC and local health departments are actively working to contain the spread of H1N1. It is expected that we will see an increase in the number of cases before it tapers off. The virulence of this strain is considered quite mild, and public health officials are now preparing to deal with the next waves of this strain in the months to come.
President Obama has requested $1.5 billion in emergency funding to pay for the emergency mobilizations. School closures are deemed unnecessary, with sick kids being told to stay home or are sent home if they manifest symptoms while in school; workers are told to stay at home as well if symptomatic. There is no ban on travel except to say not to travel if you are symptomatic.
Maybe with the exception of the CEOs and stockholders of pharmaceuticals and other medical supply companies, most everyone has a vested interest in minimizing the impact of the epidemic. While the government, the media and societal institutions appeal to a national identity and urge us all to pull together in times of crises, the capitalists do not suspend profiting from the crises, nor do they suspend exploitation.
People, not profits
I work at the California Department of Public Health in the Division of Communicable Disease Control. The statewide command and response center is located down the hall from where I work, in the Infectious Disease Branch of the Division.
At the same time as this outbreak has occurred, state workers have been forced to take a one-day furlough as a way to resolve the budget deficit faced by the state of California. Just the other day, the governor issued an executive order that enables the state to force any state worker to work a mandatory 12-hour-a-day, 4-day-a-week shift at the command center. There is no compensation for this. It is basically forced labor. Are the supply companies that are providing gloves, masks and other goods to treat the sick being forced to open their warehouses and provide to society the needed supplies for free? I think not.
I make this point not to say capitalist society is incapable of dealing with the outbreak, for that is not true. I make this point to show how the class nature of society facilitates the initiation of the outbreak, as the policies of globalization have done, and how the working class and the poor suffer disproportionately from the outbreak, while carrying the burden for resolving it as well.
In a global socialist society, the profit motive would not exist. Not only would there be no private companies that own life-sustaining medicines, the motor force of socialized production would be used to meet human needs. Many infectious diseases that kill and sicken millions of people on the planet year after year would be either completely eliminated or greatly reduced.
Take for instance this H1N1 influenza outbreak. It is possible it would have never happened in the first place because the plant now owned by Smithfield would not be run for profit. It would operate, if it existed at all, as part of a plan to feed people. With the pursuit of profits removed from the equation, precautions could be put in place to maximize the health and safety of the workers, and the health of the pigs.
If an influenza strain did originate from the plant, private property rights would not be an obstacle to resolving the matter. Now, Smithfield uses its profits, stolen labor from the community, to pay lawyers and PR people to manage the crisis for them. But in a socialist global community, those resources would be used for public health intervention and measures.
The recommended guidelines of using clean water and soap to wash your hands; to practice good health habits including getting adequate sleep, eating nutritious food, and staying physically active would be attainable because clean water and a healthy lifestyle would be part of what society provides as a basic right to each human being. This would strengthen the capacity of the individual and collective immune systems to combat the virus.
While we look forward to that time, today we must fight for the working class to have the widest possible access to treatment and vaccination, and making the corporations and the rich pay, with the wealth created by our labor, for providing social services and meeting human needs.
