Announcing a new book by Stephen Gowans from Baraka Books.
Summer 2021, the novel coronavirus is scything through populations worldwide. WHO Director-General Dr Tedros Adhanom Ghebreyesus announces the Covid-19 pandemic will end “when the world chooses to end it .… We have all the tools we need. They include proven public health and social measures; rapid and accurate diagnostics; effective therapeutics including oxygen; and of course, powerful vaccines.”
The pandemic didn’t end.
Much of the world ignored the proven health and social measures Tedros mentioned. On the other hand, China, Vietnam, New Zealand and a few other countries had used those measures successfully to drive infections to zero. The rest of the world preferred to let the virus to run riot, or impose half measures, and only when hospitals were under an unbearable strain.
The promised vaccine exit ramp turned out to be more mirage than oasis. Countries that rolled out vaccines quickly to large parts of their populations, soon turned to boosters, but with little success.
Poor- and middle-income countries meanwhile experienced a global vaccine apartheid. They were left waiting for crumbs to fall from the rich countries’ table, as new, possibly more virulent variants, threatened to emerge.
Stephen Gowans investigates why, when all the tools to avert a catastrophe were available, the world failed to prevent the Covid-19 disaster. He examines the business opportunities and pressures that helped shape the world’s failed response. His conclusion: the novel coronavirus, a killer, had a helper in bringing about the calamity: capitalism, the killer’s henchman.
Exposing the role profit-making played in creating the disaster, Gowans shows how capitalism, its incentives, and its power to dominate the political process, impeded the protection of public health and prevented humanity from using the tools available to solve one of its most pressing problems.
In this episode of By Any Means Necessary, hosts Sean Blackmon and Jacquie Luqman are joined by Stephen Gowans, author of “Traitors, Patriots, and Empires: The Story of Korea’s Fight for Freedom,” to discuss how capitalism drives vaccine inequality in the world, how pharmaceutical companies are putting the pursuit of profit over the needs of humanity, and how rich countries neglected public health measures to mitigate the pandemic and pursued a disastrous strategy focused on vaccines.
In a new editorial the British Medical Journal thunders against the monopolization of life-saving vaccines by rich countries, calling it a “moral scandal” and “crime against humanity.” Vaccine makers and “their political allies” are flayed for turning a “blind eye” “towards the innumerable deaths in disadvantaged nations” caused by their refusal to share vaccine technology with poor countries, while at the same time presenting themselves as the greatest servants of humanity. What they are really doing, the editorial fumes, is “making a killing”, both figuratively (in massive profits) and literally (in preventable deaths.)
According to the BMJ:
“Vaccine preventable deaths and illness are occurring across Africa, Asia, and Latin America at an unprecedented speed and scale” because there is an artificial shortage of vaccines, and what vaccine doses are available are being sold to the highest bidders—the rich countries.
“Contrary to claims, it is possible to make enough vaccines for the world” by sharing vaccine know-how, making vaccine technologies open source, and allowing any company, anywhere in the world, private or public, to produce vaccine doses.
“Let us be clear what is causing these deaths,” the BMJ fulminates: “a free market, profit driven enterprise based on patent and intellectual property protection, combined with a lack of political will.”
In other words, capitalism. The editorial doesn’t use the C-word, but if the argument is followed to its logical end, capitalism is the inevitable destination.
Deaths and illness are occurring in low-income countries which could be prevented if vaccine manufacturers shared their technology with poor countries and allowed them to produce the vaccines themselves.
Only one percent of people in low income countries are fully vaccinated, according to Our World in Data, while over 50 percent of the residents of rich countries have received two vaccine doses (and in some countries three. About one million residents of the United States have received three vaccine doses while health care workers, the elderly, and infirm in the world’s poorest countries have yet to receive even one.)
The disparity is due to two causes:
The rich countries’ pharmaceutical companies have exclusive rights to mRNA and viral vector vaccine technologies. Backed by their governments, they refuse to make the technology open source. If they did, spare manufacturing capacity could be engaged, and the supply of vaccines boosted, allowing a quicker roll out of doses around the world, but foregone profits for the vaccine oligopoly.
As the BMJ points out, the “world’s 30 richest nations—those able to pay high vaccine prices—have cleared the world’s shelves of doses through advanced purchase orders.”
Canada purchased enough doses to vaccinate its citizens five times over.
The United Kingdom secured enough doses for four times its population.
The United States has stockpiled 100 million doses.
Some high-income countries are administering, or planning to administer, vaccine boosters, absent evidence they’re needed, while at the same time destroying unused, expired, doses. Meanwhile, less than six percent of Africans have received even a single dose.
The real international community—over 100 countries—has proposed a temporary waiver on intellectual property protection of Covid-19 vaccine technologies. This would expand the supply of doses and expedite the roll out of vaccines to poor countries. On top of saving lives and reducing illness, a faster roll out would reduce the chances of new variants emerging that might evade current vaccines.
However, these developments, while a caress for humanity, would be a blow to pharmaceutical companies and the wealthy investors who back them. A supply shortage allows the companies to sell vaccines at monopoly prices with the attendant advantage of huge profits. Vaccine-makers argue that large margins are necessary to recover their research and development costs, but the vaccine technologies to which they have exclusive rights were produced in publicly-funded university and government labs. The truth of the matter is the companies seek large margins to do what capitalist enterprises are systemically compelled and legally obliged to do: generate profits to the highest level possible. Suffice to say, sharing technology with other manufacturers, means sharing market share. Any pharmaceutical company CEO who agreed to this repudiation of corporate responsibility would be quickly dismissed and replaced by another person whose moral qualms (if they have any) do not interfere with the pursuit of hard-headed business imperatives; namely, exploiting employees, despoiling customers, and paying out healthy dividends to the only people who matter in the calculus of capitalism: shareholders.
As for the dangers of new variants emerging, this can hardly be unwelcome to vaccine-makers. New variants, especially those that achieve “vaccine-escape”, present the pleasing prospect for vaccine company shareholders of a guaranteed future demand for new vaccines and therefore an unceasing stream of revenue stretching far into the future—the holy grail of capitalist pharmaceuticals. The prospect may be a nightmare for humanity, but it’s a pharmaceutical company CEO’s wet dream.
Oxfam, the BMJ notes, accuses the G20 rich nations of putting the interests of pharmaceutical companies and their investors ahead of ending the pandemic. The journal adds that “Vaccine manufacturers and many rich countries are working tirelessly to block waiver discussions at the World Trade Organization”, while at the same time, the WTO drags it heels. Quelle surprise. Whose interests do vaccine manufacturers, the governments of rich countries, and the WTO represent? Not those of poor countries.
The BMJ’s moral indignation is understandable and warranted, but its failure to take its analysis far enough to confront the systemic roots of the problem leads to recommendations that leave much to be desired. While the BMJ can’t bring itself to mention the C-word, it is capitalism, its incentives, and its power to dominate the political process, that impedes the protection of public health and undermines the solution to the pandemic, not the moral or intellectual failures of business people and political leaders.
Unfortunately, while the BMJ’s diagnosis is sound, its treatment plan—the liberal use of moral suasion aimed at pharmaceutical company investors and politicians—is next to useless. Capitalism, an amoral system, does not respond to moral appeals.
The BMJ urges vaccine company workers and shareholders to speak out.
But shareholders, who, as the BMJ acknowledges, are “making a killing”, are not going to vociferate against a system that bestows generous financial rewards upon them. Employees who protest will likely lose their jobs; that should be deterrent enough to their speaking out.
Leaders of rich nations are exhorted to pressure vaccine companies to share their technology.
But leaders of rich countries are not morally neutral parties, hovering dispassionately above the fray, disconnected from capitalist class politics or the pharmaceutical industry. It was these very same leaders who transferred to select firms the right to exploit commercially, publicly funded vaccine technologies, as it has been their practice to do with countless other innovations churned out of public labs (the internet, GPS, AI, to name but a few.) The architects of the system are not likely to be its grave diggers, or even agents of its temporary suspension.
Moreover, the leaders of the richest country, the United States, are interlocked with the pharmaceutical industry. Its interests are their interests. Moncef Slaoui, who oversaw the US effort to develop Covid-19 vaccines and therapeutics, held executive posts for many years at the pharmaceutical giant GlaxoSmithKline, a company in which he held $10 million in stocks. He was also a member of the Moderna board and had $12.4 million in stock holdings in that company. On top of these pharma-connections, he was a partner in Medicxi, a venture capital firm that specializes in biotech investments. Alex M. Azar II, his boss, worked for three years as president of Eli Lilly’s subsidiary in the United States.
As for the Biden administration, it has numerous direct and indirect connections to the pharmaceutical industry, and to Pfizer in particular. As Lee Fang has reported in The Intercept:
Eric Lander, the White House science adviser, holds up to $1 million in shares of BioNTech, Pfizer’s vaccine partner. Lander has recently proposed a pandemic preparedness plan which pivots mainly on providing public funding to vaccine-makers to stockpile vaccines for use against potential pandemic pathogens.
Susan Rice, Biden’s domestic policy adviser, holds up to $5 million in shares of vaccine-maker Johnson & Johnson and up to $50,000 in shares of Pfizer.
Anita Dunn, who until recently was Biden’s senior advisor, is managing partner at the consulting firm she co-founded, SKDK, which does public relations and advertising work for Pfizer.
Pfizer is a top client of Albright Stonebridge Group, a consulting firm founded by former Secretary of State Madeleine Albright. ASG counts among its former employees a number of high-level Biden administration figures, including:
Linda Thomas-Greenfield, US ambassador to the United Nations.
Jeffrey DeLaurentis, Thomas-Greenfield’s deputy.
Victoria Nuland, Undersecretary of State for Political Affairs.
Wendy Sherman, Deputy Secretary of State.
Uzra Zeya, Under Secretary of State for Civilian Security, Democracy, and Human Rights of the United States.
Molly Montgomery, Deputy Assistant Secretary in the Bureau of European and Eurasian Affairs
Philip Gordon, Vice President Kamala Harris’s national security adviser.
People who spend their careers working with or for pharmaceutical interests, and have financial stakes in pharmaceutical firms, can be expected to share the pharmaceutical industry’s point of view. This is the point of view of capitalist industry–that profits are the summum bonum. No one occupies a significant position in a capitalist state without an unswerving commitment to capitalist values. Except under the most extraordinary circumstances, capitalist governments will not pressure private enterprises to negate their obligations to their shareholders in order to prevent the illness and deaths of penniless foreigners who live in what a US president once infamously called—and rich countries treat as—“shithole countries.”
The BMJ fails to recognize that the interests of pharmaceutical company investors and those of the poor countries are irreconcilably opposed. There is an assumed common interest between these two parties, namely, the end of the pandemic. Yet, while the end of the pandemic would certainly benefit the poor, both in poor and rich countries, it would not benefit the vaccine oligopoly. Restricted vaccine supply and the monopoly pricing it allows, the opportunity to provide vaccines to a vast global market, and the prospect of an ongoing stream of revenue in vaccine boosters and vaccines for new variants, are manna for the pharmaceutical industry. For rich countries—those that produce vaccines or have purchased more doses than they need—the current state of affairs offers them leverage over the have-not countries; the have-not countries are dependent on the rich counties for access to vaccines, helping to ensure their continued pliability and openness to exploitation by the rich countries.
Clearly, a temporary waiver of patent rights would harm pharmaceutical company profits and deny rich countries their leverage, and therefore, it is naïve to expect pharmaceutical companies and interlocked political elites to voluntarily submit to demands that they sacrifice their interests for the good of the bulk of humanity. The whole idea of capitalism as an exploitative system is that the bulk of humanity exists as a means to the profit-making ends of a microscopic minority of billionaires. Profits, not people. To be sure, the Biden administration has withdrawn its objection to a temporary suspension of patent rights, but this may be a concession of little consequence. Germany and other rich countries continue to fight the proposal strenuously, and the WTO is slow-rolling the issue. If and when the waiver is approved, the damage it can do to vaccine oligopoly profits will be severely limited.
There is another reason for capitalist industry to oppose a temporary waiver. The lifting of patent rights would acknowledge what no capitalist proponent wishes to acknowledge, namely, that capitalism, or at least its intellectual property protection provisions, can produce suboptimal, even harmful, outcomes for the welfare of the majority of the world’s population. The capitalist zeitgeist holds, in contrast, that capitalism is philanthropic, a blessing for humanity. Once it is established that a pillar of modern-day capitalism is harmful for public health, it becomes easier to make the case that the system of wealth accumulation in the hands of a miniscule elite of billionaires and their servants is harmful in other ways as well—for example, in anthropogenic global warming and the promotion of war. Might calls be made for the suspension, or worse, elimination of capitalism as a danger to humanity? In other words, the notion that patent rights ought to be suspended even temporarily is equivalent to the idea embedded in the Communist slogan, “people, not profit”—to wit, that the explicit aim of capitalism is to produce profits for a minority, not to enlarge and protect the interests of the majority of the planet’s inhabitants. It doesn’t take a genius to see that a people-centered system is, from the point of view of the bulk of humanity, preferable to one whose sole aim is to satisfy the wealth accumulation imperative of a tiny elite of uncrowned monarchs. Arguing that the intellectual property rights this minority has conferred upon itself need to be suspended in the interests of the rest us, is a potential opening for a system-challenging discussion. The BMJ editorial has provided that opening. It’s up to the rest of us to carry it forward.
Capitalism makes a suboptimal form of public welfare the possible, but never necessary, incidental outcome of profit-making. Optimal public welfare based on the elimination of the exploitation of humans by humans, and not profits, needs to become the sole organizing principal of society. The development of Covid-19 vaccines was made possible by public planning and spending. The leaders of rich countries recognized that capitalism was not up to the task of developing new vaccines. The costs were prohibitive and the risks just as great. Investors will not to risk their capital on an enterprise with a high probability of failure. Thus, a kind of socialism was pressed into service, under the rubric of Operation Warp Speed, to develop vaccines and therapeutics, in which the public assumed the risk. However, this was a socialism harnessed to capitalist requisites. Once the vaccines were developed, they were licensed exclusively to a vaccine-making oligopoly. The costs and risks were socialized; the benefits privatized. But rather than privatizing the fruits of socialized innovation, vaccine technology could have been socialized and produced for need, not profit. The disincentives to sharing vaccine technologies would have been few, if any, under a system of production for need.
Under the same system, the question of how to address the pandemic would not have been biased, from the start, in favor of a techno-fix that amounted to an attractive vaccine and therapeutics business opportunity, rather than in favor of public health and social measures, which China and Vietnam demonstrated are sufficient to eliminate community transmission of the virus and which the WHO has repeatedly endorsed as a proven method of pandemic control. It now appears that vaccines may be incapable of preventing transmission of the virus; it is now obvious that the vaccine strategy—based on the notion that vaccines are the exit ramp from the pandemic—is clearly incapable of rescuing humanity from the pandemic. The end of the pandemic lies, as the director of the WHO, Tedros Adhanom Ghebreyesus announced on August 4, in “a comprehensive approach of vaccines in combination with proven public health and social measures that we know work” (emphasis added.) As the WHO has also pointed out, had rich countries acted quickly and decisively to implement public health and social measures in February and March 2020, the pandemic would have been averted. The rich countries failed to abort the pandemic in embryo, but in allowing a crisis to be born, created many lucrative business opportunities.
The route to a system based on need, not profit, does not follow along the path of moral suasion and speaking truth to power. No matter how much they’re pressured, wolves will never act as sheep. Too often it is believed that any action, no matter how unlikely to bear fruit, is better than no action, but that’s doubtful. Actions which address symptoms (IP protections), and not causes (the capitalist interests IP protections serve), bring only temporary relief at best, and usually not even that. Actions which demand capitalists ignore the imperatives of capitalism to act as socialists—as if socialism is achievable within a capitalist framework—are quixotic. Pointless actions may be worse than useless if they foster illusions about where the problem lies and therefore what the possible solutions are.
To be sure, capitalist pharmacy is a moral scandal and crime against humanity, and not only in its production, pricing, and distribution of coronavirus vaccines, but in its operations from alpha to omega. A system designed to yield profit, not to protect and promote health, routinely produces suboptimal human health outcomes, if not outright harm. This is a virtual axiom. Recognizing that the problem is production for profit, carried out by private enterprises, organized by markets, and under the political control of governments dominated by plutocrats, is the first step on the road to a solution. Another step is recognizing the promise inherent in the alternative: production for use organized by a consciously prepared plan, carried out by publicly owned enterprises, and under the political control of governments guided by democratic, not profit-making, concerns. In this kind of system resides any hope humanity has for solving its most daunting problems: the pandemic, climate change, the threat of terminal war, and the unnecessary poverty of most of humanity.
In this segment of By Any Means Necessary, hosts Sean Blackmon and Jacquie Luqman are joined by Stephen Gowans, author of “Traitors, Patriots, and Empires: The Story of Korea’s Fight for Freedom,” to discuss vaccine imperialism and the WHO’s ask that rich countries halt booster dose programs, how capitalism slows the production of vaccines and allows more variants of COVID-19 to develop, and the United States’ use of the pandemic as an opportunity to plunder poor countries and further its violence around the world.
Had all capitalist countries managed the Covid-19 pandemic as effectively as the Communist-led countries of China, Cuba, and Vietnam, nearly 147 million people would have been spared illness and over three million lives would have been saved, according to projections based on data from Our World in Data. These projections are based on applying the number of cases and deaths per million for the Communist world to the world as a whole.
Taken together, the Communist countries have limited the spread of the novel coronavirus to 134 cases per million, compared to 24,058 cases per million in the non-Communist world. At the same time, communist countries have held Covid-19 deaths to four per million, while in the capitalist world, the death rate per million has been well over a hundred times greater.
What’s more, according to reports from The New York Times and The Wall Street Journal, North Korea has likely been as successful as its Communist cohorts in protecting public health in the face of the worldwide coronavirus emergency.
Clearly, compared to the capitalist countries, the Communist-led states have not only done a better job of protecting their citizens from the dangers of Covid-19, they have done a supremely better job.
Continuity
In 1986, sociologist Shirley Ceresto and physician Howard Waitzkin published research in the American Journal of Public Health comparing the performance of Communist-led states and capitalist countries on physical quality of life indicators, including six public health measures: infant mortality, child death rate, life expectancy, population per physician, population per nurse, and daily per capita calorie intake. Using World Bank data, the researchers found that when comparing Communist-led countries with capitalist states at the same level of economic development, the Communist countries came out ahead on all six public health measures.
Waitzkin told The Los Angeles Times that he believed the Communist-led countries fared better because they considered health care to be a basic human right. Ceresto added: “The first thing a country does when it becomes socialist is improve the health care and education and feed the people.” This, she said, “is their goal: To feed their people and get them health care and education.”
In 1992, sociologist and political scientist Vincente Navarro published in The International Journal of Health Services a continent by continent survey of the performance of socialist and capitalist countries in their response to the health needs of their populations. Navarro concluded that socialism and socialist forces [had], for the most part, been better able than capitalism and capitalist forces to improve health conditions.”
Among other comparisons, Navarro contrasted China with India, showing how life expectancy in the Communist country lagged India’s by seven years when Mao’s forces came to power in 1949. A quarter of a century later, life expectancy had increased by 35 years and was 12 years greater than in India, where life expectancy had increased only 17 years. Today, China continues to lead India in life expectancy at birth.
Navarro concluded that “the socialist experience … has been more frequently than not more efficient in responding to human needs than the capitalist experience.”
Communist Countries Today
As was true in the 1980s, today’s Communist-led states outperform capitalist countries on various measures of public welfare, including life expectancy, hospital beds per thousand, extreme poverty, as well as scoring higher on the human development index, a composite measure of income, life expectancy, and education.
Table 1 shows that average life expectancy is five years greater in Communist countries than capitalist states (77 vs. 72). The lead is even greater in Cuba and Vietnam (seven years), comparing these countries with capitalist states at the same level of economic development.
Table 2 shows that Communist-led states have close to twice as many hospital beds per 1,000 people as capitalist countries, with Cuba having over three times more beds per 1,000 people than capitalist countries at the same level of economic development.
Table 3 shows that the percentage of the population living in extreme poverty is lower in the Communist-led states (for which data are available, namely, China and Vietnam) than in the capitalist world as a whole, or in capitalist countries with a similar GDP per capita.
The idea that extreme poverty is greater in the capitalist than Communist world challenges the myth, industriously cultivated in the rich countries, that capitalism means wealth and development while the Communist countries are uniquely poor. While it is true that some capitalist regions are very wealthy, specifically, those with an imperialist past and present (North America, Western Europe, and Japan), they comprise only a small part of the world’s population, about ten percent. The Communist countries comprise a further one fifth. That leaves the bulk of humanity—seven of every ten people in the world—living within less developed parts of the capitalist sphere. The capitalist norm, then, is not one of wealth and development, but of poverty and underdevelopment.
Capitalism has two faces. One is the face of great wealth. The other is the face of poverty, agony of toil, brutality, and foreign domination. For most human beings, capitalism has showed, and continues to show, only one of its faces: that of poverty, misery, and imperialism. It is from, and against, this sphere that the Communist countries have emerged.
Table 4 shows that the Communist countries have a higher level of human development (the index ranges from 0 to 1, with 1 as the highest level) compared to the capitalist world. The Communist advantage is particularly evident in the cases of Cuba and Vietnam, where human development in these countries exceeds that of capitalist states with roughly the same income per capita.
Managing the Covid-19 Pandemic
Given that the data indicate that Communist-led countries are more responsive to the human and health needs of their populations, we might expect that the Communist-led countries have also been more effective in protecting their populations from the Covid-19 pandemic. The next two tables confirm this expectation.
Table 5 shows the number of infections per million has been considerably lower in the three Communist-led states than in the capitalist world.
Similarly, Table 6 shows that the Communist countries have significantly outperformed capitalist states in limiting the number of Covid-19 deaths per million.
Note that the difference between the Communist and capitalist worlds is not trivial. The infection and fatality rates in the capitalist countries have been, respectively, 180 and 127 times greater than in the Communist states.
Capitalist Exceptions
Some capitalist states have performed better than others. Unique among the capitalist countries in pandemic management are Japan, South Korea, Australia, and New Zealand, which have not only achieved infection and mortality rates well below the capitalist average, but have done better than Cuba, as Table 7 shows.
However, while the performance of these capitalist countries has been very good relative to their capitalist peers, as Table 8 reveals, it has nevertheless been less effective than that of the Communist-led states as a group.
The achievement of the capitalist quartet in limiting infections and deaths challenges the belief that infection control is only possible in Communist-led countries and is not possible in liberal parliamentary states. Moreover, all four countries had a low rate of vaccination as of the end of April, refuting the notion, widely promoted in the Western news media, that vaccines are the sole route to managing the pandemic.
Had all countries performed as well as these four, 121 million people would have been spared illness and 2.6 million lives would have been saved. While these numbers represent a substantial improvement over how the world has performed, they are nevertheless not as substantial as the gains that would have been garnered had all countries performed as effectively as the Communist-led states.
The Confucius Hypothesis
Some analysts have attributed China’s stellar pandemic performance to the country’s Confucian culture rather than its Communist politics, pointing out that other countries with strong Confucian influences, namely Japan and Korea, have also stood out in the degree to which they have effectively managed the virus. These analysts argue that Confucian values of duty, obedience, and social solidarity, have predisposed the populations of the Confucian-influenced countries to more fully comply with government directives on infection control than is true in countries in which individual liberties are valued over the collective needs of the community.
While there may be some merit to this argument, it is still the case that within the Confucian trio, China has performed the best, and significantly better than its capitalist counterparts, as illustrated in Table 9. This suggests that China’s nature as a Communist-led country has conferred an advantage in pandemic control greater than whatever advantage it has reaped from Confucian values.
China vs. India
It is illuminating to compare China to India, a fellow Asian behemoth which differs from China in having rejected a development path under the red flag of Communism. On all seven human welfare and health indices in Table 10, India lags China, including on the number of physicians per 1,000 people; hospital beds per 1,000 people; ICU beds per capita; and health spending as a percentage of GDP.
Coincident with its poorer performance in meeting the health needs of its population, India has also failed to effectively manage the coronavirus pandemic, severely underperforming its Asian neighbor. To be fair, India’s GDP per capita is less than half that of China’s. However, the gulf between China and India in satisfying their respective population’s health needs is so great that even correcting for the income difference would fail to eliminate the gap between the two countries. On grounds of human development and health, if one had to choose between the two countries as a place of residence, Communist-led China is clearly the better choice.
Southeast Asia
Southeast Asian countries have also performed better than the average at curbing the spread of the coronavirus and limiting deaths, though not better than the Confucian trio. Within the Southeast Asian group, Vietnam’s performance is unparalleled. Again, inasmuch as Vietnam and China belong to regions with superior pandemic performance, regional factors have likely contributed to their successes in limiting infections and deaths. However, within both groups, the performance of the Communist-led countries has been ne plus ultra, pointing to their politico-economic orientation as an additional factor explaining their superior pandemic control.
Caribbean and Central American Region
The Caribbean and Central American region has performed less effectively than the rest of the world in checking the spread of the coronavirus and limiting fatalities. While Cuba does not lead the region, as its Communist-led cohort countries do theirs, it has performed much better than the regional average and more effectively than the average of all other countries. Moreover, at 0.58 percent, Cuba is second only to Saint Vincent and the Grenadines in case fatality rate, compared to 1.99 percent for the other regions, and 4.64 percent for the Caribbean and Central American region as a whole. Cuba’s low case fatality rate likely reflects the Communist state’s strong emphasis on universal access to a health care system which boasts among the highest number of physicians and hospital beds per capita in the world. Table 2 showed that Cuba not only leads capitalist countries at the same level of development in hospital beds per 1,000 people, but leads capitalist countries in the aggregate.
Table 13 shows health spending as a percentage of GDP among Caribbean and Central American countries. Cuba allocates more resources to health as a percentage of GDP than any other country in the region, demonstrating the Communist-led country’s strong commitment to meeting the health needs of its citizens.
North Korea
Publicly available data for North Korea is scarce if not altogether absent, but there are indications that the DPRK’s performance in checking the spread of the novel coronavirus is consistent with what one would expect of a Communist-led country with strong Confucian influences. Some news reports in Western mainstream news media refer to Pyongyang implementing vigorous measures of pandemic control. For example, The New York Times’ Korea specialist Choe Sang-Hun reported on July 25, 2020 that “North Korea has taken some of the most drastic actions of any country against the virus, and did so sooner than most other nations.” It is clear from the example of China, that countries that have prioritized public health, and have acted quickly and decisively to curb the spread of the coronavirus, have achieved impressive levels of infection control. Additionally, The Wall Street Journal reported on February 26, 2021, that “Alexander Matsegora, Russia’s ambassador to North Korea, said on the embassy’s Facebook page earlier this month that ‘thanks to the most severe bans and restrictions, [North Korea] turned out to be the only country which didn’t get the infection.’”
Given these reports, along with North Korea’s unquestioned ability to manage crises, including the collapse of its foreign markets in the early 1990s, flood- and drought-induced famines in the same decade, and the unremitting threat of US aggression, it seems highly likely that the DPRK has responded to the threat of Covid-19 with a high degree of competence, likely on par with that of its Communist counterparts.
Capitalist Incentives Foster Irrational Public Health Choices
It is instructive to consider that infection control as good as that achieved by the Communist-led countries would have necessitated a departure from capitalist logic in the capitalist countries.
First, it would have required the temporary closure of a greater percentage of business establishments than most capitalist governments were prepared to tolerate, and for longer periods. Since the shuttering of businesses has deleterious consequences for the profits of business owners, capitalist governments acted to limit business closures in three ways: Shutting down a bare minimum of businesses, allowing many non-essential businesses to continue to operate; re-opening businesses before local infection rates had been brought under control; and failing to require adequate infection control measures for employees in businesses that were allowed to remain open.
Second, to approximate Communist country-performance, capitalist governments would have had to have quickly mobilized substantial public health resources to undertake large-scale screening and robust contact tracing. However, rather than implementing this public solution to a public problem—one which offered no benefit to private investors (except in the UK where contact tracing was handed to a private firm which immediately botched the job)—the leading capitalist governments chose to subsidize major businesses to compensate owners for their pandemic losses and to invest untold billions of dollars in vaccine development or pre-payment of vaccine doses or both, creating a pandemic bonanza for the biopharmaceutical industry and its major shareholders. This is not to say that investing in vaccines was unnecessary or undesirable, but that the timing was driven by capitalist incentives rather than public health rationality.
The leading capitalist countries declined to address the worldwide public health emergency by mobilizing resources for “shoe-leather” epidemiology to bring the pandemic quickly to heel, with the consequence that the emergency worsened. The worsening emergency was then used to justify the roll out of vaccines under emergency use authorization before they had been adequately safety-tested in fully completed Phase III trials.
The winners in this scenario have been the investors whose business interests have been protected from the effects of pandemic disruptions by government subsidies, as well as those wealthy enough to reap the benefits of substantial investments in the biopharmaceutical industry. The losers are the 150 million people who became ill or died unnecessarily and could have been protected from the ravages of the pandemic had their capitalist governments chosen to prioritize the health of the public over the health of their business communities’ bottom lines. Business that were able to remain open to satisfy the demand for goods that shuttered businesses would have provided, Amazon, for example, were also winners.
The leading capitalist governments could have mitigated the emergency to manageable levels, equivalent to those achieved by the Communist-led states, and then worked on the development, testing, and dissemination of vaccines. This would have saved millions of lives, and spared countless millions the potential hazard of being inoculated with vaccines which may or may not be harmful over the long term. This approach, however, would have meant spending public funds on “shoe leather” epidemiology, an investment which offered no profit-making opportunities of consequence to the business class favored by capitalist states. Plus, it would have required the closing of a large proportion of businesses for a month or more, attenuating profits—an anathema in capitalist society.
From the perspective of a capitalist logic, the course chosen was far more desirable, even if it meant more illness and more deaths. Limit business closures to a bare minimum to protect profits. Channel resources into subsidies for major businesses hurt by the pandemic. Make vaccines the main plank of the pandemic management strategy. These were the choices made by capitalist governments guided by capitalist logic. Vaccines offered an alternative to business closures and public expenditures on mass screening and contact tracing—an alternative with the promise of vast profits for those wealthy enough to get in on the action in a consequential way.
The capitalist governments could have made the public health-friendly choices above to mitigate the emergency, prevent sickness, and save lives. They could have, but had they, they wouldn’t have been capitalist governments.
Conclusion
Capitalist society exists to protect and expand the interests of capitalists, not the interests of those who work for them. Capitalism may or may not exist in Communist society, but where it does exist, it is yoked to the people-centered aims of Communism, not the aims of capitalists. In Communist states, capitalists do not have political mastery.
The degree to which Communist countries have eclipsed capitalist states in protecting their citizens from Covid-19 is substantial, and is evidenced in this: Had all capitalist countries managed the pandemic as effectively as the three Communist-led states, nearly 147 million people would have been spared illness and over three million lives would have been saved.
This conclusion is arrived at in the following way: At the end of April, 2021, approximately 147.8 million people had tested positive for Covid-19. Assuming a world case rate of 134 cases per million, equal to that of the Communist-led countries, the total number of cases in the world would have been 134 x a world population of 7.7 billion x 1/1 million, or approximately one million cases. Hence, 147.8 million less one million, or 146.8 million people worldwide would have avoided the illness. By significantly reducing infections, the pandemic may have been effectively extinguished, and the circulation of the virus sufficiently retarded that it could have been held in check by wide-reaching screening programs and robust contact tracing. This would have provided breathing room for a more deliberate and careful pace of vaccine development, thereby obviating emergency authorization of vaccine use prior to the collection of sufficient safety data.
Communist-led countries limited Covid-19 deaths to four per million. This fatality rate applied to the world as a whole would have produced a little over 27,000 deaths globally, compared to the 3.1 million who have died to date. In nearly a year and a half, a capitalist logic that discouraged temporary business closures, adopted non-pharmaceutical interventions with great reluctance and abandoned the few that were adopted much too early, and by its very nature favored the profit-making opportunities inherent in the pharmaceuticalization of public health, has cost the world over three million lives to date. Many more needless deaths will follow.
What's Left 