For a real world restoration, we have to look past vaccinations: COVID pandemic amidst orbits of globalization, legislation, and improvement
Fixating on vaccinations as a way of addressing the current crisis may blind us from addressing the social fallout the developing world is going through as a result of the pandemic, DIVESH KAUL writes.
HE United States and several industrialized countries are in the grips of a supply chain hiccup, and explaining it appears to get mired in heated ideological debates that tend to miss the impact the pandemic had on much of the world’s poor, people and households who actually power these supply chains.
Whereas global poverty was on a downward trend in pre-pandemic times, multiple crises as a result of the COVID-19 pandemic and a global recession have led the World Bank to note that, almost 100 million more people were added to poverty in 2020, a majority of them living in South Asia and sub-Saharan Africa. Although vaccination drives are a positive step, the pandemic is far from over and will not be over just by inoculating the world.
Since COVID-19 was declared a pandemic in March 2020, lives have been lost, healthcare systems came under unprecedented pressure, and the global economy took a nosedive, upending countless livelihoods around the world. However, developing countries have faced significantly sharper challenges than rich nations, largely because the pandemic is not just a health emergency there, but more so a social and economic catastrophe. For instance, the pandemic has exacerbated food insecurity, with rising food prices leaving a greater impact in low- and middle-income countries. In 2020, the pandemic wiped close to 255 million jobs, with losses exceptionally higher in the global South.
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Disruptions caused in food supply by the pandemic, among other factors, may soon double hunger levels in the Global South. This is due to supply chain problems, export restrictions by on food grains, hoarding of commodities, a disruption in the supply chain of food commodities due to fear of COVID exposure among workers, limitations on the movement of migrant labour, reduction or loss of family income and inflation in food prices. A commentator notes that disruptions in the supply chain including short-term undersupply, hoarding, and overcharging have resulted in a global price rise in the food basket of 20 to 50 per cent. Even in countries with a high GDP, economic inequalities meant lower access to health which led to disproportionately high numbers of COVID cases amongst marginalized social groups. For instance, in Spain and in the United States, neighbourhoods of working class and racial minority groups, respectively, have suffered relatively more.
Disruptions in the supply chain including short-term undersupply, hoarding, and overcharging have resulted in a global price rise in the food basket of 20 to 50 per cent. Even in countries with a high GDP, economic inequalities meant lower access to health which led to disproportionately high numbers of COVID cases amongst marginalized social groups.
These far-reaching effects in the developing world are set to generate shocks to global trade due to unforeseen supply chain disruptions. Intermediate and finished commodities either slowed down or were delayed. Demand shock as a result of shrinking consumer action could translate into lower economic growth. Central banks have responded by lowering interest rates and boosting financial markets. Governments expanded some social policies, including cash transfers, food assistance, and support for low-wage workers.
The pandemic also has implications for individual rights such as the right to life, freedom of expression, the right to privacy, and protection against discrimination. Governments around the world are navigating a complex tension between patient rights and citizen privacy on one hand, and public safety and health on the other. These coercive public–curtailing freedoms in the interest of containing the virus — run the hazard of turning into absolutist measures if they are used disproportionally, extended beyond their scope or prolonged indefinitely.
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Impact on right to health
The right to health is also under threat. Although it is guaranteed as a right under international covenants, it often comes down to the ability of states to provide resources to meet that ideal.
For instance, the 1997 judgment by the South African Constitutional court in the case of Thiagraj Soobramoney vs. Minister of Health (Kwazulu-Natal) highlighted that a right is not absolute and that a State can only guarantee those rights for which it has commensurate resources available. It held that non-emergency medical treatment is qualified by the availability of resources for the progressive realization of such a right.
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In the midst of the COVID-19 crisis, there were countless media reports showing severe shortages of oxygen, beds and other medical necessities. These crises force those families to spend their entire life savings or incur debt. Many have resorted to crowdfunding portals for financial support. This health crisis will likely further complicate the economic picture in those countries.
The situation as regards healthcare calls for a paradigm shift whereby, in lieu of regarding it as an expenditure, healthcare is sought as a high-return investment which can materially reduce out-of-pocket spending and at the same time raise output.
As the 2014 Nobel Peace Prize laureate and child rights activist Kailash Satyarthi noted, there is a variance between a right and a service-delivery model of development. The situation as regards healthcare calls for a paradigm shift whereby, in lieu of regarding it as an expenditure, healthcare is sought as a high-return investment which can materially reduce out-of-pocket spending and at the same time raise output. In economist and 1998 Nobel Prize in Economic Sciences laureate Amartya Sen’s words, a basic minimum of protections is essential to justice and to further one’s freedoms and capabilities, health and access to healthcare being one such indicator.
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Impact on marginalized groups
The right to health implies that this obligation is granted without discrimination on the grounds of race, age or ethnicity. This extends to protecting vulnerable minority groups. We know that when a health crisis unravels, racial or religious minorities are often portrayed villainously as the cause of the crisis. Chinese immigrants in some cities in the U.S. were afflicted with discriminatory treatment during the bubonic plague of the 19th century. A U.S. city council’s quarantine ordinance was claimed to have been enforced only against residents of Chinese nationality or race and resulted in arbitrary, unjust and wrongful interference with their personal liberty.
We are no longer in the 19th century, yet problems of a similar kind persist.
The outbreak has spurred xenophobic rhetoric and hate crimes against Asian Americans and other racial minorities so much so that a new law, the Covid-19 Hate Crimes Act, has been needed. India is no less immune to the hate virus, fanned by disinformation and bias against religious and racial minorities. While the COVID pandemic lingers around the world, it has exacerbated the plight of refugees who have been forced to leave their homes as a result of civil war and other conflicts or hardships. Restricted access to health services and vulnerability toward the virus further aggravate their suffering and misery. At the time of a crisis, there needs to be sensitivity and empathy toward minority groups instead of blaming them for the crisis and continue a renewed support to the displaced.
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Women have also suffered disproportionately during the pandemic. They populate critical sectors like healthcare and are often the primary caregiver in households. In many communities around the world, they drive the informal economy particularly in lower- and middle-income countries. On top of that, they have suffered such an exacerbation of domestic violence that United Nations [UN] Women called it a “shadow pandemic”.
These issues will together widen the gender gap. For instance, decrease in family income, coupled with inadequate safety nets, may result in several negative coping mechanisms such as reduced nutrition, marrying-off a minor girl child, child labour, or cancelling their school enrolment.
COVID-19 is not gender-blind; the response should not be either. Governments ought to target health and social protection responses for single mothers with children, widows, or female farmers in the form of cash transfers or other adequate safety nets that are equitable and just.
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IP restrictions inhibiting vaccine access in Global South
As we attempt to address these global inequities, we need a “people-friendly” international economic law, as popularized by legal scholar B. S. Chimni. This means, for example, loosening Intellectual Property [IP] rights protection in events like the pandemic we are in. It is an instance where domestic policy needs, and the general welfare of the global community are in tension with the private commercial interests of pharmaceutical companies.
India, the “pharmacy of the developing world,” plays an important role in providing low-cost life-saving medicines to developing countries, where the key to a critical IP protection regime is maintaining a balance between economic incentives for innovation and not deprive marginalized groups of medicines. A UN panel advised that a higher threshold of international agreements in the form of TRIPS [World Trade Organization Agreement on Trade-Related Aspects of IP Rights]-plus commitments would compromise access to health technologies with serious implications for low-income groups. For instance, repudiating compulsory licensing would directly affect the supply of low-cost generic medicines,which are a lifeline to developing countries.
Also read: COVID-19 and the Shortage of Drugs: A Case for Compulsory Licensing
According to the scientific publication Our World in Data, as of January 12, 2022, in low-income countries, less than 10 per cent of people have received at least one dose against COVID-19 while in some countries with high GDP, upwards of fifty per cent of the total population (e.g., United Arab Emirates – 91 per cent; Spain – 81 per cent; Chile – 86 per cent; France – 74 per cent; United States – 62 per cent) have been fully vaccinated. Its statistics also indicate that in India, roughly 46 per cent of the total population has been fully vaccinated until January 12, 2022, whereas in the entire continent of Africa, less than 10 per cent of the total population have been fully vaccinated. A number of States such as India and South Africa have insisted that the COVID-19 vaccine be made a public good by temporarily waiving IP rights by World Trade Organization and mandating emergency production. Otherwise, as argued by Fatima Hassan, a South African social justice activist and human rights lawyer, the situation risks becoming “vaccine apartheid.”
Similarly, global leaders and philanthropists have urged the relaxing of IP rules for the vaccine, that vaccination and the distribution thereof should not rely on market forces, and that vaccines should first go to people who need them most and not the highest bidder.
Also read: How Long Must Poorer Nations Wait for Access to Covid Vaccine?
Needed: solutions with global ownership
A pandemic of such magnitude begs global solidarity and cooperation. Otherwise, we are likely to face second-order and third-order effects that will be hole we will take years to dig ourselves out of.
The implications are global and there is a socioeconomic upshot. In Africa, the COVID-19 shock can convert into a social and economic emergency with short- and long-term adverse effects such as lower trade and foreign investment, a demand slump, a supply shock affecting international trade, and a detrimental impact on people’s livelihoods and well-being.
At the time of a crisis, there needs to be sensitivity and empathy toward minority groups instead of blaming them for the crisis and continue a renewed support to the displaced.
Furthermore, the pandemic may disrupt and contract African imports from Western and Asian countries; at present, over 50 per cent of the industrial machinery, manufacturing and transport equipment utilized by African industries are imported from countries located in other continents. Similarly, in the Asia Pacific region, a protracted pandemic may result in a social crisis and a shock to critical supply chains.
A variety of measures could prevent this health crisis from becoming a social and economic nightmare.
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First, we should temporarily reduce trade barriers on health and pharmaceutical products, including ventilators, medicines, and personal protective equipment. For instance, Brazil and Pakistan have temporarily eliminated duties on medical equipment and hospital products. India has waived duties on vaccines for some time. Second, we should facilitate the mobility of health services and personnel. Cuban doctors offering medical assistance in Italy and South Africa is an instance. Third, we should enhance trade environment and production capacities and remove barriers to trade, particularly tariffs of up to 10 per cent that some countries have kept on essential items such as COVID test kits and tariffs on face marks as high as 55 per cent of the import value. Remedial steps include lowering trade measures, and avoiding unnecessary trade barriers and export restrictions on agricultural, food and other essential products, raising transparency about national trade measures and policy responses, improving access to trade finance, Fourth, we should prioritize global supply chains, particularly for essential and medical commodities. Responding to supply-side restraints and setting up “green lanes” to facilitate the processing of essential items through entry ports and border crossings with minimal human contact and delays by enabling e-payments, e-signatures and e-contracts would help restore global supplies And last, we should involve regional and global financial institutions and development banks in streamlining fiscal constraints without, however, undermining the national policy space. Mandates steered by global institutions states such as fiscal austerity must not compromise States’ capability to ensure a “social protection floor” and other public spending measures that may deprive or encroach upon people’s economic, social and cultural rights.
There is a real risk the pandemic is widening inequality, so much so that some have warned of an upcoming “neo-feudalism.” In the United States, roughly 40 per cent of households earning below $40,000 a year lost their a job early on the in the pandemic. The unemployment rate shot up from 6.8 per cent to 21.2 per cent in a month (March to April 2020) for those not possessing a high school degree. Those working in the informal sector or in blue-collar jobs mostly work in crowded urban settings where social distancing is not always a possibility. The same is true about dwelling in slums, where people live in close proximity, often without access to basic daily necessities such as clean water.
Vaccination and the distribution thereof should not rely on market forces, and vaccines should first go to people who need them most and not the highest bidder.
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Those driven into poverty as a result of our mismanagement of the pandemic will likely rise up and those with abundant socio-economic resources may concentrate more power in their hands. We are seeing glimpses of that in the recent labour strikes besetting America as workers compare their fate to their Chief Executive Officers raking in massive sums of compensation.
We should know that unless we are able to vaccinate the last human in the remotest corner of the planet, and do so as we remedy the social fallout, we will not triumph against the pandemic.
(Divesh Kaul is an SJD (doctoral) candidate at Tulane University, and a Visiting Scholar at the Center for International and Area Studies, Northwestern University. The views expressed are personal.)