Category: Health Care
Africa/Global: Decolonizing Medical Technology
worker | May 18, 2021 | 8:06 pm | Africa, Health Care | No comments

Africa/Global: Decolonizing Medical Technology

AfricaFocus Bulletin
May 17, 2021 (2021-05-17)
(Reposted from sources cited below)

Editor’s Note

“A continent of 1.2 billion people should not have to import 99% of its vaccines. But that is the tragic reality for Africa. Fixing the lack of home-grown manufacturing capacity has become a top priority for Africa’s policymakers. Last week, 40,000 people, including researchers, business leaders and members of civil-society groups, joined heads of state for a two-day online summit designed to share the latest developments and kick-start fresh thinking on how to bring vaccine manufacturing to Africa.” – Nature magazine editorial, April 21, 2021

Covid-19 has revealed the urgency of reducing the inequality in global access to vaccines, prompting a wide-ranging and ongoing debate about what must be done about what many are calling “vaccine apartheid.” But, as stressed in this summit convened by the Africa CDC and the African Union, the issue goes beyond any single disease, to the need to plan for future pandemics and address the inequities in capacity in both research and manufacture of vaccines.

This is already the case for malaria. A new vaccine with over 70% of efficacy was first reported earlier this month. African and world leaders and health officials are increasingly focused on the possibility of accelerating the fight against this deadly disease, which in 2019 caused over 84,440 deaths world-wide. Ninety-seven percent of those deaths were in sub-Saharan Africa. So while global campaigns under the slogan of “Malaria Must Die” continue, it is clear that the initiative for action must come from Africa.

Even once vaccines are available, there will remain formidable problems of manufacturing and distribution. On April 13, African leaders pledged to increase the share of vaccines manufactured in Africa from 1% to 60% by 2040. It will not be easy.

This AfricaFocus Bulletin includes (1) key links on the current status of the fight against malaria, (2) an open letter to international funders from African researchers, reposted here in full with permission from Nature magazine; and (3) excerpts from a news story and an editorial in Nature magazine on the urgency of development of vaccine capacity in Africa.

For previous AfricaFocus Bulletins on health, visit

http://www.africafocus.org/intro-health.php

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Two additional notes about this Bulletin

1. Unlike many if not most readers of AfricaFocus, including my wife, I have never had malaria, despite a total of more than five years spent in areas of the continent where the disease is endemic. But my awareness of the disease began long before I first traveled to Africa. My father, Dr. David Minter, served as a malaria control officer in the South Pacific during World War II, where in the early years the disease caused more casualties among U.S. troops than the Japanese military. Atabrine, DDT, and education of the troops brought the toll down significantly.

Unlike many wartime assignments, his posting to this position made good sense, as he had several years of experience in treating malaria in the 1930s in Mississippi, where malaria was endemic before the war.

His colleague in the South Pacific in this effort, Filipino physician Dr. Francisco Dy, who later served as the World Health Organization regional coordinator for the Western Pacific, became a life-long friend of my parents.

2. With this Bulletin, I am including a short embedded video featuring the Kanneh-Mason family cover of Bob Marley’s Redemption Song. I may make this a regular feature of the Bulletin, featuring short music videos that do not take up extra bandwidth in the email. The idea came from the editors of Quartz Africa, who often end their weekly email with a note saying “written while listening to.”

I am not good enough at multi-tasking to listen while I write. But I do find it necessary to take short breaks from writing to listen and watch short music videos. That is essential for the spirit, particularly when one is writing about subjects which more often feature grim realities than hope for change. The videos I will choose for inclusion are not linked to the specific theme of the Bulletin. But they definitely illustrate the visions of the resilience and hope needed both by Africa and the world.

I hope some of you enjoy them. If you don’t, it’s easy not to watch. They aren’t set to auto-play.

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Recent news and background on malaria

 

https://theconversation.com/new-malaria-vaccine-proves-highly-effective-and-covid-shows-how-quickly-it-could-be-deployed-159585

https://qz.com/africa/2005934/africa-can-avoid-covid-19-vaccine-missteps-with-malaria-vaccine/

https://www.who.int/news-room/fact-sheets/detail/malaria

https://www.cdc.gov/malaria/about/distribution.html

https://allafrica.com/malaria/

https://allafrica.com/stories/202105040682.html
Meeting of African Leaders Malaria Alliance

https://malariamustdie.com/
World campaign against malaria, headlined by David Beckham

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Open letter to international funders of science and development in Africa

April 15, 2021

Nature Medicine, April 15, 2021

https://www.nature.com/articles/s41591-021-01307-8

From Ngozi A. Erondu? ?1,2;, Ifeyinwa Aniebo 1,3,4; Catherine Kyobutungi 5; Janet Midega1, 6; Emelda Okiro 7; and Fredros Okumu 1,8.

1 Aspen Institute, Washington, DC, USA; 2 O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA; 3 Health Strategy and Delivery Foundation, Lagos, Nigeria; 4 Harvard T.H. Chan School of Public Health, Baltimore, MD, USA;

5 African Population Health Research Center, Nairobi, Kenya; 6 Wellcome Trust, London, UK; 7 KEMRI Wellcome Trust Research Programme, Nairobi, Kenya; 8 Ifakara Health Institute, Dar es Salaam, Tanzania. Contact email for authors: ngozierondu@gmail.com

To the Editor—Recently there was an announcement1 of a US$30 million grant awarded to the nonprofit health organization PATH by the US government’s President’s Malaria Initiative (PMI). The grant funded a consortium of seven institutions in the USA, the UK and Australia to support African countries in the improved use of data for decision-making in malaria control and elimination.

Not one African institution was named in the press release. The past year has been full of calls from staff and collaborators of various public-health entities for equality and inclusion, so one might imagine that such a partnership to support Africa should be led from Africa by African scientists, partnering with Western institutions where appropriate, especially where capacity has been demonstrated.

We write this letter to the major international funders of science and development in Africa as African scientists, policy analysts, public-health practitioners and academics with a shared mission of improving the health and wellbeing of communities in our continent and beyond. We represent a diverse group of institutions and communities dedicated to achieving the United Nations’ Sustainable Development Goals and to establishing a more equitable world.

Our work is informed by lived experiences and accumulated local knowledge of diseases such as malaria, AIDS, diarrhea, meningitis and polio, which have plagued millions of our families and friends for ages. We are therefore grateful that organizations that fund international health research have long been part of the international efforts to rid the world of these illnesses and their associated inequities. We believe the reason these organizations are financing global health and development is that they share in our dreams and aspirations.

We also believe, just like you, the decision-makers at these major funding organizations, that all humans, regardless of where they are located, are equal, even if opportunities are not. We recognize multiple injustices that have been perpetuated through historical practices, often without due consideration of their negative consequences. The current political climate has amplified the global call to ‘decolonize global health’, a more overt stance against what public-health practitioners in both high-income countries and low-income countries have known all along: that the predominant global health architecture and its business model enable ‘western’ institutions to gain more than, and sometimes at the expense of, the people and institutions in the countries where the actual problems are.

As the ‘decolonize global health’ movement has demonstrated, dismantling structures that perpetuate unequal power over knowledge and influence must support the quest for justice and equality. Global health institutions, especially funding organizations, must therefore examine their own internal policies and practices that impede progress toward justice and equality for populations that they intend to help. We write this letter as a collective, hoping to accelerate, and in some cases initiate, a process toward real fairness. We believe that there are many issues with this specific consortium focused on malaria, including the fact that there are strong African institutions with excellent capabilities this area, including some already actively engaged on the ground, such as the KEMRI Wellcome Trust Information for Malaria (INFORM) initiative that began in 2014 (http://inform-malaria.org/).

International funding, such as that from the President’s Malaria Initiative, has substantially advanced the goal of improving people’s health and wellbeing in Africa and beyond. However, funding models such as that of the PATH-led initiative are among the reasons that after several decades and billions of dollars spent, the control of diseases such as malaria is still heavily donor dependent, This type of funding has also contributed a model of implementation that puts the delivery of several health interventions directly in the hands of Western non-governmental organizations, which further diminishes the capacities and ownership of national programs to deliver to their populations and ultimately leads to weak health systems and a lack of sufficient local capacity. Decisions about such major funding initiatives should be made in consultation with in-country scientists and researchers involved in this work, alongside ministries of health and national malaria-control programs, to augment national priority research efforts. Such efforts have the best chance of success if they are run by local research agencies and institutions that can work closely with governments and are well positioned to support decision-makers in integrating data into local policies and strategies.

The new ‘high burden to high impact’ initiative from the World health Organization rightly recognizes the need for such vital work to be country-owned and country-led to reignite the pace of progress in the global fight against malaria and to increase the likelihood of success in eliminating malaria. Omitting African institutions from leadership roles and relegating them to recipients of ‘capacity strengthening’ ignores the agency these institutions have, their existing capacity, the value of their lived experience and their permanence and close proximity to policy-makers.

In 2017, the USA, UK and Canada collectively spent US$ 1.1 billion on malaria development aid, which includes research funding. When the Institute of Health Metrics and Evaluation data-visualization tool is used (https://vizhub.healthdata.org/fgh/), it appears that once global fund contributions are removed, 81% of funding was used to support institutions in the funding country and 18% went to non-governmental organizations (probably based in high-income countries)—that leaves just 1% of malaria funding available to local in-country research institutions. We recognize that the current funding structures create an imbalance of power and a monopoly that favors Western institutions and is derived in part from the perpetuation of inequities in access to funding with policies that lock out African institutions. These structural inequities must be examined, and they must end.

We know that several decision-makers of these organizations recognize the limitations of the model that you have woefully applied to the issue of which we speak. The New Partnerships Initiative from the US Agency for International Development (https://www.usaid.gov/npi) and the Alliance for Accelerating Excellence in Science in Africa (https://www.aasciences.africa/aesa) are good examples of funding local institutions for impact. The latter is shifting its center of gravity by ensuring its funding is provided directly to African scientists and institutions, which in turn empowers and enables them to shape their research agenda and to conduct research relevant to the continent. But we argue that these are the exceptions. For long-term progress, true partnerships and stronger collaborations, you, the funders, are responsible for totally transforming this model. We believe that in the same way we have to apply innovation in our work to fight diseases, innovation can be applied to the design of sustainable funding models with local researchers and organizations at their center.

We are asking that all major international funders of science and development in Africa commit to finding and implementing short-term and long-term changes to these models with consideration of the points we have listed above and with further consultation with reputable Africa-based institutions and scientists. There is a way to create equitable and dignified partnerships and to defeat the diseases that threaten everyone. We who authored this Correspondence are few, but we are committed to assisting any organization that is willing to make a substantial change.

https://doi.org/10.1038/s41591-021-01307-8

References

1. PATH. https://www.path.org/media-center/path-announces-pmi-inform-malaria-operational-research-project/ (10 February 2021).

2. World Health Organization & RBM Partnership to End Malaria. High burden to high impact: a targeted malaria response (WHO, 2019).

Author contributions

All authors were involved in the original drafting, reviewing, and editing of this letter and gave final approval of the version to be published. This letter is signed in an individual capacity. The views and opinions expressed do not necessarily reflect that of any organization they (the authors) are associated with or employed by.

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How COVID spurred Africa to plot a vaccines revolution

For decades, Africa has imported 99% of its vaccines. Now the continent’s leaders want to bring manufacturing home.

Nature magazine, April 21, 2021

https://www.nature.com/articles/d41586-021-01048-1

[excerpt from full news story available at link above]

Prompted by the pandemic, Africa’s leaders are on a path to ramp up capacity in vaccine manufacturing and boost the continent’s regulatory bodies for medicines. On 13 April, they pledged to increase the share of vaccines manufactured in Africa from 1% to 60% by 2040. This includes building factories and bolstering capacity in research and development.

The COVID-19 pandemic has left Africa woefully short of vaccines, according to John Nkengasong, director of the Africa Centres for Disease Control and Prevention (Africa CDC), based in Addis Ababa. The ambitious move represents an important step in boosting Africa’s capacity in public health, he added.

Nkengasong was speaking at a 2-day vaccines summit on 12 and 13 April, co-organized by Africa CDC and the African Union, and attended by 40,000 delegates. Also taking part were heads of state and leaders from research, business, civil society and finance.

“We have been humbled, all of us, by this pandemic,” said Abdoulaye Diouf Sarr, Senegal’s minister of health and welfare. The 1% figure “boggles the mind”, added virologist Salim Abdool Karim, formerly a science adviser to South Africa’s government.

. . .

In the next pandemic, will Africa make its own vaccines?

The AU meeting ended on an upbeat note, with delegates talking of “tipping points”, “now-or-never moments” and “global goodwill” to enable Africa to finally create its own vaccines industry. Progress will need political commitment, long-term finance and regional cooperation, said Patrick Tippoo, executive director of the African Vaccine Manufacturers’ Initiative, a group of vaccine manufacturers and research institutes.

The foundational problem, Tippoo added, is that the continent’s leaders have lacked the vision to recognize the centrality of local vaccine manufacturing in health-care policy.

The lack of manufacturing and weak regulation will require long-term governmental support if they are to be overcome, said Solomon Quaynor, a vice-president at the African Development Bank Group. Without such support, he warned the meeting’s delegates, “there will be no vaccine manufacturing in Africa”.

But momentum is on the side of new beginnings. “In the final analysis, the onus is on us as Africa. I do know we can do the job,” said Ngozi Okonjo-Iweala, Nigeria’s former finance minister and now director-general of the World Trade Organization.

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Africa’s vaccines revolution must have research at its core

It’s an injustice that Africa has to import 99% of its vaccines. COVID has sparked a push for change — and researchers have a crucial role.

Nature magazine, April 21, 2021

https://www.nature.com/articles/d41586-021-01038-3

[excerpt from full editorial available at link above]

A continent of 1.2 billion people should not have to import 99% of its vaccines. But that is the tragic reality for Africa. Fixing the lack of home-grown manufacturing capacity has become a top priority for Africa’s policymakers. Last week, 40,000 people, including researchers, business leaders and members of civil-society groups, joined heads of state for a two-day online summit designed to share the latest developments and kick-start fresh thinking on how to bring vaccine manufacturing to Africa.

For more than a century, vaccine research and development (R&D) and manufacturing have been concentrated in Europe, India and the United States. Amid a raging pandemic, one result of this is that people in low- and middle-income countries might have to wait until the end of 2023 before they can be vaccinated against COVID-19. This is simply unacceptable.

Delegates at last week’s summit vowed to accelerate plans to boost the continent’s vaccine manufacturing, research and regulatory capacity. They endorsed a proposal for 60% of Africa’s routinely used vaccines to be made in Africa within 20 years, and agreements were signed with international organizations representing companies and donor agencies. But achieving this goal will need some hard conversations in the weeks and months ahead.

One such conversation must be on the need for sustained and long-term investment, especially in domestic R&D, as a vaccines industry cannot be created without this. In spite of the best efforts of researchers such as the late Calestous Juma, who founded the African Centre for Technology Studies in Nairobi, most governments, for a variety of reasons, pushed back against the idea that domestic R&D is of long- term value. It needed a pandemic to persuade Africa’s leaders to be convinced of the case for bigger investments. That is to be welcomed — but it will need more than warm words at a conference to provide assurance that the plans being hatched will come to fruition.

There will also need to be hard conversations with donor countries, their pharmaceutical companies, and funders and researchers — essentially, all those currently involved in supplying Africa with vaccines. If the goal is now African self-sufficiency in what some call the vaccine ‘value chain’, then international partnerships with the continent’s institutions will require a different approach. A partnership in which the objective is to empower the continent’s own researchers and businesses will need to be different from existing partnerships, in which the objective is to supply Africa with vaccines. Some international companies might regard African self- sufficiency as a long-term risk to their business; some might fear a loss of influence. Firms and researchers from outside Africa shouldn’t take this view if they agree that a genuine partnership of equals is in everyone’s interests. Vaccines are essential to public health. And public health is essential to strong economies.

. . .

The world’s researchers have created, and continue to create, innovative vaccines. But it is now time to grow and share this knowledge with colleagues in under-served regions, especially in Africa. Their intervention in Africa’s vaccine-manufacturing ambitions might well be too late to make a difference during the present pandemic, but it will almost certainly help to ensure that the continent’s people are much better protected during the next.

Redemption Song (Arr. Kanneh-Mason)

312,283 views

There are many other versions of this song available on-line.

Three that I particularly like are

https://www.youtube.com/watch?v=JhtZ5SyGHFU – with Bob Marley

https://www.youtube.com/watch?v=ZncWCgN-zms – with Angelique Kidjo

https://www.youtube.com/watch?v=55s3T7VRQSc – Playing for Change with Stephen Marley

AfricaFocus Bulletin is an independent electronic publication providing reposted commentary and analysis on African issues, with a particular focus on U.S. and international policies. AfricaFocus Bulletin is edited by William Minter. For an archive of previous Bulletins, see http://www.africafocus.org,

Current links to books on AfricaFocus go to the non-profit bookshop.org, which supports independent bookshores and also provides commissions to affiliates such as AfricaFocus.

AfricaFocus Bulletin can be reached at africafocus@igc.org. Please write to this address to suggest material for inclusion. For more information about reposted material, please contact directly the original source mentioned. To subscribe to receive future bulletins by email, click here.

Caitlin Johnstone: The world’s mental health epidemic is being caused by the madness of the system we’re forced to live under
worker | March 12, 2021 | 8:00 pm | Health Care, Mental Health | Comments closed

https://www.rt.com/op-ed/517862-caitlin-johnstone-mental-health/

Caitlin Johnstone: The world’s mental health epidemic is being caused by the madness of the system we’re forced to live under

Caitlin Johnstone: The world’s mental health epidemic is being caused by the madness of the system we’re forced to live under
Are you psychologically unable to keep up with the harsh pace demanded of you by capitalism just to survive? Join the gang: we’re all depressed because we’re stuck in dead-end jobs that simply turn millionaires into billionaires.

How many of people’s mental health diagnoses are really just them struggling to function in a capitalist system that is amoral, destructive, overwhelming, overbearing, unsatisfying, and bereft of meaning?

It’s surely one of the most under-examined questions in the field of modern psychology. People in general and researchers in particular all too rarely think to take a step back from the data they are looking at and consider the large-scale framework within which that data is materializing, and to consider whether there’s anything about that particular framework which is giving rise to the particular data sets they are seeing.

How many of the mental health diagnoses given out are really just people not coping well under capitalism? It’s worth looking into. How many people end up consulting with mental health professionals because they find themselves psychologically unable to keep up with the frenetic corporate pace that’s demanded of them in order to “earn a living”? Or earlier on as children because they are unable to successfully navigate the capitalism boot camp known as school? How many people are given diagnoses, and corresponding bottles of pills, simply because they can’t march to the beat of the capitalist drum?

Beyond that, how many people are pushed into mental illness by the madness of our current system? How many people suffer from very real depression or anxiety arising from the pressure to keep churning out pieces of future landfill in meaningless jobs which serve no purpose other than to turn millionaires into billionaires? How many people simply collapse under the weight of financial insecurity, food insecurity, housing insecurity, employment and insurance insecurity, combined with the effects of  desperate attempts to self-medicate the stress?

How many of these stressors are exacerbated by being psychologically pummelled with mass media propaganda day in and day out, artificially twisting your mind into the belief that this is all normal, and that if you can’t keep up, you’re the problem? Telling you that it’s fine and normal for there to be billionaires and empty investment properties while you struggle to keep a roof over your head? Telling you it’s fine and normal for wealth and resources to go toward murdering strangers overseas while you’re forced to choose between medicine and groceries?

And by the capitalism propaganda known as advertising? How is our psychological health affected by a nonstop barrage of corporate messaging informing us that we are deficient, and that there are things we lack which we must obtain in order to become whole? That we’re not beautiful enough, not skinny enough, not fashionable enough, not affluent enough, that we don’t own enough of the top-line items which only the well-off can afford?

I’d venture to say this all has a major impact on our minds. You can have anxiety without being poor, but you can’t be poor without having anxiety. Our competition-based model uses the stress of potential homelessness and death to keep all the slaves turning the gears of the machine, and that stress is now interwoven into the very fabric of our society. It’s so pervasive you have to take a step back just to see it all.

So how best to respond to this depressing situation? How best to avoid drowning in the tar pit of a soulless, nihilistic political and economic paradigm? How to find meaning under a meaningless system which squeezes your psychological wellbeing in order to power its batteries?

Well, that question is much easier to answer. You find meaning under a meaningless system by working to destroy that system.

Do whatever you need to survive, up to and including taking psychiatric medications if you need to, and with whatever remaining time and energy you have left, throw sand in the gears of the machine. Do whatever you can to upset the status quo. Engage in activism. Join a union. Start a union. Start a podcast. Start a Twitter account. Above all, work to spread awareness of what’s really going on in our world, because that’s the weakest point in the machine’s armor right now.

The loose transnational alliance of plutocrats and government agencies which comprises our real government works so hard to manufacture consent because they require the consent of the governed in order to rule; we greatly outnumber them and we can oust their rule if enough of us decide we don’t consent to it anymore. In a western society which must try to at least appear to support free speech, the best front on which to attack such a power structure is on the front of information.

They can’t kill and imprison us all, so if we all awaken to how oppressed we are and to who has been oppressing us, we can use the power of our numbers to kick them out and replace them with a healthier model. The job of the propagandists is to prevent this from happening. The job of you and me is to make it happen.

So help wake people up to the injustices of our system, as many people as you can by whatever means you have access to. Wake them up to the abuses of capitalism. To the abuses of imperialism. To the abuses of mass media propaganda. Learn as much as you can about the madness of our current system, and share what you have learned with as many people as possible.

All positive changes in human behavior arise from an increasing awareness of the underlying dynamics which give rise to them, whether you’re talking about the psychological dynamics underlying the addictive or compulsive behaviors of an individual or the power dynamics underlying the murderous and oppressive behaviors of a globe-spanning empire. If you are looking for meaning, you will find it in the spreading of that awareness.

We absolutely do have the ability to move away from this misery-generating competition-based model that is choking us all to death and replace it with one in which we collaborate with each other and with our ecosystem toward health, beauty, truth, and thriving. If there is meaning to be found in our world, it lies in that direction.

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The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.

Private equity ownership is killing people at nursing homes
worker | March 4, 2021 | 9:34 pm | Health Care | Comments closed

Investor-owned, for-profit health care facilities—hospitals, nursing homes, dialysis centers–cause unnecessary suffering and death.  The point is made well by Dylan Scott in the article below where he reports on the findings of a recent study by the National Bureau of Economic Research. 

Representative Pramila Jayapal is preparing to re-introduce her national single payer legislation, Improved Medicare for All, in the new congress.  Please write or call her, to encourage her to include in the legislation, a ban on investor-owned, for-profit facilities and conversion of them to maintain these resources for health care. She can be reached at 2346 Rayburn House Office Building, Washington. DC 20515, @RepJayapal, Phone: 202-225-3106, or email her at https://jayapal.house.gov/contact/

 

Private equity ownership is killing people at nursing homes

A new study describes the human toll of private equity firms buying up nursing homes.

By Dylan Scott@dylanlscottdylan.scott@vox.com Feb 22, 2021

When private equity firms acquire nursing homes, patients start to die more often, according to a new working paper published by the National Bureau of Economic Research.

Private equity acquisitions of nursing homes is a pressing topic: Total private equity investment in nursing homes exploded, going from $5 billion in 2000 to more than $100 billion in 2018. Many nursing homes have long been run on a for-profit basis. But private equity firms, which generally take on debt to buy a company and then put that debt on the newly acquired company’s books, have purchased a mix of large chains and independent facilities — making it easier to isolate the specific effect of private equity acquisitions, rather than just a profit motive, on patient welfare.

Researchers from Penn, NYU, and the University of Chicago studied Medicare data that covers more than 18,000 nursing home facilities, about 1,700 of which were bought by private equity from 2000 to 2017.

Their findings are sobering.

The researchers studied patients who stayed at a skilled nursing facility after an acute episode at a hospital, looking at deaths that fell within the 90-day period after they left the nursing home. They found that going to a private equity-owned nursing home increased mortality for patients by 10 percent against the overall average.

Or to put it another way: “This estimate implies about 20,150 Medicare lives lost due to [private equity] ownership of nursing homes during our sample period” of 12 years, the authors — Atul Gupta, Sabrina Howell, Constantine Yannelis, and Abhinav Gupta — wrote. That’s more than 1,000 deaths every year, on average.

What accounts for such a significant loss of life when private equity takes over a nursing home? The researchers advance a few possible explanations.

For one, they note, the increased mortality is concentrated among patients who are relatively healthier. As counterintuitive as that may sound, there may be a good reason for it: Sicker patients have more regimented treatment that will be adhered to no matter who owns the facility, whereas healthier people may be more susceptible by the changes made under private equity ownership.

Those changes include a reduction in staffing, which prior research has found is the most important factor in quality of care. Overall staffing shrinks by 1.4 percent, the study found, but more directly, private equity acquisitions lead to cuts in the number of hours that front-line nurses spend per day providing basic services to patients. Those services, such as bed turning or infection prevention, aren’t medically intensive, but they can be critical to health outcomes.

“The loss of front-line staff is most problematic for older but relatively less sick patients, who drive the mortality result,” the authors wrote.

The study also detected a 50 percent increase in the use of antipsychotic drugs for nursing home patients under private equity, which may be intended to offset the loss in nursing hours. But that introduces its own problems for patients, because antipsychotics are known to be associated with higher mortality in elderly people.

The combination of fewer nurses and more antipsychotic drugs could explain a significant portion of the disconcerting mortality effect measured by the study. Private equity firms were also found to spend more money on things not related to patient care in order to make money — such as monitoring fees to medical alert companies owned by the same firm — which drains still more resources away from patients.

“These results, along with the decline in nurse availability, suggest a systematic shift in operating costs away from patient care,” the authors concluded.

The researchers make a point in their opening to stipulate that private equity may prove successful in other industries. But, they warn, it may be dangerous in health care, where the profit motive of private firms and the welfare of patients may not be aligned:

For example, patients cannot accurately assess provider quality, they typically do not pay for services directly, and a web of government agencies act as both payers and regulators. These features weaken the natural ability of a market to align firm incentives with consumer welfare and could mean that high-powered incentives to maximize profits have detrimental implications for consumer welfare.

This finding is likely to draw a lot of attention, as David Grabowski, a Harvard Medical School professor who studies long-term care, told me. (He said he found the result to be plausible, though he would need more time to unpack the research data in full.) Private equity has already faced scrutiny for surprise medical billing and acquisitions of physician practices.

This study of nursing homes lays down a marker in the research literature: private equity leads to worse care. For patients, it’s a matter of life and death.

https://www.vox.com/policy-and-politics/22295461/nursing-home-deaths-private-equity-firms

 

_______________

Distributed by:

Kay Tillow, Coordinator

All Unions Committee for Single Payer Health Care
P. O. Box 17595
Louisville, KY 40217
(502) 636 1551

Email: nursenpo@aol.com
http://unionsforsinglepayer.org
https://www.facebook.com/unionsforsinglepayer

March 4, 2021

Land of the fee, home of the grave? For all its international posturing and boasting, the US can’t even take care of its citizens
worker | March 4, 2021 | 9:28 pm | COVID-19, Health Care, Local/State | Comments closed

https://www.rt.com/op-ed/517130-shelter-food-failure-prison-state/

Land of the fee, home of the grave? For all its international posturing and boasting, the US can’t even take care of its citizens

Helen Buyniski
Helen Buyniski

is an American journalist and political commentator at RT. Follow her on Twitter @velocirapture23 and on Telegram

Land of the fee, home of the grave? For all its international posturing and boasting, the US can’t even take care of its citizens
Though marketed as ‘the shining city on the hill’ envied by all other nations, America is rapidly proving to its own inhabitants and the world that not only can it not keep its own people safe – it can barely keep them alive.

Between the Covid-19 pandemic and the disastrous economic fallout engendered by government responses to that outbreak, the US has proven itself shockingly incapable of actually functioning in any way its peers might consider “normal.” Whether it’s keeping the lights on in American households, providing healthcare that cures rather than kills, educating children, or merely standing out of the way while residents try to build a life for themselves, Washington has demonstrated a profound, almost malignant ineptitude at the simplest tasks, so much that one might ask if it actually wants to perform them at all.

Dozens of Texas residents perished amid the massive snowstorm that seized the state last month. The storm knocked out the electric grid and left over 4 million residents with neither heat nor light. The state’s electricity vendors added insult to injury by slapping customers with absurdly high electric bills (some over $10,000) as the utility’s money-grubbing equivalent of “surge pricing” kicked in – all in a state where energy can literally be pulled out of the ground.

ALSO ON RT.COMTexas freeze exposes cold, dark heart of America in which EVERYTHING is now politicalTexas is only one state, though – surely the rest of the country can’t be so horrifically incompetent when it comes to something as basic as electricity? But oh no, out West, there’s always California bidding to fail bigger and better. The Golden State’s own power supplier PSE&G was sued for starting the wildfires that destroyed entire neighborhoods in 2017 and 2018. Indeed, PSE&G has been blamed for more than 1,500 fires since 2014 alone and is in the process of declaring bankruptcy after being sued by over 70,000 of its victims, including the entire city of Paradise. It’s so inept when it comes to not burning down the state that for years it has shut off power – often for extended periods – during the summer, lest its equipment trigger still more wildfires.

OK, but surely such travesties are rare? It’s not like the US government just goes around displacing people from their land deliberately? Yet Georgia man Tim Leslie is living through that Kafkaesque nightmare of his own right now after having bought a plot of land in Polk County to homestead and raise animals with his family. Because they haven’t built their house yet, they’re (legally) living out of a trailer on that land – or were, until the police forced them to abandon their animals and move to a proper RV park. It’s difficult to imagine a community so free of crime that it wouldn’t have benefited from the cops finding something else to do during the hours spent harassing the Leslie family, but victimizing law-abiding citizens is much easier than going after criminals.

Policing – once the pride and joy of the world’s largest prison state – has itself deteriorated rapidly. New York City endured a major surge in crime thanks to the shutdown, while cops who might have been able to stop it were ignominiously tasked with guarding Mayor Bill de Blasio’s virtue-signaling “Black Lives Matter” mural or (somewhat schizophrenically) detailed to clobber the odd BLM protester. The NYPD even punished its own officers for public display of Trump fandom while real crimes went ignored and unpunished. (New York also released hundreds of supposedly low-level convicts last year “because Covid,” only for the public to learn they were guilty of much more serious offenses, with many ending up right back in the clink after committing further crimes. It’s an ominous state of affairs indeed for the country with the most prison inmates per capita in the world, and those numbers are almost guaranteed to further explode thanks to law enforcement’s new fixation on “domestic terrorists” – a group defined so broadly as to include anyone who’s expressed opinions outside the ever-narrowing mainstream.

Maybe the US is just focusing its efforts on combating the Covid-19 pandemic? Americans may spend more on healthcare than any other first-world country, but it wasn’t getting much for its money even before Covid. When the pandemic hit, all hell broke loose in many states, and when hospitals were barred from seeing ‘normal’ patients for lucrative procedures, they instead turned to ventilating anything that moved in order to get reimbursed by the government – even though 88 percent of those intubated died. Governors didn’t beg for lifesaving treatments – indeed, they banned some. Instead, they pleaded for ventilators, all while shunting Covid-infected patients into nursing homes where they would go on to decimate the helpless population.

If this is how the US treats its sick, what about its children? Despite some scientists confirming vanishingly few kids are falling ill, major teachers’ unions refuse to return to the classroom, never mind how poorly most children have been shown to learn over a distance model. In some areas, the shutdown of schools revealed a problem the US had been covering up for a while – the need to feed the millions of destitute children who rely on their schools not just for learning, but for free meals their families can’t afford. At the same time, these kids’ parents spent hours lined up in the cold for free groceries from the nearest food bank, and millions remain out of work or severely underemployed, many dangling on the verge of eviction. Sorely-needed stimulus checks never arrived for many, whose only recourse now is to claim the check on their taxes in the hope of maybe getting reimbursed later.

Most of these problems could be solved with some smart policies and a fraction of the infusion of cash that has already gone out to large corporations. But there’s wars to fight, and no evidence the ruling class wants its domestic problems fixed anyway. Instead, it seems to take sadistic pleasure in gaslighting Americans to within an inch of their sanity, insisting the rest of the world wants to be just like us. After all, it’s not like we can fly there to check.

 

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The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.

Games People Play
worker | February 7, 2021 | 7:25 pm | Health Care | Comments closed

Games People Play

– from Greg Godels is available at:
http://zzs-blg.blogspot.com/

If you do not wish to receive these notices, e-mail: zzsblogml@gmail.com with “unsubscribe” in the subject box.

 

Facing joblessness, eviction, foreclosure, and a broken, ineffective health care system unable to deliver hundreds of thousands of US citizens from a death sentence, the public needs more than an entertaining, sensationalist narrativeTo read more, please go to: http://zzs-blg.blogspot.com/2021/02/games-people-play.html

Africa/Global: Distant Horizon for Vaccine Equity
worker | January 26, 2021 | 7:19 pm | Africa, COVID-19, Health Care | Comments closed

Africa/Global: Distant Horizon for Vaccine Equity

AfricaFocus Bulletin
January 26, 2021 (2021-01-26)
(Reposted from sources cited below)

Editor’s Note

“I need to be blunt: the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries. Even as they speak the language of equitable access [to Covid vaccines], some countries and companies continue to prioritize bilateral deals, driving up prices and attempting to jump to the front of the queue. This is wrong. … The situation is compounded by the fact that most manufacturers have prioritized regulatory approval in rich countries where the profits are highest, rather than submitting full dossiers to WHO.” – Dr. Tedros Adhanom Ghebreyesus, WHO Director-General

The Covid pandemic has not only revealed but also dramatically widened structural inequalities separating rich and poor, both within and between nations. The effect of the virus itself has been compounded by massive failures in the response, as the most vulnerable are also last in line in access to new treatments and to vaccines.

Now, even as unprecedented scientific collaboration around the world has yielded multiple vaccines, the rollout of the virus is hindered not only by predictable organizational obstacles but also by the dominance of profit-driven pharmaceutical companies and heightened price competition. In June 2020, the Global Vaccine Summit produced pledges to advance equal access for all to the vaccines. But, despite the efforts of WHO and other multilateral agencies, progress has been slow and crippled by lack of transparency in pricing.

Almost five months ago, the People’s Vaccine Initiative launched an appeal that vaccine production be understood as a global public good. A global call from Covid survivors demanded that, to make this possible, corporations immediately license any intellectual property rights related to vaccine technologies to the WHO COVID-19 Technology Access Pool (C-TAP).

Unfortunately, that demand has yet to find an echo in the decision-making of governments and corporations. And predictions are that many around the world will not receive vaccines until 2022 or even later.

This AfricaFocus Bulletin contains (1) brief excerpts on the fundamental issue of equitable provision of vaccines; (2) excerpts from speeches by Dr. Tedros Adhanom Ghebreyes and Dr. Anthony Fauci; (3) a commentary by Steven Friedman on South Africa’s failure to prioritize public health measures rather placing too much hope in the potential for technical solutions such as vaccines, and (4) links to additional recent articles and sources of data.

For the most recent updates see the following link:Data and analysis on vaccine roll-out worldwide
Updated every 1 to 2 weeks
https://launchandscalefaster.org/covid-19

Data updated daily
https://ourworldindata.org/covid-vaccinations

For previous AfricaFocus Bulletins on health issues, visit http://www.africafocus.org/intro-health.php

++++++++++++++++++++++end editor’s note+++++++++++++++++

Key Points to Consider

Oct. 2, 2020
https://freethevaccine.org/2020/10/02/a-peoples-vaccine-the-global-call/

Excerpt:

On September 28th, over one thousand COVID-19 survivors, along with family members and susceptible individuals, signed an open letter to pharmaceutical corporations, demanding that they leave their monopoly-seeking greed behind as the world struggles to fight and recover from a virus that has already taken the lives of over one million individuals worldwide.

The letter asks that corporations immediately license any intellectual property rights related to vaccine technologies to the WHO COVID-19 Technology Access Pool (C-TAP). By doing so, Oxfam, UNAIDS, Free the Vaccine for COVID-19, and other organizations involved in the alliance are calling on governments around the world to keep diagnostic tools, treatments, and vaccines for COVID-19 away from the restrictive world of patents.

Jan. 5, 2021
What Will It Take To End The COVID-19 Pandemic?
Transcript and 4-minute audio clip.
https://www.npr.org/sections/goatsandsoda/2021/01/05/953653373/some-experts-say-temporary-halt-on-drug-patents-is-needed-to-stop-pandemic-world

Excerpt:

About 7 billion people live on the planet. Many of the new COVID-19 vaccines require two doses. So to stamp out the pandemic, companies need to manufacture about 12 to 15 billion doses.

Problem is, right now, the world doesn’t have near that many doses and likely won’t have them this year, Lusiani says. “In many pockets around the world, it’s becoming increasingly likely that people will not get access to the COVID-19 vaccine in 2021.”

Many families will have to wait until 2023 or 2024. And the pandemic will likely continue until then.

So why can’t the world simply manufacture more doses? Lawyer Brook Baker at Northeastern University believes there’s an underlying root cause: international patents on COVID-19 vaccines.

“The [vaccine] innovators hold patent rights and trade secret rights over those technologies, and they’re unwilling to share them broadly to other manufacturers. So we have artificially constricted supply,” says Baker, who studies how laws affect access to medicines.

The patent rights come from agreements within the World Trade Organization. Members of the WTO, which includes 159 countries, have agreed to honor patents for new pharmaceutical products at least 20 years after they’re developed.

“This agreement was the brainchild of the pharmaceutical industry back in the 1980s,” Baker says. “It ended up being a monopoly-based agreement, which preserves the rights of the pharmaceutical industry instead of allowing competition.”

Jan. 23, 2021

If Poor Countries Go Unvaccinated, a Study Says, Rich Ones Will Pay
https://www.nytimes.com/2021/01/23/business/coronavirus-vaccines-global-economy.html

Excerpt:

In monopolizing the supply of vaccines against Covid-19, wealthy nations are threatening more than a humanitarian catastrophe: The resulting economic devastation will hit affluent countries nearly as hard as those in the developing world.

This is the crucial takeaway from an academic study to be released on Monday. In the most extreme scenario — with wealthy nations fully vaccinated by the middle of this year, and poor countries largely shut out — the study concludes that the global economy would suffer losses exceeding $9 trillion, a sum greater than the annual output of Japan and Germany combined.

Nearly half of those costs would be absorbed by wealthy countries like the United States, Canada and Britain.

In the scenario that researchers term most likely, in which developing countries vaccinate half their populations by the end of the year, the world economy would still absorb a blow of between $1.8 trillion and $3.8 trillion. More than half of the pain would be concentrated in wealthy countries.

**************************************************************

WHO Director-General’s opening remarks at 148th session of the Executive Board

18 January 2021

https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-148th-session-of-the-executive-board

Your Excellency Dr Harsh Vardhan, Chair of the Executive Board, thank you for your leadership for your leadership during these difficult times.

Excellencies, dear colleagues and friends,

Good morning, good afternoon and good evening to you all, and happy New Year.

40 years ago, a new virus emerged and sparked a pandemic. Life saving medicines were developed, but more than a decade passed before the world’s poor got access to them.

12 years ago, a new virus emerged and sparked a pandemic. Lifesaving vaccines were developed, but by the time the world’s poor got access, the pandemic was over.

One year ago, a new virus emerged and sparked a pandemic. Life saving vaccines have been developed. What happens next is up to us.

We have an opportunity to beat history; to write a different story; to avoid the mistakes of the HIV and H1N1 pandemics.

The development and approval of safe and effective vaccines less than a year after the emergence of a new virus is a stunning scientific achievement, and a much-needed source of hope.

Vaccines are the shot in the arm we all need – literally and figuratively.

The recent emergence of rapidly-spreading variants makes the rapid and equitable rollout of vaccines all the more important.

But we now face the real danger that even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots.

It’s right that all governments want to prioritize vaccinating their own health workers and older people first.

But it’s not right that younger, healthier adults in rich countries are vaccinated before health workers and older people in poorer countries.

There will be enough vaccine for everyone. But right now, we must work together as one global family to prioritize those most at risk of severe diseases and death, in all countries.

For the past 9 months, the ACT Accelerator and the COVAX vaccines pillar have been laying the groundwork for the equitable distribution and deployment of vaccines.

We’ve overcome scientific barriers, legal barriers, logistical barriers and regulatory barriers.

We have secured 2 billion doses from five producers, with options on more than 1 billion more doses, and we aim to start deliveries in February.

I use this opportunity to thank Gavi and CEPI.

COVAX is ready to deliver what it was created for.

But in recent weeks I have heard from several Member States who have questioned whether COVAX will get the vaccines it needs, and whether high-income countries will keep the promises they have made.

As the first vaccines begin to be deployed, the promise of equitable access is at serious risk.

More than 39 million doses of vaccine have now been administered in at least 49 higher-income countries. Just 25 doses have been given in one lowest-income country. Not 25 million; not 25 thousand; just 25.

I need to be blunt: the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.

Even as they speak the language of equitable access, some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue. This is wrong.

44 bilateral deals were signed last year, and at least 12 have already been signed this year.

The situation is compounded by the fact that most manufacturers have prioritized regulatory approval in rich countries where the profits are highest, rather than submitting full dossiers to WHO.

This could delay COVAX deliveries and create exactly the scenario COVAX was designed to avoid, with hoarding, a chaotic market, an uncoordinated response, and continued social and economic disruption.

Not only does this me-first approach leave the world’s poorest and most vulnerable people at risk, it’s also self-defeating.

Ultimately, these actions will only prolong the pandemic, the restrictions needed to contain it, and human and economic suffering.

Vaccine equity is not just a moral imperative, it is a strategic and economic imperative.

A recent study estimated that the economic benefits of equitable vaccine allocation for 10 high-income countries would be at least 153 billion U.S. dollars in 2021, rising to 466 billion dollars by 2025. That’s more than 12 times the total cost of the ACT Accelerator.

It’s not too late. I call on all countries to work together in solidarity to ensure that within the first 100 days of this year, vaccination of health workers and older people is underway in all countries.

It’s in the best interest of each and every nation on Earth.

Together, we must change the rules of the game, in three ways.

First, we call on countries with bilateral contracts – and control of supply – to be transparent on these contracts with COVAX, including on volumes, pricing and delivery dates.

We call on these countries to give much greater priority to COVAX’s place in the queue, and to share their own doses with COVAX, especially once they have vaccinated their own health workers and older populations, so that other countries can do the same.

Second, we call on vaccine producers to provide WHO with full data for regulatory review in real time, to accelerate approvals. We also call on producers to allow countries with bilateral contracts to share doses with COVAX, and to prioritize supplying COVAX rather than new bilateral deals.

And third, we call on all countries introducing vaccines to only use vaccines that meet rigorous international standards for safety, efficacy and quality, and to accelerate readiness for deployment.

The theme for World Health Day this year is health inequality.

My challenge to all Member States is to ensure that by the time World Health Day arrives on the 7th of April, COVID-19 vaccines are being administered in every country, as a symbol of hope for overcoming both the pandemic and the inequalities that lie at the root of so many global health challenges.

I hope this will be realized.

*******************************************************************

Dr. Anthony S. Fauci Remarks at the World Health Organization Executive Board Meeting

January 21, 2021

Contact: HHS Press Office, 202-690-6343, media@hhs.gov

https://www.hhs.gov/about/news/2021/01/21/dr-anthony-s-fauci-remarks-world-health-organization-executive-board-meeting.html

“Director-General Dr. Tedros, distinguished representatives, friends and colleagues:

It is an honor for me to be here, representing the United States of America, on behalf of the newly inaugurated Biden-Harris administration, and as the Chief Medical Adviser to President Biden.

I also am here to represent the scientists, public health officials and frontline healthcare workers, and community health workers who have worked so heroically this past year to fight COVID-19, developing medical countermeasures at truly phenomenal speed, adapting policy responses as we learn more about the virus, and courageously treating the millions of people who have been stricken by this historic scourge.

One year ago, to the day, the United States confirmed its first case of SARS-COV-2, in the State of Washington. Today, in my country and around the world, we have surpassed 90 million cases, a devastating number that continues to grow.

I join my fellow representatives in thanking the World Health Organization for its role in leading the global public health response to this pandemic. Under trying circumstances, this organization has rallied the scientific and research and development community to accelerate vaccines, therapies and diagnostics; conducted regular, streamed press briefings that authoritatively track global developments; provided millions of vital supplies from lab reagents to protective gear to health care workers in dozens of countries; and relentlessly worked with nations in their fight against COVID-19.

I also know first-hand the work of WHO with whom I have engaged in a collaborative manner touching all aspects of global health over the past 4 decades.

As such, I am honored to announce that the United States will remain a member of the World Health Organization. Yesterday, President Biden signed letters retracting the previous Administration’s announcement to withdraw from the organization, and those letters have been transmitted to the Secretary-General of the United Nations and to you Dr. Tedros, my dear friend.

In addition to retracting the notification of withdrawal and retaining membership in the WHO, the United States will cease the drawdown of U.S. staff seconded to the WHO and will resume regular engagement of U.S. government personnel with the WHO both directly and through our WHO Collaborating Centers.

The United States also intends to fulfill its financial obligations to the organization. The United States sees technical collaboration at all levels as a fundamental part of our relationship with WHO, one that we value deeply and will look to strengthen going forward.

As a WHO member state, the United States will work constructively with partners to strengthen and importantly reform the WHO, to help lead the collective effort to strengthen the international COVID-19 response and address its secondary impacts on people, communities, and health systems around the world.

The Biden Administration also intends to be fully engaged in advancing global health, supporting global health security and the Global Health Security Agenda, and building a healthier future for all people.

I am also pleased to announce today that the United States plans to work multilaterally to respond to and recover from the COVID-19 pandemic. President Biden will issue a directive later today which will include the intent of the U.S. to join COVAX and support the ACT-Accelerator to advance multilateral efforts for COVID-19 vaccine, therapeutic, and diagnostic distribution, equitable access, and research and development.

The United States will also work with the WHO and Member States to counter the erosion of major gains in global health that we have achieved through decades of research, collaboration and investments in health and health security, including in HIV/AIDS, food security, malaria, and epidemic preparedness.

And it will be our policy to support women’s and girls’ sexual and reproductive health and reproductive rights in the United States, as well as globally. To that end, President Biden will be revoking the Mexico City Policy in the coming days, as part of his broader commitment to protect women’s health and advance gender equality at home and around the world.

We realize that responding to COVID-19 and rebuilding global health and advancing health security around the world will not be easy. And in this regard:

We are committed to transparency, including those events surrounding the early days of the pandemic. It is imperative that we learn and build upon important lessons about how future pandemic events can be averted. The international investigation should be robust and clear, and we look forward to evaluating it;

We also will work with the WHO and partner countries to strengthen and reform the WHO, improve mechanisms for responding to health emergencies across the United Nations, and strengthen the International Health Regulations;

We will commit to building global health security capacity, expanding pandemic preparedness, and supporting efforts to strengthen health systems around the world and to advance the Sustainable Development Goals;

We will work with partners to develop new international financing mechanisms for health security;

We will seek an improved, shared system for early warning and rapid response to emerging biological threats;

We will support scientifically robust and ethically sound collaborative science, research and research capacity building, as well as the rapid sharing of research results, pathogen samples and data essential to research progress;

We will look to strengthen pandemic supply chain networks;

And we will work with partners around the world to build a system that leaves us better prepared for this pandemic and for the next one.

And finally, given that a considerable amount of effort will be required by all of us moving forward, the United States stands ready to work in partnership and solidarity to support the international COVID-19 response, mitigate its impact on the world, strengthen our institutions, advance epidemic preparedness for the future, and improve the health and wellbeing of all people throughout the world.”

*************************************************************

No cure for South Africa’s colonised medical minds

Elites have ignored the countries successfully using preventative measures against Covid-19. Instead, they’ve followed Western nations with their blind faith in technical solutions.

By: Steven Friedman

18 Jan 2021

https://www.newframe.com/no-cure-for-south-africas-colonised-medical-minds/

South Africa is no longer colonised. But the minds of its elites, including its medical scientists and health officials, still are. This is why Covid-19 stalks the land, sowing avoidable disease and death.

After months of indifference, the elites and the connected who use media now care about Covid-19 again. Rising infections and deaths, labelled “the second wave”, fuelled in part by a new strain that spreads more easily, have bitten more deeply into the suburbs, which house the people who shape the debate. So, it is again the centre of attention, as it was when it arrived and no one knew who it would affect.

One sign of this new seriousness is that television channels, to the extent they are allowed to, now show the illness and pain inside hospitals. Until now, broadcast coverage of Covid-19 consisted largely of a parade of business people complaining about restrictions. If South Africans wanted to see what Covid-19 does to people, they had to watch international news channels.

But, while the virus is back on the agenda, there is still a strong air of fantasy about the way the elites see the disease. There is no recognition that the country faces a severe plague now because of what they did – and didn’t do – about Covid-19 since it arrived.

In the main, the government, scientists and private power holders are doing what elites do when things go wrong – blaming the people. The president leads the way, offering televised addresses at which he announces weak measures to fight the virus and then berates citizens for behaving badly. The elite follows suit, blaming teenage parties, taverns, shoppers – everyone except those responsible for containing the virus.

For the rest, we are told either that a severe “second wave” was inevitable or that the new mutation took the scientists by surprise. Both are clearly false.

Prevention is better

Since Covid-19 arrived, medical scientists here – or at least those who are endlessly available for media interviews – have parroted the claim that it was inevitable that Covid-19 would ravage the population because no country could escape a severe outbreak.

This fails to explain why much of East Asia, New Zealand and Australia have avoided this – as have countries in Africa. Until a while ago, South Africa had as many cases and deaths as the rest of Africa combined – the gap is still so wide that, even if other countries have recorded only a quarter of their cases and deaths, this country is still the worst performer by a long way.

And, while almost the whole world is experiencing new infections and deaths, countries that have contained Covid-19 have a fraction of the 1,600 cases a day this country experienced between August and November, supposedly a time of “low transmission”. (It is not clear that we ever got rid of the first wave, given how high our case numbers were when we were supposedly doing well.)

The claim that the mutation was a surprise is odd since scientists know viruses always mutate. What was avoidable is declared a law of nature; what was predictable is dismissed as a freak.

The power of the Global North

What has this to do with colonialism? This country has not fought Covid-19 because its elites, including its medical scientists, believe North America and Western Europe are the centre of the universe.

Those countries have done poorly at fighting the virus, although their health systems are touted as the best in the world. There, medicine is about using technologies to cure people, not preventing illness. But curative medicine is not that useful if there is no cure, which there isn’t for Covid-19. East Asian countries have endured several pandemics and so have become very good at protecting public health. Some African countries, despite limited resources, have learned from experience how to make prevention measures work in the face of epidemics.

Our elites (including the scientists) never showed any interest in how South Korea, Taiwan, Rwanda and Senegal were dealing with Covid-19 – they weren’t even interested in New Zealand, which should be more up their cultural alley. Instead, they reacted as decision-makers in North America and Western Europe did – their priority was to ready the health system, not to nip the virus in the bud. When they said no country had avoided a severe epidemic, they meant no country they take seriously – no major Western country. And they assumed, as those countries did, that the only way to fight disease is to get people into hospitals and give them the latest technical fix.

This seemed so obvious here that no one questioned it, despite the fact that where there is no cure and it is not even clear how well treatments work, there is a limit to what hospitals can do: even if they can help, they cannot prevent many people becoming ill and dying, which public health measures can do.

Given this, it is no surprise that the elites now punt a vaccine as the only way to fight Covid-19 – they understand only technical solutions. Vaccines do help people, and the country does need them. But the claim by some medical scientists that a vaccine is the only solution to Covid-19 shows the same tunnel vision as that which thought protecting hospitals was better than stopping the virus.

As important as vaccines are, they are products of the Global North to which our elites aspire. We are last in line for them because the rich countries know how to hog the best and leave the rest of us with crumbs.

This means we will, for some time, need the preventive health measures our elites don’t understand. We won’t get them as long as the heads of our scientists and power holders remain the property of rich Western countries.

************************************************************

Links to Additional Recent Sources of Interest

Jan. 24, 2021
https://www.theguardian.com/commentisfree/2021/jan/24/coronavirus-vaccines-offer-the-world-hope-unless-you-live-in-africa

Jan. 24, 2021
Why Vaccines Alone Will Not End the Pandemic
https://www.nytimes.com/interactive/2021/01/24/us/covid-vaccine-rollout.html

Jan. 23, 2021
https://www.washingtonpost.com/opinions/global-opinions/rich-countries-me-first-vaccine-hoarding-is-leaving-behind-low-income-nations/2021/01/23/3830e7d4-5c23-11eb-a976-bad6431e03e2_story.html

Jan. 22, 2021
https://www.theguardian.com/world/2021/jan/22/south-africa-paying-more-than-double-eu-price-for-oxford-astrazeneca-vaccine

Jan. 21, 2021
https://www.forbes.com/sites/roberthart/2021/01/21/fauci-praises-world-health-organizations-pandemic-leadership-says-us-will-rejoin/?sh=2ad1d3987a06

Jan. 21, 2021
COVID ‘vaccine hoarding’ putting Africa at risk: WHO
https://news.un.org/en/story/2021/01/1082692

Jan. 21, 2021
Africa’s long wait for the Covid-19 vaccine
https://www.bbc.com/news/world-africa-55751714

Jan. 18, 2021
https://www.reuters.com/article/uk-health-coronavirus-safrica-vaccine/south-africa-to-get-9-million-jj-vaccine-shots-ministry-idUSKBN29N1D9

Jan 17, 2021
https://www.dailymaverick.co.za/article/2021-01-17-africas-covid-19-response-has-been-admirable-but-the-economic-costs-will-linger-for-years/

Jan. 17, 2021
Equitable recovery from COVID-19: bring global commitments to community level
https://gh.bmj.com/content/6/1/e004757

Jan. 16, 2021
How Africa Is Leading From Behind in Global Coronavirus Vaccine Race
https://allafrica.com/stories/202101180313.html

Jan. 6, 2021
https://www.hrw.org/news/2021/01/06/au-should-press-equitable-access-covid-19-vaccines

Jan. 3, 2021
https://www.theguardian.com/world/2021/jan/03/palestinians-excluded-from-israeli-covid-vaccine-rollout-as-jabs-go-to-settlers

Dec. 17, 2020
https://africacdc.org/news-item/majority-of-africans-would-take-a-safe-and-effective-covid-19-vaccine/

Dec. 10, 2020
https://www.gavi.org/vaccineswork/are-african-countries-ready-covid-19-vaccine

Dec. 5, 2020
An African plan to control COVID-19 is urgently needed

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32580-0/fulltext

Oct. 6, 2020
COVID-19 vaccines: how to ensure Africa has access
https://www.nature.com/articles/d41586-020-02774-8

AfricaFocus Bulletin is an independent electronic publication providing reposted commentary and analysis on African issues, with a particular focus on U.S. and international policies. AfricaFocus Bulletin is edited by William Minter. For an archive of previous Bulletins, see http://www.africafocus.org,

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Cuba Beats Swords into Plowshares
worker | January 2, 2021 | 1:26 pm | Cuba, Health Care | Comments closed

Cuba Beats Swords into Plowshares