Adam Hanieh

British political scientist

Adam Hanieh is a development studies academic based in the United Kingdom.

QuotesEdit

This is a Global Pandemic – Let’s Treat it as Such, 27 March 2020Edit

This is a Global Pandemic – Let’s Treat it as Such, 27 March 2020, Verso Books
  • Even inside Europe there is extreme unevenness in the capacity of states to deal with this crisis — as the juxtaposition of Germany and Greece illustrates — but a much greater disaster is about to envelop the rest of the world. In response, our perspective on this pandemic must become truly global, based on an understanding of how the public health aspects of this virus intersect with larger questions of political economy (including the likelihood of a prolonged and severe global economic downturn). This is not the time to pull up the (national) hatches and speak simply of the fight against the virus inside our own borders.
  • Foregrounding these historical and global dimensions helps make clear that the enormous scale of the current crisis is not simply a question of viral epidemiology and a lack of biological resistance to a novel pathogen. The ways that most people across Africa, Latin America, the Middle East, and Asia will experience the coming pandemic is a direct consequence of a global economy systemically structured around the exploitation of the resources and peoples of the South. In this sense, the pandemic is very much a social and human-made disaster — not simply a calamity arising from natural or biological causes. One clear example of how this disaster is human-made is the poor state of public health systems across most countries in the South, which tend to be underfunded and lacking in adequate medicines, equipment, and staff. This is particularly significant for understanding the threat presented by COVID-19 due to the rapid and very large surge in serious and critical cases that typically require hospital admission as a result of the virus (currently estimated at around 15–20 percent of confirmed cases). This fact is now widely discussed in the context of Europe and the United States, and lies behind the strategy of "flattening the curve" in order to alleviate the pressure on hospital critical care capacity.
  • Yet, while we rightly point to the lack of ICU beds, ventilators, and trained medical staff across many Western states, we must recognize that the situation in most of the rest of the world is immeasurably worse. Malawi, for example, has about 25 ICU beds for a population of 17 million people. There are less than 2.8 critical care beds per 100,000 people on average across South Asia, with Bangladesh possessing around 1,100 such beds for a population of over 157 million (0.7 critical care beds per 100,000 people). In comparison, the shocking pictures coming out of Italy are occurring in an advanced health care system with an average 12.5 ICU beds per 100,000 (and the ability to bring more online). The situation is so serious that many poorer countries do not even have information on ICU availability. [...] Of course, the question of ICU and hospital capacity is one part of a much larger set of issues including a widespread lack of basic resources (e.g., clean water, food, and electricity), adequate access to primary medical care, and the presence of other comorbidities (such as high rates of HIV and tuberculosis). Taken as a whole, all of these factors will undoubtedly mean a vastly higher prevalence of critically ill patients (and hence overall fatalities) across poorer countries as a result of COVID-19.
  • Debates around how best to respond to COVID-19 in Europe and the United States have illustrated the mutually reinforcing relationship between effective public health measures and conditions of labor, precarity, and poverty. Calls for people to self-isolate when sick — or the enforcement of longer periods of mandatory lockdowns — are economically impossible for the many people who cannot easily shift their work online, or those in the service sector who work in zero-hour contracts or other kinds of temporary employment. Recognizing the fundamental consequences of these work patterns for public health, many European governments have announced sweeping promises around compensation for those made unemployed or forced to stay at home during this crisis. It remains to be seen how effective these schemes will be, and to what degree they will actually meet the needs of the very large numbers of people who will lose their jobs as a result of the crisis. Nonetheless, we must recognize that such schemes will simply not exist for most of the world's population. In countries where the majority of the labor force is engaged in informal work or depends upon unpredictable daily wages — much of the Middle East, Africa, Latin America, and Asia — there is no feasible way that people can choose to stay home or self-isolate. This must be viewed alongside the fact that there will almost certainly be very large increases in the "working poor" as a direct result of the crisis.
  • Without the mitigation effects offered through quarantine and isolation, the actual progress of the disease in the rest of the world will certainly be much more devastating than the harrowing scenes witnessed to date in China, Europe, and the United States. Moreover, workers involved in informal and precarious labor often live in slums and overcrowded housing — ideal conditions for the explosive spread of the virus.
  • One microcosm of this can be seen in the Gaza Strip, where over 70 percent of the population are refugees living in one of the most densely packed areas in the world. The first two cases of COVID-19 were identified in Gaza on March 20 (a lack of testing equipment, however, has meant that only 92 people out of the 2-million-strong population have been tested for the virus). Reeling from thirteen years of Israeli siege and the systematic destruction of essential infrastructure, living conditions in the Strip are marked by extreme poverty, poor sanitation, and a chronic lack of drugs and medical equipment (there are, for example, only sixty-two ventilators in Gaza, and just fifteen of these are currently available for use). Under blockade and closure for most of the past decade, Gaza has been shut to the world long before the current pandemic. The region could be the proverbial canary in the COVID-19 coalmine — foreshadowing the future path of the infection among refugee communities across the Middle East and elsewhere.
  • We are entering an alarming situation where many poorer countries will face increasingly burdensome debt repayments while simultaneously attempting to manage an unprecedented public health crisis – all in the context of a very deep global recession. And let us not harbor any illusions that these intersecting crises might bring an end to structural adjustment or the emergence of some kind of "global social democracy." As we have repeatedly seen over the last decade, capital frequently seizes moments of crisis as a moment of opportunity — a chance to implement radical change that was previously blocked or appeared impossible.

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