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You’re probably well aware of my view of Davos as a so called “global health event” by now. Earlier this week, an observer in my country – a wealth fund manager, mind you – labelled Davos “organized crony capitalism”, which is probably not too far from the truth. The people “inside” Davos tend to call it a ‘superior networking opportunity’, though 😊. Paraphrasing Klaus Schwab, who thanked the Donald for “his multiple contributions to a more inclusive America” after his speech, fortunately, all this networking in Davos takes place with a view on “a better, more sustainable and more inclusive” world.
Anyway, I won’t really go into that in this week’s intro. Instead, I would like to draw your attention to one of the focal areas of this year’s Oxfam report on global economic inequality, published in the run-up to Davos: why we need, urgently, a global care economy (and feminist economics). A key quote perhaps: “Economic inequality is out of control. In 2019, the world’s billionaires, only 2,153 people, had more wealth than 4.6 billion people. This great divide is based on a flawed and sexist economic system that values the wealth of the privileged few, mostly men, more than the billions of hours of the most essential work – the unpaid and underpaid care work done primarily by women and girls around the world. …”
Or as my witty colleague would have it, in addition to “She Decides”, there’s also “She Works (mostly un(der)paid)”.
I humbly admit I don’t always pay enough attention to the urgent need for a care economy in this weekly intro (and I’m afraid that’s an understatement). A global shift in this respect is long overdue, however. If, as many observers say, 2019 was the year of ‘awareness’ (they mean, mostly, of the climate emergency), and 2020 should kick off ‘real action’, then this surely also goes for a global care economy.
Let’s make the link with global health, then. I understand 2020 is, among others, WHO’s “year of the nurse and midwife”. Not to mention the many female, and not exactly overpaid, community health workers. Now, how much of a no-brainer can it be, then, to link the care economy to the issue of global tax justice?
Winnie Byanyima (the new UNAIDS boss) clearly gets this. She spoke, not for the first time, truth to power in Davos, sensing rightly that the momentum is shifting worldwide. Unlike many others in global health power circles, she’s also not shy to admit the current economic model is broken. Too many other global health leaders in Davos, however, seem happy to just advocate for global health security & AMR, “talk the Davos talk”, or are there to protect their own organisation’s replenishment. In short, although they’re there for very worthy causes, and the WEF has arguably been instrumental in setting up a few very important PPPs (GAVI, GF, CEPI, …), they certainly won’t upset the status quo on this planet. The arguments usually having been, ‘in Davos at least you can get some stuff done’ and ‘you can raise a key global health issue on the agenda’. Dr. Tedros and WHO are perhaps somewhere in the middle on this spectrum, being fond of investment framing in Davos (although for extremely important causes like PHC & UHC).
While I agree that PPPs do have their merits, certainly in global health, unfortunately, by failing to really challenge the status quo at a plutocrat event like Davos, these global health leaders help create a vicious feedback loop. The loop goes like this: yes, the killer stats from annual Oxfam reports are covered all over the globe, which is great in terms of raising awareness on global inequality, but unfortunately, it’s mostly radical right-wing parties now that manage to “cash” in on this widely shared feeling of global injustice. With global solidarity as the first victim, I’m afraid. There’s no way that can be a good thing for global health.
This is not the MDG era anymore. Similarly, the status quo is no option anymore. Not unequivocally saying this, in the year 2020, in a setting full of billionaires (119, combined net worth: 500 billion) and business CEOs is a grave strategic error. In fact, perhaps Davos is the very venue where you should say this, loud and clear, over and over again. At the risk of not getting invited next year, like Rutger Bregman 😊.
So here’s a suggestion for global health leaders if they insist on continuing to go to Davos, next year and the years after as well. Put the Global Action Plan on Health and Wellbeing for All (aka “the GAP”) into practice, also in Davos, and streamline your discourse on global tax justice – in line with the GAP’s intention to harmonize the work of international global health & development organisations. Speak with one voice, that is, Winnie Byanyama’s voice, on this all-important issue of global tax justice. That would certainly ‘accelerate’ many important global health agendas, I reckon. Just one final killer stat, for example, from the Oxfam report: ““Getting the richest 1% to pay just 0.5% tax on their wealth – just on their wealth, not their income – would create enough money over the next 10 years to pay for 117m jobs, in education, health and elderly care. ”
As it’s “Davos week”, let me also quickly come back on this notion of ‘capitalism has to go’ from last week ( including, we better make some great progress on this during this decade). I know that sounds fairly naïve, even if a global survey just pointed out that Capitalism is now seen as doing ‘more harm than good’ by a majority of people, all over the globe. Naive, because most of us (including myself on most days) can more easily imagine a completely destroyed planet, than a world that has gone “beyond capitalism”. You hear all the time about capitalism being ‘the only game in town’ (Milankovic), and even adapting (or rather mutating) once again in the 21st century, with current trends like disruptive platform capitalism, financialized capitalism, rentier capitalism, surveillance capitalism, disaster capitalism, and, especially these days, Klaus Schwab’s beloved “stakeholder capitalism”.
That’s all true. However, Larry Elliot’s assessment in the Guardian was also spot on, comparing the world after WWII with now: “… whereas the threat in 1948 [i.e. for Western dominated capitalism] was the spread of communism, now it is the much greater danger that capitalism will eat itself. “
You all know what that would imply, given human beings’ sorry track record on this planet: war & destruction, 21st-century style. Decades ago, the Club of Rome already expected that social limits would present themselves earlier than biophysical limits (for example, exhaustion of resources). Nowadays, given how dire the climate emergency scenes are, I’m less sure about the sequence, but it’s safe to say that a full-blown implosion of capitalism (as compared to structured transformation) would turn very ugly, very soon. I notice UN Secretary-General Guterres is also a fan of the book Apocalypse these days, referring to the Four horsemen, so for the biblical fans among you: “either we tame the Beast or the Beast will devour itself” 😊. PS: Even capitalists seem to understand “they must do better”, a Guardian editorial gauged the mood in Davos, this week. And Patriotic Millionnaires went global with their message, in Davos, that we face the choice between (higher and fairer) ‘taxes’ or ‘pitchforks’.
To sum up, it’s about time global health leaders move to ‘the right side of history’ on global tax justice. Winnie’s side, I reckon. We’ll get a lot closer to a global care economy as well, then.
PS: For a more sophisticated conceptual view on capitalism & health, I strongly recommend a new special issue in the Review of International Political Economy, introduced neatly in ‘Health under capitalism: a global political economy of structural pathogenesis’ (by Susan Sell & Owain Williams).
Enjoy your reading.