Subscribe to our weekly International update on Health Policies
The weekly IHP newsletter offers a digest of key global health (policy, governance, research) reads.
Select a newsletter issue or browse the topics in the current issue.
The danger of vaccine nationalism is getting increasing attention, for obvious reasons. Things look rather gloomy on that front, even if Bill Gates sounded fairly optimistic a while ago (in spite of some worries he had as well in this regard), when addressing the International AIDS society. He emphasized “we’ve done this before” – obviously, he was referring to the Global Fund. Yes, humanity came together, back then, but these are no MDG times anymore. Bill Gates (with an IQ at least twice mine, I’m guessing 😊) should know by now. It’s thus likely other avenues and mechanisms (than sophisticated PPPs) will have to be explored to get to ‘global solidarity’. Both in what we used to call the ‘North’ and ‘South’.
Let’s start with countries in the ‘North’. With many citizens of former ‘rich’ countries feeling that social contracts in their countries are under great pressure or have been downright betrayed, due to austerity policies – with the current massive Covid-19 economic carnage (and sometimes warped ‘stimulus/relief packages’) probably adding to this sentiment -, I’m pretty sure that to get their support for global solidarity and a global social contract, you’ll have to fix tax justice. With clear emphasis on the 0.0001 %. I know, that’s only one element in the rise of populism, but it’s a vital one, if you want to do something about the current, often justified, distrust in elites. Even if it’s also about respect and dignity, not just about (redistributing) money. If we fail to fix global tax justice, we’ll get instead fifty shades of populism, nationalism (including vaccine nationalism), autocracy, or worse. And pitchforks, plenty of pitchforks. This is one key driver of populism where “global health” can actually help, by being on the right side (i.e. Winnie Byanyima’s side 😊). For other aspects (migration, climate skepticism, anti-science …) triggering populism, that’s not really an option. And let’s face it, Bill, especially in Covid-times, all around the world, people want billionaires to contribute. As Simon Kuper put it in a FT (!) piece, “Taxing the rich may now be the most consensual proposition in politics”. Frankly, there’s really no reason for global health to lag behind.
Over to the South then, where – from a very different angle – you more or less come to a similar conclusion: the urgent need to fix the global tax system.
Focusing on LMICs, Christian Aid summed it up well in a new report, Building Back with Justice.
“… A growing burden of unsustainable debt before the pandemic has now become a major brake on public spending. The G20 debt standstill only postpones, rather than cancels, debt servicing in poorer countries. At the same time, steep falls in commodity prices and a halt to most international tourism have hit the revenues of many of the poorest countries. Capital outflows of $100bn from emerging markets in February and March added to the pressure. While the world’s richest countries need to step up to the plate, the biggest factor in the ability of countries to respond to the pandemic and forge a sustainable recovery is their ability to raise domestic revenues. The current crisis presents an opportunity to mend a global tax system that was already deeply dysfunctional and regressive. In some of the African countries worst affected by the global economic downturn triggered by the pandemic, revenues lost to tax abuses exceed public expenditures in key sectors. Taxation has increasingly fallen on lower income groups, as major corporations and the wealthy have taken advantage of ever more elaborate tax avoidance measures, or simply evaded tax. Plans to recover from the crisis should begin with a commitment to tackle tax abuse, and to ensure that tax and spending is progressive, with those people and businesses with the broadest shoulders paying the most into the system. With private wealth having grown spectacularly in recent decades, now is the time to introduce wealth taxes that can help to fund the recovery and narrow the gaps in polarised societies. International financial institutions and governments must work to close corporate tax loopholes, and ensure that bailout funding provided to businesses is made conditional on their tax record….”
That analysis holds firmly, even if you should surely also read Why African countries are reluctant to take up COVID-19 debt relief (in the Conversation).
So I hope that global health scholars who rightly lament vaccine nationalism also make it a habit to argue for global tax justice in the very same piece. It might not help avert vaccine nationalism in the short term, but I bet it’ll be good for global health and global solidarity in the longer term.
On a side note: I fully agree that in global health, you shouldn’t listen too much to political scientists – rumour has it that among global health ‘insiders’, people with political science background aren’t very popular (I’m guessing because, like most social scientists, we tend to be better at analysing than at actually getting stuff done 😊) – but sometimes it’s good to have a few on the team anyhow. For more on the global health “insiders-outsiders” divide, see Katri Bertram’s great recent blog.
Let me finish with a short comment on that other major emergency, the climate emergency.
Johan Rockström argued again, forcefully (in the FT), Why we need to declare a global climate emergency now. He’s damned right. However, for WHO to join that effort, I’d wait a few months (till Joe Biden takes over from the Donald – trust me, that will happen, sometimes you do need to have some faith in the wisdom of human beings (even Americans 😊)). I agree with Harmer et al’s proposition for WHO to declare climate breakdown a PHEIC, sooner rather than later, in fact the emergency probably deserves the term ‘super-PHEIC’. However, if you see how WHO currently is being attacked and blamed from all populist sides (especially the US administration side) in the Covid-19 pandemic, you can only imagine how Pompeo & other dickheads would react if dr. Tedros now declared the climate emergency a PHEIC. So no, let’s wait a few months, strategically. (PS: obviously, we hope the climate emergency then doesn’t “react” the same way as Covid-19 did, after WHO’s PHEIC declaration, i.e. “exploding” 😊.)
Meanwhile, do stay safe! As far as I can tell, the virus still hasn’t figured out how to spread via Zoom, so most of you should be fine 😊.
Enjoy your reading