Epidemiologists have long warned that HIV/AIDS might be only the first of a new generation of hellish plagues. Now the World Health Organisation (WHO), as well as Nature and Science magazines, are sounding the alarm about an imminent double peril that might surpass even HIV in lethality.
Avian flu, of course, is a pandemic waiting to happen—a viral asteroid on a deadly collision course with humanity. But the world public health community is equally worried about the rapid evolution of antibiotic-resistant strains of tuberculosis and other classical bacterial killers.
In both cases microbiology is less important than political economy.
In the Third World a quarter of a century of debt-induced recession and “structural adjustment” has left a billion slum dwellers at the mercy of the microscopic captains of death.
But the threat is also acute in the rich countries where pharmaceutical companies—so brilliant at producing new cures for “erectile dysfunction” and other minor maladies—have almost abandoned the “unprofitable” production of new vaccines and antibiotics.
Market-driven medicine, in other words, now stands in direct contradiction to the health, even survival, of hundreds of millions of our fellow humans.
The sacrifice of millions of African AIDS victims to a marketplace that prices their poverty outside the reach of lifesaving anti-retrovirals may soon be repeated with avian flu and other emergent diseases.
Last week the WHO’s influenza Tsar, Klaus Stohr, told journalists that “we are closer to the next pandemic than we ever were”. He also warned that the world is utterly unprepared to deal with a virus that could burn like biological wildfire through the poor continents.
Oseltamivir phosphate, the sole anti-viral believed to be effective against avian flu, is manufactured by a single plant in Switzerland and could not be produced in quantities to meet the pandemic demands of a single country, much less the world.
Only the US, moreover, has started production of a very limited quantity of avian flu vaccine. And, as Stohr points out, Washington is proceeding “with its own interests in mind, not to supply the world”.
Europe—so zealous in protecting its borders against poor refugees—has signally failed to coordinate a pandemic emergency plan or to initiate large-scale production of a vaccine. “The EC has not the flexibility or the political will,” complains Stohr. The Third World, as usual, is the orphan.
Although the WHO is convening an unprecedented emergency summit on avian flu in Geneva on 11 November, it is unclear what help poor countries can expect. In the event of a pandemic, the rich countries would inevitably hoard their scarce supplies of anti-virals and vaccines.
As with the HIV holocaust, Africa—the poorest continent—would be the most defenceless. “The situation [there] will be much, much worse than anywhere else,” Stohr told Nature in October. “Access to vaccines will not be an option, let alone anti-virals.”
Even if an avian flu pandemic is a near-miss, the drug companies themselves have already opened the Pandora’s box of antibiotic resistance. The massive, unethical marketing of antibiotics to the beef, poultry and pork industries has accelerated the evolution of resistant strains of bacteria.
Meanwhile, as Nature recently pointed out (21 October), “Drug companies have all but stopped developing new antibiotics. From a marketing standpoint, antibiotics are the worst sort of pharmaceutical because they cure the disease.
“Until ten years ago all major drug companies ran anti-bacterial research programmes. Today these programmes have been drastically pruned, and many have been cut altogether as companies pursue more lucrative areas, such as chronic illnesses and mood disorders.”
As a result, Nature concludes, “Industry’s retreat from developing new antibiotics is leading to a loss of expertise in both practical and theoretical aspects of antibiotic biology.”
The drug multinationals, in other words, have abdicated the essential research and development required to protect humanity from the new plagues. Could there be a more compelling case for social ownership?
Meanwhile, drug-resistant infections ravage hospitals worldwide and tuberculosis kills three million people each year. The logic of profit is literally murdering us.
In a world at peril, socialists need to be intransigent tribunes of the poor—fighting for universal, free access to lifeline vaccines, anti-virals and antibiotics.
As the WHO so urgently reminds us, there is not much time.
Mike Davis is professor of history at the University of California, Irvine. His latest book is Dead Cities.