The coronavirus pandemic is a turning point in history. The world economy is receiving one savage blow after another. Healthcare systems are totally overwhelmed in the advanced capitalist countries as a result of decades of attacks on living standards. The inefficient and ghastly nature of capitalism is in full display in the west, where people until recently enjoyed at least a semi-civilised existence. In Africa, Asia and Latin America the consequences of a full-scale outbreak will be catastrophic.
It is not difficult to predict the total catastrophic consequences of COVID-19 in Africa, where a majority of countries do not have functioning healthcare systems and where millions of people exist on the brink of starvation in crowded slums and refugee camps without proper housing, sanitation and water. Then there is the impending economic disaster which could be even more devastating than the virus itself, leading to mass starvation and hunger affecting tens of millions of people.
This state of affairs is a direct result of imperialism. The colonial subjugation of Africa and the wholesale looting and plundering of the resources of the entire continent for centuries by ‘civilised’ imperialist countries are the direct reasons for the structural underdevelopment of the continent. The impending catastrophe should be laid at the feet of the ruling classes in Paris, London, Brussels, Lisbon, New York, Beijing as well as their lackeys on the African continent and the capitalist system they uphold.
Although the Coronavirus outbreak has a foothold on a continent of 1.2 billion people, African countries are yet to see the worst of the effects of this outbreak. The reason countries in the West and China are reporting more significant numbers than African countries is primarily due to the availability of testing and real-time information. In the absence of mass screening, testing and contact tracing, the official numbers are pretty useless.
South Africa, which has the most advanced healthcare system on the continent, has conducted 60,000 tests in the first three weeks of the outbreak, more than 87,000 at present, and screened more than 438,000 people. The National Health Laboratory Service said that by the end of April, it will have the capacity to process approximately 36,000 tests a day. [Note: this does not mean that they will do 36,000 tests daily]. This is still low in comparison to the advanced capitalist countries, but it is far higher than other African countries. Over the same three-week period, Nigeria, with a population of 200 million, carried out less than 5,000 tests. Kenya also has conducted less than 5,000 tests. Zimbabwe and Namibia had about 300 tests each over the same period.
Many African countries simply don’t have the capacity for treating severely ill COVID-19 patients. Kenya, with a population of 50 million people, only has 130 intensive care beds and only about 200 intensive care nurses. Mali only has 37 intensive care beds. Somalia has 15. 17 governments, including Angola, Côte d’Ivoire, Mozambique and South Sudan have told the WHO they have no intensive care unit capacity to treat severe cases of the Coronavirus.The situation in many other countries is similar. Sierra Leone has 13 ventilators. The Central African Republic and Liberia has three ventilators each. These figures, in addition to the lack of proper housing and sanitation, make the strategy of “flattening the curve” in many African countries an absurdity.
Compounding the misery
The coronavirus pandemic will not introduce anything new to the African continent. Before coronavirus, some of the world's highest rates of infectious diseases resulting in death were found in Africa. Every year millions of people die from preventable health issues and diseases like HIV, tuberculosis, malaria, measles and cholera.
The highest rates are in the countries of Sub-Saharan Africa, where, according to the World Health Organisation, almost 62 percent of deaths are a result of communicable diseases and nutritional problems. By comparison, the global rate of deaths from these causes is around 23 percent. This means that, although Africa has a very youthful population compared to the rest of the world, the exposure to these diseases as well as problems with malnutrition, result in weakened immune systems and underlying health problems. It could lead to a situation where a disproportionate number of young Africans compared to the rest of the world could get sick or die from COVID-19.
In 2015, there were about 212 million reported cases of malaria in the world, resulting in about 429,000 deaths. 90 percent of those cases, and 92 percent of those deaths, were in Africa. In the United States, diarrhea causes no deaths. But in Africa diarrheal diseases are one of the leading causes of death. Another of the top killers in Africa are lower respiratory tract infections, notably pneumonia, influenza, bronchitis, and tuberculosis. These viral or bacterial infections of the lungs were the number two cause of death in Sub-Saharan Africa.
Millions of people in Africa die every year from these diseases. But these deaths are entirely preventable. Diarrheal diseases, for example, are caused by parasites that are found in unclean food or water. Malaria can be prevented with targeted insecticide spraying to kill mosquito larvae and with mosquito nets. Access to medicine to treat malaria symptoms can also save millions of lives. But access to life-saving medicine is blocked by profit-driven pharmaceuticals which simply do not see these poor people as a viable market. Additionally, the conditions that large parts of Africa are being kept under by imperialism mean that, for many people, simple things such as clean drinking water, food and proper sanitation are inaccessible. Consequently, diseases which have been eliminated in the West still kill millions of people each year in Africa.
It is in these conditions that the COVID-19 outbreak occurs in Africa. It will simply compound the misery of the people. The Democratic Republic of Congo, for instance, is currently suffering its 10th outbreak of Ebola. This by itself has devastated the country. The current outbreak is the second worst in history. The DRC is already ravaged by a simultaneous outbreak of Ebola and measles, with measles by far the most deadly. Now, with the outbreak of COVID-19, even moderate levels of coronavirus infection would overwhelm the near nonexistent health system. The human cost will be appalling.
One of the main reasons why the initial spread of the virus seems slow to develop in Africa is simply the sheer lack of volume of international travel compared to countries elsewhere. People move around much less. Even where community transmission begins, it may move more slowly initially because the traffic between cities, towns and villages is less frequent than in other parts of the world. Some countries like the Central African Republic for example, have no domestic airline or railway service, or even a domestic bus network. But while this may temporarily delay the initial spread of the virus, it will only have the effect of delaying the inevitable. The virus could devastate densely populated slums and crowded areas but could spread slowly between villages, towns and cities. This would mean that the pandemic could linger much longer in Africa, wreaking havoc long after the worst medical effects have been reduced in the rest of the world. It will become one more deadly disease ravaging the continent, killing millions of people year after year with the rest of the world hardly noticing.
The usual racist attitudes and cold calculations
The comments by two prominent French scientists during a televised debate suggesting that Africa is the ideal place for coronavirus vaccine trials because of the poor health infrastructure, caused outrage from across the continent.
Speaking during the debate, Jean-Paul Mira, head of the intensive care unit at the Cochin Hospital in Paris, suggested:
“If I can be provocative, shouldn't we be doing this study in Africa, where there are no masks, no treatments, no resuscitation?... A bit like it is done elsewhere for some studies on AIDS? In prostitutes, we try things because we know that they are highly exposed and that they do not protect themselves.”
Camille Locht, research director at France's national health institute, Inserm, agreed: “You are right. And by the way, we are thinking in parallel about a study in Africa using this same approach.”
The reaction from all over Africa was one of outrage and anger. “Africa is not a testing lab” and “Africans are not lab rats” were trending for two days on social media. The backlash forced the Director-General of the World Health Ordination, Tedros Ghebreyesus to condemn these racist statements.
Given the appalling history of western medical experimentation in Africa over the last century, the reaction from many Africans is hardly surprising. For decades African countries have been sites for clinical trials by large pharmaceutical companies with devastating outcomes.
Some examples include the following:
In the 1990s Pfizer used the drug Trovanin in a clinical trial against meningitis in Kano, Nigeria which resulted in the death of 11 children, and caused blindness, deafness and brain damage in an undisclosed number of children. An investigation later concluded that the drug had been administered illegally without authorisation from the Nigerian government or consent from the children's parents. The effect of this criminal behaviour by this multinational giant was an overall rise in other treatable diseases such as polio cases in Kano because people simply did not trust the health system and refused to be vaccinated.
In another case in 1994, the United States Centre For Disease Control and Prevention funded testing for the antiretroviral drug AZT on 17,000 HIV-positive women in Zimbabwe without explaining the possible dangers or effectiveness of the treatment. The result was that an estimated 1,000 babies contracted HIV/AIDS although a proven life-saving regimen already existed.
There were also the sterilisation experiments conducted by German doctor Eugen Fischer on Herero women in Namibia to prevent ‘mixed-race’ marriages. He later joined the Nazis and carried on with his experiments in Jewish concentration camps. There were many other such cases over the past 100 years on the African continent.
Then there was the comments made by David Malpass, head of the World Bank, who supported a suspension of all debt payments for the poorest countries on the condition that they should implement total free-market economic policies, such as removing regulations and subsidies. The irony is that countries in the West are turning more to state intervention methods to deal with the crises, while less-developed countries are given the marvels of the free-market system precisely when it has so spectacularly failed! But given the World Bank’s history in Africa this suggestion is not a surprise. This is one of the first imperialist institutions that should be booted out of the African continent.
Imperialist domination is the reason for the catastrophe in Africa
The fight against the coronavirus in Africa is a fight against imperialism. The ravages of centuries of imperialist domination has left the entire African continent vulnerable to even more suffering.
With the world economic crisis of 1974 and the later fall in commodity prices, many countries saw their economies shrink and their debts increase. The policies represented by figures such as Thatcher in the UK and Reagan in the USA, resulted in the International Monetary Fund and World Bank moving in and imposing their ‘Structural Adjustment Programmes’ on these countries. These economic policies, far from benefiting the mass of people, were just another way of further liberalising the markets for the interests of multinational corporations.
In the past four decades, the so-called structural adjustment programmes of these institutions have set very narrow limits for public spending in these countries, leaving little funds for such ‘luxuries’ as healthcare. In return for loans, these countries in dire straits have been forced to carry out extreme austerity measures and wholescale privatisation of whatever public welfare there was. Thes ‘conditionalities’, as they are called, have also placed these countries in a debt trap which they will never escape as long as capitalism remains.
The IMF and World Bank programmes often imposed conditions that specify ceilings on the public sector wages, which forced government cuts to wages and workers in the healthcare sector. But the reduced wages and lack of job security often drove health workers to move elsewhere, producing a ‘brain drain’. These measures had a negative effect on the healthcare workforce, altering the quality and quantity of healthcare staff. In 2007, the IMF changed their wage bill ceiling policy in recognition of its adverse effects and have argued this issue no longer stands. Nevertheless, wage bill ceilings remain a persistent feature of recent programmes.
The IMF also endorsed so-called state retrenchment in the provision of healthcare, which is another way of saying that the state was forced to abandon these and other service sectors and leave them in the hands of western-controlled entities. In many cases, healthcare services are often administered by Western NGOs and international ‘aid’ organisations with African governments hardly playing any role. But what is often described as ‘aid’ to Africa is in fact part-and-parcel of the cycle of dependency on imperialism. These Structural Adjustment Programmes have been implemented as part of aid conditionality in Africa and Latin America since the 1980s.
A clear example of the devastating consequences of these imperialist imposed programmes on Africa was the deadly cholera epidemic outbreak in Zimbabwe in August 2008.
The outbreak first appeared in the impoverished high-density township Chitungwiza, in Harare’s metropolitan area. It then quickly spread into semi-urban and rural areas in Zimbabwe before crossing the country’s borders into South Africa, Botswana, Zambia and Mozambique. Over the course of 10 months, the disease infected over 98,000 people, killing thousands. The high case-fatality rate at the peak of the epidemic made the 2008 cholera outbreak the largest and most extensive in recorded African history.
Cholera is one of the most feared infectious diseases in Africa. It is an acute bacterial infection of the intestine caused by the ingestion of food or water contaminated by certain strains of the organism vibrio cholerae. The disease is characterised by acute watery diarrhoea and vomiting. In the most severe cases, it can be fatal due to rapid dehydration or water loss. When left untreated, mortality from cholera can be as high as 50 percent.
The outbreak of the epidemic is a direct consequence of the IMF’s Structural Adjustment Programme, which was implemented by the Mugabe regime in the 1990s. The economic reforms of the 1990s led to a deterioration of urban living conditions. Because of unemployment due to mass retrenchments, Harare’s townships accommodated increasing numbers of people, within limited space, who had turned to informal trade to escape extreme poverty. Worsening public health standards, overcrowded housing and limited access to clean water and sanitation facilities became widespread in the townships. There was a collapse of water supply and with it a collapse of basic hygiene. Lacking the workforce and systems to deal with the pandemic, the healthcare system collapsed, enabling the disease to spread uncontrollably for 10 months. It was then followed by a second wave of infections lasting through June 2011.
The deaths and infections were entirely preventable. With effective replacement of fluids and electrolytes, through simple oral rehydration therapy, mortality can be reduced to less than one percent. But the privatisation and deregulation of the water and sanitation facilities caused unaffordable fees for water access, leading the poor to rely on degraded water sources. This led to the collapse of the water supply and together with the collapse in the health sector, facilitated by the IMFs imperialist imposed policies.
The fight against coronavirus is a fight against imperialism
The crushing domination of imperialism means increased exploitation of countries in Africa, Asia and Latin America, making things such as pandemics, war, climate catastrophics, locust outbreaks and famine inevitable. Astronomical amounts of wealth are transferred from these countries to the imperialist countries. The domination of imperialism is now even greater than in the past. The old direct military-bureaucratic rule by individual colonial masters has been replaced by the domination by a handful of imperialist states through the world market.
The only way out of this barbaric nightmare for the 1.2 billion people in Africa is to struggle against imperialism. But the struggle against imperialism is the same as the struggle against capitalism as a whole. In Africa and elsewhere in the ex-colonial world, we see the true face of the system. It must be overthrown in a socialist revolution. This task falls on the shoulders of the working class, in particular those of South Africa, Nigeria and Egypt. The special role of the workers in the collective production process means that the working class alone is capable of developing a socialist consciousness. The weak and degenerate bourgeoisie in Africa is too dependent on foreign capital and imperialism to carry society forward. It is tied head and foot, not only to foreign capital, but with the class of landowners, with which it forms a reactionary bloc that represents a bulwark against progress.
It is entirely possible for the proletariat to be victorious in an African country and, by starting with the bourgeois-democratic tasks of the revolution, immediately go over to the socialist tasks. But, in the end, the necessary condition for holding onto power is to extend the revolution to the advanced capitalist countries. The current crisis of capitalism is creating favourable conditions for the extension of the revolution throughout the whole world. Ultimately, the final victory against imperialism can only come about with the overthrow of capitalism in the imperialist countries.