Globalisation and infectious diseases

IAM again this week referring to an article which I wrote in November 2018 titled ‘Inequalities in globalisation and liberalisation: Ignoring the appeals of developing countries’. The trade and economic inequalities of globalisation between developed and developing countries and within countries were actually ignored by those supporting and benefiting from it.

We are now seeing that globalisation is not only about trade and economic issues but it extends to environmental, health, and other social and cultural issues as countries and peoples are more interdependent and mobile. Globalisation has facilitated the rapid spread of infectious diseases, which take advantage of inequalities and vulnerabilities. Like globalisation itself, the global spread of diseases is not new.

The point of reference is now the Spanish flu of 1918-1920 which, I have read, affected 500 million people worldwide with possibly 50 million deaths. There has been little to no mention that when the Europeans came to the new world in the 15th century in search of new trade routes and wealth, they brought with them numerous contagious diseases, smallpox, whooping cough, diphtheria, cholera, scarlet fever, influenza, the common cold, measles, and others, unknown to the indigenous peoples.

These diseases decimated the populations across the Americas and the Caribbean. They had no immunity and infected, they were debilitated and died in large numbers. The social impact was devastating, leading to extinction and depopulation, which had a greater effect than wars or enforced labour. It is said that the Taino population in the Caribbean, of possibly two million, were incapacitated and close to elimination 50 years after the arrival of Christopher Columbus due in part to epidemics.

Some of these diseases, such as smallpox, are hardly known today as modern medicine with vaccines, drugs, improved hygiene and precautionary measures have led to their eradication, mitigation and containment. This positive result has been due to multilateral cooperation, and the World Health Organization (WHO), established in 1948, has played a vital role. For many years, the WHO has warned that globalisation, while having benefits, has the ability to facilitate rapid transmission of new infectious and deadly diseases. It advised its member countries to be alert and prepared. Since 2003, we have seen SARS, MERS, swine flu, H1N1 and Ebola.

There has even been the re-emergence of some old diseases, for example, measles, due to suspicion of vaccines in developed countries. Here in the Caribbean, we remain concerned about mosquitoborne diseases, yellow fever, malaria, dengue and new ones resulting, possibly from climate change, such as chikungunya and Zika.

So, we have not overcome infectious diseases and we still have all the other non-communicable diseases for which the scientific and medical communities continue seeking effective treatments and cures. For these, we can help ourselves by changing our lifestyles, being more health-conscious, accessing screening tests, having better sanitation systems and hygiene. Regular provision of potable water and proper garbage disposal would make a significant contribution.

TRADE IS NOT UNILATERAL

No economy can have sustained success with an unhealthy population. Properly functioning national health sectors are critical and need to be funded. They also require support from international and regional public health organisations, WHO, the Pan American Health Organization and the Caribbean Public Health Agency, which require funding too.

As countries contemplate reopening economies from the COVID-19 lockdown, there are some looking to turn inwards, to move to protectionism, but the fact is, globalisation may undergo some changes post-COVID-19, but it will remain with us. The 1930s demonstrated that trade is not unilateral. It involves everybody, regardless of the size of the country. We need to be more self-sufficient in food supplies, but in the Caribbean, where we are dependent on trade for production inputs and on tourism, we cannot be entirely self-sufficient.

We all want to reopen and return to some semblance of normality but it must be done properly. There has to be cooperation. Now is not the time to be selfish and to reduce funding to the WHO. For the good of all economies, we must be sure that COVID19 is contained.

Joseph Stiglitz in his April 6 article‘ Inter nation ali sing the crisis’ wrote “… the COVID-19 pandemic is a global problem that demands a global solution. In the world’s advanced economies, compassion should be sufficient motivation to support a multilateral response. But global action is also a matter of self-interest. As long as the pandemic is still raging anywhere, it will pose a threat – both epidemiological and economic – everywhere.”

I fully agree. Nationally, we must be disciplined and do what is required to contain this virus though it is difficult, and internationally and regionally, collaboration is required to contain, find treatments and a vaccine, and to stabilise economies. It is not only about two countries and their interests.