What Africa can learn from Cuba in combating the Covid-19 pandemic – The Mail & Guardian

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It is close to four months since the first case of Covid-19 was reported in China, and today the world is facing one of the worst health, humanitarian and economic crises in modern history. The pandemic not only threatens to take hundreds of thousands of human lives, but also to drive the global economy into recession and render millions of people unemployed.

The crisis triggered by Covid-19 is voracious to the extent that highly industrialised countries which constitute the centre of the global economy, such as the United States of America (US), the United Kingdom (UK), France and Germany, are some of the worst affected, with health systems that are failing to cope.

A number of analysts have argued that Covid-19 represents the failure of the global capitalist system, which survives on greed and the plundering of resources and the ecosystem (see Shivji 2020; Editorial 2020). In essence, this may mean the collapse of the system. The Covid-19 outbreak is a long-anticipated signal that has called for a rethink of a broader economic trajectory and policy frameworks to liberate people in peripheries from a hierarchical globalised capitalist system that has plunged the people of the South into deteriorating living conditions.

For example, the African continent has borne the brunt of the globalised capitalist system, as shown by the below-substandard, life-threatening healthcare system. To date, there are countries in the South that have been able to contain and deal with the pandemic, and this article draws lessons, inspiration and courage from Cuba and Venezuela. In what follows, the paper discusses policy frameworks, the importance of solidarity and other crucial interventions that African countries can immediately implement in the short to medium term to contain Covid-19 and eliminate poverty.

Covid-19 and neoliberal capitalism

There is no doubt that the spread of Covid-19 is directly linked to neoliberal capitalism, a global economic system that has been dominant over the past four decades. The effect of neoliberal capitalism on the health system has been a retreat of the state in providing basic healthcare services in many African countries, and this has seen the privatisation of the healthcare sector.

Globally, this phenomenon has resulted in a catastrophe, particularly during Covid-19, where access to healthcare has been the preserve of the rich.

Many African countries have, since their transition from colonialism, been unable to fully develop their public health systems due to fiscal constraints imposed by World Bank and International Monetary Fund (IMF) prescriptions centred on limiting government expenditure in the public health sector.

Cuban doctor Liz Caballero and two medical students go door-to-door looking for possible cases of Covid-19 in Havana in March 2020. (Adalberto Roque/AFP via Getty Images)
Cuban doctor Liz Caballero and two medical students go door-to-door looking for possible cases of Covid-19 in Havana in March 2020. (Adalberto Roque/AFP via Getty Images)

The privatisation of the health sector now manifests itself in the inability to absorb the growing number of Covid-19 victims not only in the metropolis, but in peripheral countries as well. The failure to provide free or affordable tests, and the shortages of personal protective equipment (PPE) for health workers who are leading the fight against this pandemic are all indicators of a capitalist system that has failed to deliver in this neoliberal era.

Amidst crisis there is hope. Despite attempts by neoliberal apologists and the mainstream international media to project capitalism as the only solution to the crisis we are facing, Cuba has made advances in fighting this pandemic and there are specific features inherent in this country and others that we must closely analyse. These include development paths pursued by such countries that place emphasis on egalitarianism, complete repudiation of the capitalist path, strong investments in public healthcare systems, internationalism, solidarity and voluntarism.

It is important to state at this point that in spite of sanctions and other economic and political destabilisation tactics employed by the US and its key allies against Cuba for close on six decades, the number of Covid-19 fatalities it has recorded is among the lowest worldwide. Cuba’s Minister of Public Health, Dr Jose Angel Miranda, reported that by March 29 2020, a total of 139 cases and three deaths had been recorded. This is in contrast to the USA which, despite its wealth, had over 100 000 Covid-19 cases and more than 4 000 fatalities at the end of March with the fatality level surpassing 800 on some days.

This present Covid-19 lethality in the capitalist system calls for analysis as it defies the common narrative that a privatised healthcare system is efficient and accessible when services are required. Thus, the capitalist system’s touts — under the so-called banner of the invisible hand — that it can sort out any demand and supply challenges, defies logic. And so we discuss the health sector in Cuba.

Socialising the healthcare system

It is important at this stage to acknowledge the wisdom of Fidel Castro, the former leader of Cuba, who saw through the evils of privatisation and commodification of the public health sector. Unlike many countries in the North and the South that privatised their public health systems, Castro did the opposite by ensuring that support for this sector was increased and made available to all members of the society.

Although faced with an economic embargo, it must be emphatically stated that the country has been a shining star in the fight against Covid-19. Quite clearly, the successes are rooted in the universal healthcare system and tough measures put in place by former president Raul Castro. These measures include the declaration of a health emergency, home visits to all citizens suspected to be infected and offering free treatment. This is unlike many countries, where such services could only be accessed after payment of a certain fee.

Patnaik (2020a) notes that the current crisis has brought about: “The socialisation of healthcare and production of some essential services, which departs from the capitalist norm; and the more severe the crisis, the greater is the degree of socialisation.”

There is no doubt that the socialisation and nationalisation of healthcare services is something that was learnt from countries such as Cuba. This phenomenon has advanced with varying intensity in highly capitalist countries such as Spain, the UK and the USA. It is an approach which must be emulated by African countries in the fight against Covid-19.

When we talk of Africa, we must however, take into account its historical and present realities. Colonialism, neoliberalism and, in some cases, poor leadership have rendered African states almost incapable of resolving some of these emerging issues. The plausible way forward is to rethink development models best suited for the continent instead of adopting prescriptions from the Bretton Woods institutions that have stalled development on the continent. Key in this will be a reversal of privatisation and the adoption of universal healthcare.

The continent, alongside other developing regions, has experienced a brain drain in the health sector, and the time to put this to an end is now. The presence of healthcare workers is critical in minimising the damage in times of outbreaks such as Covid-19.

As Max Ajl (2020) notes: “Training excellent nurses and doctors can be done extremely cheaply, part of the reason Cuba has a world-class medical system. But if wrenched from a nation through the quiet inducement of market coercion or the louder process of social dislocation/primitive accumulation on a national scale, the commonwealth resource of medical training can become a resource to be pillaged.”

The loss of health personnel to the metropolis is not only a loss of human personnel but also of financial resources for peripheral states. This is so because underdeveloped countries pour resources into training health personnel for the benefit of developed countries; this is

an important indicator highlighting new forms of imperialism under global contemporary neoliberal capitalism. Although recognising that it is almost impossible to halt the brain drain given the unequal power relations on the world stage, it is equally important for developing countries to put in place mechanisms to slow this brain drain.

Another key lesson to be drawn from Cuba in the face of a massive skills haemorrhage, is the use of an important untapped resource in the form of medical students and volunteers who can be equipped to work under supervisors in times of outbreaks such as Covid-19. The story of Cuba’s containment of Covid-19 would be incomplete without mentioning the role of volunteers in spreading the message and door-to-door treatment of affected and infected people. This can only happen when there is a sense of patriotism which compels everyone to save people and the nation.

Venezuela has also shown that the issuing of food packs, which is a socialist approach, can, despite the battering of its economy, help during times of a disaster such as Covid-19. This is a recognition that during disaster-enforced lockdowns, most people are unable to work and fend for their families. A food distribution programme, if implemented alongside suspension of payment of rentals and protection of worker rights, can go a long way in protecting Africans during these difficult times. This is an important lesson to be drawn from Venezuela.

International solidarity

One of the major failures of neoliberal capitalism at this current juncture has been its resort to inward-looking strategies and the practice of “new nationalisms” (see Shivji 2020) and fascism (Patnaik 2020b; Yeros and Jha, 2020). By this we make reference to what we have seen of late in developed countries, with the exception of Portugal, where the state has turned against immigrants in offering health and other social services. This phenomenon has also been witnessed in some countries located in the South. Instead of sending medical supplies to rescue a continent that has been ravaged by imperialism for over a century, Western countries are sending aeroplanes to evacuate their nationals, as if Covid-19 originated from Africa. The metropolis has been found wanting when it comes to international solidarity.

Turning to Cuba, we learn a number of lessons. Despite having its own challenges whose origins are rooted in the international onslaught led by the US, Cuba is currently present in 13 countries, which include Andorra, Italy, Spain, China, Venezuela and Caribbean nations, to help fight Covid-19. Turning to Africa, there is clearly a need for close co-operation among African states at this stage and it is surprising that since the outbreak, there has been no notable collective action or statement coming from the leadership of the African Union on how it proposes to tackle the pandemic. The continent can build on the already existing sub-regional blocks to launch an offensive against the pandemic.

Conclusion

To end, emphasis must be placed on the need to abandon the neoliberal path in economic development and social service provision for the continent to be able to deal with Covid-19 and other health system challenges that are likely to emerge in future. Apart from denouncing the privatisation agenda of health and other social services, it is also important to socialise the health services and the production of essential services.

The need to utilise the untapped resource of medical students and volunteers while dealing with the brain drain in the health sector cannot be overemphasised. Lastly, as already highlighted, international solidarity is critical when dealing with global challenges such as Covid-19.

The African Union and sub-regional bodies must step up and be counted in critical times like these. Covid-19 is a real test for the African leadership and an opportune platform for charting a new pro-poor development path. — Freedom Mazwi

References related to the feature are available on request: contact [email protected]

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