by TARIQ ALI and ALLYSON POLLOCK
Tariq Ali: But the entire world capitalist system as it functions is basically not in favour of public health services, they are in favour of privatised solutions, privatised facilities which means that in most countries increasingly you have a two or three tier system; you have very good quality hostpitals for the rich and people who can afford them, you have a second tier for more middle class people who also have to pay but not so much and their facilities aren’t so good and then you have public hospitals, not just in Africa but in countries like India and Pakistan and Sri Lanka, which are a total complete disgrace and nothing is done about it on a global level at all because this is not a priority. I mean it is just outrageous. Do you think, I mean, given that this is how the health system functions from what you said, the obvious solution, medium-term and long-term, is to create a strong social infrastructure in these countries but that is what the International Monetary Fund asked them not to spend money on, the last four decades so what do you think they can do?
Allyson Pollock: Well I think you are raising important issues; what is the role of the IMF, the World Bank, the African Development Bank because again if we look at Liberia and Sierra Leone and Guinea, which actually have a lot of natural resources, what is happening to these countries, in terms of their economics is that increasingly the lands are being privatised and being occupied by foreign investors who are coming in and they are simply stripping out the resource and the assets. Liberia has a GDP, gross domestic product, of a couple of billion dollars, and a population of five or six million, so how are they meant to rebuild when actually you’ve got foreign directors coming in and public private partnerships and great flows of money going out and you don’t have any mechanism for redistribution because redistribution means you are trying to build a fairer society and you are trying to put the resources back in.
So it starts with the economy, it starts with what’s happening to the land, it starts with the fact that palm oil and cocoa and rubber are important cash crops and there’s land, and these ownership, has been transferred and I mean this is very well documented by important organisations like Global Witness but also the Oakland Foundation in the US, who have actually chartered what is happening to the land and remember, many of the farmers, for instance in Liberia, 70% of the population, live in rural areas. They will be subsistence farmers so this is an issue and when you have the population spending 80% of the money on food and then you have all these cordons around them, then of course you have got a real problem because the poverty is actually going to be accelerated in these countries because of the Ebola virus, because the borders are closing and because you don’t even have economic flow any more. So I think we need to start with the economics because that is the cause of the structural problems and then we’ve got the World Health Organisation, which is the international global authority on health. It has the law making powers but systematically over 20 years it has been completely starved of funds and such funding as it gets are tied to all sorts of conditions and those conditions are being set by large, global NGOs such as the Bill & Melinda Gates Foundation, which have no democratic base, no accountability and which in turn are doing untold harm through their vertical disease programmes because they are not rooted in public health and the public health systems. And a good example of a vertical disease programme is when you take Ebola and then you bring in your operation to tackle Ebola and you ignore all the other causes of disease, such as TB or malaria, or poverty, malnutrition and at the same time when you focus all the efforts of the industry on vaccine development.
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