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Covid-19: India and Pakistan show need for global plan

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As the second wave proves deadly on a large scale for India, the situation seems to be worsening, albeit on a smaller scale, in Pakistan. Both states have been doing their best to prevent a national lockdown against the advice of health experts. As a result, thousands more people are being infected daily and what is happening here is repeated in semi-colonial countries around the world.

Reported numbers show over 25 million cases in India, with more than 280,000 dead. Experts say the real toll is several times higher. Even with reported numbers, India has the second-highest number of cases in the world after the US. There have been reports of metal structures of furnaces at some crematoria in Gujarat melting or breaking. Why? They are being used round-the-clock due to the rush of bodies amid the pandemic.

Many people are struggling even to find the means to cremate their loved ones. Hundreds of corpses have been found floating in the Ganges or buried in the sand of its banks. This is particularly worrying. Even though some Hindu communities float the bodies of children, unwed girls, or those who die from infectious diseases in the river, there is a rising number of poor Hindus who cannot afford cremation in the face of the rapidly rising number of deaths. Therefore, they wrap the body in white muslin and send it away into the Ganges waters. This can potentially poison the river.

Shortages of oxygen and hospital beds are common. Those from the propertied classes can afford to pay extra to get their hands on scarce oxygen cylinders and drugs. However, an always inadequate health system means that there are only so many hospitals. One can have as much money as one wants but what good is that if there are no facilities? Meanwhile, the vast majority of the working and lower classes are left to just sit and watch their loved ones die. Of course, the gravity of the situation was and is downplayed by the government.

So far, only about 26 million people in India have been fully vaccinated, in a population of 1.4 billion, while about 124 million have received a single dose. India has orders placed for millions more doses, but the country is still far short of what it needs. It has the world’s largest vaccine manufacturer, the Serum Institute of India, yet only 10 percent of its adult population has had the first dose and just 2 percent are fully vaccinated. After donating or selling more than 66 million doses as exports, it was only in March this year that corporate greed was temporarily contained with a halt on export of vaccines. Yet the Serum Institute was among the 418 Indian companies in 2019-2020 that reported revenue exceeding INR5,000 crores (55 billion Euro). It was also the company that earned the maximum net profit for every rupee of revenue.

The situation in Pakistan, too, is worrying. The official death tally stands at 19,617, while total cases number 880,362. Active cases were 16,000 in the first week of March and they rose to more than 140,000 in April alone, as well as over 3,000 deaths. According to BBC, official data reveal that bed occupancy in the intensive care units (ICUs) of Lahore’s major public and private hospitals was already more than 93 percent on 28 April, while some of the major cities in the largest and worst-hit province, Punjab, are seeing over 80 percent utilisation of ventilators and beds with oxygen. Should the number of infections rise, the shortage of beds will not be the only problem; the country is already using 90 percent of its oxygen supply, with more than 80 percent already going towards healthcare needs.

Meanwhile, the upper and middle classes have started to use their contacts to access not just private hospitals but also government health facilities when the former are at full capacity. In this manner, the working class and poor are further excluded from receiving treatment. Furthermore, there are reports that the government is deliberately conducting fewer tests, with people refused tests despite clear symptoms, in order to play down the severity of the situation. This means that the impoverished masses will continue to die of the virus, but the cause of their deaths will not be officially recognised.

According to the Special Assistant to the Prime Minister for Health, Pakistan has given just over two million doses since February 2. That amounts to just 0.95 doses per hundred people. This is obviously insufficient. India, which began its vaccination programme in January, has given out more than 144 million doses, which is roughly 10.5 doses per hundred people.

Pakistan, with a population of over 220 million, has so far secured just 18 million doses, of which it has received only just over five million. According to data compiled by the Duke Global Health Innovation Centre, the country requires at least 86 million doses. The Economist Intelligence Unit says in its report that Pakistan will only achieve widespread vaccination, that is, 60-70 percent of its adult population, by early 2023.

The situation in semi-colonial countries like India and Pakistan poses a danger not just for the two countries but the entire world. The likelihood of new variants emerging in a country increases with rising number of Covid cases, every single infection gives the virus a chance to evolve. One major concern is that mutations could arise that render vaccines ineffective. In this scenario, lockdown of non-essential industry, social distancing and vaccination are the only way forward.

While countries like India and Pakistan have no chance to ensure effective vaccination of their vast populations on their own, their governments are not interested in a lockdown of non-essential industry either. The Indian Medical Association earlier this month said a “complete, well-planned, pre-announced national lockdown” for 10 to 15 days would give the country's overstretched health system time to “recoup and replenish both the material and manpower” it needs.

Similarly, health experts in Pakistan have also stressed the importance of a lockdown. Both governments insist that a national lockdown would be a last option. Imran Khan would like to wait for our circumstances to become “the same as India”. With more than 280,000 Indians dead, one wonders when the time would be right for the Bharatiya Janata Party-led government to implement the so-called last option.

Both prime ministers cynically use the suffering of the common labouring masses as an excuse to prevent lockdowns. It is certainly true that the working class, particularly its most vulnerable layers, suffers heavily with no means to provide food or to pay for rent and other expenses. But both states completely fail to take any responsibility when it comes to providing for the needs of the masses in such trying times. They have all the means to give relief packages to the capitalist class, but they have nothing for the common masses.

The reason for the resistance to lockdown of non-essential industry is simply the safeguarding of the interests of capital. While events like Kumbh Mela have certainly contributed to the huge surge in the number of cases, every single day workers are forced into cramped sweatshops to reap profit for the capitalist class. We hardly find any journalists talking about this daily super-spreader.

A huge crackdown on democratic freedoms is underway in India and Pakistan in the name of Covid-related measures. Both states have empowered their military forces even further to enforce restrictions. This is not done out of an actual concern for people’s lives, it is done so that, should an uprising break out due to the governments’ criminal negligence, it may be nipped in the bud. Already, the BJP-led government has seen two general strikes in the previous year against its neoliberal, anti-worker and anti-farmer policies.

Meanwhile, jingoistic rhetoric against Pakistan has seen no decline on the part of the BJP. The Pakistani premier offered help to India on April 25 in view of the Covid-related crisis. Edhi, a well-known charity in Pakistan, also volunteered to send medical aid amid rising Covid-19 cases in the country. Modi’s Hindu nationalist BJP government rejected such help on the grounds that it will not seek any help from its “enemy nation”.

Most likely, the Pakistan government was expecting such a response, which is why it made the offer. Realistically, Pakistan does not have the means to take care of its own population’s healthcare needs, let alone aid a population as vast as India. Yet such an exchange is useful for the Indian and Pakistani ruling classes as it helps keep alive the nationalist hatred and chauvinism on both sides.

Finally, the example of Kerala has illustrated what could be done, even under capitalism, to mitigate the impact of the pandemic. There, the reformist government of the Left Democratic Front, a coalition dominated by the Communist Party of India - Marxist, CPIM, has established a community-based health service and used governmental powers to support the response to the pandemic. As a result, while most of India struggled, there was no shortage of oxygen in the state because measures were taken in October last year.

They also procured sufficient stocks of remdesivir and tocilizumab and other drugs well in advance. While these cannot prevent infection, they dramatically reduce the mortality rate from the virus. As the pandemic advanced, these drugs were later being sold for exorbitant prices on the black market in the capital and other cities. Last week, Kerala returned 100,000 unused vials of remdesivir to the Centre for redistribution among other states in need.

While Kerala is no communist state, its strategy has had a significant impact in containing the spread of the virus. It is not only a sharp contrast to the policies of the central government but a pointer to what is required to deal with such a huge crisis. All of society's resources need to be mobilised, irrespective of patents, profits or property rights. We need a government that genuinely represents the interests of the masses, is directly accountable to them and can plan the efficient allocation of resources.

While we need planning on the state and provincial level, we also need centralised planning not just for individual countries but also between them. The plight of the masses in the semi-colonial world when it comes to vaccines, combined with the hoarding and over-supply of vaccines in the imperialist countries, underlines the need for democratic planning on a global scale.

Some demands that we should advance in this scenario are:
- Imperialist countries must be forced by workers’ movements to take responsibility for paying for mass vaccination and treatment in semi-colonial countries like India and Pakistan! Britain and Australia have both secured three times more vaccines than their entire populations needed. Vaccine hoarding must stop immediately.
- Cancel all debts of the semi-colonial countries! The governments of Pakistan and India must refuse to pay back debts to all imperialist countries, local and international companies and banks, and international financial institutions. The debt servicing funds set aside in budgets must be used for immediate and free supply of vaccines, drugs, oxygen and beds as well as protective gear for health workers.
- Workers’ organisations and movements in imperialist countries must organise protests around the issue of cancellation of debts and politicise it! Indebtedness is something nearly all semi-colonies are faced with, so we need to build transnational movements to cancel the debts. International solidarity is the way forward.
- Big hotels, private schools and luxury sites must be turned into free and public quarantine facilities! Institutions that refuse to comply must be nationalised under workers’ control.
- Lockdown all non-essential industry! All businesses must send workers home with full pay. Businesses that refuse to comply must be nationalised under workers’ control.
- Provide free protective gear, frequent testing and rotational schedules for all essential workers!
- Open the books of all businesses to see their actual standing! Progressive taxation must be implemented on the rich to provide for saving lives of the common masses through provision of not just free healthcare but also free food.
- Free supply of electricity, gas and water to all!
- Refusal to pay rent until the pandemic is over! We must build tenants’ unions, which, combined with the refusal to pay rent, should lead to the need for nationalisation of the housing sector. We demand of the state to introduce legislation that criminalises eviction of people who cannot pay their rents during the pandemic.
- All educational institutions be immediately closed! Teaching staff be equipped with proper training to impart online classes free of charge! All students and teachers be provided with free internet and free devices for online learning through public funding!
- Increase health and education budgets to 10 percent of GDP each by cutting the military budget!
- Right to assemble for protests and demos! The class must protect itself by following safety measures. We can only fight for our future if we live, therefore social distancing, masks and washing hands are necessary measures.
- The state must provide minimum food rations (or money for it) to those who need it!
- Public control and transparency over all Covid-related charities and donation drives!
- Patent rights must be abolished now!
- Expropriate big pharma companies such as the Serum Institute of India without compensation. They can no more be allowed to profit from the misery of humanity. Share the technology and the expertise for vaccine production to maximise production around the world. Big pharma industry must be forcibly nationalised under workers’ control.