Why capitalism is dangerous to your health

THERE ARE conflicting opinions emerging about how serious this outbreak of swine flu is, and how fast it could spread. How worried should we be? What does this tell us about the state of public health and the environment?

I THINK we should be very worried about absence of any capacity, even in this country, to deal with a pandemic or an epidemic of almost any kind.

Even 10 years ago, the Sydney influenza overwhelmed Los Angeles hospitals, largely because so many hospital beds has been lost to just-in-time inventory methods of private hospitals and private consolidations.

But the bigger question is that pandemic preparation has come down to hoarding antivirals and vaccine capacity in a handful of rich countries. Most of the world has no means whatsoever to respond to a pandemic. And the overwhelming consensus of scientists--and this has been true since the 1990s--is that new pandemics and emerging diseases are inevitable.

Whether this flu outbreak behaves like the 1918 influenza, and goes to sleep for part of the summer and then reemerges in a more virulent form in the fall; whether it continues to spread through the Southern Hemisphere this fall; or whether it just goes AWOL--there's no way to know.

But there's a lot of backslapping about how successful the response has been, and about the resources that have now been developed to fight them, and this is a total illusion.

There have been very important breakthroughs in terms of the development of vaccines. But none of them can be brought online in any reasonable amount of time, and none of them are really intended to be available as a world vaccine.

The whole strategy for pandemic preparedness is basically the same as the bank bailout--that is, to try to rectify the situation while leaving the basic structures intact.

When avian flu was almost imminent a few years ago, countries like India were demanding the generic manufacture of drugs like Tamiflu, the leading antiviral. But rich countries, including the U.S. and Great Britain, successfully lobbied inside the World Health Organization to protect the copyrights and patents held by Roche and the monopoly on private drug production.

In exchange, Roche gave the World Health Organization a stockpile of Tamiflu. But the Tamiflu was to be used in an entirely dubious--and now totally discredited--scenario that if you could quickly identify the pandemic at outbreak, you could douse the surrounding population and stop the outbreak from becoming a conflagration.

This certainly seemed to some people to be an idea worth trying. But what wasn't recognized is that this wasn't a stopgap measure on the way to developing vaccines for everybody in the world--it was a substitute for it.

And in fact, very little of any kind of significant technology transfer has gone to poor countries--or for that matter to poor areas in rich countries. A couple years ago, the Rand Corporation did a report on pandemic preparedness in California, and they discovered huge inequalities between poor areas and rich areas.

There are so many levels of illusion here. But there's a lot that's comparable to the federal government's approach to the bank bailout--in the sense that private property rights remain paramount, and there's no real discussion of addressing the deficit in basic health care.

For instance, one of the most effective ways to fight influenza or any other respiratory disease is a newly developed vaccine that provides immunity to not all, but many of the strains of bacterial pneumonia. This was a tremendous breakthrough.

But it's been developed at a very, very high cost--around $80 or $90 per vaccination, I think, which puts it out of reach of anybody without a health plan, of many public health services, and, of course, of most of the people outside a handful of wealthier countries.

So you have a combination of industrialized agriculture, private control of lifeline medicines, Big Pharma's failure to invest in research and development of these medicines, and government policies that approach pandemic preparedness with the priority, first of all, on proprietary rights.

And these policies also triage medicines and vaccines on the basis of a set of priorities about who should get them. One of the accomplishments of Donald Rumsfeld, for instance, was to ensure that the Pentagon gets first dibs on antivirals and a potential vaccine. Children come last.

I think that if people knew more about the actual availability of medicines and vaccines, and the priorities in their distribution, it would be clear that even if swine flu were to suddenly disappear or prove not to be so dangerous, the structural dangers are still there. And those dangers almost assure mega-death epidemics or pandemics at some point.

WHEN THE threat of avian flu was finally admitted by the government several years ago, one initiative of the Bush administration was to use this as an opportunity to expand the scope of the domestic powers of the U.S. military. Are there any echoes of that here, for example in the response of the Mexican government?

TO BE honest, while there are lots of people in Mexico who do see this as a pretext for further militarization, personally I'm not sure that's true.

One reason is that the militarization has already occurred in the guise of the narco war. But secondly, I think you have to see this not as the usurpation of liberty, but the the government acting in a situation in which has few recourses--because it doesn't possess vaccines, drugs, hospital beds or adequate facilities.

We'll see if the level of restrictions is lifted after Cinco de Mayo. Under previous regimes, the first thought that would jump to mind is the ulterior motive.

I know there's a lot of rumors about this, but I'm not sure that this is a case the left can make in the same way that we can make the connection between agribusiness and the flu outbreak, or all the things having to do with absence of means to fight a pandemic.

YOU'VE TALKED about the role of global agribusiness in this outbreak. Is that one of the reasons why scientists have had a hard time identifying the origin of this variant of swine flu?

AT FIRST, it was hard to understand the identity of this strain because initial statements from the Centers for Disease Control indicated this was a triple reassortment of swine, avian, and human strains of influenza--giving everybody the impression that three strains of influenza had contributed genes to this new hybrid.

The World Health Organization has said this is actually a reassortment of two different strains of swine flu, one American and one Eurasian. And it turns out that the World Health Organization is more nearly right. The avian and human components of this strain actually appeared back in 1998, when you had the outbreak of a new strain of swine flu in Midwestern American hogs. It was that strain--the already mutated strain--that somehow in the recent past combined with Eurasian swine flu to create a new hybrid.

So the question, then, is how the Western and Eastern Hemisphere swine flus came to interchange. There are all kinds of possible answers to that, because there's a big cross-border trade in hogs, both in boors and sows, and America, in particular, exports pigs to Asia, and they come in contact with European pigs. Nobody knows the exact process.

The danger that industrial livestock poses is, first and above all, the creation of these unprecedented conurbations of animals on factory farms, but secondly, the greatly increased traffic of animals across the world, which can spread genes and infections from one place to another.

So I think the general evolution of this influenza almost certainly lies in the networks of industrialized livestock.

There have been doubts cast on the association between the first outbreaks in Mexico and a huge Smithfield plant in Veracruz. But all we have so far is Smithfield's word that there are no infections at this plant, and the inspections conducted by the Mexican government were, last I heard, visual inspections. It's likely that in hogs themselves, the swine flu infection is benign. There's nothing you can tell just by looking at the hogs.

So I don't think anything has diminished the circumstantial evidence of the tie between the outbreak and this Smithfield facility.

It's also possible that there are other explanations--like people returning to Mexico who worked on hog ranches in the U.S. But I think the odds are that this outbreak couldn't have happened on this scale outside of industrialized livestock.

As your readers know, Smithfield used every dirty trick in the book to resist organization by the United Food and Commercial Workers union for 16 years.

Its hog production facilities in North Carolina have had regular spills of toxic sewage into the estuaries. I believe their complex has been implicated, at least partly, in a nightmare outbreak of pfiesteria in Chesapeake Bay--this protozoan that's killed a billion fish and sickened dozens of fisherman.

The accounts of what happens in these complexes are horrifying. I've seen the one in Milford, Utah, and it's pretty astonishing to see 50,000 acres of hog farms and 120 different sewage lagoons. As people have pointed out, the biggest of these complexes produce as much or more sewage as a big city.

Just on the face of it, this seems to violate all common sense about public health and sanitation. But on top of that is the fact that in this country, livestock inspection is largely handed off to the states--to agencies that so often are controlled by the businesses they regulate. So much depends on self-inspection by the corporations.

It's been said that Smithfield built this site in Mexico to escape regulation in the U.S. I don't know if that's true or not, but regulation in Mexico at the production end is almost non-existent.

So at the end of the day, everybody's left having to go by the word of the corporation itself, or by very scant, totally insufficient inspections--usually by state agricultural agents.

In my book on avian flu, I talked about the case that originated here in San Diego County--of chickens that had a new flu. But it seemed to be low pathogenic--that is, it that wasn't killing chickens, so it didn't fall under federal inspection. Under state inspection, these chickens were transferred to the Central Valley, where the low pathogenic infection became a high pathogenic infection--very, very dangerous.

There was an area that was called the "Triangle of Doom," where tens of thousands of chickens were slaughtered, and there was virtually no reporting of it. I spoke to a veterinarian scientist who was the one who had analyzed the outbreak, and she was fearful and intimidated. It was like the famous case of Kerr McGee and its facility--I felt like I was talking to Karen Silkwood. Because these people have the power to destroy your careers.

In the Pew report on industrialized livestock that came out last year, from a commission of distinguished scientists headed by the former governor of Kansas, in the preface of their report, they talk about intimidation--about how cooperative researchers were threatened with the loss of research grants if they would testify or work with the commission.

So this is a familiar story. We see an immensely powerful industry--in many ways, an outlaw industry--that controls its own regulators and is capable of exporting all of its environmental costs onto nearby communities.

A LOT of times, the question of disease and pandemics and disasters are approached as something natural and unavoidable. But you've described a number of social factors that go to the way the system of capitalism is organized.

THERE ARE a number of factors. There's the concealment of social and environmental costs, not only by the corporations, but the public agencies that are supposed to regulate the corporations, but which they, in fact, control.

There's the control of the pharmaceutical industry over lifeline medicines, which they've chosen not to spend any money investing in or developing unless they receive huge government subsidies.

There's the pretense of a world health system that, in fact, enshrines the inequality between countries.

There's a pandemic preparedness plan mainly involves the hoarding of antivirals and vaccine production ability in a handful of rich countries, rather than the assertion of a global human right to these medicines.

And there's a media industry that isn't reluctant to emphasize the horrors and dangers, but rarely reports on the structural problems with public health.

Obama is probably the best you could expect in the White House on this issue--at least in the Senate, he made the question of pandemics one of his issues. But he shows no more sign than anyone else of wanting to raise questions about private ownership, development of medicines, reconstruction of public health.

And above all, the transfer of resources to Third World countries that are actually on the front lines. The World Health Organization itself has calculated that 95 percent of the people who could be killed in a serious flue pandemic would die in developing countries, and they're basically off the radar screen.

Transcription by Andrea Hektor.