Not strong enough, not loud enough

“If we fail as civil society on Covid-19 it will take us many decades to recover.” South African human rights activist Mark Heywood on the global health crisis and the need of activism from the ground.

Sometimes an event only becomes an anniversary in the course of history. January 30, 2020, is one of those. Hardly noticed by the European public, Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO), declared an international health emergency exactly one year ago because of the spread of Covid-19. This was a bold move, as the WHO had repeatedly been accused of scaremongering. A year ago, 8,100 people had been infected with the coronavirus. In the meantime, the number has risen to 101,605,084.

medico:After a long period of hope that African countries would be spared from the Covid-19 pandemic, news are now reaching us of rising infection rates and overburdened hospitals mainly in South Africa. Could you describe the current situation?

Mark Heywood: Well correct. In the so called first wave most of Africa was relatively mildly affected by Covid-19. People had expected, that because of our weak health systems, because of tuberculosis, because of HIV, because of the other epidemics, that once Covid-19 reaches Africa we would be hit really hard. But and we still don’t understand completely why, we weren’t during the first wave. Many African countries are now in the middle of the second wave and it proved to be very much worse than the first wave. In South Africa we have reached officially about 40 000 deaths. The death rate compared to what is normal is now 110 00 people higher since the epidemic began. Which means that South Africa is, I think, as bad as the UK. When it comes to mortality its comparable with the United States or Brazil. So we really are in a desperate Situation. Our health care workers are exhausted. We are losing many health care workers including many that have years and decades of experience in the health care system. So when eventually this pandemic is over the toll will be enormous.

Is South Africa the only country in the region to be so badly affected?

It’s not just South Africa. The second wave in southern Africa, for example in Zimbabwe has been much worse than the first one. Just like in many other African countries. One of the problems that we have is that the health systems are very poor. And I think it has not been enough of an international focus on what is happening in Africa. The problem is that because it is a virus that is affecting developed countries and rich people, they are looking at themselves and ignoring what is happening in the poorest parts of the world, like Africa. From our side as Africans we need to do more to force the world to look at the crisis in our countries and to recognize the need for international solidarity that we need to confront this crisis.

In Germany, the debate about the speed of vaccination deliveries is raging right now. The initial nationalistic focus is giving way to a Eurocentric one. The global perspective is largely ignored. There is no global strategy identifiable…

The thing is that we are in the middle of a very intense pandemic wherever you are in the world right now. And of course, many governments are having to respond to the rates of infections and deaths and the immediate challenges of the health systems. But you know I expect more from governments. Governments have the resources, they have the expertise, the have excess the most important and up to date information that is generated by scientists. I expect that governments should be fighting the immediate effects of the crisis but should also be looking at the underlying structural and the socioeconomic questions – they are doing terrible on this. This is obvious when we are looking at the United States at the moment, with the relief packet and the so called stimulant packet. But even worse in a country like South Africa there is no stimulants on that at all and there is no pressure for it as well. In our country the number of unemployed people has grown by millions! The number of hungry people has grown by millions. You have to remember that in the most development countries there is no social state. For people here there is next to nothing in terms of social security. Really this is the time of rational but radical change in the world. Capitalism and the system of health for profit, which has broken our health care systems and broken our social systems can not resolve this crisis. It is now time for the governments of this world to recognize that something different has to be done. This is to me a situation very akin to the situation at the end of the Second World War when governments where prepared to really think differently. They were prepared to drastically increase taxation on the rich in order to increase the resources available to the state. They we prepared to invest in public services and infrastructure, including things like the national health care systems. And this is the type of response that we should be demanding right now. And if we don’t demand that there is the danger that once enough people are vaccinated for Covid-19 we will have to live with the new inequalities created by Covid-19 instead of using this moment for overthrowing these inequalities.

Docked on the WHO, the Covax Facilitiy was launched, a public-private partnership aiming to secure the supply of vaccine doses in poorer countries. Can this be a solution for South Africa?

No, I don’t think so. Until now there has not been a single person vaccinated in South Africa. Same in most of the other African countries. So the global inequalities that we have seen in global health care systems in relation with every other disease are now manifesting again with Covid-19. Even though Covax is an important innovation it’s not enough. What we need is vaccine development and vaccine supplies to be treated as a human right and as a public good. And what we all should be looking at now, is if the global leadership and if the WHO is strong enough – right now unfortunately it’s not strong enough – to mobilize all global capacities for vaccine productions and to not have any intellectual property to get in the way of that. Because what we have also seen is that the development of vaccines was not financed by private money but by public money. And now the supply is being strangled by the fact that the supply is linked to private property. So I would say Covax is not a complete waste of time but it’s simply not enough for the crisis that we are facing.

Unlike Germany, South Africa has a strong civil society commitment, the C-19 People’s Coalition. Can you tell us something about that and their call for an Action Plan?

So right at the beginning of the pandemic we decided that we need to create a civil society united plan on Covid-19. We developed a consentient statement on which civil society could agree and over the month ahead over 400 organizations have become part of what we call now the C-19 people’s coalition. It is a very broad alliance and its working on a wide range of issues and is organized in different working groups. There is a working group on health systems, there is a working group on education, there is a working group on social security. And it also mobilizes in communities and of course acts to create pressure on governance and on the private sector to some extent. At the end of last year when the C-19 People’s Coalition saw that we were going to be discriminated as a country in access to vaccines and when we saw that our government had failed to negotiate vaccine access at the right time and that it was going to be month until South Africa would get the first load of vaccines the C-19 Peoples Coalition called for a People’s vaccine alliance to develop a vaccine plan. And this is where we are right now. We are developing a plan to show the government what a good plan on vaccine rollout would look like, because you cannot separate providing vaccinations for people from dealing with the vulnerability of the people and from dealing with the levels of infections and death. This is a very important development.

Can this be a model for the international movement?

What we haven’t done so far during this pandemic is building up strong international alliances across borders. Here and there people are communicating with each other but there is no internationally coordinated strategy of civil society and social justice organizations. And if there is something like that it’s not strong enough and not visible enough. I can say if there is international organizations working on that we are not feeling you on the ground. And we need to be feeling you on the ground. The other thing is that civil society need to shape the narrative. During the HIV crisis we made the governments and the United Nations talk to us. We had a plan. We were ahead in terms of what needed to be done next. I think at the moment civil society on an international level is not strong enough and not shaping that narrative. And I really think that that is the challenge. It has to be put to NGOs and social movements. It has to be put to all the many organizations that are working at the level of international NGO’s. So we have to come together and shape a common agenda.

If we fail as civil society on Covid-19 it will take us many decades to recover. Civil society has to get stronger fast if we want to make a difference at this moment. The C-19 Peoples Coalition is good and it’s important but it’s not enough. Its not strong enough. It's not loud enough. Its not radical enough. It’s not fighting enough. It’s not embedded enough in poor people’s lives and poor people’s communities. This is the time when activists need to take risks for human rights and public goods. We can’t sit behind our computers and think that you can change the world with a phone call. We have to be out on the streets. We have to do it in a way that is safe to ourselves and safe to others but that is what really is required. There’s great urgency to do all of that because there is not just the threat of the virus. It’s the threat of the politics that will follow if we fail to address the virus properly. The politics of populism, the politics of the strengthening of authoritarian regimes. Every democratic government has used this pandemic to step up attacks on civil society and in some terms of other countries to suppress human rights.

I hope our upcoming conference will be a little contribution to come together with people from all over the world to push a common strategy a step forward.

I hope it will not be a little but a big contribution. I keep talking about HIV. I remember when we had global days of action as civil society on HIV, against pharmaceutical companies. I remember when activists where protesting outside of pharmaceutical companies in London, in Germany and in many other countries because of patents. That’s what we have to do now. We need to be out there and we need to be winning the argument about the way the world has to look and what the values and the priorities of the world are!

The interview was conducted by Anne Jung.

Mark Heywoodis a South African human rights activist focusing on the right to health. He served as secretary general of the Treatment Action Campaign, which advocates for free and open access to AIDS medicines, and until 2019 chaired SECTION 27, a nongovernmental organization that uses public relations campaigns and legal tools to fight for the right to health and education. Since then, he has served as co-editor of the new civil society section in South Africa's most widely read online newspaper, the Daily Maverick, Maverick Citizen. He also conducts research on activism and strategies for asserting socioeconomic rights and aligning economic policy with the realization of those rights.

Published: 29. January 2021

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