Ebola is not merely a medical problem. It is foremost a social question, the product of a system that has all the technology and scientific know-how to reduce the suffering of the people in the world by epidemics to a minimum, but isn’t able to achieve this.
Mankind masters the explosive outbreaks of the most contagious epidemics
In its history mankind was regularly confronted with the outbreak of natural diseases, killing huge amounts of the world population. But the evolution of knowledge made mankind increasingly capable of finding the means to diminish their devastating effects and the number of people killed.
Probably the first massive and global pandemic was the so-called “Black Death”, peaking in Europe in the years 1346–1353. It was one of the most devastating epidemics, leading to the death of an estimated 30–60% of Europe's total population. By applying measures of quarantine mankind succeeded in preventing it spreading further. In the 19th century, in1826, a cholera epidemic broke out, hitting Europe and infecting tens of thousands of people in Britain. At first the idea was that it was caused by direct exposure to the products of filth and decay. But using simple research methods a small number of doctors showed that a lack of hygiene in the water supply spread the disease, something Friedrich Engels showed clearly:
“…..in spite of the excitement into which the cholera epidemic plunged the sanitary police (…) it is in almost the same state as in 1831! (….) Not only the cellars but the first floors of all the houses in this district are damp; a number of cellars, once filled up with earth, have now been emptied and are occupied once more. (….) In one cellar the water constantly wells up through a hole stopped with clay, the cellar lying below the river level, so that its occupant, a hand-loom weaver, had to bale out the water from his dwelling every morning and pour it into the street!” (The Condition of the Working Class in England)
In Hamburg, one of the fastest growing cities in Germany, cholera again raged for ten weeks, bringing all commerce and trade to a complete standstill. 8,600 people died.
In the year 1892 Friedrich Engels hoped that “The repeated visitations of cholera (…) and other epidemics have shown the British bourgeois the urgent necessity of sanitation in his towns and cities.” (Preface to The Condition of the Working Class in England, 1892). Science finally found that cholera was transmitted through contaminated water supply and by exposure to the faeces of an infected person.
In the course of the 19th century medicine achieved enormous break-throughs. The development of vaccines and, more importantly, the introduction of environmental sanitary measures, coupled with a better understanding of infectious disease (epidemiology), have been invaluable weapons in the fight for human health. “The most crying abuses described in this book have either disappeared or have been made less conspicuous...” (Idem)
In the first half of the 20th century, the development of science continued, still achieving a considerable progress. The discovery of antibiotics, the introduction of effective drugs vaccination against an increasing number of diseases, have meant that a number of diseases no longer cause anything like the same number of deaths as before WWII. Thus sixty years ago the bourgeoisie was convinced that the global war against infectious diseases in the world was on the road to victory.
A new outbreak of pandemics in the decadence of capitalism
However with the aggravation of the contradictions of the capitalist system, the onset of decadence of capitalism, the historical crisis of the bourgeois system, the conditions had ripened for the outburst of two world wars and a numerous number of local wars. This was to have a dramatic impact on public health. World War I in particular led to the outbreak of a new pandemic.
The war had lead to a complete devastation of large regions of Europe, the displacement of millions of people, the destruction of the means of production and habitation, the massive transport of army troops from and to all regions of the world …. In other words: the creation of a huge chaos and a major regression of sanitary conditions and hygiene.
A new strain of influenza – dubbed Spanish flu as a result of wartime censorship rules - became highly contagious in the fall of 1918 in France. Chinese labourers, shipped from northern China to France, working just behind the frontline in the most horrible circumstances, already on the brink of starvation, infected the soldiers in the trenches. The flu quickly spread to the US and parts of Asia. The influenza killed an estimated 50 million people worldwide, ranking as one of the deadliest epidemics in history. The bourgeoisie has always denied or played down any links between the conditions created by the war and the huge number of deaths from flu.
The aggravation of living conditions under decomposition
The progress in medical science and health systems which was achieved from the middle of the 19th century on was never extended towards and put into practice in all the countries of the world. In the so-called “developing countries”, access to such improvements remained blocked for the large majority of the workers and peasants. And this has never changed since. Increasing alarms about contagious diseases in these regions of the world are casting a shadow of doubt over the propaganda about the “bright future” and the “good health” of the present system.
For marxism, there is nothing surprising here. These diseases are expressions of the fact that the capitalist system is rotting on its feet, because of the existing stalemate between the two main classes in actual society: the bourgeoisie and the proletariat. As the proletariat is not able to affirm its perspective of revolution, the contradictions of capitalism in decay only aggravate more and more.
The phase of the decomposition, beginning at the end of the 1980’s, provokes a spirit of ‘every man for himself’, tears away at social cohesion and leads to an ever-increasing moral decay. Decomposition has been marked by the tendency towards complete chaos in all corners of the world. Capitalism in decomposition not only fails to counter diseases, but even tends to aggravate and even initiate them.
Against the background of this growing chaos and because of the corresponding worsening of hygienic conditions, at the beginning of this millennium:
approximately 3.3 billion in the “developing countries” had no access to clean drinking water;
nearly 2.5 billion people (more than one third of the world population) has no access to basic sanitary supply.
each year 250 million people get sick by contaminated water, in 5 to 10 million cases leading to death.
The advent of new infectious diseases and the re-emergence of old ones in different areas of the world, avowedly free of such diseases, have precipitated a new health crisis, which threatens to overwhelm all the gains made so far. Diseases that used to be geographically restricted, such as cholera, are now striking in regions once thought safe. While some diseases have been almost completely subdued, others such as malaria and tuberculosis, which have always been among the greatest “natural” enemies of mankind, are fighting back with renewed ferocity, causing millions of deaths every year.
It is the decomposition of society that is clearly responsible for healthcare getting out of control. SARS for instance, one of the last dangerous pandemics before the outbreak of Ebola. SARS “is thought to have jumped species in a poverty-stricken area of South East China where people live crowded together with their animals in conditions, reminiscent of the Middle Ages. This [situation] is at the origin of many of the most serious flu epidemics world wide. The ‘success’ of the world market in decadence lies not in preventing the emergence of the disease, but in providing the means for its spread across the globe.” (‘SARS: Symptom of a decaying society’, World Revolution, May 2003).
The conditions of decomposition in Africa
“It’s in Africa that capitalism’s descent into militarist barbarity is most clearly pronounced. In continuing conflicts, in the fragmentation of capitalist states, the wearing away of frontiers, the role of clans and warlords (……,) it’s possible to see fragmentation and chaos extending across a continent, giving us an idea of what the decomposition of capitalism could have in store for the whole of humanity. (‘The spread of war shows capitalism is at a dead-end, World Revolution, May 2013)
In the past decades, of the three countries worst hit by Ebola (Liberia, Sierra Leone, Guinea), two have been ravaged by civil wars and ethnic massacres. Between 1989 and 2003 Liberia’s infrastructure was devastated by two civil wars. Sierra Leone had been plagued by a civil war of 11 years. More than 100,000 people lost their lives and many more of them had suffered ‘special’ punishment in the form of barbaric mutilation.
Moreover extractive projects by foreign companies, ruthlessly exploiting oil and gas or one of the mineral sources for the new economies, has lead to a massive deforestation and the destruction of the local habitat and natural infrastructure. The breakdown of social cohesion severely affected the livelihoods of the rural population. Indigenous people were forced to quit their land and shift to urban shanty towns.
Among the three countries, Liberia is one of the least economically developed and most impoverished countries in the world. According to the World Food Programme (WFP), 1.3 million people in Liberia live in extreme poverty. In Sierra Leone 70% of the population live in extreme poverty. Half the population of the three countries live in the greatest misery, lacking the most basic hygiene such as access to clean drinking water.
Continuous deforestation has also led to a radical change of the climate conditions in the countries of western and central Africa. Precipitation extremes are projected to increase. Sudden shifts from dry to wet conditions are favourable for the outbreak for Ebola. It is the combined effect of exploitation by foreign companies, the radical change of weather conditions and the global economic crisis that has created the conditions for the present health catastrophe.
Ebola’s devastating impact
The outbreak of the Ebola in the course of this year was not the first one. There have been repeated outbreaks almost every year since it was first discovered in 1976 in central Africa. Ebola is primarily a rural disease, where food gathered from hunting exposes people to infected animals, and where lack of clean water spreads infection. The isolated conditions in rural areas limited the numbers affected, only killing some hundreds of people.
This year the Ebola spread for the first time to the heavily populated areas along the west African coast. In these areas not only the conditions of sanitation, but also the state of health care, are disastrous, increasing the vulnerability of the township communities to the epidemic.
The virus completely overran the capacity of the local health systems. It is permanently racing ahead of the ability to control it. After 60 health care workers had died in the Ebola outbreak, there was a certain level of panic. Joseph Fair: “There’s been a lot of abandoning ship.” After the disease had killed nearly 1,000 people and infected nearly 2,000, on August 8th the World Health Organisation declared the Ebola epidemic an international public health emergency.
The pace of the infection is still accelerating. The public health system in Monrovia is nearing total collapse. All the most basic units for health care, including malarial drugs for children and medical care for pregnant women, have been closed.
In the West Point township in Monrovia local residents, upset by the events and out of deep distrust for the government, attacked a school that the authorities had quietly turned into an isolation center for people with Ebola symptoms. The protesters broke into the school and took bedding and other supplies. On Saturday August 18th West Point’s angry residents attacked health care workers.
On August 19th, a quarantine was announced forWest Point, trapping an estimated 75,000 people, turning the township in a huge graveyard. Residents were now in the killing fields of the epidemic. They can die, but at least it’s among themselves! The quarantine, causing the death of hundreds of people, not only because of Ebola, but also through malaria (children) and lack of food and clean water, had to be lifted after 10 days. In any case residents broke out in huge numbers.
The Ebola virus has all the potential to become a disaster on a scale never seen since the Spanish Flu of 1918-1920, nearly one hundred years ago.
The cynicism of the world bourgeoisie
Until now there has only been a tiny influx of aid from the wealthy countries. Half way through September documented pledges or donations totalled $326.7 million dollars. Besides the mobilisation of a few hundred dedicated volunteer doctors and nurses, for the greater part little actual deliveries of supplies, equipment and healthcare personnel take place. The documented contributions still fall short of the $600 million that will be needed for hospital beds, personnel and other needs to subdue an outbreak that is spreading with alarming speed.
US spending, over the past nine months, amounts to barely $100 million dollars. This contrasts dramatically with the billions made available by the imperialist powers, and their allies among the Gulf monarchies, for the new war in Syria and Iraq, let alone the hundreds of billions squandered on wars in Libya, Iraq and Afghanistan. Nevertheless Obama described the Ebola outbreak as a “national security priority” for the US, for it could trigger the destabilization of west Africa, posing “profound economic, political and security implications”. So he could think of nothing else than the sending of three thousand troops.
Reports from the WHO point to an exponential increase in cases, doubling roughly every three weeks. The IRC, on behalf of 34 NGO’s, has warned that the globe has only four weeks to stop the crisis from spiralling out of control (October 2, 2014). At the same time it finds that, of the 1,500 new drugs that were made available worldwide between 1974 and 2004, only 10 targeted the tropical illnesses. Regarding Ebola, since 1976, hardly any research has been done. So tropical diseases continue to affect more than a billion people in the world and kill up to 500,000 a year.
John Ashton, Faculty of Public Health in London, described the actual situation as “the moral bankruptcy of capitalism acting in the absence of an ethical and social framework.” The New Yorker bluntly stated that“diseases that mostly affect poor people in poor countries aren't a research priority, because it’s unlikely that those markets will ever provide a return”.
The actual spreading of the Ebola provokes a huge anxiety in the central countries. As always, the very 'anti-racist' states are quite keen to use the fear of African travellers to stir up xenophobic sentiments among the population of Europe. The dominant fractions of the ruling class make their own use of the climate of fear and panic:
- to make everyone to forget the much greater threats that we face today, such as war or nuclear disasters;
- to encourage the population of the central countries to side with the bourgeois state for protection;
- to block with all possible means people from African countries searching for refuge in the central countries.
By using soap and clean water the Ebola virus can be rather simply contained. But present day capitalism is even not capable of applying such a simple measure. The Ebola outbreak is the product of a sharpening of the contradictions of capitalism which, for a century, “has only brought more misery and destruction in all their forms. Faced with the advanced decomposition of its system, the dominant class has nothing other to offer than ideological lies and repression”. (‘SARS: It is capitalism which is responsible for the epidemic’, World Revolution May 2003)