Year LXII, 2020, Single Issue, Page 125
THE PANDEMIC CRISIS AND EUROPE
Scientists have long been predicting the arrival of a virus capable of infecting almost half the world’s population and causing countless deaths, comparing the disastrous effects of such an event to the consequences of the Spanish flu pandemic of 1918-19, which killed millions of people in less than two years. In a report published in 2005, the National Academy of Science’s Institute of Medicine drew attention to a large-scale outbreak of a form of avian influenza capable of infecting humans. “Evolution does not function on a knowable timetable”, and influenza variants, especially, are highly unpredictable.[1] This is even truer when, particularly in the setting of today’s globalised world with its dramatically increased levels of movement of goods and people, they become transmissible to humans. It should be pointed out that the Spanish flu epidemic did not originate in Spain. It is simply that the disease, which spread rapidly as a result of the movement of people at the end of WWI, was more widely reported in Spain, which was therefore believed to have been particularly badly hit. In a three-month period in 1918, over 40,000 US soldiers died of it, while police forces struggled to control unrest and riots due to widespread hysteria caused by fear of the disease. At that time, many deaths worldwide were not even officially attributed to the disease, which spread rapidly even to areas as far flung as Russia and South America. Spanish flu is estimated to have killed at least 5 per cent of the Ghanaian population in less than two months, while 20 per cent of that of Western Samoa fell victim to it. Official US and European estimates attribute at least 40-50 million deaths to the effects of the pandemic. Over a two-year period (1918-1919), at least a third of the world’s population was infected and around 100 million people died. In 1917, hygiene movements sprang up both in America and in Europe, but were unable to limit the spread of the disease. It was not until 1933 that a British team finally isolated the virus responsible! Other flu waves followed in the late 1950s and the 1960s, resulting in tens of thousands of deaths in the USA. Later on, in the mid-1970s, the US president of the time, Ford, ordered the production of a vast quantity of anti-flu vaccines, sufficient to vaccinate the entire US population. In the end, however, the anticipated epidemic never materialised, and a kind of protest movement, opposed to government health policies, grew up as a result.
Influenza viruses are known to be harboured by wild animals, especially birds; it is also known that they can jump from these species to farm animals (mammals), and thence to human beings. China, for example, has tens of billions of chickens, 60 per cent of which are raised on small family farms. This facilitates transmission of these viruses. Indeed, when an avian flu virus infects another species — pigs, for example —, it can mutate and become capable of attacking humans. As with many infectious diseases, individuals who have had and recovered from influenza develop antibodies that protect them, for variable periods of time, against further infection by the same pathogen. But, as we see with influenza viruses in particular, the genetic material of a virus frequently undergoes changes with subsequent viral generations. These changes modify the characteristics of the viral particles and make the virus undetectable, at least in part, by the immune system of a previously infected individual. This explains why one year’s flu vaccine can be ineffective the following year, and also why, over time, infections and epidemics tend to occur in cycles, as we saw most recently in the 1990s and the first decade of the XXI century. To date, at least a hundred viral influenzas of avian or animal origin have been identified. And yet in spite of this, the vaccine market in general still accounts for only 2 per cent of the global pharmaceutical market! Even though new technologies offer the promise of greater production capacity, pharmaceutical companies currently seem unable to market more than 300 million vaccine doses annually! On this basis, it is believed that, under current conditions, 30 to 50 per cent of the world population could be infected in the course of an influenza pandemic. The terms of the problem are clear if we consider that the number of doses needed to vaccinate the entire US population against a flu virus is the same as the total number of vaccines produced globally in a year!
In this regard, and also with regard to the production and supply of crucial drugs, Europe is particularly dependent on China and India. Hubei, for example, the Chinese region where the coronavirus threat originated, produces a significant amount of pharmaceutical raw materials: Chinese drug exports to the rest of the world have quadrupled in recent years and are now worth over $120 billion per year. India, in turn, relies on China to meet about two thirds of its internal needs and to support its pharmaceutical exports. As pointed out by Federico Fubini “in the course of this century, India and China have become the back kitchens of the major world brands whose names we see on the packets of the drugs we buy when we are not feeling well. We perceive a drug as ‘German, ‘Italian’ or ‘Swiss’, whereas in actual fact sometimes even the producer itself does not know exactly where, in the world, its ingredients originated. Only the supplier of the supplier of its supplier knows that. But an unforeseen event occurring at the original production site can be enough to upset the entire supply chain, with this effect even trickling down to our local pharmacies.”[2] In the case of Italy, according to the OECD, the added value created in India by medicines subsequently exported from Italy to the rest of the world more than tripled in the seven years from 2005. India and China have de facto become the sources of the big pharmaceutical brands exported and re-exported around the world.
In any case, the greatest challenge facing societies hit by a pandemic is ensuring that their healthcare facilities are able to cope with the sudden and unpredictable mass influx of patients into hospitals. Indeed, any pandemic will test healthcare systems, both globally and locally, to their limits. One need only consider that the World Health Organisation (WHO), despite operating a global pandemic surveillance and monitoring system, has an annual budget of just several million dollars. (Consider that against the budget of the city of New York, which tops $1200 billion!).
It is also important not to make the mistake of thinking that one epidemic is enough to guarantee the immunity of an entire society. In times past, when no remedies were available, recurrent outbreaks in Europe of smallpox, typhus, measles and influenza were linked to poor harvests. However, while epidemics nevertheless managed to leave the European populations partially immunised, the same cannot be said, for example, of those of the Americas. Spanish and Indian sources attribute the fall of the Aztec capital to an explosion of smallpox, while in South America, epidemics of smallpox, measles, typhus, plague, mumps, flu, diphtheria and measles recurred in ten-yearly cycles from 1519 to 1600. In that part of the world, it was not until the XVI century that the populations of the Mesoamerican and Andean areas began growing once again.[3]
While Covid-19 has not (yet) transformed our modern world, there can be no doubt that its impact on technological and social development will be felt for years to come, moreover in a situation of progressive US disengagement on the world stage and evident European powerlessness to offer real alternatives that might lead to the establishment of a new supranational institutional order, at both continental and global level.[4] Increasingly evident, too, is the need to establish a structured system of government at different levels, from local to continental and eventually global.[5]
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Today, around 50 per cent of global GDP depends on Asia, whose interdependence with the rest of the world is increasing all the time. Inevitably, therefore, mechanisms like those seen in the past, i.e., the outward expansion of European trade and production into the world,[6] are now recurring today, but this time they are originating from Asia and unfolding on a global scale, thanks also to the growing levels of interdependence in all fields. Species are showing less and less genetic drift, and cultural and geographical distances are reducing. And all of this can be attributed, at the root, not only to the Europeans’ economic, industrial and political expansion, but also, on a biological level, to more intensive farming… and the diseases this brings.[7]
In the wake of the outbreak and spread of Covid-19 in Europe, the European Commission proposed “stronger crisis preparedness and response for Europe”.[8] This proposal, which is actually more of an appeal to the member states to act correctly and to strengthen surveillance and the exchange of information, is not enough.[9] Coordination of European, national and local policies must instead be institutionalised through federalisation of the system of government. Creating a “European Health Union” would, in fact, entail federal reform of Europe, so as to allow better coordination of the actions of the different levels of government, from continental to local. But the template for such a reform cannot be the centralised model of the Chinese state,[10] which in any case proved unable to stop the spread of the pandemic; nor can we rely on the American model which, although federal, has proved woefully inadequate. Similarly, we need to move away from the current European model, which continues to trapped by intergovernmental mechanisms, national vetoes and local particularisms. In the wake of the international spread of a “Brussels effect” in the economy and trade,[11] it has now become both necessary, and possible, to promote the spread, globally, of a Brussels effect at institutional level, too. On this topic, however, great uncertainty and confusion reign. Not just because of the strength of the resistance of the opponents of European unification and of those determined to protect the, now anachronistic, sovereignty of small states, but also because, even among those who understand the need for deeper political unification, there is still great uncertainty and only timid support. And yet, as even the “timid supporters” acknowledge, the time for a forward leap has come. This whole situation is illustrated by a famous report presented, in the 1970s, to the President of the French Republic. In it, Alain Minc, together with Simon Nora, clearly set out the implications and potential of the imminent computer revolution.[12] While Minc recognised Europe’s potential, he was not yet able to see the need to move decisively towards a European federation, which he called “une construction sui generis”. And this remark confirms the truth of Machiavelli’s famous affirmation in The Prince, namely that, “…that there is nothing more difficult to carry out (...), nor more dangerous to handle than to initiate a new order of things”. But, as the challenge of Covid-19 now underlines, the time has certainly come to build a new order of things, and to build solidarity into a stable supranational federal institutional framework.
Franco Spoltore
[1] Laurie Garrett The Next Pandemic, Foreign Affairs, Vol. 84 (July-August 2005), pp. 3-23.
[2] Federico Fubini, Sul vulcano. Come riprenderci il futuro in questa globalizzazione fragile, Milan, Longanesi, 2020.
[3] Marcello Carmagnani, L’altro occidente, Turin, Einaudi, 2003, pp. 40-46.
[4] Olivier Zajec, L’ordre international qui vient: “Il faut espérer que des évolutions politiques démocratiques sur le continent européen viendront perturber cette « mort cérébrale » qu’illustre en ce moment la focalisation exceptionnelle sur les résultats électoraux du suzerain américain. Ce réflexe révèle moins l’importance des États-Unis dans l’ordre international que l’impuissance européenne à imaginer une autre solution stratégique effective. Malgré les leçons de l’ère Trump.”, Le monde diplomatique, November 2020.
[5] The US public health chief in 1971 remarked that predicting influenza epidemics is like predicting meteorological changes, because pandemics, like hurricanes can be identified and their developments envisaged. However, epidemics are more unpredictable than hurricanes and the best thing to do is to estimate probabilities. Laurie Garrett, The Next Pandemic, op. cit..
[6] Alfred W. Crosby, Ecological Imperialism. The Ecological Expansion of Europe, ’900-1900, Cambridge, Cambridge University Press, 1986: “The breakup of Pangaea was a matter of geology and the stately tempo of continental drift. Our current reconstitution of Pangaea by means of ships and aircraft is a matter of human cuture and the careening, accelerating, breakneck beat of technology. To tell that tale we have to go back not 200 million years, fortunately, by only a million or three.”, p. 12.
[7] Charles Darwin in this autobiography remarked: “Wherever the European had trod, death seemed to pursue the aboriginal”.
[8] Building a European Health Union: Stronger crisis preparedness and response for Europe. https://ec.europa.eu/eip/ageing/news/building-european-health-union-stronger-crisis-preparedness-and-response-europe_en.html.
[9] Ben Hall et al., How coronavirus exposed Europe’s weaknesses, Financial Times, 20/10/20, “When the pandemic struck, many countries were ill-prepared. As a second wave hits, what have they learnt from their early decisions?” https://www.ft.com/content/efdadd97-aef5-47f1-91de-fe02c41a470a.
[10] The Chinese government grasped the gravity of the situation in Wuhan, but was very slow to raise the alarm internationally, waiting weeks before interrupting air traffic, as stated in Federico Fubini, Sul vulcano. Come riprenderci il futuro in questa globalizzazione fragile, op. cit..
[11] Anu Bradford, The Brussels Effect, How the European Union Rules the World, Oxford, Oxford University Press, 2020.
[12] A summary of the 1978 Nora-Minc report can be found at https://fr.wikipedia.org/wiki/Rapport_Nora-Minc. In his book La mondialisation hereuse, Paros, Tribune libre PLON, 1997, Minc wrote: “The European Union is a sui generis construction. From a macroeconomic point of view it will be federal: a currency, a market, a right to competition and a fiscal policy framework. Strategically and diplomatically, it will remain confederal for a long time, even though internally, and without recognisng it, France and Germany are now developing a complementary relationship”, p. 75.
