Early into the Jacob Zuma presidency, the then Minister of Agriculture, Forestry and Fisheries lambasted the Agricultural Research Council, accusing the body of catering only to big (white) agribusiness. A Board member rose to the occasion, reminding the minister that the council mandate covered animal and plant diseases, and that these insects, fungal, bacterial or viral pests had the habit of being blind to wealth or social status.
“In effect, neglect the public goods provided by the Science Councils at your peril, minister.” Fortunately, that minister no longer holds senior office. Unfortunately, publicly funded research organisations, and scientific and technical services have been underfunded for the last two decades.
This anecdote encapsulates the trial by virus that the world is facing. It is simple to pay lip service to the World Health Organisation concept of “One Health”, but achieving this is another matter.
One Health is the understanding that we humans are in the pit along with animals, plants, and the biosphere. Neglect one and all pay. Hence the idiocy of the Donald Trump administration in curtailing the US Global Health Security office. An own goal if ever there was one. To which add the cuts in the budget of the Centres for Disease Control. But then, the CDC has supported African health, the “shithole” as Trump called us.
The coronavirus pandemic strips bare the tenuous hold that the global village and networked society maintain on planet Earth, and how social order will be stretched to breaking point in the days and weeks ahead. Comedian Tom Walker’s character Jonathan Pie tells it as it is: We are in the shit. How deeply, varies country to country and region to region.
All praise therefore to President Cyril Ramaphosa and his team for declaring a National State of Disaster and enacting the associated regulations.
Regrettably, this is not the first health disaster we have faced. Recall the cholera epidemic of 2000, with some 200,000 infections, yet the very low mortality rate of 0,1%. That outbreak arose from the failure to prevent by providing affordable potable water to poor communities. The low number of deaths, way below the world norm, speaks to the ability to detect and respond. To this grim tale add the 2017 listeriosis outbreak that, with 200 deaths, was the worst on record, anywhere. Yet there is something gained from these shortcomings, namely learning as to what went wrong. And, the National Institute for Communicable Diseases (NICD) is serving us well, as are the private pathology labs with their national (and African), footprints.
So where does this leave us? According to the 2017 WHO Joint External Evaluation that measures country compliance with the WHO International Health Regulations of 2005, we in South Africa scored poorly on 11 of the 48 criteria. But we score very well on the 17 indicators that matter for dealing with Covid-19, especially surveillance of priority zoonotic diseases and pathogens, mechanisms to respond to infectious and potential zoonotic diseases, laboratory testing, specimen referral and transportation, integration and analysis of surveillance data, emergency operation programmes, and measures to link health monitoring with the security agencies.
This expertise has been built over more than a century, dealing with rinderpest, tuberculosis and HIV. It draws on public research organisations, the universities, private sector and NGOs. A quadruple helix at work.
Fact is that we may be doing rather better than the Joint External Evaluation might predict. We have strong, well-informed leadership on health matters at Cabinet level – thank you Minister Drs Mkhize, Motsoaledi, Dlamini-Zuma and Phaahla. The regulations are in force; their enforcement is the test.
By 23 March 2020, we are likely to see about 500 confirmed cases in South Africa, meaning that we are nearing the critical point where the rate of infection must decline, barring which, we move into very difficult circumstances, with tighter lockdowns and huge pressure on our social fabric.
Be it the Biblical injunction to neighbourly love, or Ubuntu, access to basic necessities of sufficient and balanced foods, medicinals, water and power, plus sanitation, during recession and blackouts, will stretch us to breaking point. Me, then my brother, then my cousin, then my clan and only then, others. One may look to prior events that have scared us – the 1957 polio epidemic, even fear of nuclear incineration in the Cuban missile crisis. This one is different. It spreads silently and touches us all.
Premier Alan Winde put it well: We need physical distancing and social solidarity.
This means careful thought for all in our country, those we care for and those who offer care to us. We need to think of the impact of crowding, in dwellings, taxis and buses. We need to call out those who think that we can have a semblance of business as usual. Not possible.
The cautious move of the Reserve Bank to cut the cost of borrowing is a welcome start, but it offers small comfort, and does nothing to compensate the genuine, hard-working, real economy of commodities, manufacturing, real services, logistics and leisure, that are facing bankruptcy. A week hence, we may need another 100-point rate cut and then another. In the United Kingdom, the Bank of England repo rate is a stellar 0.1%.
At some point, within the next month, more radical fiscal measures will be needed to prop up society to carry us through until the infection curve comes right down. Question is, where does the money come from? Answer – we enjoy low inflation, so that increasing money supply, also known as printing money, is an option. But this new money is not printed in order to lend it out.
It must be given away, intelligently, with targeting to relieve hardship and keep the economy ticking over. We may pay for this through higher taxes a year hence. For the living, that will be a small price.
And fund public goods research. DM