Soziologische Perspektiven auf die Corona-Krise –

Transkript: Joseph Harris: The Politics of Coronavirus Response in South Africa

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Silvio Suckow
Welcome to the new edition of our podcast on sociallogical perspectives on the corona crisis.
My name is and I'm a research fellow at the Berlin social science center and I'm co-organizing the stitch to take.
On December 1 Joseph Harris gave a talk titled coronavirus response in South Africa.
Joseph Harris is an associate professor at Boston University. He conducts comparative historical research that lies at the intersection of sociology, political science, and global health.
His talk is about to diverse findings and comparing the handling of the corona virus pandemic globally with the focus on South Africa.
The role of Germany as well as various thought provoking ideas for supporting the global south.
We'll also be presented and now enjoy the talk by Joseph Harris.
Joseph Harris
I'm so thanks to Bay for the opportunity to share my work today on the coronavirus response in South Africa.
A bit of background about who I am I'm a sociologist from Boston University who read a book called Achieving Access about the politics of Universal Health coverage in.
Infectious disease response focusing on HIV Aids and Tyler and Brazil and South Africa
More recently, I've revisited some of that work in a book chapter on South Africa's coronavirus response. That's part of an edited volume on the comparative politics and policy of corona of COVID-19.
University michigan press and is actually free for download if you'd like to take a look at this chapter or others.
Then I have a blog that will be on the basically website as well. So, I'd like to start today by talking about
What made South Africa so vulnerable to the coronavirus pandemic and hit it has been and hit hard,
Yeah and officially today 90 thousand people have died.
Of coronavirus in South Africa but excess deaths those that have occurred beyond what we would normally expect.
Expect number 273 thousand so most of these we could expect to be
Corona related and so the country has been hit enormously and impacted by coronavirus. And this is largely due to the fact that life in South Africa is incredibly precarious. People are deeply affected
By what we sociologist call the social determinants of health. South Africa has the largest HIV positive population in the world. 7.5000000 people about 20% of the population. TB is the leading cause of death there has one of the largest TB burdens in the world.
Multi drug resistant extra drug resistant to burgundy as well and so there's a large proportion of immunocompromised people there
And on top of that, more than half of South Africans live in poverty.
Unemployment officially hovers it right around 25% unofficially 50%
And those numbers are pre COVID and as you can imagine with shutdowns and people going out of work those numbers have got even higher during the pandemic.
It's an incredibly unequal society and a lot of this goes it's it's self to the legacies of apartheid the top 10%
Holds the hot 86% of the wealth and we have a private health system
There again reflects the history of apartheid where people with medical schemes who use the private health system medical schemes is the South African word for health insurance private health insurance serves 15% of the population but holds 70% of the ICU bets in the country
In that private health system receives the same amount of financing as the public health system that serves 85% of the population in so real
Two tiered system there and we can't forget that during the coronavirus rich countries 40 PPE and later vaccines
By late July 2020.
More than 13 thousand healthcare workers were infected and 100 had died of a lot of that is owed to insufficient.
PPE. And so with that context in mind let's talk a little bit about the features of the initial response there
The country introduced the strictest lockdown on the continent which included school closures,
A border closures prohibitions on large gatherings banning
People from high-risk countries from Edrick and this lockdown bot time for the country to prepare and it's stemmed the initial spread.
They also had severe social consequences unemployment went out even more. People went hungry.
And there were more than 230 thousand arrests and 12 people killed in enforcement actions trying to maintain the lockdown.
Now, there were some social innovations that happened in response to the initial coronavirus wave.
South Africa deployed more than 28 thousand community health workers going door to door and community screening more than 11 million people
Approximately 20% of the country's population and referred more than 70 thousand for testing
South Africa was also able to use an extensive lab PCR system testing system that had used for HIV to be redirected for testing for the coronavirus
Uneven roll out of social programs in this precarious environment we can imagine that that would be problematic.
A temporary employee employer release system that was set up to benefit the
Unemployed benefited just 20% of the target population if it was in place from the beginning of the crisis it would have reduced poverty
By as much as 40%.
But even more importantly there was a lack of continuity in terms of food programs and in particular when schools were shuttered that shutter preschool lunches and free school breakfast and this had big impacts on the population.
14 million people were said to be hungry before the coronavirus pandemic and increased and in fact people like Jeffrey Jeremy seeking in South Africa have noted
That the actual distribution of food went down during the coronavirus pandemic in relation to what it had normally been.
There were also consequences on access to anti-retrorrels by the pandemic and the lockdown at one point HIV viral load and TB testing were both down by as much as 50%.
In May alone and hot tank province 12 thousand TV in HIV patients did not collect their medication
And there was a growing number of excess deaths by mid September 2020.
Less than 16 thousand official COVID deaths have been recorded but there were more than 44 thousand excess deaths and corruption began to surface as the money began to flow.
Not only in provincial health authorities but also in golfing even the president's on spokeswoman
And so, lots of issues, some lessons, we're never learned, a food grant, to support people.
What was wowed down before again being reinstated reinstated.
A basic income grant about which discussions had started was never implemented and this was just in
There was an ab after this of course and then two more ways one driven by the beta strain and another driven by the delta strain before the current one that is beginning now which brings us to today. South Africa
In the news again with Elma Cron. So much of you many of you have heard about this already. I think probably everyone here. We we've heard about the first detected case being reported in Botswana. This was due.
Because of genomic sequencing that took place in South Africa it's now been found in 20 countries and growing and across
Course, we now know that Umber Crohn was in Netherlands a week before South Africa reported it. And this is concerning, right? Because we know in.
South Africa there's been rapid spread that strain his out competed other.
Strains of the virus that we don't yet know the degree to which I would crime
Has worse or or better hospital, hospitalization, and disease, severities, statistics, but there's also additional concern about its potential to escape vaccines due to mutations on which there are no
Where the 30 SG meditation. So, there's a lot we don't know yet. But it is here. And what I wanna,
Ask is is how should Germany approach this new challenge what can it do better to ensure the health of it's home people it also the world.
Well Akuma can be sent to Tanji and infectious disease physician verologist in global health expert in university says this was predictable.
If the virus has the opportunity to spread unshacked in the population that we're giving it multiple ways.
Hey which to evolve and adapt and more pointedly doctor Cecilia tomorrow says let's get this straight. Rich countries with whole life saving vaccines for most of the world
They watch millions of people die then they blame those who suffered most for the new Barrett's cannot get a clear picture into racism in colonialism
And that and so not understanding the importance of solidarity in this context is not only ridiculous but in fact,
Has disastrous consequences. And so, how could Germany support South Africa?
First we have to give great credit to the South African scientist who were the first two I did this new strain of crime
We can use surgical policy instruments rather than blanket travel bags to target new cases there's important research by people like Karen Repin and others that
Pointed to the effectiveness of things like 14 day quarantines without exemptions testing before and after arrived.
These are much more surgical targeted instruments than blanket bands. We can support South African pandemic relief programs. We know hunger
Hits South Africa hard.
We know unemployment has grown and we know people aren't getting access to the medicine that they need which can spur resistance
Germinate any other industrialized nations can help and we can get south African scientists three agents that they need Tulia.
Are they all over who's one of the important people who is part of the identification of.
Companies as soon we will run out of reagents as airplanes are not flying to South Africa
It will be evil if we cannot answer the questions the world needs about due to the travel ban and he went on to see later I will not accept charted flights with re agents as the travel ban is so damaging to work there are other ways to deal with that
I think we should take his concert seriously. Now.
It's not just a global health as german health german health is also global health and there are changes that germinate can make at home to support the world
Including vaccinating and boosting more people faster. On Monday, I was just at the mall. Waiting for over 3 hours to get my own books. There are quicker ways to do this. And better ways to do.
We can engage nurses at pharmacies in the delivery of vaccinations particularly boosters
Can open more sites particularly in at risk communities that suffer from poverty and other social determinants of health that make them more vulnerable.
You can expand access by increasing hours and days that sites are open.
You can offer vaccination for ages five through 11 at schools when those vaccinations are available
Now there are other things that we can do in schools and doing these things was really important because we know that Germany's school children are among the most vulnerable because ages five through 11 don't yet have vaccines
There's been uneven rollout I've had the filters which have been shown to be effective in cleaning out virus particles from the air
You can have more effective policy related to masking a week before.
The travel the fall vacation here in Berlin, the mash requirement was dropped.
And then people went travelling. You can only imagine. The consequences that that may have had.
You can keep free testing sites open even after the current wave events because this will not be the last wave and something Germany does quite well at enforcing masks and mask compliance you can continue to do that
And we're going to need to see a shift too.
Vaccinate hand test and mask rather than just these either rules. Another thing,
That Germany could do to strike that it's response globally is to open a new center
Add vase b or a new live niece institute altogether dedicated to global public health and basically may have some history in public health there was a long standing public health research group in the base of bay
There's two really tremendous research groups. Now, I'm global humanitarian medicine and global health governance. And so the basically would be a great place to do this. But now it's really the right time.
Germany has been trying to take up the mantle of leadership and global health it hosts the World Health Summit
The WHO has just chosen it as the new site the pandemic intelligence hub with Brexit you have.
Big funders like the gates foundation and welcome trust moving to Berlin
A new center or institute dedicated to global public health would add a lot to that you can give
Social science a bigger place in the conversation each night we see droston in the news verologist who's given Germany a great deal knowledge about the virus but social science can tell us a lot more about other dimensions of virus than just hits
Biology. We have to recognize that there's an uphill climb in Germany to do this with an emphasis on hard sciences and medicine rather than.
Public health institutions of public health are relatively new here there is a hierarchy cool educational system that
Gives cheers at directors great power and determining programs and of course patriarchy a recent,
Tweet ran around that suggested that just 28% of researchers in Germany are women and then that's on the lower end in all of Europe
But Germany has a chance to create something permanent that is woman lad and there's a lot of really highly visible internationally recognized experts that we see in the news every day like in a horseshiter Tina Henritter
This is a really exciting opportunity.
And then finally more broadly Germany can play its part they're trying to end the patent monopoly on him or an A maxi humanity's future just simply shouldn't be decided by two private companies.
That have already made millions. If you think about it, they haven't incentive actually to elongate the pandemic. It's your morning needs to be done.
Putting pressure on that. And of course promoting global solidarity, financing, and vaccine, access. I'll stop there. Thanks.
Silvio Suckow
Thank you so much for your insightful presentation Joseph and I think what stands out from both presentations is some more of availability where the viewed residential state
Australia, Germany, South Africa, or globally, and how we deal with this, and so my first question to you is how has COVID affected,
The all registration relationship between the white and non white population and South Africa and is there any indication that violence has increased or other maybe quantitative data.
Joseph Harris
It's an interesting question. I would say that, you know, tensions in South Africa have been simmering for a long time related to a number of different issues. Obviously,
Apartheid is a is a big part of that and those legacies will will always be there, but.
We've seen a great deal of unpopularity in recent elections due to matters that hit close to home likes,
But we call service protests. Service delivery protests in South Africa. So people aren't getting the water that they need the electricity that they need to live and so we've seen the vote count of the ANC falling
Over subsequent elections over time and so that's a real flash point.
Another big flash point has been the recent indictment and imprisonment of past President Jacob Zumba
And from jail. He's essentially tried to
Stir a rust and so this has been another source of of of confrontation in the country and one that has created fractures even with in a usually sort of cohesive
African National Congress and so I would say that that the the color line is not the only line where fracture has happened but it is of course due to the legacy of part side one of many.
Silvio Suckow
In a mayor ask you about the measures you propose for which countries to help developing countries and how would you
How do you imagine the coordination of this measurements because with the question is it should we go about the EU or is it about voluntary alliances of,
Some countries helping so how do you imagine it in a political way where.
Joseph Harris
Sure, I think in a biral lateral animal, have a role to play, and this week at the WHO, there's been negotiations and discussions over a
Pandemic treaty and your own Angela Merco has played an important role trying to.
Stir countries to make bigger commitments, right? To finance in the WHO, which only makes sense. During pandemic, and so
Hopefully we'll see concerted multilateral action not just internship getting people vaccines but in making commitments to health more generally but I think that you know.
Bilateral relations also play key role and as I said before there's much that Germany could offer for example South African support of its food relief programs and other really programs it's not always just about getting
Supply a vaccines to a place there are also sometimes bottlenecks and different issues that have to be dealt with in country and so that's one reason that I said you know food relief would be an area that it could play well.
In other nations as well.
Silvio Suckow
And the pandemic also has lot to do with our hyper modern
Lifestyle and with all the practices that have merged in the last 200 years and I remember a catchy statistics from Ox Farm I guess from an Oxford study that for every dollar that goes down to the global staff.
$2 go back to the global roughly speaking so from all that developing help and so on so where do you see opportunities to change certain practices now
With the corona pandemic including global exploitation and neocolionism to not fall back to that you know ever reproducing
Schemes of we want to help but we only gain profits are not only but we we gain profits with the help.
Joseph Harris
Yeah, I mean, in our field right now, there's a enormous.
Decolonized global health movement and I think it's calling attention to a lot of really important inequalities and and power relations that.
Have been there for for decades and.
I've tried to undo so that and I think that there's a lot of work that we have to do obviously I think you know addressing the sort of inequality with relation to vaccine access as part of the story but it's also.
You know, pointed to buy a lot of the other things that have surfaced during this pandemic, right?
Some of the leading nations that we I think before before the pandemic had been looked to for health. I've really feel that, right? That the response.
Here I'd be the first to to mention the US the response had been a bismal
In the US and you know, people now question you know, what is the CDC to
And we're finding models in the response to the virus. In other countries. Particularly in in parts of the global south. For the first year,
Of the coronavirus Tyler the country I study in no very well had almost not recorded cases the WHO held it up,
As a model there was a lot that we could learn there.
In terms of the way that they like South Africa use community health workers in their response and the way that they try to connect to vulnerable migrants.
And so I think that.
Important part of what we can learn at this moment is appreciating the way that coronavirus has turned.
Are are understanding our assumptions upside down. I mean, Omo Chrome was discovered by the South African side.
Everyone can learn from that. So, so I would say that.
Silvio Suckow
Learning from mothers a good it's a good key route how how do you you know from obviously you are comparing different countries and how do you see the management of the corona pandemic.
In South Africa may be compared to other countries who have your research maybe even countries that have similar,
Developing status.
Joseph Harris
In my book I compare talent Brazil in South Africa in their in politics of their struggled with HIV Aids.
And also show us for expanding access to health care and I think that there's a lot of good reasons to make comparisons to these countries they're all countries that grappled with Aids epidemic extremely high levels of inequality.
Going through democraization at that time and so the scope conditions are relatively similar and I think that.
Obviously, things have changed. Since that time, a time can no longer be called Democratic.
South Africa has seen some changes in leaders, Brazil, is.
HIV Aids, pandemic, and so.
There has been a real shift in these countries and we see Thailand do quite well for the first year of its pandemic and I think that there's still a lot we don't know about why.
It did well it had a lot of exposure to you know cases from.
Wuhan there's a lot of direct links to Wuhan in the airport there.
But strangely we didn't see a lot of spread early on in Thailand. So what accounts for that? Well Tyler had a lockdown as well. Obviously it has a universal health coverage system.
That has made people I think.
More comfortable to come forward when they need help it had a really great system of community health workers much like.
South Africa that it directed to help with screening and testing for the coronavirus.
Brazil really in my book the entire Brazil really did well with respected HIV Aids expanding access to healthcare but we see a real.
Backsliding that happened in a blame really falls on bolsonar shoulders there. I mean, it did have some important different.
Structural features that had to contain with like sound app it has a real biker in the.
Versus private health care systems there and resources could be directed more equitably but you had.
You know, governor is at the state levels that were really trying to get out ahead of the pandemic and do things to come back in lieu of a federal government response. And so,
You know I think that Balsinar is not taking the disease seriously it's a real factor in that story.
And many other people know that and so, you know, I would say that South Africa you know, South Africa has had its own response. It has had its own innovations in responding to headed some challenges but.
You know I think these comparisons are important because they draw out what is different and what has worked and what hasn't in these countries.
Silvio Suckow
This was a talk given by Joseph Harris at i wanted to take a on December 1 we hope you were able to take away some ideas feel free to subscribe and share the.
Follow us on Twitter at at corners thanks for tuning in see you next time.