Neither pandemic is over. HIV continues to infect, sicken, and kill. Current funding commitments suggest that the limited control achieved over the AIDS pandemic may falter. The powerful “anti-vax” movement will be a hurdle to distribution of any effective HIV vaccines that should be discovered, compounding the longstanding problem of profit-driven vaccine research on a disease that affects the poor.
The COVID-19 pandemic is also far from over. Vast numbers of people sicken and die from it—and long COVID is a mass disabling event. As this paragraph is being written, the People’s CDC, an invaluable resource for understanding how to respond to the pandemic from a socially involved public health perspective, stated in their weekly “Weather Report” that “at least 3,907 people died of COVID nationally.”40“People’s CDC COVID-19 Weather Report,” People’s CDC, January 16, 2023.
We are likely to experience more major pandemics.41Rob Wallace, Dead Epidemiologists: On the Origins of COVID-19 (New York: Monthly Review Press, 2020); Matthew Baylis, “Potential Impact of Climate Change on Emerging Vector-Borne and Other Infections in the UK,” Environmental Health 16 (2017); Erica E. Short, Cyril Caminade, and Bolaji N. Thomas, “Climate Change Contribution to the Emergence or Re-Emergence of Parasitic Diseases,” Infectious Diseases (Auckland) 10 (2017); Andrew W. Bartlow et al., “Forecasting Zoonotic Infectious Disease Response to Climate Change: Mosquito Vectors and a Changing Environment,” Veterinary Sciences 6, no. 2 (2019); Andrew P. Dobson, “Ecology and Economics for Pandemic Prevention,” Science 369, no. 6502 (2020); Mike Davis, The Monster at Our Door: The Global Threat of Avian Flu (New York: New Press, 2005); Samuel R. Friedman, “Environmental Change and Infectious Diseases in the Mediterranean Region and the World: An Interpretive Dialectical Analysis,” Euro-Mediterranean Journal for Environmental Integration 6 (2021); Andreas Malm, Corona, Climate, Chronic Emergency: War Communism in the Twenty-First Century (London: Verso, 2020); Sharp and Hahn, “Origins of HIV and the AIDS Pandemic”; Bianca Wernecke et al., “‘Preventing the Next Pandemic’ – A 2020 UNEP Frontiers Series Report on Zoonotic Diseases with Reflections for South Africa,” South African Journal of Science 116, no. 7/8 (2020); Rob Wallace, Big Farms Make Big Flu: Dispatches on Infectious Disease, Agribusiness, and the Nature of Science (New York: Monthly Review Press, 2016); Rob Wallace, Alex Liebman, Luis Fernando Chaves, and Rodrick Wallace, “COVID-19 and Circuits of Capital: New York to China and Back,” Monthly Review 72, no. 1 (2020); Robin A. Weiss and Anthony J. McMichael, “Social and Environmental Risk Factors in the Emergence of Infectious Diseases,” Nature Medicine 10 (2004); Samuel R. Friedman et al., “Big Events Theory and Measures May Help Explain Emerging Long-Term Effects of Current Crises,” Global Public Health 16, no. 8/9 (2021); Samuel R. Friedman, Diana Rossi, and Naomi Braine, “Theorizing “Big Events” as a Potential Risk Environment for Drug Use, Drug-Related Harm and HIV Epidemic Outbreaks,” International Journal of Drug Policy 20, no. 3 (2009). Capitalism puts humans into contact with viruses and bacteria through constant business, military expansion, and travel. Capitalist industrial agriculture forms a perfect breeding ground for viral and bacterial mutations, as evidenced by frequently emerging new varieties of avian and swine flu. Careless over-prescription of medicines to get workers back on the job and to increase meat production accelerates the development of bacteria and viruses that medicines can then no longer cure.
Pandemics, then, happen more rapidly and spread far more rapidly than they did in earlier historical eras due to advanced capitalist production and distribution. Science under capitalism has, to be sure, provided new ways to try to counteract these dangers. But the history of the responses to HIV/AIDS and COVID-19 shows that the needs of capital and the states that serve capital hamstring our ability to respond to pandemics. The COVID-19 response history indicates a major defeat for those favoring “public health” approaches to pandemics that prioritize worker protection over “opening up.” Capitalist interests skeptical of pandemic and climate change science have successfully reduced executive authority for health emergencies and opposed vaccination and masking rules. This retreat suggests Democrats and Republicans will prioritize immediate economic profitability over public health in future pandemics.
Some public health response limitations to pandemics stem from firms’ profit interests, evident in government support for intellectual property rights. This has enhanced profits for HIV antiretroviral therapy and COVID-19 vaccine makers, leaving billions poorly protected and millions dead. Fortunately, these “rights” are firm-specific, so they can be challenged without total opposition from capital, as when the global efforts of AIDS movements enabled additional firms to produce generic HIV antiretrovirals that let millions of people get them more cheaply.
By the beginning of 2022, capitalists decided that vaccination provided sufficient protection against devastating declines in labor power availability for behavioral protections to be ended and employees who had worked from home to be forced to work at their workplaces.42Jirmanus et al., Too Many Deaths, Too Many Left Behind; Feldman, “How to Hide a Plague.”
Although polls globally have shown that large proportions of the population support more masking and other behavioral protections, the holders of these beliefs seem to be less organized and less willing to mobilize in demonstrations and other actions than the right-wing-inspired anti-maskers. In countries where the more “science”-focused political parties and leaders are at loggerheads with the far right, or where they are losing ground to it, this has provided political inducement to these leaders to support opening up. Politically, this developed in part out of (perceived) advantages in productivity and in workplace control from opening up, and in part due to the existence of a lot of people who disliked wearing masks.
Our argument in this piece helps to understand China’s COVID policies. One partial reason why China opened up was that its approach was creating a significant competitive disadvantage when other countries opened up. Specifically, regular city-wide lockdowns in 2022 were hindering Chinese capital’s ability to ensure prompt product delivery to both domestic and international customers. In the era of global neoliberal just-in-time production, supply chain disruptions from these lockdowns were fueling inflation and undermining Chinese capital’s competitiveness. Amid escalating inter-imperialist tensions and U.S.-led diplomatic offensives against China, this disadvantage risked becoming debilitating. When worker revolts against the zero-COVID approach erupted at Foxconn and elsewhere, paralleled by university and street demonstrations, China’s rulers opted for global opening up. The subsequent COVID-19 outbreak has been significant, but likely not enough to substantially weaken China’s economy.
In essence, 2022 saw a global decision by capital and state leaders to risk workers’ health and lives to maintain competitive standing. This gamble is fraught with uncertainty. The dynamics of long COVID, which incapacitates many workers, remain unclear. Depending on virus mutations and worker responses, this mass disabling event could become more prevalent and economically—and perhaps militarily—debilitating. Capitalists are also gambling on being allowed to let the virus run rampant without workers rising up and threatening to end the system itself. 43In extreme examples, capital’s view of workers as simply commodities whose labor power creates surplus value has led to the disregard of worker health and safety in mines and fields on a global basis, and the throwing of enslaved people into the Atlantic Ocean if their profitability became negative due to disease or their resisting orders. Christina Heatherton, Arise! Global Radicalism in the Era of the Mexican Revolution (Oakland: University of California Press, 2022).
Pandemics present a dilemma for capital: it must balance public health measures to preserve the labor force for future exploitation against letting workers sicken and die for immediate exploitation. COVID-19 is unique in that capitalists initially chose to protect workers’ health, leading to issues like massive production decline, enduring supply chain shortages, inflation, and worker strikes, partially offset by the significant income increase for billionaires and major corporations during the period of worker self-protection.44Chuck Collins, “Updates: Billionaire Wealth, U.S. Job Losses and Pandemic Profiteers,” inequality.org, November 21, 2022; Saima May Sidik, “How COVID Has Deepened Inequality — in Six Stark Graphics,” Nature, June 22, 2022; Amat Adarov, “Global Income Inequality and the COVID-19 Pandemic in Three Charts,” World Bank Blogs, February 7, 2022.
The lessons from HIV/AIDS and COVID-19 are vital for public health and global populations, especially as neither pandemic is waning, and capitalism’s dynamics will prompt future pandemics. Moreover, these pandemics coincide with escalating climate change disruptions. Massive global migrations induced by climate change will inevitably accelerate disease spread, including HIV/AIDS and SARS-CoV-2/COVID-19, while simultaneously disrupting the capacity to manage pandemics.
We underscore the need to eradicate capitalism and establish a new social order rooted in revolutionary democracy, where workers sustainably organize the production and distribution of necessities and thereby prevent mass pandemics. Just to add to the difficulty, we will need to do this “on the ashes of the old” —that is, while dealing with the catastrophes of global climate change, the pandemics capitalism spawned, and whatever disorganization and destruction takes place in the struggle to end capitalism.45Quotation from Ralph Chaplin in Solidarity Forever. Friedman has written a number of articles about ending and then replacing capitalism. These include: “What Is the ‘Working Class?,’” Against the Current 163 (2013); “Creating a Socialism that Meets Needs,” Against the Current 186 (2017); “Yes, There is an Alternative!” Against the Current 169 (2014); “Hegel’s Absolutes and Revolution: An Expanded Review of Eugene Gogol’s Toward a Dialectic of Philosophy and Organization” Critical Sociology 41, no. 6 (2015); “What Might Socialism Look Like?” Critical Sociology 38, no. 4 (2012); “Sociopolitical and Philosophical Questions of Organization in Making a Human Society,” Interface 2, no. 1 (2010); “Making the World Anew in a Period of Workers’ Council Rule,” We! Magazine 2, no. 63 (2008).
For now, we must remember that the way to total transformation—that is, a social and ecological revolution—is through mass movements that struggle for reforms in ways that build workers’ power and their consciousness of their power. Such struggles require a thorough understanding of the ways in which racial, gender, and other oppression can create new forms of mobilization and struggle, and can develop new ideas and proposals of how we will organize a new society. The historical memory of the caring communities and hard-won infrastructure built by groups like ACT UP and Stop AIDS is an invaluable lesson in how to respond to health emergencies with solidarity and people-centered programs, not austerity and profit-focused individualism.