New Viruses, Old Foundations. COVID-19, Global Health, and the Bill and Melinda Gates Foundation

A long history: philanthropic foundations & health organizations [Photo: Getty Images/juanmonino]
On May 19 this year, U.S. President Donald Trump threatened to permanently cancel U.S. payments to the World Health Organization (WHO). One month earlier, Trump had already announced that the U.S. would not honour its biannual 500 million USD commitment. The next day, the Bill and Melinda Gates Foundation stated that they would donate an additional 150 million to the WHO, on top of a previous 100 million USD. The Gates’ largesse precedes COVID19. Since 2000, their foundation has granted almost four billion USD to the WHO to support a gigantic program against polio, and additional hundreds of millions for other programs on malaria, HIV, and maternal health, and the escalated use of technology in health. The Gates Foundation is a crucial contributor to the WHO, second only to the U.S.

Despite its pre-existing involvement with the WHO, the Gates Foundation’s statement surprised many. The public wondered how it could be possible for a private actor to replace the contribution of a state to an international organization. In reality, there is nothing to be surprised about. For at least a century, philanthropic foundations have funded international organizations involved in health issues, including fighting pandemics, or even conducted what we call today global health policy. Actually, the continuities are so fundamental that the foundations from the early twentieth and the early twenty-first century seem to choose to globally fund health policies for similar reasons. Because the arguments are similar, and the means they used comparable, the criticisms raised against philanthropic foundations generally and their health policies also remain remarkably stable. The similarities between the past and the present suggest that the criticisms are here to stay. Indeed, certain observers would venture that older and newer philanthropic foundations are built upon the same questionable bases: unequal income distribution and lack of transparency and accountability.

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When norms collide: The COVID-19 pandemic and difficult choices on the hierarchy of norms and values

Norm collisions due to COVID-19 inevitably lead to societal conflicts [Image: Uriel Soberanes/Unsplash]

Note: A shorter version of this post was published earlier on Duck of Minerva.

Politics, as famously defined by David Easton, is the “authoritative allocation of values”, such as welfare, security, and liberty. Politicians thus have to make decisions on hierarchies between these values – and they have to weigh values against each other in cases in which they collide. It is still too early for an in-depth analysis of the numerous norm collisions in the responses to the COVID-19 pandemic. And yet, we can already see how the previously found balance between the three aforementioned values, and the norms revolving around them, is destabilised.

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The WHO’s Paradoxical Mandate

The WHO: Heeded during crises, ignored otherwise [Image: Markus Spiske/Unsplash]
In many countries around the world, the WHO is currently setting the agenda for a strategy to contain the Covid-19 pandemic. Its campaigns and recommendations on how to deal with Covid-19 are, though not entirely uncontroversial, widely distributed, while reaffirming one of its central roles: that of the epidemiological expert and crisis advisor, especially for poor countries.

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The Corona Outbreak and the Real

The Corona crisis lays bare the asymmetries in global capitalist production [Photo: GettyImages]

It is not surprising that in capitalist societies, especially with their neoliberal inflections, different forms of work have unequal worth. This inequity existed before the Corona outbreak and is only becoming more acute during it. Taking psychoanalysis’s reality principle – which emphasizes the need to be suspicious of any reality presenting itself as natural 1 – and a Lacanian understanding of the Real, which argues that the Real is what any ‘reality’ must suppress 2, one must see the Corona outbreak with all its articulations in the demand for certain workers over others as a crack – a fracture and inconsistency in the field of apparent reality under capitalism. This outbreak, therefore, invokes the Real, which is essentially a void that is usually unrepresented but can be glimpsed in the fractures underlying the reality that capitalism so wonderfully orchestrates and presents to us.

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  1.  

    Zupancic cited in Fisher M 2009, Capitalist Realism: Is there no Alternative?, Zero Books, England, p. 17 

  2.  

    ibid., p. 18 

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The WHO After Corona: Discretionary Powers for the Next Pandemic?

The WHO headquarters in Geneva, Switzerland [Copyright : WHO/Pierre Virot]

Note: This post was originally published on verfassungsblog.de.

Imagine the World Health Organization (WHO) had declared the outbreak of the mysterious lung ailment in the Chinese city of Wuhan a potential public health emergency of international concern already in late December 2019. Imagine it had immediately decreed a precautionary lockdown of the metropolitan area until the severity of the illness was assessed or the virus extinct. It might have been just in time to halt the spread of the disease which by now has become a supreme global emergency of unforeseen proportions.

Of course, this scenario was far from realistic given the WHO’s limited mandate and political authority. In reality, far from stopping the crisis dead in its tracks, its approach of appeasement and applause vis-à-vis China may have exacerbated the situation. The coronavirus crisis exposes deep gaps in the global governance of infectious diseases. Tragically, rectifying those problems would mean painful adaptations not only at the costs of national sovereignty, but also of democracy and constitutionalism.

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Back to the future

A regression of economic globalization due to Corona seems unlikely [Photo: Bene A/GettyImages]

It is not only the elderly and those with pre-existing illnesses who are among the potential victims of the Corona pandemic. The end of globalization itself, too, is seen as a possible long-term effect. Crises are indeed moments of historical recalibration. However, not everything changes after a crisis.

It is indeed questionable that the pandemic will lead to the end of globalization, at least economically. Undoubtedly, there are alternatives to the global production chains, and a partial renationalization of economic cycles is possible. That, though, comes at high costs and welfare losses. Upon the return of normalcy, public and private debt will have skyrocketed. This kind of environment does not make further globalization less likely.

The situation looks a bit different with regards to political globalization. Many view the current crisis as the hour of the executive, while others point to the fact that we are witnessing a renaissance of political regulation rather than the return of the sovereign nation-state.

Until an accurate assessment can be made, many things will happen.  The outcome of the crisis will be determined not only by objective facts, but to a large extent also by battles over their interpretation.

Read more on the global implications of the Corona pandemic in the full German article here.

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Don’t believe the lull: Corona politics from the unity of social distancing to populist social division

The political and economic implications of social distancing vary substantively [Gordon Johnson/Pixabay]

The coronavirus forced an unprecedented emergency brake on liberal democracies in recent weeks. Governments enacted sweeping social distancing measures to buy time in learning to control the virus and prevent health systems from collapsing. This new normal under an external threat appears to have changed politics. Governments rally support everywhere, even where populists govern badly. In contrast, even populist opposition actors lose support and acquiesce to the national emergency, as citizen priorities have shifted starkly. Does the Corona crisis thus mark an abrupt ending to the oft-lamented divisive politics of recent decades? Does it rein in a phase of historical unity or even herald the beginning of the end of populism?

In contrast, the emerging political economy of social distancing suggests otherwise. The standard ingredients for populist political conflict are already visible. Existing challenges to material inequalities and privileged social status within constrained democracies which feed populists are likely to exacerbate over social distancing, particularly at the international level. The momentary lull of national unity is thus more likely to give way to the forceful return of familiar distributive and constitutional conflicts of the last decades, but at even higher stakes.

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The ugly face of health politics – COVID-19 and the hypocrisy of the ‘saving lives’ metaphor

Public health must remain a key concern also outside times of crisis [Ashkan Forouzani/Unsplash]

As more and more people are voluntarily or forcefully retreating to their homes and isolating themselves from public life and social contact due to the ongoing global health crisis, it might be a good time to reflect on the circumstance that, according to estimates by WHO and UNICEF, in 2018 globally every five seconds a child or young person under 15 died of preventable infectious diseases, such as measles, or of complications in childbirth – many of them a consequence of unsafe births, lacking personnel, equipment, hygiene, infrastructure, and poor maternal health. A few days ago, I met an acquaintance, whose school-aged children have not been vaccinated against measles, carrying a stack of toilet paper packages in preparation for what was bound to come, the German-wide COVID-19 lockdown. The encounter made me aware of the imbalance between our plausible and humane concern for the safety and well-being of ourselves and those close to us on the one hand and a lack of awareness of our own role in preserving public health beyond COVID-19 on the other.

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Reflections of a disgruntled liberal

Liberals must ask themselves what it is that they stand for. [Photo: Getty Images]

I tend to avoid the word liberal as much as possible in conversation. My reticence does not come from any ideological aversion (although that could be forgiven), but from an abundance of caution. What exactly do my peers mean by liberal? ‘Does it include respect for the rule of law, freedom of expression and other unenumerated rights?’ Yes, they nod. ‘What of free markets and a rules-based international order.’ Their enthusiasm is now palpable. Here, I cannot help but goad them. ‘Or does it merely guarantee that my rent increases without end and that I’ll never actually own anything?’ A dose of cynicism and the conversation stalls. ‘That’s not the point,’ they usually reply! ‘It’s dishonest to confuse neo-liberalism with classical liberalism, and besides, it’s certainly better than the alternatives.’ Ah yes, the perfunctory defense: it could be worse. ‘Is that the best we can do?’ I ask. ‘That it could be worse?’ On cue, the coffee machine growls, and the conversation ends. The comment is barbed, but not without making a point. What are the liberal values worth defending? And why does it matter now?

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Northern dogmatism damages European solidarity

Zero deficits might not always be economically advantageous [Photo: GettyImages]
Germany’s current debate about the ‘schwarze Null’ is heating up. Last month, SPD-frontwoman Saskia Esken threw her weight behind existing calls to let go of Germany’s unwritten rule that bans government deficits and has yielded eight consecutive years of budget balance for the federal government. Even Jens Weidmann, notorious throughout Europe for his hawkish stance as president of the Bundesbank, has said Germany should not fetishize the black zero. The debate is a welcome development not only for Germany but for the EU as a whole.

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