{"id":11174,"date":"2020-03-19T23:34:52","date_gmt":"2020-03-20T02:34:52","guid":{"rendered":"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/?p=11174"},"modified":"2020-07-09T23:21:32","modified_gmt":"2020-07-10T02:21:32","slug":"covid-19-and-globalization-epidemics","status":"publish","type":"post","link":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/covid-19-and-globalization-epidemics\/","title":{"rendered":"Covid-19 and Globalization Epidemics"},"content":{"rendered":"<p style=\"text-align: right;\">March 2020<\/p>\n<div id=\"attachment_11175\" style=\"width: 265px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-11175\" class=\"wp-image-11175\" src=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/wp-content\/uploads\/2020\/03\/Marcos_Cueto2019_hor.jpg\" alt=\"\" width=\"255\" height=\"309\" \/><p id=\"caption-attachment-11175\" class=\"wp-caption-text\">Marcos Cueto<\/p><\/div>\n<p><em>Marcos Cueto*<\/em><\/p>\n<p><span style=\"font-weight: 400;\">Epidemics return every so often to remind us of our vulnerability: vulnerability to disease and to the powers that be. Within a few months, something that appeared to be a catastrophe in a distant land became an everyday tragedy at home. This disease, produced by a highly insidious infectious agent \u2014 popularly known as the coronavirus \u2014 has spread like few past epidemics to almost every corner of the world. It is revealing the vileness of the right-wing, populist authoritarian governments that have attacked science and public health \u2014 encouraging their partisans to think irrationally \u2014 creating the conditions for the despair, misinformation, stigma and chaos that we are now suffering.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This epidemic is just the latest edition of a sad after-effect of the changes that began in the 1980s, when most governments embraced neoliberalism and globalization and its cruel doctrine that called for a drastic reduction in public spending and dismantling of State intervention in social programs. This created a culture in which profit was more important than everything and everyone; where national and international health system medical staff were cut and where a never-ending sequence of healthcare disasters has become commonplace, such as AIDS, Dengue, SARS, H1N1, Ebola, Zika and the epidemic that oppresses us now.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These epidemics have magnified the relationship between unfair economic systems and adverse living conditions, and have confirmed the persistence of racism \u2014 one need only recall the unfortunate comments by the President of the United States regarding a &#8220;foreign&#8221; virus and his deliberately associating it with the Chinese. This doctrine idealizes the neoliberal lifestyle and remains silent on the structural vulnerability in which most people live. This does not mean that personal hygiene and self-isolation are not important, but these measures do not reflect the living conditions of the vast majority of poor families on the outskirts of cities. They are crowded into small spaces with limited access to water, far from health centers, and with elderly family members already victimized by the principal social determinants of respiratory diseases: poverty, lack of adequate rest and poor diet.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The pandemics mentioned above arose or were aggravated by discrimination, climate deterioration, exploitation of natural resources through unregulated extractive practices and the denial of human rights, such as each person&#8217;s right to healthcare\u2014factors that openly or inherently glorified neoliberalism. These crises were accompanied by the banalization of preventable deaths and illnesses and the reproduction of criminal stereotypes regarding the victims of epidemics, such as minorities, the poor, indigenous people and women.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The terrible epidemic we are experiencing is evidence not only of the economic, social and environmental forces that neoliberalism unleashed, but also of its inability to build an inclusive future. It also marks the almost irreparable erosion of one of the most valuable supranational laws that has now been all but forgotten: the International Health Regulations (2005).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to these regulations, which all countries signed, the World Health Organization (WHO) is responsible for articulating and coordinating responses to pandemics (Cueto, 2015). It was developed after many discussions of fundamental agreements that date back to the beginning of the 20th century. As has been evident almost since the beginning of Covid-19, each country, state or city has done whatever it preferred, heeding and quoting WHO when convenient. It is important to recall that there has been a recurring lack of international financing for these regulations and persistent erosion of the legitimacy of this United Nations multilateral agency by industrialized countries.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The differences between the 2008 economic crisis and the 2020 health crisis are important. In 2008, the U.S. government raised more than $700 billion in a few days to save private banks. In contrast, during the Covid-19 epidemic, the U.S. government initially allotted just over two billion dollars (fortunately, congress has increased this figure by a few billion, but this is still clearly insufficient). To make matters worse, in the last few years the White House has cut about $700 million in funding to one of the best epidemiological centers in the world\u2014the Centers for Disease Control (CDC)\u2014and eliminated the White House team responsible for monitoring international epidemic outbreaks.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, sometimes catastrophes provide unique opportunities to reflect and improve. In a world where a series of scandals compete for time on mass media, epidemic diseases allow public health practitioners, scientists and healthcare historians to raise their voices and make sure that the importance of their work\u2014our work\u2014is recognized. We must remind everyone of the consequences of the preventable endemic diseases that afflict society. We must reveal the lethality of discounting scientific methods. We must demand prevention and solidarity. We must restore and increase funding for public healthcare systems and redirect public services and employees, who must not be subservient to private economic interests.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As historians, some of us have devoted ourselves, at times, to thinking about epidemic catastrophes, and we have concluded that the incompetent leadership of blind, hysterical authorities\u2014in addition to xenophobia, despair and chaos\u2014aggravate the disaster (Cueto, 1997) .<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In the case of Covid-19, there are urgent problems to be solved. The lack of exams, the small number of laboratories that can process the exams, the inadequate training of healthcare professionals regarding how to administer these exams and analyze the results, the extent to which people follow medical advice, the strong possibility that the medical centers providing treatment will become overburdened and the estimated serious economic impact all presage a disaster. As with the worthy responses to other epidemics by healthcare practitioners and scientists, we must respond to the present situation and, at the same time, look to the future.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It appears that, in poor and middle-income countries, the most effective inexpensive measures are &#8220;social distancing&#8221; (at least one and a half meters between individuals), cancellation of events and meetings, and the reduction of public transport to a minimum, since public transport has become the great urban vector for Covid-19.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to medical historian Charles Rosenberg, epidemics generally have a cycle that begins with denial, passes through resignification and resignation, and ends in forgetfulness (Rosenberg, 1992). As in other epidemics, one of the main dangers we face is not only that the Covid-19 epidemic worsens, but that afterward we once again tolerate the lack of investment in public health and miss an opportunity to end the feedback between fragmented, insufficient responses and the recurrence of epidemics.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The hope of this author is that this time things will be different: that we can not only control, mitigate and implement public health measures with full political and financial support, but also convince ourselves that public health\u00a0<\/span><i><span style=\"font-weight: 400;\">is<\/span><\/i><span style=\"font-weight: 400;\">\u00a0intrinsically global and an obligation of the State toward all citizens, and that we must allocate significant funding for research, including historical research, which can tell us much more about the challenges of healthcare in order to understand and act in the present and plan the future with hope.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">* Marcos Cueto is the science editor of the Revista Hist\u00f3ria, Ci\u00eancias, Sa\u00fade &#8211; Manguinhos, the author of works on epidemics in Peru and Latin America, and co-author, with Theodore M. Brown and Elizabeth Fee, of a book on the history of the World Health Organization entitled The World Health Organization, a History (New York: Cambridge University Press, 2019)<\/span><\/i><\/p>\n<p><b>References:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">CUETO, Marcos.\u00a0<\/span><i><span style=\"font-weight: 400;\">El regreso de las epidemias: salud y sociedad en el Per\u00fa\u0301 del siglo XX.<\/span><\/i><span style=\"font-weight: 400;\">\u00a0Lima: Instituto de Estudios Peruanos. 1997.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">______.\u00a0<\/span><i><span style=\"font-weight: 400;\">Sa\u00fade global: uma breve hist\u00f3ria.<\/span><\/i><span style=\"font-weight: 400;\">\u00a0Rio de Janeiro: Editora Fiocruz. 2015.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">ROSENBERG, Charles.\u00a0<\/span><i><span style=\"font-weight: 400;\">Explaining Epidemics and Other Studies in the History of Medicine.<\/span><\/i><span style=\"font-weight: 400;\">\u00a0 New York: Cambridge University Press. 1992.<\/span><\/p>\n<p><strong>Read articles by Marcos Cueto in HCS-Manguinhos:<\/strong><\/p>\n<p>Anderson, Warwick, Cueto, Marcos and Santos, Ricardo Ventura.\u00a0<strong><a href=\"http:\/\/dx.doi.org\/10.1590\/s0104-59702016000500012\" target=\"_blank\" rel=\"noopener noreferrer\"><span class=\"negrito\">Applying a southern solvent: an interview with Warwick Anderson<\/span><\/a><\/strong>. Dec 2016, vol.23, suppl.1.<\/p>\n<p>Cueto, Marcos.\u00a0<strong><a href=\"http:\/\/dx.doi.org\/10.1590\/S0104-59702016000300013\" target=\"_blank\" rel=\"noopener noreferrer\">Activismo estadounidense en la historia de la salud internacional<\/a><\/strong>. Set 2016, vol.23, no.3.<\/p>\n<p>Cueto, Marcos.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702015000100255&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\"><b>La \u201ccultura de la sobrevivencia\u201d y la salud p\u00fablica internacional en Am\u00e9rica Latina: la Guerra Fr\u00eda y la erradicaci\u00f3n de enfermedades a mediados del siglo XX<\/b><\/a>. Mar 2015, vol.22, no.1<\/p>\n<p>Cueto, Marcos.\u00a0<strong><a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702013000200709&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\">Salud en la adversidad: un resumen de la historia sanitaria del Brasil<\/a><\/strong>. Jun 2013, vol.20, no.2<\/p>\n<p>Contreras, Carlos and Cueto, Marcos.\u00a0<strong><a href=\"http:\/\/contreras%2C%20carlos%20and%20cueto%2C%20marcos%20caminos%2C%20ciencia%20y%20estado%20en%20el%20per%C3%BA%2C%201850-1930.%20hist.%20cienc.%20saude-manguinhos%2C%20set%202008%2C%20vol.15%2C%20no.3\/\">Caminos, ciencia y Estado en el Per\u00fa, 1850-1930<\/a><\/strong>. Set 2008, vol.15, no.3.<\/p>\n<p>Brown, Theodore M., Cueto, Marcos and Fee, Elizabeth.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702006000300005&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\"><b>A transi\u00e7\u00e3o de sa\u00fade p\u00fablica \u2018internacional\u2019 para \u2018global\u2019 e a Organiza\u00e7\u00e3o Mundial da Sa\u00fade<\/b><\/a>.\u00a0 Set 2006, vol.13, no.3<\/p>\n<p>Cueto, Marcos and Puente, Jos\u00e9 Carlos de la.\u00a0<strong><a href=\"http:\/\/dx.doi.org\/10.1590\/S0104-59702003000400016\" target=\"_blank\" rel=\"noopener noreferrer\">Vida de leprosa: the testimony of a woman living with Hansen\u2019s disease in the Peruvian Amazon, 1947<\/a><\/strong>. 2003, vol.10, suppl.1.<\/p>\n<p>Cueto, Marcos.\u00a0<strong><a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702003000100022&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\">Norteamericanizaci\u00f3n de Brasil<\/a><\/strong>. Abr 2003, vol.10, no.1<\/p>\n<p>Cueto, Marcos.\u00a0<strong><a href=\"http:\/\/dx.doi.org\/10.1590\/S0104-59702002000100010\" target=\"_blank\" rel=\"noopener noreferrer\">El pasado de la medicina: la historia y el oficio. Entrevista con Roy Porter<\/a><\/strong>. Abr 2002, vol.9, no.1.<\/p>\n<p>Cueto, Marcos.\u00a0<strong><a href=\"http:\/\/dx.doi.org\/10.1590\/S0104-59702002000400002\" target=\"_blank\" rel=\"noopener noreferrer\">El rastro del SIDA en el Per\u00fa<\/a><\/strong>. 2002, vol.9.<\/p>\n<p>Cueto,\u00a0Marcos.<a href=\"http:\/\/www.scielo.br\/scielo.php?pid=S0104-59701999000100007&amp;script=sci_arttext\">\u00a0<b>Im\u00e1genes de la salud, la enfermedad y el desarrollo<\/b>:\u00a0<b>fotograf\u00edas de la Fundaci\u00f3n Rockefeller en Latinoam\u00e9rica<\/b><\/a>.\u00a0 Feb 1999, vol.5, no.3<\/p>\n<p>Cueto, Marcos and Birn, Anne-Emanuelle.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59701996000100011&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\"><b>Syllabus del curso:historia social de la salud p\u00fablica en Am\u00e9rica Latina<\/b><\/a>. Jun 1996, vol.3, no.1<\/p>\n<p><strong>Read on epidemic diseases in HCS-Manguinhos blog:<\/strong><\/p>\n<p class=\"p1\"><strong><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/the-brazilian-unified-health-system-and-coranavirus\/\" target=\"_blank\" rel=\"noopener noreferrer\">The Brazilian Unified Health System and Coronavirus<\/a><\/strong><br \/>\nThe Sistema Unico de Saude (SUS) will be decisive against Coronavirus in Brazil. To understand how the system was created and its rationale read our selected article by two Historians from Casa de Oswaldo Cruz\/FIOCRUZ.<\/p>\n<p class=\"p1\"><strong><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/el-coronavirus-y-la-epidemia-de-gripe-de-1918-19-paralelos-historicos\/\" target=\"_blank\" rel=\"noopener noreferrer\">Coronav\u00edrus y la gripe de 1918-19: paralelos hist\u00f3ricos<\/a><\/strong><br \/>\nPara Mar\u00eda Isabel Porras Gallo no bastan recursos m\u00e9dicos y tecnol\u00f3gicos eficaces. \u201cEs imprescindible la existencia de m\u00ednimas condiciones higi\u00e9nico-sanitarias, econ\u00f3micas y sociales\u201d.<\/p>\n<p class=\"p1\"><strong><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/crisis-del-coronavirus-despierta-el-interes-por-la-historia-de-las-grandes-epidemias\/\" target=\"_blank\" rel=\"noopener noreferrer\">Coronavirus despierta inter\u00e9s por la historia de las epidemias<\/a><\/strong><br \/>\nCon el mundo en estado de alerta para evitar la diseminaci\u00f3n del coronavirus, acceda a una selecci\u00f3n de nuestras publicaciones sobre el tema.<\/p>\n<p class=\"p1\"><strong><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/malaria-epidemics-in-europe-after-the-first-world-war\/\" target=\"_blank\" rel=\"noopener noreferrer\">Malaria epidemics in Europe after the First World War<\/a><\/strong><br \/>\nThis paper discusses the initiatives against Malaria epidemics over this period and identifies them as early stages of an international approach to the control of the disease.<\/p>\n<div class=\"entry-content clearfix\">\n<p class=\"p1\"><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/contagion-historical-views-of-diseases-and-epidemics\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Contagion: Historical Views of Diseases and Epidemics<\/strong><\/a><br \/>\nThis online collection provides information on diseases and epidemics worldwide, and is organized around significant \u201cepisodes\u201d of contagious disease.<\/p>\n<p class=\"p1\"><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/epidemics-helped-build-amazonias-colonial-society\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Epidemics helped build Amazonia\u2019s colonial society<\/strong><\/a><br \/>\nArticle by Rafael Chambouleyron, Benedito Costa Barbosa, Fernanda Aires Bombardi and Claudia Rocha de Sousa.<\/p>\n<p class=\"p1\"><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/the-history-of-a-mosquito\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>The history of a mosquito<\/strong><\/a><br \/>\nThis article analyzes the initial reactions of scientists and public health authorities against the epidemics of malaria caused by this species.<\/p>\n<p class=\"p1\"><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/two-views-on-malaria\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Two views on malaria<\/strong><\/a><br \/>\nThis research compares two views of malaria in the Amazon that coexisted side by side during the First Brazilian Republic (1889-1930). April 25, World Malaria Day.<\/p>\n<p class=\"p1\"><b><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/the-influenza-epidemic-in-portugal-1918-1919\/\" target=\"_blank\" rel=\"noopener noreferrer\">The influenza epidemic in Portugal, 1918-1919<\/a><br \/>\n<\/b>The 1918 influenza pandemic was a catastrophe on a global scale. This paper investigates the epidemic in Coimbra, Portugal, using information found in the pages of a local newspaper.<\/p>\n<p class=\"p1\"><b><a href=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/influenza-digital-archive\/\" target=\"_blank\" rel=\"noopener noreferrer\">Influenza digital archive<\/a><br \/>\n<\/b>The website is an open access digital collection of archival material related to the history of the 1918\u20131919 influenza pandemic in the United States.<\/p>\n<p class=\"p1\"><strong>Read on epidemic diseases in HCS-Manguinhos:<\/strong><\/p>\n<p class=\"p1\">Ballester, Rosa, Porras, Mar\u00eda Isabel and B\u00e1guena, Mar\u00eda Jos\u00e9.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702015000300925&amp;lng=en&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\"><b>Pol\u00edticas sanitarias locales puestas a prueba: consultores, expertos, misiones internacionales y poliomielitis en Espa\u00f1a, 1950-1975<\/b><\/a>.\u00a0<i>Hist. cienc. saude-Manguinhos<\/i>, v. 22,\u00a0n. 3,\u00a0p. 925-940,\u00a0 Sep.\u00a0 2015.<\/p>\n<p class=\"p1\">Lopes, Gabriel. <b><a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702019000300823&amp;lng=pt&amp;nrm=iso&amp;tlng=en\" target=\"_blank\" rel=\"noopener noreferrer\">Anopheles gambiae in Brazil: the background to a \u201csilent spread,\u201d 1930-1932.<\/a>\u00a0<\/b><em>Hist. cienc. saude-Manguinhos<\/em>, v. 26,\u00a0n. 3,\u00a0p. 823-839,\u00a0 Sep.\u00a0 2019.<\/p>\n<p class=\"p1\">Pemberton, Rita. <strong><a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702012000500004&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\">Dirt, disease and death: control, resistance and change in the post-emancipation Caribbean<\/a>.<\/strong><b>\u00a0<\/b><em>Hist. cienc. saude-Manguinhos<\/em>,\u00a0 v. 19,\u00a0supl. 1,\u00a0p. 47-58,\u00a0 Dec.\u00a0 2012.<\/p>\n<p class=\"p1\">Serr\u00f3n, V\u00edctor.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702011000300006&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\"><b>Epidemia y perplejidades m\u00e9dicas<\/b>:\u00a0<b>Uruguay, 1918-1919<\/b><\/a>.\u00a0<i>Hist. cienc. saude-Manguinhos<\/i>, v. 18,\u00a0n. 3,\u00a0p. 701-722,\u00a0 Sep.\u00a0 2011.<\/p>\n<p class=\"p1\">Spesny, Sara Leon. <strong><a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702014000401498&amp;lng=pt&amp;nrm=iso\" target=\"_blank\" rel=\"noopener noreferrer\">Les politiques du corps: l\u2019approche critique de Didier Fassin \u00e0 l\u2019\u00e9pidemie du Sida en Afrique du Sud<\/a>.\u00a0<\/strong><em>Hist. cienc. saude-Manguinhos,<\/em>\u00a0 v. 21,\u00a0n. 4,\u00a0p. 1498-1500,\u00a0 Dec.\u00a0 2014.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;The terrible epidemic we are experiencing is evidence not only of the economic, social and environmental forces that neoliberalism unleashed, but also of its inability to build an inclusive future&#8221;. 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