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la pandémie qui menace l'avenir de l'humanité est appelée capitalisme

Ce travail approfondi (initialement publié en mars par Lucha de Clases en espagnol) expose qui contrôle les ressources économiques et sanitaires du monde, comment nous pouvons rompre avec le système capitaliste exploiteur et irrationnel qui étrangle la santé publique, et comment nous pouvons assurer des soins de santé à la classe ouvrière du monde entier.


Plusieurs mois se sont écoulés depuis que l'un des marchés humides les plus traditionnels de Wuhan – la septième plus grande ville de Chine – a vu la première épidémie de pneumonie atypique. Depuis que le nouveau virus a été isolé, les enquêteurs chinois et leurs homologues de l'OMS ont identifié le nouveau pathogène comme appartenant à la famille des coronavirus, qui se propage largement dans la nature et infecte principalement les animaux, bien que certaines souches – en particulier celles du bêta coronavirus genre – faites le saut aux humains.

Depuis lors, comme si un tremblement de terre secouait la planète, le monde entier a été bouleversé. Du jour au lendemain, dans tous les pays, les régimes bourgeois, leurs États et leurs gouvernements de tous bords, font face à la plus grande crise sanitaire, sociale et économique de mémoire d'homme. Maintenant, tout le monde suppose que les perspectives les plus favorables seraient un scénario similaire à celui des années 1930 avant la Seconde Guerre mondiale, et dans le pire des pronostics, cela pourrait devenir la crise la plus grave de l'histoire du capitalisme.

L'incapacité de tous les gouvernements du monde à faire face à la pandémie de COVID-19 a été claire dès le début, montrant l'anarchie qui caractérise l'économie de marché, son incapacité à anticiper et son épuisement en tant que système progressif.

La première réaction, à commencer par le régime chinois, a été de masquer et de minimiser le risque posé par l'épidémie. Ils ont probablement calculé que l'épidémie pouvait être contrôlée et que, comme en 2003, le SRAS-COV provoquant le soi-disant syndrome respiratoire aigu sévère, la transmission ne se propagerait pas largement et le virus disparaîtrait rapidement. C'est l'expérience qu'ils ont eue avec le SRAS. A cette occasion, depuis le premier cas du Guangdong en novembre 2002, l'épidémie s'est étendue sur plusieurs mois pour toucher 29 pays entre l'Asie, l'Amérique et l'Europe, totalisant (selon l'OMS) 8 403 personnes infectées et 775 tués. Ensuite, l'épidémie a disparu et depuis décembre 2003, aucun nouveau cas n'a été signalé.

Malheureusement, à cette nouvelle occasion, le virus s'est propagé de manière massive car – entre autres raisons – contrairement au SRAS, de nombreuses personnes infectées sont asymptomatiques. Après un mois à nier les preuves, le gouvernement chinois a commencé à prendre des mesures drastiques, d'abord à Wuhan, puis dans tout le Hubei, mais le virus s'était déjà propagé dans le reste du monde.

Loin d'apprendre les erreurs commises par la Chine, la plupart des gouvernements des grandes puissances mondiales ont initialement suivi la même voie d'improvisation et de minimisation du danger. Ce n'est que lorsque la crise a atteint des dimensions incontrôlables que les gouvernements ont commencé à réagir et à dire que la lutte contre la pandémie devait être considérée comme une guerre mondiale.

Bien sûr, comme cela arrive toujours en temps de guerre, la première victime est la vérité. Dans chaque pays, la classe dirigeante et ses gouvernements ont utilisé l'État et toutes les ressources à leur disposition pour masquer l'incapacité de leur système à faire face à cette pandémie. Ils ont l'intention de cacher leur responsabilité pénale en disant cela si tout le monde lutte, et que le virus ne fait pas de distinction entre les riches et les pauvres.

Rien ne pourrait être plus éloigné de la vérité! Cette lutte, comme les autres guerres, a un caractère de classe clair, comme le montrent les données objectives. Ce sont les travailleurs et nos familles qui subissent les conséquences sanitaires, économiques et sociales les plus néfastes de la pandémie. Ce sont des travailleurs ordinaires qui, mettant notre santé en danger, sans aucun moyen de protection, garantissent que la société peut continuer à fonctionner.

Les milliardaires qui possèdent et contrôlent les richesses de la planète et leur cohorte d’agents privilégiés n’épargnent aucune ressource pour assurer leur propre protection. Ils nous disent que, même s'il n'y a pas suffisamment de moyens de protection et que notre santé est menacée, la production ne doit pas s'arrêter. Leur objectif est de s'assurer que les bénéfices continuent de leur arriver, et même de transformer la pandémie en opportunité commerciale.

Ce message qu'ils nous répètent tout le temps, que les conséquences de ce virus nous affectent tous également, est un gros mensonge. La réalité est que les travailleurs subissent les conséquences de cette crise, c'est notre avenir et nos familles qui sont en danger. Pour la bourgeoisie, ce qui est vraiment important, comme dans tout conflit passé ou futur, c'est de réaliser le maximum de profits possibles, peut-être même de profiter directement de la pandémie.

L'impérialisme au 21e siècle, la concentration de la production et la domination des monopoles

Dans son livre L'impérialisme: la plus haute étape du capitalisme publié en mai 1916, Lénine a conclu que, d'un point de vue économique:

«L'impérialisme est le capitalisme à ce stade de développement où la domination des monopoles et du capital financier s'est établie; où l'exportation de capitaux a acquis une importance considérable; où la division du monde entre les trusts internationaux a commencé; dans lequel la division de tous les territoires du globe entre les plus grandes puissances capitalistes a été achevée. »

Aujourd'hui, analysant la situation économique mondiale, sa thèse n'a pas seulement été confirmée par les faits, mais le processus qu'il anticipait a connu une évolution exponentielle.

Selon le rapport Global 500 du magazine américain Fortune, depuis le début du 21e siècle, les 500 plus grands groupes d'entreprises produisent et vendent 40% de toutes les richesses générées sur la planète. En 2018, les ventes de ces énormes conglomérats capitalistes mondiaux ont totalisé 32,7 billions de dollars: 38,12% du PIB mondial (estimé à 85,7 billions de dollars), avec des bénéfices nets de 2,15 billions de dollars. Au cours de la dernière décennie, les ventes du G500 ont augmenté de près de 10 billions de dollars (de 23 à 32,7 billions de dollars) et les bénéfices ont augmenté de 650 milliards de dollars. Le nombre de travailleurs actuellement employés par ces 500 entreprises est de 69,3 millions. Ce qui est exprimé dans ces données, c'est que cette énorme concentration de production est générée par une petite fraction des travailleurs du monde: 69,3 millions sur 3 milliards, soit seulement 2,4% de la main-d'œuvre mondiale.

Revenu % Bénéfices % Les atouts Personnel
Secteur Entreprises Quadrillions ($) Total Rev.

F 500

Billions ($) Total F 500 Milliards ($) Des millions
Énergie 83 7.061 21,59% 436,588 20,31% 9.132 9.179
La finance 118 6.869 21,00% 709.859 33,02% 98,93 11,722
Véhicules à moteur et composants 34 2,77 8,47% 115,682 5,38% 3.897 6.081
La technologie 37 2,408 7,36% 312.449 14,53% 3.232 5.524
Santé 26 2.0 6,12% 112.076 5,21% 2,36 3.126
Ventes au détail 17 1,559 4,77% 67,22 3,13% 1.026 5.724
Télécommunications 16 1.235 3,78% 92,971 4,32% 2,994 3.115
Grossistes 23 1.173 3,59% 28,349 1,32% 0,931 1,347
Épiceries et pharmacies 18 1.152 3,52% 19,922 0,93% 0,758 4.111
Matériaux 24 1.066 3,26% 25,506 1,19% 1,244 2.3
Transport 20 0,949 2,90% 45,851 2,13% 2,87 4.674
Métallurgie et construction 12 0,872 2,67% 20,533 0,95% 1.213 2,464
Commerçants 18 0,839 2,57% 25.487 1,19% 1,189 2,449
Nourriture, boisson et tabac 18 0,76 2,32% 55,34 2,57% 1,251 2.089
Aérospatiale et défense 14 0,692 2,12% 43,371 2,02% 0,993 2,344
Produits chimiques 8 0,402 1,23% 32,7 1,07% 0,641 0,583
Autres 14 0,893 2,73% 6.096 0,73% 2,423
Total 500 32,7 100,00% 2.150.000 100,00% 132,651 69,3

Tableau 1: 2018 – Répartition du F500 par secteur. La source: Fortune magazine

Monopole de la santé

En analysant les données du tableau 1, nous pouvons voir que les soins de santé sont le cinquième secteur du F500 en termes de chiffre d’affaires et de bénéfices. Les 26 groupes monopolistiques qui la composent ont réalisé un chiffre d'affaires de 2 milliards USD en 2018 et gagné 112 076 000 USD. Ces grandes sociétés multinationales comprennent des assureurs, des prestataires de services médicaux, des fabricants de matériel médical et chirurgical, des distributeurs de matériel médical et de grands laboratoires pharmaceutiques, avec 13 groupes représentés.

Pays Sous-secteur des entreprises Revenu Bénéfices Les atouts Personnel
Milliards ($) Milliards ($) Milliards ($)
Etats-Unis UnitedHealth Group – Assurances 226.247 11,986 152.221 300 000
Etats-Unis McKesson – Distributeur pharmaceutique 214.319 0,034 59,672 70 000
Etats-Unis CVS Health – Distributeur pharmaceutique 194,579 -0,594 196,456 295 000
Etats-Unis Amerisource Bergen – Grossiste 167,94 1,658 37,670 20 500
Etats-Unis Cardinal Health – Distributeur pharmaceutique 136.809 0,256 39,951 50 200
Etats-Unis Hymne – Assurances 92.105 3,75 71,571 63 900
Chine China Resources – Pharma 91,986 3,475 209,652 421 274
Etats-Unis Johnson et Johnson – Pharma 81,581 15.297 152,954 135 100
Suisse Groupe Roche – Pharma 60.846 10,738 79,680 94 442
Etats-Unis Centene – Assurances 60.116 0,9 30.901 47 300
Chine Sinopharm – Pharma 59,98 0,884 49.823 128 600
Etats-Unis Humana – Assurances 56,912 1,683 25.413 41 600
Etats-Unis Pfizer – Pharma 53,647 11.153 159,422 92 400
Suisse Novartis – Pharma 53.166 12,611 145,563 125,161
Etats-Unis Cigna – Assurances 48,65 2,637 153.226 73 800
Allemagne Bayer – Pharma 46,718 2.0 144,344 116,998
Etats-Unis HCA Healthcare – Installations médicales 46,677 3,778 39.207 229 000
Etats-Unis Merck – Pharma 42.294 6.22 82,637 69 000
France SANOFI – Pharma 42.105 5.082 127,339 104,226
G. Grande-Bretagne GlaxoSmithKline – Pharma 41.109 4.832 73,941 95 490
Allemagne Fresenius – Installations médicales 39,571 2,392 64,812 276 750
Etats-Unis AbbVie – Pharma 32,753 5.687 59,352 30 000
Etats-Unis AbbotLaboratories – Pharma – Fournitures médicales 30,578 2,368 67.173 103 000
Allemagne Phoenix Pharma – Pharma 30.296 -0.1745 9,600 29,631
Irlande Medtronic – Fournitures médicales 29,953 3.104 91,393 98 003
Japon Medipal Holding – Grossiste 28,699 0,31 14,619 15 623
26 monopoles 2 009,636 112.0755 2 338,592 3,126,998

Tableau 2: Entreprises du secteur de la santé dans le F500. La source: Fortune magazine

La première chose qui ressort de l'examen des données du tableau 2 est la prédominance écrasante du capital nord-américain. Les multinationales basées aux États-Unis comprennent 15 des 26 plus grands conglomérats du secteur, générant plus de 1 485 billions de dollars US, soit 73,90% du total, avec des revenus de 66 822 000 $ US ou 59,74%. Les autres pays représentés sont l'Allemagne avec trois sociétés; La Chine et la Suisse avec deux chacune; et la Grande-Bretagne, la France, l'Irlande et le Japon avec un par pays.

La prédominance des entreprises américaines reflète l'énorme taille du marché nord-américain des soins de santé: 2,93 milliards USD en 2018, 17% du PIB américain et près de 40% du marché mondial. Le système de santé américain, dépendant de la gestion et du contrôle privés et défendu par le régime bourgeois et les deux partis qui le soutiennent, utilise le plus de ressources sur la planète. Il est le troisième en importance par habitant, dépensant avec 9403 $ US par personne, dépassé uniquement par la Suisse (9674 $ US) et la Norvège (9 522 $ US), et il est le plus rentable pour le monopole international des soins de santé. Paradoxalement, cet énorme flux de ressources ne garantit pas la santé universelle. Seuls les secteurs riches de la population ayant le plus de pouvoir d'achat bénéficient de soins de santé de qualité. Les travailleurs, s'ils ont une assurance d'entreprise ou peuvent payer pour une police privée, voient au mieux des prestations de santé limitées. Le système laisse beaucoup de ceux qui passent à travers les mailles du filet, plus de 30 millions de personnes, sans prestations ni assurance médicale.

Pays Investissement dans les soins de santé

Des milliards

% du PIB national consacré aux soins de santé Investissement dans les soins de santé
Par habitant
Etats-Unis 2.934,3 17% 9 403 $
Chine 316.568 2,60% 225,72 $
Japon 417.371 9.21% 3 308,04 $
Allemagne 346,825 9,35% 4 189,32 $
G. Grande-Bretagne 194,75 7,72% 2 938,68 $
France 236,936 9,06% 3 540,2 $
Italie 124.135 6,43% 2 052 $
Canada 117.196 7% 3 173,04 $
Corée du Sud 71,748 4,86% 1 390 $
Espagne 81,47 6,06% 1 746,36 $

Tableau 3: Coûts des soins de santé en milliards de dollars, le pourcentage représente le PIB et le coût par habitant dans les principales économies mondiales. La source: Expansion

Big Pharma

Un autre facteur important qui se dégage de l'examen des données du secteur de la santé est l'importance des grands laboratoires pharmaceutiques, ou Big Pharma. En termes de nombre de groupes (13, soit 50% des 26 du secteur qui composent le F500) et de chiffre d'affaires (624 464 000 USD, soit 31,08% du total), il est le plus important. Ses marges bénéficiaires sont de 71 991 500 USD, soit 64,25 pour cent du total du secteur de 112 076 000 USD.

Les ventes mondiales de médicaments en 2017 représentaient entre 20 et 25% des dépenses de santé mondiales, 1,1 milliard USD, réparties comme suit:

  • Amérique du Nord (États-Unis et Canada): 37%
  • Pacifique / Asie: 22 pour cent
  • Europe: 20%
  • Reste du monde: 21%

Cette même année, les 50 plus grands laboratoires de la planète ont réalisé des ventes de 642 478 000 USD et gagné 121 259 000 USD, avec un taux de retour sur ventes de 19%.

L'origine des brevets et leur signification aujourd'hui

Pas par coïncidence, l'apparition et la réglementation légale des brevets – c'est-à-dire le droit accordé par les gouvernements à un inventeur de l'utilisation exclusive de son invention, en la gardant hors de portée des autres pour une période de temps donnée – est étroitement liée à les origines mêmes du capitalisme. La première loi sur les brevets enregistrée a été adoptée dans la République la plus sereine de Venise en 1474. Elle a fixé une durée de 10 ans. Par la suite, après le triomphe de la révolution bourgeoise américaine en 1787, une loi relative aux brevets a été incluse dans la Constitution américaine (article 1, section 8, paragraphe 8), qui a habilité le Congrès américain «à promouvoir le progrès de la science et l'utilité les arts, garantissant aux auteurs et inventeurs, pour des périodes limitées, le droit exclusif sur leurs écrits et découvertes respectifs. »

Image de l'OMC Organisation mondiale du commerce FlickrLa lutte pour obtenir de nouveaux brevets pour de nouvelles thérapies, loin de promouvoir la connaissance et de renforcer la lutte contre les maladies, ne vise qu'à garantir des prix élevés et des profits monopolistiques / Image: OMC, Flickr

Un régime internationalement accepté de réglementation juridique des brevets était essentiel, surtout après la fin de la Seconde Guerre mondiale, lorsque le commerce international est devenu essentiel pour l'ensemble de l'économie capitaliste. Ainsi, l'accord par lequel l'Organisation mondiale du commerce (OMC) a été créée en 1995 a établi dans son annexe 1-C l'Accord sur les aspects des droits de propriété intellectuelle qui touchent au commerce (ADPIC). Il détaille les principes de base de la propriété intellectuelle visant à harmoniser les systèmes de droit des brevets entre les pays signataires et dans leurs relations avec le commerce mondial.

Aux États-Unis, les brevets sur les médicaments sont régis par plusieurs lois, notamment la loi Hatch Waxman de 1984. Cette loi établit une durée de brevet de 20 ans à compter de la date de la demande, renouvelable pour cinq ans à compter de la date d'expiration du brevet. En Europe, à partir de 2004, la production de médicaments génériques peut être demandée huit ans après l'autorisation du médicament d'origine. Ces médicaments génériques peuvent être vendus après 10 ans.

À ses débuts, les brevets ont contribué à favoriser la concurrence entre les bourgeois, entraînant de nouvelles inventions et applications technologiques, qui ont révolutionné en permanence le développement de la technique et des forces productives. Cependant, cette situation est rapidement devenue son contraire et la fermeture du marché à des entreprises moins compétitives a favorisé la concentration de la production dans des entreprises de plus en plus grandes. Ceux-ci ont fusionné les uns avec les autres et avec une concentration intense et rapide du capital financier, a créé un monopole.

Aujourd'hui, dans l'industrie pharmaceutique, la lutte pour l'obtention de nouveaux brevets pour de nouvelles thérapies, loin de promouvoir la connaissance et de renforcer la lutte contre les maladies, ne vise qu'à garantir des prix élevés et des profits monopolistiques.

Brevets, recherche et développement et prix des médicaments

Dans l'argot du marketing pharmaceutique, les médicaments sont divisés en deux groupes principaux:

  1. «Essential Health»: médicaments déjà testés et largement utilisés. Les brevets ont expiré sur ces médicaments, donc n'importe qui peut les synthétiser à partir de leurs ingrédients actifs ou produire des médicaments biosimilaires à moindre coût.
  2. «Blockbusters»: nouveaux médicaments dont le développement et la protection par brevet garantissent un contrôle monopolistique pendant la période des droits exclusifs de production et de commercialisation.

En ce qui concerne les «superproductions», les grands laboratoires investissent principalement dans la recherche et le développement sur les maladies qu'ils considèrent les plus rentables, en particulier l'oncologie, le VIH, l'hépatite, les maladies auto-immunes et les maladies chroniques.

Selon les estimations du secteur, l'investissement moyen en recherche et développement nécessaire pour se conformer aux exigences légales nécessaires, enregistrer le brevet et commercialiser un nouveau médicament chimique ou biologique s'élève entre un et deux milliards de dollars américains.

Les investissements monopolistiques les plus importants sont consacrés à la production de médicaments dits biologiques. Contrairement aux médicaments chimiques, ils ne sont pas produits par un processus de synthèse chimique, mais sont des molécules beaucoup plus complexes dérivées d'organismes vivants. Ce sont des protéines telles que des hormones ou des anticorps que les humains produisent dans des conditions normales. Lorsque les gens tombent malades, ils ne produisent pas ces substances dans les quantités requises, en particulier dans le cas de maladies chroniques graves telles que le cancer, le diabète, l'asthme et les maladies inflammatoires de l'intestin.

Contrairement aux médicaments chimiques, les médicaments biologiques ne sont pas produits sous forme de pilules; la plupart ne sont disponibles que sous forme injectable. Quelques exemples des produits biopharmaceutiques les plus connus sont les hormones de croissance, l'insuline et celles utilisées par les patients en chimiothérapie pour augmenter leur taux de globules rouges et blancs: EPO pour les globules rouges et G-CSF pour stimuler les colonies de granulocytes des globules blancs. Ces médicaments sont essentiels pour le traitement de nombreuses maladies graves et leur accès est vital pour les patients et leurs familles.

Au fil du temps, les médicaments biologiques sont devenus la principale source de revenus de l'industrie pharmaceutique pour plusieurs raisons. D'abord et avant tout, les prix qui peuvent être exigés pendant la durée de vie des brevets applicables sont astronomiques. Selon une étude de l'Association nord-américaine «Patients for Affordable Drugs», les médicaments pour le traitement du cancer sont parmi les plus chers aux États-Unis et au cours des 15 dernières années, leurs prix ont décuplé.

Un autre facteur qui aide les entreprises à maximiser les bénéfices de ces médicaments est qu'ils sont complexes, ce qui les rend coûteux et difficiles à copier. Depuis 2006 en Europe et 2015 aux États-Unis, tout laboratoire peut légalement produire un médicament biosimilaire à un autre dont le brevet a expiré. Cependant, même si onze laboratoires développent depuis des années des versions biosimilaires moins chères, les exemples sont encore très limités.

Le développement d'un médicament biosimilaire est beaucoup plus coûteux en temps et en argent que la synthèse du générique d'un médicament chimique. Pour produire un médicament générique, l'investissement moyen varie de 600 000 $ à 4 000 000 $ USD et le temps nécessaire à son développement est d'environ trois ans. Dans le cas d'un biosimilaire, l'investissement s'élève à une fourchette comprise entre 100 et 300 millions de dollars US et son développement prend en moyenne six à sept ans. En conséquence, les moyennes entreprises développent et produisent souvent des médicaments dans les pays en développement: par exemple, 26% des génériques consommés en Europe et 24% de ceux vendus aux États-Unis sont produits en Inde. Sur le marché des biosimilaires, la guerre se déroule entre les grands monopoles du secteur.

Les bénéfices en jeu sur ce marché sont si importants que la grande industrie pharmaceutique consacre des centaines de millions de dollars au financement de conférences médicales et d'articles dans des revues spécialisées, simplement pour mettre en doute la sécurité des biosimilaires. Ils remettent en question les critères d'expertise des autorités sanitaires, qui affirment que le médicament biosimilaire a les mêmes effets thérapeutiques que le médicament d'origine. Ils soutiennent que, si le traitement commence par un médicament biologique original, il serait dangereux de continuer à traiter le patient avec un biosimilaire moins cher. L'objectif est de générer de l'incertitude et de la peur chez les malades et leurs familles. L’arsenal médiatique et juridique de Big Pharma vise à garantir qu’après la fin du brevet, la concurrence avec les biosimilaires soit aussi minime que possible, maintenant ainsi les taux de profit élevés garantis par les prix de monopole.

La propagande des lobbyistes de l'industrie pharmaceutique fait passer le rôle de la recherche et du développement privés dans le développement de médicaments comme un moyen de justifier leurs marges de profit colossales. Cependant, la réalité, selon la plupart des études financées par des fonds publics, est qu'au moins 60 pour cent de la recherche fondamentale et du développement de nouveaux médicaments sont effectués dans les universités et les instituts de recherche publics. Bien entendu, lorsqu'il existe une molécule susceptible d'être utilisée dans un médicament rentable, Big Pharma en achète les droits d'exploitation et poursuit sa recherche et son développement. Si le processus se termine, le laboratoire qui a acheté l'idée vend le nouveau médicament au secteur public quel que soit le prix à payer par le marché. Via ce cercle vicieux, le monopole récolte des marges bénéficiaires de plusieurs millions de dollars.

Pays Compagnie pharmaceutique Ventes Bénéfices % Milliards de ventes ($)
Milliards ($) Milliards ($) Bénéfices / Ventes Marques principales
1 Etats-Unis Pfizer

45.906

7.841

17,1%

* Prevnar13 5.718
* Lyrica 4.966
2 Suisse Novartis

41,554

7,916

19,05%

* Gleevec 3.323
* Gilenya 3.109
3 Suisse Roche

39,552

8.7171

22,04%

* Rituxan 7.410
* Avastin 6.885
* Herceptin 6,884
4 Etats-Unis Merck

35,563

9,76

27,44%

* Januvia 3.908
* Zetia 2.560
5 France Sanofi

34.174

5.722

16,74%

* Lantus 6.322
6 Etats-Unis Johnson & Johnson

31,671

6,967

22%

* Remicade 6.184
* Stelara 3.232
* Xarelto 2.288
7 Etats-Unis Gilead

29.992

3.925

13,1%

* Harvoni 9.081
* Sovald 4.001
8 G. Grande-Bretagne GlaxoSmithKline

27,775

4.6966

17%

* Advair 5.625
9 Etats-Unis Abbvie

25.299

4.152

16,41%

* Humira 16.078
dix Etats-Unis Amgen

21.892

3,775

17,15%

* Enbrel 5.965
* Neulasta 4.648
11 G. Grande-Bretagne AstraZeneca

20,967

5.631

26,86%

* Crestor 3.401
* Symbicort 2.989
12 Etats-Unis Allergan

18,597

2.8451

15,3%

* Botox 2,786
13 Israël Teva

18.462

2.111

11,43%

* Copaxone 4.223
14 Etats-Unis Bristol-Myers Squibb

18.163

4.405

24,25%

* Opdivo 3.774
* Eliquis 3.343
15 Etats-Unis Eli Lilly

17.173

4.9281

28,7%

* Humalog 2.769
* Cialis 2.456
* Alimta 2.283
16 Allemagne Bayer

16.886

3.0834

18,26%

* Xarelto 2.698
* Eylea 1.798
17 Danemark Novo Nordisk

16,610

2.1641

13,03%

* Victoza 2.979
* NovoRapid 2.964
* Levemir 2.539
18 Allemagne Boehringer Ingelheim

13,316

3.1752

23,84%

* Spiriva 3.314
* Pradaxa 1.532
19 Japon Takeda

12,773

2,8017

21,93%

* Entyvio 1.307
* Velcade 1.033
20 Etats-Unis Celgene

11.114

2,7616

24,85%

* Revlimid 6.974

Tableau 4: les 20 plus grandes grandes sociétés pharmaceutiques au monde en 2017, bénéfices en millions de dollars et en pourcentage des ventes, chiffre d'affaires en millions de dollars des principales marques de médicaments commercialisés. Source: ventes sur le marché de la prescription PMFarma-Pharmaceutical Executive

Dans ce tableau, nous voyons cela se refléter de manière concrète la part du lion des ventes et des bénéfices du secteur est concentrée dans très peu de marques de médicaments.

Par exemple, la société suisse Roche, la troisième plus grande société pharmaceutique au monde, a gagné 8717 millions de dollars en 2017 avec ses trois médicaments les plus vendus, Rituxan, Avastin et Herceptin, qui sont tous utilisés pour le traitement du cancer (pour le rectum, du côlon et du sein) et a réalisé un chiffre d'affaires de 21 179 millions de dollars cette année-là, soit 53,55% du total.

Ce processus atteint ses niveaux les plus extrêmes dans certains des grands laboratoires des États-Unis. Prenons le cas d'Abbvie, où les ventes d'un seul médicament, Humira – destiné au traitement des pathologies du système immunitaire telles que la colite ulcéreuse, la polyarthrite rhumatoïde ou le psoriasis – s'élevaient en 2017 à 16078 millions de dollars, soit 63,55% de son chiffre d'affaires. Rien qu'au premier semestre de 2018, ses ventes ont atteint un incroyable chiffre d'affaires de 13960 millions de dollars. La même situation est évidente dans le cas de Celgene avec des ventes de Revlimid – impliquées dans le traitement des cancers hématologiques comme le myélome et les lymphomes – qui s'élevaient à 6974 millions de dollars en 2017 contre un chiffre d'affaires de 11114 millions de dollars, soit 62,75% du total.

Les bénéfices du monopole et la fusion du monopole de la santé avec l'État

Big pharma 2 Image PxfuelBig Pharma n'hésite pas à mettre en danger la santé et la vie de millions de personnes malades / Image: Pxfuel

La production de marchandises est inhérente au capitalisme. Il est axé sur le marché et vise à atteindre le taux de profit le plus élevé possible. Il s'agit d'un thème courant dans tous les secteurs productifs. Il ne se soucie pas de répondre aux besoins fondamentaux ou sociaux de l'humanité, ni de se soucier d'améliorer ou de prendre soin de la santé humaine.

Dans un article publié l'année dernière, Laura Marcos, de la Right to Health Association, détaille ce qui suit: neuf entreprises sur dix en Europe qui ont reçu le plus de subventions pour des projets de santé entre 2010 et 2016 étaient de grands produits pharmaceutiques. Néanmoins, 75 pour cent des nouveaux médicaments approuvés en Europe en 2015 ne contribuaient pas du tout au marché ou existaient parallèlement à de meilleures alternatives thérapeutiques. Nous en sommes maintenant au point où les estimations ont montré que le gaspillage de la R&D dans les soins de santé pourrait représenter jusqu'à 85% du financement total.

Dans sa recherche du profit maximum, Big Pharma ne réfléchit pas à deux fois avant de mettre en danger la santé et la vie de millions de personnes malades. Il peut compter sur des organismes gouvernementaux de contrôle sanitaire qui ferment les yeux sur toute l’affaire et sont ouvertement complices des activités du monopole.

Bayer et les effets secondaires de Xarelto

Bayer, la multinationale pharmaceutique allemande, a lancé la première molécule de rivaroxaban synthétisée sur le marché en 2008 avec un large succès auprès des autorités de santé publique allemandes et européennes. Ce médicament est utilisé pour diluer le sang et prévenir les caillots, ce qui pourrait provoquer des accidents vasculaires cérébraux. Il visait à remplacer deux anticoagulants qui étaient déjà sur le marché depuis des années: Sintrom, avec l'acénocoumarol comme ingrédient actif; et Aldocumar, un composé dérivé de la warfarine. Le médicament a été commercialisé sous la marque Xarelto, et Bayer a conclu un accord avec Janssen, la division des soins de santé de Johnson & Johnson, pour distribuer le médicament en Amérique du Nord.

Grâce à une campagne de marketing agressive, elle a rapidement dominé le marché. En 2017, 42 millions de patients se sont vu prescrire le médicament, et cette année, les ventes ont rapporté 2,669 milliards de dollars pour Bayer et 2,288 milliards de dollars pour la multinationale pharmaceutique nord-américaine.

Cependant, ils n'ont pas averti le public d'un effet secondaire particulier: l'utilisation du rivaroxaban peut provoquer des hémorragies massives chez certains patients. Des cas de patients souffrant de l'effet secondaire ont commencé à apparaître dès sa mise sur le marché et des milliers d'entre eux ont souffert de séquelles graves ou sont décédés des suites d'hémorragies. Aux États-Unis seulement, Bayer et J&J ont été tenus conjointement et solidairement responsables de 25000 actions en justice par des membres de la famille de personnes décédées des suites de l'utilisation de Xarelto, et à la fin mars 2019, ils ont dû payer 777 millions de dollars aux personnes concernées aux États-Unis.

Une situation similaire s'est produite avec le dabigatran, un anticoagulant, également synthétisé en 2008, par la multinationale pharmaceutique allemande Boehringer Ingelheim et lancé sur le marché sous la marque Pradaxa. En 2014, ils ont dû affecter 650 millions de dollars à plus de 4 000 actions en justice en raison des effets secondaires mortels de leur anticoagulant.

Paradoxalement, lorsque les décès de Xarelto ont commencé à être rendus publics, le célèbre British Medical Journal a averti dans un article que les essais cliniques menés pour justifier l'approbation de la mise sur le marché de Rivaroxaban étaient truffés d'erreurs et de défauts.

Purdue Pharma, la famille Sackler et la crise de santé publique provoquée par la consommation d'opioïdes aux États-Unis

En octobre 2017, le président américain récemment élu, Donald Trump, a déclaré une urgence de santé publique afin de faire face à la vague de dépendance aux opioïdes qui affecte des millions d'Américains. La précédente alarme de santé publique a été décrétée en 2009 afin de lutter contre la flambée de grippe A (H1N1).

La situation était si grave que les décès par surdose sont devenus le plus grand tueur d'adultes aux États-Unis, à égalité avec les décès liés à la circulation et aux armes à feu combinés. En fait, les décès par surdose sont passés de 16 849 en 1999 à 36 000 en 2007, 60 000 en 2016 et plus de 70 000 en 2017.

Des pilules contre la douleur sur ordonnance sont vues jetées sur une table à Grissom Air Reserve Base, Ind. Les aviateurs qui prennent des pilules qui ne sont pas les leurs ou qui sont prises après le temps imparti pourraient se retrouver confrontés à une discipline sévère. (U.S.Air Force photo illustration / Tech. Sgt. Mark R. W. Orders-Woempner) La crise des opioïdes a fait de la mort par surdose le plus grand tueur d'adultes aux États-Unis / Image: Mark R. W. Orders-Woempner

Trump a fait valoir, dans un discours pour justifier la déclaration d'une urgence sanitaire, que la lutte contre le trafic de drogue joue un rôle essentiel dans la lutte contre l'épidémie de toxicomanie, et le moyen le plus efficace de lutter contre le commerce est de construire un mur à travers la frontière mexicaine . Bien sûr, comme c'est généralement le cas avec Trump, la réalité derrière les milliers de décès dus à l'abus de drogues ne figurait pas du tout dans le discours présidentiel.

La véritable cause des plus de 400 000 décès par surdose au cours des 20 dernières années aux États-Unis a ses racines au milieu des années 90, lorsque les autorités de santé américaines, sous la pression des services de santé et des lobbies Big Pharma, ont déclaré que la douleur chronique était le cinquième signe vital, ce qui signifie son l'évaluation, la gestion et le traitement doivent être considérés comme aussi importants en termes de santé que la température corporelle, la pression artérielle, la fréquence respiratoire et la fréquence cardiaque.

Immédiatement après cette décision, la réglementation est devenue laxiste, ce qui a facilité la production d'analgésiques beaucoup plus puissants que ceux déjà sur le marché. L'année suivante, les autorités sanitaires ont autorisé l'utilisation de deux opiacés: l'oxycodone et l'hydrocodone. Les ingrédients actifs de ces médicaments sont extraits du pavot à opium, ou du Papaver somniferum. Ni les laboratoires ni les autorités n'ont expliqué que la puissance accrue des effets antidouleur de ces nouveaux médicaments était directement proportionnelle au risque que les patients auxquels le médicament était prescrit développent une forte dépendance.

En décembre 1995, la première décision de la FDA a été d’autoriser l’utilisation et la distribution d’OxyContin, un analgésique introduit par Purdue Pharma des frères Sackler. La subordination totale des organismes d'État aux intérêts du monopole a été rendue publique trois ans plus tard, en 1998. Cette année-là, le Dr Curtis Wright, le médecin de la FDA qui a donné le feu vert aux Sacklers, a quitté son emploi à la FDA et a ensuite occupé un poste de direction à Purdue Pharma.

Après avoir obtenu l'approbation du gouvernement, la société pharmaceutique a lancé une campagne de marketing intense pour tenter de renforcer la vente massive de l'analgésique à base d'oxycodone. Synthétisée pour la première fois en 1916 en Allemagne, l'oxycodone est un dérivé de la thébaïne, la même molécule d'héroïne est obtenue à partir de. Elle est trois fois plus puissante que la morphine.

Dès le début, la société pharmaceutique a orienté sa stratégie de commercialisation vers les habitants de la «Rust Belt» (une région des États du Midwest frappée par le déclin industriel) et les zones rurales du pays. They focused on the poorest states: those suffering from huge social issues, where job losses, subsequent drops in self-esteem and broken homes were the perfect breeding ground to get hooked on OxyContin.

They spared no resources in achieving their aims; their advertising budget rose from $187,500 in 1996 to $4m in 2001 and continued to increase year in, year out. In 2016, much of the media denounced the four biggest manufacturers of the three most-sold opioid painkillers in the U.S. (OxyContin and Vicodin, which contains hydrocodone; and Percocet, which contains oxycodone and paracetamol) for paying $46m in food, travel and other fees to over 68,000 doctors in order to encourage them to prescribe their opiates.

Their million-dollar strategy was simple: they had to normalise opioids, and the best way to do that was by counting on highly qualified medical speakers to back up the virtues of OxyContin and other drugs. In the Sacklers’ case, among their most active collaborators, they had secured the support of the AAPM (the American Academy of Pain Medicine) and the APS (the American Pain Society). They were generously reimbursed in compensation, and many of the two association’s members were contracted as lab consultants. In fact, Dr David Haddox, chair of the APS committee and staunch defender of the therapeutic benefits of opiates, was contracted by Purdue from 1999 to 2019.

The practical outcome of their actions became evident in no time. Sales of OxyContin shot up from $80m in 1997 to $2.1bn in 2001, and year-on-year turnover and profits continued to increase. In 2010, turnover surpassed $3bn and made up 80 percent of the lab’s sales and profits. It is estimated that, between 1996 and 2016, thanks to OxyContin sales, Purdue made over $35bn. This is in parallel with the exponential growth in wealth of the Sackler brothers, owners of the laboratory, making them one of the richest families in the exclusive American Billionaire Boys Club. According to Forbes magazine, they have amassed a fortune of over $13bn.

As the labs earned billions of dollars in profit, social and public health consequences rocked towns and cities in every U.S. state. Millions of Americans began to take opiates prescribed to them by the healthcare industry. Middle-aged Americans were the first to take them, as they are more likely to suffer from pain. No one informed them that they were strong, addictive drugs and that they could easily get hooked.

The situation was so extreme that, in 2012, over 286 million prescriptions were given for OxyContin, Vicodin and Percocet (that is, one prescription per U.S. inhabitant). States such as West Virginia, with little more than 1,800,000 inhabitants, were literally flooded with pills, as reported by Eric Eyre in the Charleston Gazette Mail in 2013. According to the DEA, between 2007 and 2012, labs and pharmaceutical distributors dispatched over 780 million opioid pills, 87 pills per inhabitant per year, to West Virginia. In the small town of Williamson alone, with a population of 3,000, Dr. Katherine Hoover gave out 333,000 prescriptions for opiates between December 2002 and January 2010 (14 per inhabitant per year). The little town soon became known as “Pilliamson”. According to the NBC network, Williamson emergency services treated an average of 50 patients each month due to overdoses in 2017.

State authorities and federal government were cognizant of the public health crisis from the outset. In 2006, Dr. Leonard Paulozzi of the CDC (the Centre pour Disease Control and Prevention) published an article that warned of a 91 percent increase in opiate-related deaths between 1999 and 2002. A direct consequence of the exponential rise in painkiller addiction was the increase in the consumption of illegal drugs that were cheaper than the pills, such as heroin. Following this, and other such whistleblowing reports in 2007, the state of Virginia sued Purdue Pharma and three of its executives for the first time. The company reached a settlement in order to avoid a public trial. It acknowledged its role in deceiving doctors, patients and regulatory authorities and in hiding the serious addictive effects of OxyContin, and agreed to pay a fine of $635m.

Following the settlement in 2007, Purdue continued to break records in sales and profits with OxyContin. From 2013-2015, when their legal troubles started to mount and their sales in the North American market began to fall, the company turned to Mundipharma, its international affiliate, to use the same tactics to advertise the analgesic’s treatment of pain and to extol the drug’s virtues. This was in an effort to achieve high OxyContin sales in markets in Brazil, China, Russia, Great Britain, Spain etc.

Before the federal government was forced to recognise the gravity of the situation – which according to estimates by some economists, in the year 2015 alone cost the public $504bn dollars – and before finally declaring a public health emergency in autumn of 2017, over 500 cities and counties in Alabama, California, Illinois, Kentucky, Massachusetts, Wisconsin, Virginia, Utah, Tennessee, Missouri, New Hampshire, New Mexico, Indiana y Michigan and eight Native Indian tribes had already brought thousands of lawsuits against the labs responsible: Purdue, Janssen, Teva Pharmaceutical, Abbott Laboratories, McKesson distributors, Cardinal Health, and AmerisourceBergen, claiming over $50bn.

Despite all the evidence on the disastrous effects of these drugs on public health, business continues on unabated, and even continues to supply over 58.7 prescriptions of opiates per 100 inhabitants in the U.S. two years following the declaration of a Public Health Crisis.

Alzheimer’s, Parkinson’s and the anti-inflammatory Enbrel from Pfizer

In January 2018, Pfizer, the world's leading pharmaceutical company, announced the closure of its neurological department and the dismissal of its 300 employees. In its statement, Pfizer explained that its decision to abandon research for the development of new drugs, aimed at treating Parkinson's and Alzheimer's, had been adopted to reallocate those resources to investment areas where its product portfolio and scientific expertise were much greater.

A year later, on 5 June, 2019, journalist Christopher Rowland of the Washington Post, made public that, since 2015, Pfizer had hidden from the public that one of its teams of researchers, based on statistical treatment of hundreds of thousands of claims from insurers in the health sector, had made an important discovery that linked the intake of its star anti-inflammatory drug Enbrel – intended for the treatment of rheumatoid arthritis – with a reduction in the risk of contracting Alzheimer's by at least 64 percent. The researchers reached that conclusion by contrasting the incidence of the severe neurological disease between a similar number of people taking the anti-inflammatory drug, and the same number of those who did not.

Pfizer Finland HQ February Image Lauri SilvennoinenPfizer's crimes are numerous and shocking / Image: Lauri Silvennoinen

To verify the potential therapeutic effects of Enbrel in the prevention, treatment, and delay of Alzheimer's, the researchers proposed to the executives of the multinational that a clinical trial be carried out among a trial of 3,000 to 4,000 people, both those who were treated or not with the anti-inflammatory drug. The estimated cost was $80 million.

The decision made by the Pfizer board of directors was not to conduct the clinical trial, nor to make public the conclusions of the study by its researchers.

Once the Post uncovered their scandalous conduct, the directors of the multinational were forced to try to explain it. They then claimed that their decision was based on the fact that their experts had concluded that Enbrel was not a therapy that could offer results in the treatment of Alzheimer's. Their rationale was that, according to them, the active ingredient in Enbrel was a molecule too large to pass through the blood-brain barrier and be able to act on inflammations of brain tissue. For that reason, they gave up the clinical trial. Likewise, they maintained that the decision not to make the study public was to prevent scientists outside the firm from directing their efforts in the wrong area.

Their ‘arguments’ did not convince anyone, and many front-line researchers on Alzheimer's from Universities like Harvard, John Hopkins, Southampton, demanded that the studies be made public and that it should be the scientists who evaluate their usefulness.

What Pfizer executives never mentioned was that the Enbrel patent expired in 2018; in fact, they had been marketing their new arthritis medicine, XELJANZ, for several years. What motivated their decision was the low return that their investment would have yielded, even in the case of a positive result, having to compete from the outset with much cheaper similar generics.

Their refusal to disseminate information that would open a promising field of research in Alzheimer's prevention was motivated by the same reason that at other times leads them to hide the harmful side effects of a new drug. The search for the maximum profit was prioritised, regardless of the therapeutic suitability of the medicine to be marketed.

In search of El Dorado, or the race to find the COVID-19 vaccine

Days after the first cases of COVID-19 occurred in Wuhan, Chinese authorities identified the new coronavirus and informed the WHO. Studying the new pathogen, the Chinese researchers and those of the WHO reference laboratories, found that it was very similar to the SARS-CoV that in 2002-2003 caused the epidemic of the Severe Acute Respiratory Syndrome. The new virus shares with SARS between 80 percent and 90 percent of its genetic material and its similarity is such that scientists named it SARS-CoV-2. There were also quite a few similarities with the so-called MERS-CoV, which in 2012 caused the first cases of the so-called Middle East Acute Respiratory Syndrome in Saudi Arabia.

The similarity between the two viruses is reflected in the fact that some of the symptoms and characteristics of COVID-19 coincide with those displayed by people infected by SARS. The similarity is greater in the most-severe cases, in which both pathogens have been found to cause pneumonia and excessive inflammation in the lungs, which stop working properly.

The most significant differences are also known. First, in the case of SARS, it was known from the beginning what was the animal from which the jump was made to contagion in humans: a civet. This information is still unknown in SARS-CoV-2. Secondly, the average mortality rate for SARS was 9.2 percent – 775 deaths of the 8,403 infected – and among those over 65 years of age or with preexisting hypertension, cardiac, respiratory or immune complaints, it shot up to 50 percent. In the case of COVID-19, with the partial and incomplete data available, the average rate ranges between 1.5 percent and 4 percent, and, as in SARS, it rises significantly among those over 65 and the chronically ill, where 20 percent of serious cases requiring hospitalisation are concentrated.

Finally, the qualitative difference between the two lies in their differing effectiveness in spreading contagion. In the case of SARS, the prevalence of contagion was 10 days and asymptomatic patients were not contagious. In COVID-19 patients, the prevalence can be up to 28 days and the asymptomatic ones are very much contagious. The much greater efficiency of SARS-CoV-2 in its transmission between humans facilitates massive contagion, which is what makes the new virus much more dangerous.

To all this previous information was added the sequencing of the genome and of the virus proteins, which China made public in early February. So the target protein (AC2) became known, which, as in SARS, the new virus uses as a key to penetrate the human cell.

Based on the similarity of the new virus with those of the SARS CoV and MERS, what a priori would seem more promising to accelerate the development of a prototype of vaccine and effective antivirals against COVID-19 would be to build on the progress made in the research carried out over the past 18 years on those other coronaviruses.

This has been the guideline followed by the team of researchers from the National Centre for Biotechnology (CNB) – belonging to the Spanish National Research Council (CSIC) – led by virologists Luis Enjuanes and Isabel Sola.

As Dr. Sola explained, with 35 years of accumulated experience working with coronaviruses, the combat strategy against COVID-19 is twofold: guarantee prevention; that is, to obtain a vaccine that provokes an effective immune response, and to produce antivirals to treat already infected patients.

Based on this double strategy, the objectives that have been set at the CNB are to create a prototype of the vaccine, using a technique called reverse genetics, which her team was the first to develop precisely for the study of SARS in 2002. It consists of eliminating the genes of the virus that neutralise the defences of the infected person – what they call virulence genes – which are the ones that induce such an excessive inflammation of the lung to the point of damaging it.

Once those genes are removed, the pathogen attenuates and becomes a good vaccine candidate. Once the attenuated virus has been generated, it is tested in cells and it is verified to behave as expected, then it will go on to the next phase: animal tests.

To start this second phase, an adequate animal model must be created in which the virus can be injected and cause a disease similar to that observed in humans. This model would be transgenic mice. At the time, they were created for SARS but they were not kept active in the animal facility and now they have to be recreated. This is accomplished through genetic engineering techniques. The aim is to ensure that the human virus receptor protein, AC2, is integrated into the mouse genome, thus guaranteeing that, when viral infection is induced, it is expressed in the target organ of interest, which in this case is the lung.

Once the animal model is available, the vaccine is given two to three weeks before the animal subject is infected with the virus, allowing time for an immune response to develop. When the vaccine prototype is confirmed to be effective and safe, it could then be moved to human testing. After verifying its efficacy and safety in humans, a so-called virus or vaccine strain would be produced, and from that moment on, the vaccine manufacturing process can begin.

As for antivirals, the starting point of the CNB laboratory will be to resume the tests with the prototypes that they have already developed to be used against SARS. On that occasion, the animal testing phase was reached, confirming that the antivirals were effective and that, when injected into the infected specimens, they protected them at a rate of 80 percent.

Given the similarity between SARS and the new SARS-CoV-2, it seems reasonable to think that compounds that already demonstrated their efficacy in 2002 could also be valid now. This possibility has already been confirmed with the antiviral Remdesivir that the multinational Gilead tested on animals, and then abandoned. Based on this hypothesis, their first objective, once they have the virus, will be to inoculate them into cells and check if they can contain the inflammatory response that the virus causes at the cellular level and thus combat one of the main causes of the disease.

The same guideline as that of the CNB team is the one being followed in other coronavirus groups by virologists around the world, who also started in those years the development of effective drugs against these viruses.

The handicap faced by all the research teams was synthesised based on Dr. Sola's personal experience:

“What happens is that when there is an epidemic, like with SARS in 2002, in that initial moment, there is greater investment in research, but once it has been contained, we forget. Lost is the opportunity to continue advancing the studies that had been initiated, to finish the development of a vaccine, or to complete the identification of antivirals that may be useful when a new epidemic appears.

“In our team, we have found that, at the time of presenting a research project to obtain funding for a vaccine against MERS-CoV, responses from the evaluation committees affirming that the research of a virus that affected a relatively low number of people, was not relevant. I have heard these kinds of comments personally when evaluating our project to develop a vaccine for a coronavirus very close to SARS COV2. With that idea in mind, one is not realistic, because viruses such as influenza and coronaviruses are emerging viruses and have pandemic potential, as we are seeing now. That reality should not be ignored. It would be irresponsible to abandon the research thinking that once an epidemic has been overcome, it will never happen again. Heaven forbid, the ability of viruses to emerge in the human population and to wreak havoc with this virus, or that could cause pandemic influenza is there. All this serves to make us aware of the importance of research.”

The same reflection was made by the professor at the UAB Animal Health Research Centre, Joaquim Segales, who in an article published in the Vanguard on March 23 recalled:

“For the SARS epidemic of 2002-2004, very effective vaccine prototypes were obtained and there were even several very successful clinical trials, but no product was registered. The same thing happened again in 2012 with MERS.”

Without a doubt, their opinions are shared by the overwhelming majority of the scientific community, which for years has been warning that it was necessary to prepare to be able to respond to a possible pandemic like the one we are suffering today.

Dr. Sola is absolutely right in highlighting the irresponsibility of abandoning research, the significance of which is evident today. We too sympathise with her sincere wishes that this will serve to convey the importance of scientific research.

Unfortunately, all those good wishes collide against the wall of laws that govern the market economy, and, in the case that concerns us, with the interests of the pharmaceutical monopoly. The motive that pushed large laboratories to invest in the research of Severe Acute Respiratory Syndrome was to take advantage of the business opportunity and the juicy profits, and, if the epidemic were to spread and lengthen over time, the patent for the vaccine and antivirals for the treatment of SARS. It was the same reason that moved them to abandon the research months later once the epidemic was extinguished.

Now that the pandemic, which researchers have been warning about for years, is a cruel reality, the rulers of the world do not tire of repeating to us that, only by joining together will we defeat the virus. If there were only one atom of truth in their proclamations, the first measure they would have taken would have been to coordinate the efforts of researchers from all countries, and make available to them all the necessary economic and technical resources. Undoubtedly, such an appeal would have had the enthusiastic support of the entire scientific community and in record time, a viable prototype of the vaccine could be available, with effective drugs to combat the disease and then be able to be manufactured and distributed throughout the world.

COVID 19 test Image PixabayDozens of pharma firms are hunting for the COVID-19 vaccine: but their priority is profit, not curing people / Image: Pixabay

Instead of collaboration, behind a toxic cloud of propaganda, is an open confrontation between the most-powerful states. Their objective is to defend their prestige and the interests of their respective bourgeoisies. They compete to be first in the race to get the vaccine and antivirals necessary to treat COVID-19. Rather than defending public health, the interests that are truly at stake are strengthening power and prestige in the international sphere and having their industries obtain the largest portion of business and the potential profits.

In mid-March, when the first confinement measures began to be taken in Spain and Italy, many leaders still continued to question the importance of the pandemic, among others this was the case with the loquacious Mr. Trump. All his speeches were limited to lashing out at the “damn Chinese virus.” His cynicism knows no bounds! While in public they denied the gravity of the crisis, for weeks at the White House discreet meetings had been happening between the executive branch, regulatory administrations, and the pharmaceutical industry. This same process was happening in the ministries of the other powers.

On 23 March, in the Spanish newspaper La Vanguardia, the data published the previous day by the World Health Organisation was echoed. According to the WHO, at the moment, there are at least 40 institutions, public bodies, and pharmaceutical multinationals involved in the fight against the clock to synthesise the vaccine. There are already four prototypes for which animal clinical trials have started, and another two that will start in April. From all of these, the two most-advanced projects are being developed in China and the USA.

In China, research is conducted by the Ministry of Defence through the Military Academy of Medical Sciences in collaboration with the biotech company Cansino Biologics. As of mid-March, The South China Morning Star reported several successful clinical trials with primates had already been conducted. They are planning to start human trials with 108 volunteers in April.

The US project is being undertaken by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Health (NHI), the Coalition for Epidemic Preparedness Innovations (CEPI), and Moderna Therapeutics, which is the laboratory that is developing the vaccine, using a new genetic engineering technology called messenger RNA. The first human tests were scheduled to start on 14 March with 45 healthy volunteers between the ages of 18 and 55.

The main handicap of the Moderna project is that until now, health authorities have never authorised any of the drugs based on this technique, as they did not meet the safety standards required by the regulations. Coincidentally, a few days later, a meeting was held in which the International Coalition of Medicines Regulatory Authorities (ICMRA), the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) all participated. In this meeting, it was decided – in view of the exceptional nature of the COVID-19 crisis – to relax the criteria and requirements that have been applied until now. Anything goes in the search for El Dorado!

State response, improvisation and lies

Without drawing any conclusions from China’s experience, where on 23 January drastic lockdown measures were implemented in Wuhan and Hubei; across the globe, most governments continued to spread reassuring messages in the media. They asserted that the symptoms of the novel virus would be akin to those of the flu and that there was no cause for alarm. According to experts, the only thing for us to do if imported infections were detected would be to monitor the infected and their network of contacts, place them under quarantine, prevent the virus from spreading and prevent local transmissions.

A month and a half after China, on 8 March, once the situation was already spiralling out of control (118,000 people testing positive in 114 countries, and 4,291 dead), WHO declared a pandémie mondiale. From that moment on, at a speed worthy of the best conjurer, both authorities and experts changed tack completely and decided to defend the need to wage a global war against the virus.

The situation has forced them to change the script to such an extent that, in order to justify their incompetence and lack of foresight, everyone started to repeat the same piece of misinformation at once:

“No one is responsible for the improvisation or the lack of resources because it was not possible to anticipate the pandemic, nor its extreme severity. Such severity is comparable only to the events of World War II”.

Working by Goebbels’ old maxim that the biggest lie, if permanently repeated, will end up looking like an unquestionable truth, they got to work and began a campaign of large-scale indoctrination which continues on today.

They cover their backs with the intellectual authority of every manner of experts in any position and repeat the same message to us ad nauseum: “We are not responsible because no one, not even the scientists, could anticipate the virus that would surface and when and where it would do so, nor could they anticipate its severity or its infection capacity.”

Behind their forceful assertion is a truism. They are reaffirming what any moderately intelligent person already knows, which is that: every scientific prediction has its limits, whether these limits be in the field of virology or in any scientific branch, and these limits reveal the level of developed knowledge and technology at that moment in time.

The unanswered questions they use to attempt to justify their lack of foresight are certainly obvious enough that only a fortune teller could be asked to answer them beforehand. Everyone knows, or has at least heard, that constant mutations and changes that produce new virus strains, distinct from the original, form part of the intrinsic nature of the broad spectrum of viruses that live within animals and occasionally infect us humans – you do not need to be an expert in virology to know this. Just like reliable weather forecasts, they have a time limit, and if this limit is exceeded, a good forecast becomes less probable. Virologists and epidemiologists could anticipate the risk and bet on the family of viruses the pandemic would emerge from using current resources and knowledge, however it was not feasible for them to know the specific mutation beforehand.

Even with the influenza virus, WHO’s Global Influenza Surveillance and Response System (GISRS) has been tracking the virus systematically for 65 years. It doesn’t know if the vaccine developed each year to combat the two periodic seasonal outbreaks – one for each hemisphere – will be more effective or less; it all depends on whether the three or four targeted strains are right or not.

The scientific evidence: a report on the predicted pandemic

The thesis that achieved practically unanimous consensus among researchers, but as of yet has not provoked an “institutional” reaction, was contextualised within the current situation by Julià Blanco, PhD in biochemistry and director of the Cellular Virology and Immunology Group at IrsiCaixa (La Vanguardia, 23 March 2020).

“What’s important is to think long term, not only regarding this coronavirus but for the other viruses to come. We have to get used to viral cross-species transmission becoming more and more common. Humans and animals live very close to each other. We are experiencing elevated population density levels and we are so mobile that any virus can travel globally in no time.”

He concludes with this:

“It is therefore important to prepare for future outbreaks by creating vaccines, capable not only of combatting the virus specifically, but all the other possible viruses to come.”

In stark contrast to the official arguments, simply listing out pandemic episodes and the emergency of new zoonotic viruses in the last 100 years more than justified the appeal from experts to healthcare authorities to adopt necessary preventative measures. All empirical evidence pointed to the urgent need to provide enough resources and funding to scientists in order to prepare for the threat to human life posed by the emergence of new pandemic viruses.

What was a predicted risk yesterday has turned into a harsh reality today, and the future is still uncertain.

YEARS Pathology Disease outbreak Virus Infected Dead
1900-1980 Smallpox Pandemic Variola virus 900,000,000 300,000,000
1900-2000 Measles Pandemic Morbillivirus —————– 200,000,000
1918-1920 Spanish flu Pandemic Influenza A(H1N1) 500,000,000 50-100,000,000
1957-1958 Asian flu Pandemic Influenza A(H2N2) Global 1.5-2,000,000
1968-1969 Hong Kong flu Pandemic Influenza A(H3N2) Global 0.75-1,000,000
1981-2020 AIDS Pandemic HIV 77,000,000 35,400,000
2014-2016 Ebola Épidémie Ebolavirus 28,646 11,323
2002-2003 SARS Pandemic SARS-CoV 8,403 775
2012-2019 MERS Periodic outbreaks MERS-CoV 2,468 851
2020-? COVID-19[feminine Pandemic SARS-CoV-2 ? ?

Table 5: Summary of the most severe epidemic and pandemic outbreaks triggered by the influenza virus, smallpox virus and other viruses of the past 100 years. Source: WHO and Wikipedia

Notes:

1. In the case of SARS-CoV, although the number of affected people was small, it was dubbed a pandemic because infections were transmitted in 29 countries across many continents.

2. In addition to the cases in question, two seasonal influenza outbreaks had to be added to the total, which lead to an average of between 3 to 5 million critical cases and between 250,000 and 500,000 dead.

Behind the “institutional explanation” lies their true objective: by any means possible, to avoid responding to these two main questions:

  1. Would we already have adequate (antiviral) vaccines for COVID-19 if we had heeded the researchers’ warnings?
  2. Why were the necessary resources and funding not being dedicated to preventing what today has become a harsh reality?

They know that simply asking these questions places the burden of criminal responsibility on their system – capitalism – where all is sacrificed on the altar of profits. The class that stewards this system is also culpable; a negligible minority of big bourgeois who, counting on the obedience and collusion of states and governments, control the commanding heights of the world economy with an iron fist, and also decided that investing in preventing a hypothetical pandemic was not profitable.

Nature, pandemics and humanity: a shared history

Last 12 April, the Spanish Público newspaper interviewed archaeologist and anthropologist Eudald Carbonell Roura, who has been co director of the Atapuerca excavations for over 30 years. A figure of international renown, Roura is one of the most famous experts in his field. The interview was published with this enlightening header: “COVID-19 is our last warning and humanity will soon collapse without collective awareness of our actions as a species”.

Anyone willing to understand the watershed moment we currently find ourselves at and explore the future of humanity must familiarise themselves with and bear in mind the deep reflexions and conclusions drawn in the interview, both of which contribute significantly to good judgement.

In response to one of the many questions put forward in the interview on the existence (or lack thereof) of epidemics in prehistoric times, Carbonell made the following statement:

“Of course, pandemics have always existed, but it’s difficult to find evidence of them because you have to consider that pandemics work according to the demographics of the time. It is not the same when 200 to 1,000 people are affected in an area to the point where they all end up dying and the virus does not have a host to infect because many kilometres away no one was aware of it. Today, in a globalised world, with large media outlets and means of transportation, virus hosts multiply exponentially.”

At least 70 percent of human diseases are of animal origin and that viruses and bacteria were already an integral part of nature long before our birth as a species. Bacteria have been found in the teeth, stomachs and faeces of fossil fish from 350 million years ago, and traces of pathogenic bacteria from 70 million years ago in mammal fossils. It would be logical to think that, through our contact with plants and animals, the emergence of pathogens transmitted between species would be inevitable. In fact, just as all who are born must die, health cannot be conceived of without disease; they are both an inherent part of the experience of any living being.

During much of prehistoric times, humans could only rely on a small set of tools and had not yet made a significant impact on nature. Human groups were isolated, and few and far between. The risk of an epidemic existed, but low population density and infrequent contact between distant groups reduced the potential for it to spread.

This limited interaction between humans and infectious pathogens begins to change from the Neolithic Revolution. The discovery of agriculture and the domestication of wild animals provide the guarantee of sufficient levels of food for increasingly higher human populations. The growth in population encourages exchange and contact between different settlements, and indirectly encourages the development of new microorganisms capable of sparking an epidemic.

It is no accident that there is evidence of the emergence of some of the more well-known viruses in this period. This is the case with smallpox (or the variola virus) the presence of which has been confirmed in 11,000-year-old Indian farming communities. Polio (or the poliovirus) is a disease found in an Egyptian funerary stele from the 18th dynasty in 1580 BC. The same is true of measles (the morbillivirus) of which there are traces in the Middle East and India dating from 2,500 BC.

Researchers are mostly of the same opinion that most of the pathogens we know have probably been with us for thousands of years, some of which include influenza. Hippocrates describes flu symptoms in 412 BC. They are of zoonotic origin: influenza and diphtheria derive from the pig, measles from the dog, tuberculosis from cattle and leprosy from the buffalo. Their hypothesis is based on the similarity between other viruses present in animals. It is also based especially on the close contact between humans and animals due to their domestication, a process which began in 8,000 BC in the Mediterranean Basin.

Pandemics in classical antiquity

One of the first epidemics for which there is written evidence is the one caused by smallpox in Athens in 430 BC, which was described by the Athenian historian Thucydides.

Plague in an Ancient City Image public domainEpidemics have plagued humanity since ancient times / Image: public domain

The first written references to pandemics affecting large geographic areas take place after the consolidation of the Roman Empire. Rome controlled large geographical areas in Europe, Asia, and North Africa, grouped a very large population that lived in cities, and had excellent land and sea communication routes, which facilitated exchanges and trade. Without intending to, they created the ideal conditions through which an infectious disease could spread among the population.

The first known historical episode of a pandemic was called “Antonine Plague or Plague of Galen”, which took place between the years 165 and 180 during the mandate of the emperor Marcus Aurelius. According to the description by the great physician Galen of Pergamumit was a smallpox epidemic, the first outbreak of which in 165 was unleashed among Roman troops besieging the city of Seleucia in the Middle East. The contagion quickly spread throughout the empire. Nine years later there was another outbreak that mainly affected Rome. An estimated five million people died.

Many historians describe Marcus Aurelius as the last of the great emperors. The slow decline of the empire began later with the reign of his son Commodus and the subsequent rise to power of the Severan dynasty, which culminates with the fall of Rome and the western empire in the latter part of the second half of the 5th century.

The second pandemic was the “Plague of Justinian", between 541-543. It occurred a few decades after the fall of Rome. According to Procopius of Caesarea, the plague, which is known today as a bubonic plague, spread throughout the Byzantine empire, Africa, Europe and Asia. It is estimated that between 25 and 50 million people could have died, from 13 percent to 26 percent of the world population at that time. The pandemic coincides with the attempt by the Emperor of Byzantium, Justinian the Great, to reconquer the lost territories in the West and rebuild the Roman Empire. This objective finally failed, despite the initial military successes, with the victories against Vandals and Ostrogoths by the great general Belisarius, opening the way in Europe to the consolidation of the Barbarian kingdoms and at the beginning of the Early Middle Ages.

The early Middle Ages

The fall of Rome, with which the Early Middle Ages began in Europe (6th to 10th centuries), meant the collapse of commerce and the physical destruction or irreversible deterioration of much Roman public works: roads, ports, bridges, aqueducts. This led to the abandonment of cities and a general process of ruralisation of the population.

The tremendous setback that occurred in all spheres, economic, technological, and cultural, together with the continuous wars to divide up control of the territory, caused a drastic fall in the population, which in the 10th century barely exceeds half of the population 400 years earlier. This explains why the more or less serious periodic epidemic outbreaks that continue to occur had a limited geographic and population extension.

The exceptional period of “The High Middle Ages”

Between the 11th and 13th centuries – a period that some historians call the High Middle Ages – the situation changed drastically.

The Vandal, Norse, and Hungarian wars over the search for territories to settle had ended. In the Iberian Peninsula, after the disappearance of the Caliphate of Córdoba in 1031, the Muslim advance stopped. Soon after, the crusades to conquer the Middle East and Jerusalem began in 1095-1291. The Islamic sphere was reduced to the Southern Mediterranean Basin and the Interior of Asia, and was no longer a threat, generating a situation of relative political and military stability in Europe.

The appearance of the iron plough with wheel and mouldboard, the use of the horse as a draught animal instead of the oxen, the cutting of forests for new crops and their triennial rotation, the installation and use of water and windmills, the use of iron tools – all these innovations came to pass alongside exceptional climatic conditions. Some historians speak of the Medieval Climate Optimum that even allowed the cultivation of vines in England. Production and agricultural surpluses multiplied, which in turn encouraged and developed trade. At the same time, there were important technical improvements in navigation and shipbuilding, such as the incorporation of the rudder and the compass.

In the Far East, Mongol rule over much of Asia ensured the safety of trade expeditions and allowed the Silk Road between China and Europe to be restored during the 13th century.

The sum of these factors led to a demographic explosion. The population doubled, and in the middle of the 13th century, it reached 73 million inhabitants. The increasing importance of trade caused cities to gain in size and power, multiplying the urban population. In some areas, such as northern Italy, the process was even more intense. In 1300, per capita income had tripled, the literacy level of the urban population was the highest in Europe, 50 percent of men could read and write, and 20 percent of the total population lived in large cities with more than 100,000 inhabitants such as Milan, Venice, and Florence, and many others such as Bologna, Lucca, and Genoa that exceeded 50,000.

‘The Black Death’, or the greatest biological disaster in human history

The previous situation of exceptional climatic boom and intense economic and social advances began to show signs of exhaustion at the beginning of the 14th century. The fertile land under cultivation was not enough to meet the needs generated by the large increase in the population. In addition to the shortage of new lands and draught horses to increase crops, there was a sudden worsening of climate conditions, with the start of the ‘Little Ice Age’, which caused a drastic drop in temperatures that further reduced agricultural production. Malnutrition and famine became widespread in many areas.

Black death Image public domainIt is estimated that in Europe between 24 and 48 million people died of the Black Death, from 30 percent to 60 percent of the population, with 75 to 200 million deaths worldwide / Image: public domain

That was the scenario across Europe when the Black Death Plague of 1347-1353 was unleashed.

Although the exact place where the first cases occurred is not known, it is known that it started in Asia and also that it reached Messina, on a ship from the Genoese colony of Caffa in the Black Sea. From there, it spread throughout the Italian peninsula. That same year, Louis I of Hungary had started a military campaign to impose his dynastic rights on the crown of Naples. The contagion between his troops and the death caused by plague forced him to demobilise his army, and it was the soldiers that returned to their home countries who spread the epidemic to the rest of Europe. Ultimately, only Iceland and Finland were spared from the pandemic.

The name black plague or black death described the symptoms that patients developed in the final phase of the disease. It started with blue or black spots on the skin, caused by small skin haemorrhages. Later, black buboes appeared in the neck, arms, legs or behind the ears, due to the inflammation of the lymph nodes. The fingers and toes became gangrenous and finally the rupture of the buboes festered a liquid with a rancid smell. The duration of this final phase was about five days, causing the death of the infected in 90 percent of cases. There was no effective treatment.

After observing thousands of cases, it was concluded that the development of the disease was a maximum of 39 days, and any infected person that exceeded that time was not going to relapse again. From that moment, anyone who tried to enter a town or city had to remain isolated for 40 days.

From then on, the term “quarantine” was coined, which is used universally to describe any case in which it is necessary to isolate someone to check whether or not they have an infectious disease.

Although the exact number of victims is not known, it is estimated that in Europe between 24 and 48 million people died, from 30 percent to 60 percent of the population, with 75 to 200 million deaths worldwide. The incidence by geographical areas was very variable. While Florence and other cities in Northern Italy lost up to 80 percent of their populations, in the west of what is now Germany, one in 10 inhabitants died, and in France and England it was between 30 percent and 50 percent.

Many historians consider this pandemic to this day the worst biological disaster in the history of humanity, which continued to make its mark on all aspects of life for several decades.

Flu, smallpox, measles, and the colonisation of America

The 15th and 16th centuries represent the swan song of the Middle Ages throughout Europe. The deep meaning of this historical stage was summed up by Karl Marx in Revolutionary Spain:

“It was in the sixteenth century that were formed the great monarchies, which established themselves everywhere on the downfall of the conflicting feudal classes – the aristocracy and the towns. But in the other great States of Europe absolute monarchy presents itself as a civilizing centre, as the initiator of social unity. There it was the laboratory in which the various elements of society were so mixed and worked, as to allow the towns to change the local independence and sovereignty of the Middle Ages for the general rule of the middle classes, and the common sway of civil society.”

And referring to the particularities of the process in Spain, Marx added:

“In Spain, on the contrary, while the aristocracy sunk into degradation without losing their worst privilege, the towns lost their medieval power without gaining modern importance.” (1854)

In the Iberian Peninsula, the two ascending monarchies, Portugal and Spain – once their internal unification process was completed, with the defeat and annexation in the Spanish case of the last Muslim strongholds – focused all their interests on the search for new territories and trade routes.

The central objective that moved them was to discover new sea routes that would facilitate their access to new sources of raw materials and to trade in spices and other goods with Asia. The Ottoman conquest of Constantinople in 1453, with the closure of the Bosporus and therefore access from the Black Sea to the Silk Road, propelled them further in that direction.

Competing with the Portuguese sailors who, bypassing Africa and through the Red Sea, managed to reach the Indian Ocean, in 1492 the Spanish expedition began, led by Christopher Columbus, who in his search for a new Atlantic route to the Indies ended up reaching the American continent. The confusion lasted until in 1507, when they verified that the new world had no land connection with Europe.

For the first time, since the end of the last ice age when the rise of the Bering Sea made the so-called “Bering Land Bridge” that connected Siberia and Alaska disappear, the arrival of the Spanish broke the 10,000 years of isolation between America and Eurasia. Accidentally, the confrontation between civilizations with an uneven degree of development was combined with the time bomb that involved putting millions of Amerindians in contact with new diseases and pathogens against which they were immunologically virgin.

The Spanish conquerors came into contact, first in the Caribbean Islands and later on the continent, with peoples and civilizations such as the Aztecs, Mayans and Incas who had formed powerful empires, with very large populations, and who had their own highly developed cultures. The enormous, quantitative disproportion between the few thousand men that made up the bulk of the occupying forces and the millions of inhabitants that populated the entire continent is only partially offset by the comparative advantage of the much superior means of transportation, iron tools, supplies, and above all the armaments (swords, armor, cavalry, firearms and artillery) which they received by sea from Europe.

From the first contact with the native Caribs and Arawaks, the inevitable occurred. The latest studies confirm that, already in 1494, the troops of the second Columbian expedition were accompanied by an unexpected visitor: the swine flu virus. The infection did not take long to spread, ravaging the native population. Along with the flu, most of the pathogens responsible for the contagious diseases of Eurasia reached the coasts of the new world: smallpox, measles, typhus, cholera and so on. In this way, with each new military expedition of conquest, contagion would spread throughout the continent, generating a demographic hecatomb.

According to historian and writer Chris Harman, in his book A People’s History of the World, of the more than one million natives who, upon the arrival of the Spanish, populated the island that they baptised “Hispaniola” (Santo Domingo and Haiti), in 20 years the census fell to less than 28,000, and in 1562, only 200 survived.

At the beginning of the 17th century, in little more than a century of colonial rule, practically all pre-Columbian cultures had disappeared. Of a population of between 10 and 25 million that lived in what is now Mexico and Central America, barely 2 million survived, the same happened with the peoples encompassed by the Inca empire, which went from 7 million inhabitants to just over half a million.

There is no doubt that the impulse that led to the conquest and colonisation of the Americas reflected the historical need to break with the particularism and limitations of the old feudal order, thus laying the foundations for the development of a new economic model: capitalism, which from a historical point of view was progressive. But it is also evident that, in this development, the biological accident caused by the rupture of the American continental isolation accelerated the process in a very significant way.

As a cruel historical irony, the two powers that made their mark throughout the sixteenth century were soon relegated to an irrelevant position in the new scenario that they inaugurated worldwide, which also took shape with the rise of the bourgeoisie between the 17th and 19th centuries.

As Leon Trotsky masterfully explained in his book The Revolution in Spain:

“Spain belongs unmistakably to the group of the most backward countries of Europe. But its backwardness has a singular character, weighed down by the great historic past of the country Spain knew periods of great bloom, of superiority over the rest of Europe.

“The discovery of America, which at first enriched and elevated Spain, was subsequently directed against it. The great routes of commerce were diverted from the Iberian peninsula. Holland, which had grown rich, broke away from Spain. Following Holland, England rose to great heights over Europe. Beginning with the second half of the sixteenth century, Spain had already begun to decline. With the destruction of the Great Armada (1588), this decline assumed, so to speak, an official character. The condition which Marx called ‘inglorious and slow, decay’ settled down upon feudal-bourgeois Spain. The old and new ruling classes – the landed nobility, the Catholic clergy with its monarchy, the bourgeois classes with their intelligentsia – stubbornly attempted to preserve the old pretensions, but alas! without the old resources." (1931)

Objective data shows us that pandemics that have endangered humanity's very existence coincide with turning points in historical evolution. The necessary preconditions for the biological incident to occur are generated or greatly facilitated by the social situation of the time, and at the same time, this delays or accelerates the original process.

The qualitative difference between the COVID-19 crisis and all the previous pandemics, including the one caused by the Spanish flu of 1918-1920, is that today, for the first time in the history of humanity, there are the necessary technological and scientific means to anticipate an epidemic emergency and combat it. The biological disaster that yesterday was unpredictable and uncontrollable, today is a direct product of the incapacity of the bourgeois system.

The revolutionary implications of COVID-19

The health and socioeconomic crisis caused by COVID-19 represents an abrupt change in the lives of millions of people around the world, faced with an unprecedented situation: an emergency about which no one warned them.

Overnight, the outbreak of the pandemic has caused one of the greatest biological disasters in human history, with potentially more serious consequences than those of the 1918 Spanish Flu.

The tragic result, with millions of infection and tens-of-thousands of deaths endured by workers of the most developed countries, is only a small preview of the endless horror faced by hundreds of millions of disinherited in the Indian subcontinent, Central Asia, Africa and Latin America. These regions of the world, in which millions of human beings are crammed together in the suburbs of large megalopolises, with hardly any services and minimal health infrastructure, will be the ones that suffer the most devastating health and social consequences of the pandemic.

COVID 19 Europe Asia FoundationCOVID-19 has performed the work of the old mole of history, which for years moved hardly perceived, and in a few months has taken a giant leap / Image: Europe Asia Foundation

The virus has detonated all the explosive material in the foundations of economy, which has been accumulating for years in the form of underutilisation of current productive capacity, fall in productive investment, public and private indebtedness, financial speculation, trade tensions, and open battles for the control of raw materials and markets. COVID-19 has opened Pandora's Box: all the evils that were anticipated and expressed in 2008 have come to light, reflecting the organic and global nature of the crisis of a system that threatens the future of humanity.

The experts of the ruling class are astonished to see how, with each new economic downturn, their worst omens are confirmed. Although many questions remain, everything indicates that the acceleration and deepening of the contradictions that the virus has fueled are pushing the world economy into a crisis so deep that it will make 2008 seem like child's play.

The immediate consequences in the lives of millions of people have in many cases have meant moving from a situation of relative stability to seeing their jobs, living conditions, and the future of their families at risk.

The uncertainty over the epidemic, together with the slowdown in the economy, are a tremendous psychological blow that has suddenly broken all the securities, certainties, and routines that until recently marked people’s lives. Faced with such a radical and unexpected change, it is not surprising that what predominates at first are fear, confusion and doubt. Tomorrow, when the situation finally begins to normalise and the confinement is lifted, the pendulum of consciousness will swing violently and thousands will begin to reconsider, ask questions, and demand responsibility. Starting with young people and the most conscious sectors of the working class, the incipient questioning of capitalism that had been developing since the 2008 crisis will make a leap in quality. Breaking with the ideological ties of the past, thousands will ask themselves: how do we end this nightmare? Many will look to organise and take action.

The accident of COVID-19 has performed the work of the old mole of history, which for years moved hardly perceived, and in a few months has taken a giant leap, bringing to light all the contradictions of capitalism.

Abruptly, a parallel process of revolution and counterrevolution has opened, the outcome of which will be decided in the coming years!

The dilemma to be solved comes down to: who will prevail? There are two alternatives. Either the multiform hydra of the old social order will triumph, which uses all the material and ideological shields of states and governments to hide and protect the Dictatorship of the Capital, to whose selfish benefit the general interest is subordinated, putting at risk the very future of humanity.

Or, the tremendous potential power of the working classes that make society function, and who, learning from the harsh experience of the dramatic events of the current period, will become an effective creative force to expropriate the Aristocracy of Capital to create a new social order, based on the socialisation of knowledge, and accumulated technological and productive resources. Planned and controlled collectively, these would in a short time put an end to all the ills of unemployment, misery, disease, and barbarism. This would lay the foundation for a giant leap into a new era in the history of humanity.

The dilemma that humanity faces is the same that Frederick Engels anticipated more than 150 years ago: “Socialism or Barbarism”. Today, in the 21st century, this acquires an even sharper character and is reduced to: socialism or destruction of humanity.

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