Solidarity and System Change - the antidotes to COVID

 A Statement by the Asia Pacific Regional Civil Society Organizations Engagement Mechanism (AP RCEM) on the COVID-19 Pandemic

The Covid-19 global pandemic is an unprecedented crisis and likely to be a defining moment in history. The United Nations says it is the greatest crisis the UN has ever faced. We, 610  civil society organisations from 18 constituencies and in 38 countries across Asia and the Pacific, recognise that the pandemic is a tragedy of unprecedented proportions and will require responses unlike any governments are accustomed to. We issue this statement as both an offer of solidarity, inviting governments to work with civil society to solve this together, and as a statement of intention – we commit to doing everything we can to solve this crisis and to deepen our resolve to shape a healthier, fairer, kinder, more just and sustainable world. This crisis will change our societies, our economies, our political systems. We cannot rely on existing systems to solve it and we can never go back  to business as usual. Let this crisis give birth to the era when we turned away from greed, authoritarianism, individualism, from hatred and paranoia, and moved toward Development Justice.

Whilst no government can be blamed for the existence of the virus, the crisis is exacerbated by the violence of neoliberalism, of privatisation and inadequate funding for public health and social protection. Neoliberalism shifted societal risks, including the risk of public health crises, on to individuals. The crisis has exposed the failure of globalised capitalism to deal with any crises. It is time to put aside the pernicious rules that prevent governments from properly dealing with this crisis.

Some people in our communities are more vulnerable to the virus than others. Some of the vulnerability arises from who they are – older people, people with disabilities, people living with HIV,  and people with existing health conditions . Some vulnerability arises from jobs that  people do – health workers who risk their health to serve others, aged care workers, cleaners, emergency service workers, food workers. And some vulnerability arises from the failure of the existing systems to protect and respect human rights – people who live in communities without access to public health system, the homeless, people living in slums who cannot self isolate, migrant workers, precarious workers who are forced to continue working because they do not have the luxury of self isolation and have no access to sick leave. Casteism, racism, feudalism render Dalits and indigenous communities vulnerable and without adequate health rights.   

The burden of lockdowns and failures in public health will primarily fall on the shoulders of women who too often shoulder the responsibility to care for children without schooling and care, for sick family members unable to access healthcare and for sustaining families without incomes. Women are also experiencing increased threats of domestic violence, with the shutdown making it more difficult to escape violent men. . 

The crisis has revealed how dependent we are on informal and undervalued workers - those who continue to deliver food, clean public spaces, keep our energy water and sanitation going, without access to decent work and with  risks of exposure and discrimination.

Unless we deal with the systemic failures that render exploited groups more vulnerable, we will not get through this crisis. Solidarity is not just morally right, it is a public health necessity.

We recognise the sacrifice and efforts that health workers - over 70% of whom are women -  are performing to keep communities healthy, often without adequate personal protective equipment or resources. We express our deep respect, sincerest gratitude and solidarity to those workers. Genuine and lasting recognition of their efforts would be best demonstrated by building and nurturing  a functioning quality public health system globally. This crisis can usher in  new global goods for public health.

The world is expected to experience a more rapid economic downturn than we have ever experienced. To avoid a prolonged depression we will need to see public investments akin to a post-war reconstruction. Those new public goods can deliver the public health, care, energy, water, education, transport, social support systems we need for a sustainable future.

We offer the following recommendations in the spirit of solidarity and willingness to work with governments:

Implement WHO directives
We endorse the directive of the World Health Organisation that governments now need to:

expand, train, and deploy their healthcare and public health workforce
implement a system to find every suspected case at the community level
ramp up production capacity and availability of testing
identify, adapt, and equip facilities to treat patients
develop a clear plan and process to quarantine contacts
refocus the whole of government on suppressing and controlling COVID-19
We also call on the WHO to make greater efforts to make its information available in the region. The pandemic has made it clear that the WHO needs a more audible, directive voice with the ability to shape policies impacting on public health, including those that negatively impact on the capacity to fund public health emanating from International Financial Institutions.

Prioritise protection and decent work for health, emergency services workers
Health and other workers go with  inadequate personal protective equipment, working unsustainable hours without allowing them to take leave and being given inadequate information. The underfunding of public health means inadequate staff and with many health workers being exposed to the virus and having to be quarantined or receive treatment, workers in some countries are already completely overwhelmed. Long shifts and increased staff-to- patient ratios are public health risks. Health workers also reported being evicted from their homes and suffering other forms of harassment and  discrimination.

Community health workers, working without the right to a minimum wage (let alone a living wage) or to be recognised as public health staff in a number of countries in the region, are being asked to do some of the most difficult work in the community. They go door to door to check on the community, often check on those in isolation, provide vital information and will be critical in delivering vaccines once that becomes a reality. Now more than ever we must recognise them as essential to the public health system and provide them with a guaranteed minimum living wage, leave entitlements, pension, social security and other provisions that public sector workers receive.

Governments must work with health worker unions to ensure that staff are properly protected, that their shifts are reasonable, that any overtime is compensated, that discrimination and harassment are prosecuted, that psycho-social support and child-care are provided for those who need it,  that temergency housing of a high standard is available and accessible for any worker delivering health and emergency services who needs it, and that all workers receive sick leave and isolation leave. Compensation pay for working in dangerous conditions must be equitable and equally given to doctors, nurses, allied health staff, community health workers and cleaners and other care staff working in the  health system.

Increase public health workforce
Governments have known for some time that the world would inevitably face another global pandemic. Governments have also known that there is a global shortage in health workers.

In 2017 governments adopted a Five Year Action Plan on Health Employment and Inclusive Economic Growth at the UN World Health Assembly.  The plan recognised that governments have not sufficiently funded their public health workforces and that there will be a shortfall of 18 million health workers by 2030 . The largest shortfall of health workers is in Asia.  To address the shortage governments need to significantly increase funding to the public health system and improve the wages and conditions of health workers to attract and keep health workers and reduce the large loss of workers through health migration out of the region.

Provide universal, free access to health treatment and pharmaceuticals
Health systems designed to deliver profits are perverse and dangerous. If testing, treatment or vaccines are not free, large numbers of people will not seek treatments. The result of health privatisation is large scale public health problems.

Government spending on public health in many countries in the region has failed to match growth, let alone increase to the level required to meet its obligations to deliver universal quality public health.  It is indefensible and immoral for governments to continue  prioritizing military and defense spending over health and wellbeing of the people. We must see a global and regional commitment to universal and free public health.

However, international financial institutions (IFIs) that have promoted privatisation are doubling down on their failed model and using the crisis to expand private health. The World Bank, for example, uses the existing public health limitations to justify further funding of privatisation in India. “Given the limited public sector capacity for isolation and intensive care services for COVID-19, the private sector will be contracted to surge India’s capacity for diagnostic and intensive care treatment services for the disease.” (Ministry of Health and Family Welfare, India)

Substantial public resources are being mobilised to support the development of diagnostics, treatments and vaccines. However these resources have not come with a guarantee that they will deliver universal, free services to the public and will stay in the public domain. In some cases, for example in the funding made available by the European Commission which could be awarded to institutions involving the private sector, the absence of a clause banning exclusive exploitation licences leaves the door open to profiteering and puts lives at risk. The effort of big pharmaceutical giants to keep proprietary data and information on possible vaccines to fight SARS-Cov-2, the causative agent of Covid-19, to themselves is immoral and antithetical to the global solidarity needed to surmount this unprecedented crisis.

Governments must ensure that all research, data, samples relating to Covid-19 are made available in the public domain. When a vaccine is found it must be made freely available and replicable as a generic vaccine in all countries under the auspices of the WHO.  Governments are obliged to ensure the right of everyone “to enjoy the benefits of scientific progress and its applications” as stated in the article 15 of the International Covenant on Economic, Social and Cultural Rights..

Nationalise private health and services required for the crisis and to sustain future livelihoods
Governments must be free to nationalise essential services and industries including health, pathology testing, production and distribution of pharmaceuticals, aviation as well as requisition of private production for public goods like the production of ventilators and other essential equipment. Hotels should be available for public requisition required for housing, quarantine, emergency medical or related purposes.  The sovereign right of countries to impose such extraordinary measures to respond to public health emergencies must be respected.

Guarantee wages to all impacted workers
Hundreds of millions of workers across the region are now unable to work. Millions of precarious workers face starvation, homelessness and destitution. The ILO estimated that up to 25 million jobs could be lost due to the economic impact of the virus. But that figure has already proven to be vastly underestimated.  The rapid imposition of lockdown in India meant millions of internal migrant workers were immediately locked out of their livelihoods. Workers left homeless cannot self-isolate and many many more are now begging and sleeping in streets. Precarious workers in the Philippines who demanded food have been threatened with extrajudicial murder.

The gravity of the situation for these workers and their families shows once and for all that we can no longer tolerate precarious work. Employers should be made to keep paying workers where possible and governments must provide wage subsidies directly to workers who can no longer earn a decent living.  Workers must be guaranteed just living wages, leave entitlements and universal social protection.

Include migrants in government response and address the problem of labor migration
Temporary migrant workers, on the other hand, reel from the socio-economic impact of the pandemic. Their pre-existing working and living conditions have rendered them vulnerable not only to contracting the contagion but to threats of unemployment, exclusion from government support, insufficient or lack of access to health services or even PPEs, discrimination and xenophobia, and criminalization.

Travel restrictions have already caused the jobs of prospective migrant workers. In Singapore, new infections are mostly migrant workers living in cramped dormitories.  In Malaysia and some countries in the Middle East, undocumented migrants have been reportedly rounded up, detained and deported to their respective home countries.

Migrants, immigrants and refugees, including undocumented migrants and those who are in detention,  should be included in the comprehensive policy responses of governments to the pandemic - from health responses to economic relief packages. Repatriation services should likewise  be provided for those who wish to return home voluntarily.

In the long run, governments need to rethink the migration for development framework. The pandemic has only exposed its failure to uphold the comprehensive rights, welfare and dignity  of migrant workers everywhere. Long-term, sustainable solutions to unemployment need to be addressed without relying first and foremost to labor export.

Strengthen local food systems and promote agroecology
The role of competing claims on natural resources, land degradation and deforestation and the consequent displacement of poor farmers and indigenous peoples as underlying causes of Covid-19 and other zoonotic diseases cannot be overemphasized. Resource-poor farmers who are driven into wildlife habitats and into eking  a living from illegal trade of wildlife have been unfairly blamed for the spread of zoonotic diseases while private interests and corporations that profit from wide-scale destruction of forests and wildlife habitats  for expansion of industrial plantations and agribusiness even receive  government subsidies. Meanwhile, the FAO acknowledges that  80% of the world’s population depend on small-scale farmers, producers and fishers for  food and nutrition.

Governments need to adopt agricultural value chain development guidelines that promote transformational partnership with small scale producers founded on food security/sovereignty, resilience, sustainability and women’s economic empowerment.  Cooperatives and social enterprises engaged in sustainable local economic development initiatives that enable the poor and marginalized to advance food security and access to basic social services need to be recognized and supported by governments.

The massive disruption in the food system that resulted from the lockdown measures imposed by governments worldwide to contain the contagion is a demonstration of the failure of centralized food production, processing and distribution.  One of the few silver linings in the gloom of the pandemic is the activation of local food supply systems particularly in rural and peri-urban areas across the region.  The closure of borders between and within countries that have cut off transportation  have opened up opportunities for small-scale food producers and artisans to establish direct connections to consumers and local communities. Barter systems among households and communities have even emerged, and solidarity economies have sprouted to support those that have no or limited resources to buy food during lockdowns.  Such efforts to activate local markets, promote community-supported agriculture and strengthen the  local food web must be sustained and encouraged as part of the new normal that humanity needs to put in place in the aftermath of the pandemic. 

Suspend patents and lift trade rules that impede access to medicines and medical technologies and that limit government actions required to address the crisis
Trade rules have been designed to benefit multinational corporations that profit from  the vast majority of people in the region and at the expense of public health. Both the WTO and preferential trade and investment treaties include provisions that; prevent governments from nationalising essential services and industries, protect monopoly patents on essential medicines,  and prevent governments from establishing domestic industries to ensure access to supplies.

We call on governments to put in place a waiver on the Trade Related Aspects of Intellectual Property Agreement (TRIPS) of the WTO on all medicines, medical devices and other medical products that will allow the suspension of future and current patents on all such products. In the meantime  governments must fully use the TRIPS flexibilities such as compulsory licensing, including unfettered rights to import those medical necessities made under compulsory license in other countries. Unilateral measures that prevent countries from obtaining essential medical equipment and medicines must end immediately.

Trade rules that impose corporates’ interests through ISDS undermining the regulatory capacity of the states to protect public interest and public health, as well as  prohibit nationalisation or expropriation of public services or of private facilities for production must also be suspended.

Cancel sovereign debt payments and provide financing that does not create debt to developing countries.
We endorse the global call for the permanent cancellation of all principal, interest and charges on sovereign external debt due in 2020ly and should not accrue into the future. Cancelling debt payments is the fastest way to keep money in debtor countries and free up resources to tackle the urgent health, social and economic crises resulting from the Covid-19 pandemic.

 Establish participatory mechanism for assessing technological solutions
In times of a global crisis such as this pandemic, the aspiration to bring quick technological fixes or silver bullets often mutes the quest for long-term solutions to address the root causes and structural problems that led to the crisis.  The aggressive approach of countries like South Korea in containing the pandemic that focused on widespread testing and massive contact tracing have become a model for others in the region.  Such an approach is often wrongly reduced to mere technological intervention,  losing sight of other factors that enabled the government to respond swiftly and decisively to the pandemic. This includes the presence of a robust biomedical industry made up of small companies run by scientists that has built-in capacity to produce and deploy effective and affordable test kits, existing universal health care and  public health system, as well as civil society's critical role in reaching vulnerable groups, in monitoring and policy advocacy work on the appropriate balance between protecting the public, and respect for basic human rights. Without appropriate measures  in place,  technological  measures adopted by China, Singapore and South Korea  in using digital technologies to track, trace and identify Covid-19 infected and recovered patients aspired by other countries in the region  may be misused to further suppress democratic rights,  impinge on privacy and institutionalize state surveillance. Technology companies have started to position their digital technologies to enable digital tracking and identification to be embedded in the new normal that will characterise our daily lives in the aftermath of this pandemic.

Without societal oversight, digitalisation of information on public health and pandemic could make this public good inaccessible to people, concentrated in the hands of few countries and controlled by  giant corporations.  The UN must take the lead in laying down basic principles to protect peoples’ rights in technological measures that aim to address the pandemic  tackling its structural roots. The UN and governments must establish mechanisms for participatory assessment of new and emerging technologies that are presented as solutions to crisis to ensure that technological fixes will not cause harm to peoples, society, livelihoods and the environment.

Uphold human rights and protect democratic institutions
Whilst governments need to move quickly to address the situation, some have done so unilaterally, and effectively suspended democracy. While some new restrictions are temporarily necessary to contain the virus, too often they are being imposed to cement authoritarian power and flagrantly violate the rule of law. If health authorities in a  country have deemed it necessary to impose lockdowns, governments must ensure that livelihoods can be maintained and safeguard  the rights to food, water, energy, housing, health and education safeguarded. 

Across the region violations have occurred ranging from direct threats to authorised  extrajudicial killings of protesters (e.g., in the Philippines), to expanding discretionary police and military powers with emergency rules, to heavy surveillance and direct violations of the freedom of expression and opinions (e.g. Fiji, Thailand, the Philippines).  Internal migrant workers in India have been forced to walk tens or even hundreds of miles to their home villages, putting them at risk of police violence for being in the streets during the national lockdown and exposed to serious health risks. In Malaysia, the enhanced movement control order has prohibited migrant workers from accessing food and other basic needs. In Cambodia, the government has bestowed upon itself unrestricted draconian emergency powers that can be applied not only for pandemics but also for future threats against “social order”. Police forces have been given new discretionary powers in many countries that can be used to target the most vulnerable.

Establish oversight committees and commit to transparent, accountable governance
Despite the enormity of the situation, democracy and accountability cannot be suspended. Instead they must be enhanced. We have seen some leaders make unilateral, uninformed decisions with disastrous consequences. Accountability and oversight are even more urgent at a time when the enormity of decisions are unprecedented and potentially cataclysmic. 

Media censorship, already a significant threat to democratic accountability in the region, has been escalated  in Thailand, India, Cambodia. For people to put their trust on both government and media,  oversight and effective checks and balances on power should be in place.

All countries need to establish both decision making and oversight committees. Decision making should not be in the hands of an individual alone but be guided by public health experts, multi-party parliamentary representatives, representatives of different levels of government and public administration, including local governments, independent human rights commissions where they exist, trade unions and civil society.  These committees should provide daily information to the public on the state of the pandemic , on decisions being made and the evidence relied on. Where possible major changes should be signalled in advance to allow people to prepare themselves without panic. Oversight committees, like that established in New Zealand, should review decisions and ensure they are just and accountable.

This crisis will be overcome only with cooperation and if the people trust the decisions of the government.


A recovery that delivers a just and equitable transition to a decarbonised economy
The pandemic has provided a glimpse of what could transpire with runaway global heating leading to increased epidemics and the inability of public health and public institutions to deal with a crisis. It also shows us that it is possible to take monumental steps to address a crisis when required. Governments can deliver good jobs, increased access to energy and water and a more cohesive society by designing a recovery that priorities public sustainable goods, services and infrastructure.

Government commitment to sustainable agriculture and sustainable consumption and production systems need to be founded on harnessing indigenous knowledge systems, community-based natural resource management and innovations of social and community enterprises working for just and sustainable local economies.

We must use this opportunity to deliver a just and equitable transition away from a consumption-based,  extractive and exploitative economy to a just, sustainable and caring economy focused on the needs of communities.This requires ending fossil fuel energy dependence and building energy democracy. It is time for a new, sustainable social contract that stops the climate crisis, the health crisis and the crisis of inequalities.

Rebuild a gender just society that redistributes care work
Governments need to ensure that gendered impacts of the measures implemented during the pandemic are taken into account and negative impacts are avoided; as well as use  intersectionality analysis to map differentiated impacts of vulnerable groups that are already affected by the intersecting power of globalisation, fundamentalism, militarism and patriarchy. Ensure these affected communities including women are involved in the development and implementation of COVID-19 responses in all levels. Any response to COVID-19 must be gender-sensitive, gender-responsive, and advance gender equality by ensuring fulfillment of women’s human rights as recognized in CEDAW and other treaties and agreements.

Rebuilding a gender just society requires directly challenging economic policies, institutions and accounting that have entrenched social  inequalities and often undermined the regulatory capacity of the state. A gender just society can only happens when economic activities are no longer rely on devaluation of women’s work as source of competitive advantage, when women’s unpaid care work are no longer use as rationalisation of social safety nets and essential public services, and when the true value of women’s unpaid care work are fully recognised, supported by the State and redistributed. 

Create new global public goods for public health  and solidarity
New global public goods should be part of the legacy of this crisis. It’s clear that the WHOs limited powers are insufficient to ensure that the public good of all humanity drives the response to a crisis. It’s also clear that we will need new systems for taxing corporations, for addressing sovereign debt crises and for just climate action. We need an agency on viral diseases as a global public good with regulatory power over essential medicines. We need a global tax body.

A recovery that delivers a legacy of development justice
Governments will need to build recovery plans unlike any seen outside of war. Political leaders have the unprecedented opportunity to leave a lasting legacy of a more just, equitable and sustainable society. They will have to put aside orthodox economic neoliberal advice. Short term stimulus packages and future austerity will be catastrophic responses likely to deliver civil unrest.

Only a state-led recovery will be possible. The global financial crisis demonstrated that economic bailouts of big corporations simply delivered higher inequality and more wealth hidden in tax havens.

The economic downturn can be cushioned by immediate large-scale investments in public health infrastructure, training, research and employment. Governments can also have the privilege of planning the largest delivery of public goods in a lifetime – new universities, new public broadcasters and data systems, new public clean energy, new public spaces and guaranteed universal social protection.

It is clear that governments must rapidly expand their revenue base. We can no longer rely on existing tax systems. It is time to implement a minimum global tax rate and to create a global tax body capable of ensuring corporations are taxed as single entities with those taxes distributed fairly across countries. It is also time to lift the constraints on the ability of governments to manage their own common wealth and end the Washington Consensus.

Conclusion

Throughout history, major crises have resulted in significant political, economic and social changes – sometimes for better, sometimes for worse. This pandemic will change the world forever. We must make sure that the crisis delivers our region a healthier, kinder, more equitable future for all.

We are determined to come out of this pandemic with hope, deeper solidarity within and across nations and with a path toward development justice.