Healthcare – The Cooperative Society

Covid 2022: Five Lessons and Three Predictions

The Cooperative Society Newsletter
January 2022, Issue 33
by E.G. Nadeau, Ph.D.

I had planned to write about the resurrection of the Build Back Better legislation in the United States Congress, but as of this writing, it is stalled.

Instead, the big news I’d like to reflect on is what appears to be a plateauing of worldwide Covid cases, and significant declines in some countries. South Africa, where the Omicron variant originated, has one-sixth the number of cases that it had a month ago. The United Kingdom, the first European country hit hard by Omicron, has experienced an almost 50% decline in weekly cases since its peak level. The United States has begun a downward trend in just the past week.

New cases and deaths. Graphic from *The New York Times*.

Thus, it’s time to look back at the world’s almost two-year ordeal (so far) with the pandemic and to prepare for what comes next.

This is a fitting Cooperative Society topic because, if we’re going to shape a better world, we have to learn from the lessons of catastrophic events like the worldwide spread of the coronavirus and do a much better job when the next killer virus or other worldwide disaster comes along.

The five lessons and three predictions:

Lesson 1. Avoid complacency about potential future disasters

In many ways, international health organizations, governments, pharmaceutical companies, and the scientific community got caught with their pants down when Covid emerged in China in December 2019. There had been a lot of discussion in the early 2000s about creating a quick response system to address new viruses and other major international health threats. However, when Covid arrived, the world’s response capabilities were woefully inadequate and had to be cobbled together anew.

The lesson? After more than 5.5 million global Covid deaths and counting, let’s get serious this time. We need to create and maintain a worldwide readiness system.

Lesson 2. Act quickly and cooperatively when disaster strikes

This lesson builds directly on the previous one. It’s not enough to have a system in place to deal with potential worldwide health and other disasters. The system needs to be activated quickly, effectively, and universally. China dawdled, mostly in secrecy, when the country’s leaders became aware of the seriousness of a new virus that first emerged in Wuhan in mid-December 2019. China’s leaders were slow to warn the rest of the world about the potential threat of a pandemic. And when they did come clean, many of the world’s political leaders minimized the threat and/or were slow to act. For example, the infamous comment by then-President Trump on January 22, 2020: “We have it totally under control. It’s one person coming in from China. It’s going to be just fine.”

Lesson 3. Denial is the hobgoblin of little minds

Speaking of Trump, the United States, under his lack of leadership, became the world’s bastion of incompetence in limiting the spread of coronavirus cases, hospitalizations, and deaths in 2020. His denial mentality continued even after his presidency ended, carried on by other Republican leaders and followers. As a result, in January 2022, the U.S. still has the lowest vaccination rate among developed countries and the highest number of Covid deaths of all the countries in the world.

On the international stage, there were a number of other governmental leaders who exacerbated Covid deaths through their attempts to minimize the seriousness of the pandemic. For example: Modi in India, Bolsonaro in Brazil, Lukashenko in Belarus, and Lopez Obrador in Mexico.

The lesson? To avoid unnecessary suffering and death in pandemics and other health crises, governmental leaders should avoid political posturing and, instead, take actions based on science.

Lesson 4. We have the ability to solve complex problems

On the positive side of the Covid ledger, the world has an incredible ability to solve scientific and logistical problems. In the United States and in other countries, major funding was provided to pharmaceutical companies and scientific institutions to develop vaccines, tests, and other means to combat the pandemic. In an unprecedentedly short period of time, several effective vaccines were available for widespread use in some countries.

Lesson 5. The distribution of resources

We still need to learn how to distribute resources equitably when disaster strikes. Almost two years into the pandemic, only about 5% of people in low-income countries are fully vaccinated compared to an average of over 70% in high-income countries. And in some countries that have good access to the vaccines, there are groups of people – usually people of color, the poor, and those in rural communities – who were last in line to get vaccines and, in some cases, still haven’t received them.

Prediction 1. Covid and its variants will decline steeply soon

By early summer, people around the world will emerge from their Covid bunkers and become sociable again. Recent data suggest that the rapid International spike in Covid caused by the Omicron variant will soon be on a swift downturn. In addition, Pfizer announced in early January that it will be releasing a new vaccine beginning in March specifically targeted to protect against Omicron. What these events most probably mean is that life for many of us will almost return to normal by the end of June.

Prediction 2. Covid will become more effectively preventable and treatable by the fall

An extension of the previous prediction is that by the fall of 2022, Covid will cease to be a pandemic. Instead, it will be a nuisance virus like the flu, for which many of us will receive an annual, or possibly semi-annual, vaccination. Covid cases will still occur, and there may be incidents of troublesome mutations that cause temporary flareups and vaccine adjustments. But Covid will no longer be a major threat to world health.

Prediction 3. The lessons from Covid will provide a model for addressing future disasters

Our battle with Covid will make us better able to solve the climate change crisis and be better prepared for future worldwide disasters.

This is the iffiest of the three predictions. Will we really learn from all the suffering and death wrought by the coronavirus and our bumbling response to it? Or will we just saunter blithely along, forgetting about the international nightmare caused by the pandemic?

Despite our tendency as a species to ignore the lessons of the past, there is a real possibility that we will learn from the Covid pandemic, and apply that learning to other world disasters, such as global warming caused by the burning of fossil fuels; the gross inequality of people around the world not having adequate access to food, healthcare, and other necessities of life; or another killer virus.

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Videos, books, and downloads
• We invite you to view a brief, informative video on community solar co-ops. It’s a summary of E.G.’s December 2021 presentation at the World Cooperative Congress in Seoul, Korea. E.G. describes the ease, affordability, and benefits of establishing a solar co-op.

• Also newly released is a video during which E.G.’s son, Luc, interviews E.G. about his 2021 book Strengthening the Cooperative Community. Luc is co-founder – with E.G. – of The Cooperative Society Project. The book is based on E.G.’s 50 years of international cooperative research and development experience. Of special interest are the 16 recommendations E.G. provides for realizing future cooperative development opportunities.

Strengthening the Cooperative Community is available as a free PDF and as a print book through Amazon and local booksellers. Shown below are some comments E.G. received about the book:

“Anyone interested in concrete ideas for reducing inequality domestically or internationally should read this book,…”—Dave Grace, Managing Partner, Dave Grace and Associates

“Thank you for this lively, agile, and accessible introduction to the cooperative world…”—Gianluca Salvatori, CEO, Euricse

“E.G. has made a major contribution to the history and future impact of cooperative enterprise…I hope the 16 recommendations in this narrative will be given serious consideration by cooperative leadership at the global, regional, national and local levels across all sectors.”—Dr. Martin Lowery, Executive Vice President Emeritus, National Rural Electric Cooperative Association, International Cooperative Alliance board member and Chair, ICA Cooperative Identity Committee

And we remind you that E.G’s book The Cooperative Solution is available on our website as a free download. Published in 2012, EG’s points about making both economic democracy and political democracy the foundations of American society continue to be very relevant today.

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COVID-19’s effect on population trends and poverty

COVID-19 is disrupting more than 70 years of population trends and setting back poverty alleviation by more than a decade.

The Cooperative Society Newsletter
September 2021, Issue 31
by E.G. Nadeau, Ph.D.

This is the third in a four-part series of newsletter articles on the impact of the pandemic on major issues affecting progress toward a more cooperative society. The May article focused on economic concentration and wealth inequality. The July article was about conflict and democracy. The November article will look at the effects of the pandemic on the climate crisis.

This issue analyzes the impact of COVID-19 on global population trends and the quality of life around the world during the past year and a half.

Population

COVID-19 is affecting the world’s population in several major ways. It is lowering the average lifespan, decreasing the birth rate, and slowing current and projected population growth.

Let’s take a look at each of these demographic changes.

Life expectancy

The number of deaths worldwide from COVID-19 is expected to exceed 5 million sometime in October. This is probably an undercount, because some countries are attributing coronavirus deaths to other causes.

In the United States, there were almost 350,000 COVID deaths in 2020, and another 350,000 by the end of September or early October 2021. Deaths from the coronavirus are estimated to have reduced the average life expectancy of Americans by one and a half years in 2020, the biggest single-year decline in life expectancy since World War II. This reduction in average life expectancy does not include the effects of the 2021 death toll. COVID deaths among Blacks and Hispanics are substantially higher than among Whites in the U.S.

Life expectancy in many other countries has not been as dramatically affected by the coronavirus as it has been in the United States. ”It is impossible to look at these findings and not see a reflection of the systemic racism in the U.S.,” Leslie Curtis, chair of the Department of Population Health Sciences at Duke University School of Medicine, told NPR. “The range of factors that play into this include income inequality, the social safety net, as well as racial inequality and access to health care,” Curtis said.

Birth rate

The global birth rate has been declining each year since 1964. It is projected to drop off somewhat more sharply in the United States in 2021, and to a lesser extent, in a number of other countries as a result of the pandemic. According to a recent article in New Security Beat, “The pandemic has caused many young people to delay major life events, such as marriage. This delay will likely manifest in lower birthrates in the years to come. Likewise, pandemic-related unemployment and financial insecurity, particularly among young people, women, and marginalized groups, may cause further decline.”

The impact of the pandemic on lowered birth rates may continue for several years as the world economy gradually gets back on track.

Long-term demographic trends

In the remainder of the 21st century, the effect of COVID-19 on population change is likely to be a minor, but painful, blip. Longevity very probably will continue to increase gradually after the brief, virus-related, downward spike. The lower birth rate, however, may have a longer lasting, if modest, impact.

Independent of COVID, however, a group of analysts, writing in the prestigious medical journal The Lancet, recently projected a more rapid deceleration and then a downturn in world population growth in the remainder of this century:

Our findings suggest that continued trends in female educational attainment and access to contraception will hasten declines in fertility and slow population growth. A sustained TFR [total fertility rate] lower than the replacement level in many countries, including China and India, would have economic, social, environmental, and geopolitical consequences. Policy options to adapt to continued low fertility, while sustaining and enhancing female reproductive health, will be crucial in the years to come.

Primarily due to the effect of this projected lower birth rate, world population (now at 7.8 billion) is expected to peak at about 9.7 billion in 2064, and then decline to around 8.8 billion by 2100. This pattern of population growth and decline is likely to occur unevenly across the world, with some countries experiencing significant reductions in population, and others, especially many low-income countries, continuing to grow through most of the rest of the century. (The author will not go into an in-depth analysis or discuss the policy implications of these trends here, but will address them in future articles and the next edition of The Cooperative Society.)

Quality of life

There has been a recent slowdown in accomplishing the United Nations 17 Sustainable Development Goals (SDGs), including those directly related to the quality of life of poor people around the world, that began before the coronavirus. The slowdown appears to be the result of reduced commitment by some UN members, an overly ambitious agenda by the UN, and the magnitude of the climate-change crisis overshadowing other SDGs.

The first two sustainable development goals are, “End poverty in all its forms everywhere” and “End hunger, achieve food security and improved nutrition, and promote sustainable agriculture.” This section of the newsletter focuses on the impact of COVID-19 on these two goals of ending poverty and hunger by 2030.

Poverty

Extreme poverty, defined as, “Living below the international poverty line of $1.90 a day,” rose for the first time in over 20 years in 2020 as approximately 100 million people were pushed back into extreme poverty, bringing the total number of the world’s population in this category to about 730 million. Even though the World Bank recently projected that there will be a decrease of about 20 million people in extreme poverty in 2021, it will take several years to get poverty reduction back on its pre-COVID track. Despite the overall upward trend in 2021, many low-income countries in Africa will continue to experience an increase in extreme poverty this year, and thus suffer through a longer time period before they return to pre-COVID trends of extreme-poverty reduction.

Despite these grim data on COVID-related poverty around the world, there was actually a decrease in poverty in the United States in 2020. A headline in The New York Times recently reported that, “Poverty in U.S. declined last year as government aid made up for lost jobs.” The percentage of people living below the poverty line dropped from 11.8% in 2019 to 9.1% in 2020. This decline in poverty may not continue in the coming years if Congress doesn’t pass several anti-poverty measures this fall.

Hunger

The COVID-related story for world hunger is much the same as that for poverty. According to the Food and Agricultural Organization (FAO) of the United Nations:

The number of people in the world affected by hunger continued to increase in 2020 under the shadow of the COVID-19 pandemic. After remaining virtually unchanged from 2014 to 2019, the PoU [prevalence of under nourishment*] increased from 8.4 percent to around 9.9 percent between 2019 and 2020, heightening the challenge of achieving the Zero Hunger target in 2030.

The above percentages mean that about 120 million more people were undernourished in 2020 than in 2019, bringing the world total to about 768 million. More than 80% of undernourished people live in Asia and Africa.

The conclusion that the FAO draws related to world hunger applies equally well to extreme poverty:

With less than a decade to 2030, the world is not on track to ending world hunger and malnutrition; and in the case of world hunger, we are moving in the wrong direction. This report has shown that economic downturns as a consequence of COVID-19 containment measures all over the world have contributed to one of the largest increases in world hunger in decades, which has affected almost all low- and middle-income countries, and can reverse gains made in nutrition. The COVID-19 pandemic is just the tip of the iceberg, more alarmingly, the pandemic has exposed the vulnerabilities forming in our food systems over recent years as a result of major drivers such as conflict, climate variability and extremes, and economic slowdowns and downturns. These major drivers are increasingly occurring simultaneously in countries, with interactions that seriously undermine food security and nutrition.

The United Nations recently held a world summit on food systems, in which, “. . . more than 150 countries made commitments to transform their food systems, while championing greater participation and equity, especially amongst farmers, women, youth and indigenous groups.”

But the summit was not without controversy. For example, in an article entitled, “The UN summit on food systems took two years to plan. It’s offered nothing to help feed families,” Michael Fakhri, UN special rapporteur on the right to food, made the following comment:

The Covid-19 pandemic has highlighted what we have known for decades – hunger, malnutrition and famine are not caused by inadequate amounts of food. They are caused by the political failures that restrict people’s access to adequate food.

Conclusion

COVID-19 has significantly contributed to a global reduction in longevity and the birth rate. It has also increased poverty and hunger around the world. The effects of these negative impacts are projected to last for a number of years. In particular, poor people, especially in Africa and Asia, will continue to experience economic hardship and undernourishment well beyond 2021. The optimistic UN goals of ”No poverty” and “Zero hunger” by 2030 will almost certainly not be realized.

It would be a mistake, however, to throw up our hands in despair at these recent setbacks. Since the UN Millennium Development Goals , the predecessors to the sustainable development goals, were first established in 2000, there have been dramatic improvements in the social, health-related, economic, and environmental well-being of hundreds of millions of people around the world.

The recent setbacks related to COVID-19 and other factors mentioned above can be overcome, especially through universal access to coronavirus vaccines, and a recommitment to the 17 sustainable development goals by the international community.

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* Prevalence of undernourishment is “an estimate of the proportion of the population whose habitual food consumption is insufficient to provide the dietary energy levels that are required to maintain a normal active and healthy life.”

Healthcare

An Introduction To Community-Based Healthcare In Developing Countries

The Cooperative Society Newsletter
November 2017, Issue 6
by E.G. Nadeau

The major challenges facing access to healthcare in Africa and other developing countries include: a shortage of doctors and other health professionals, a high percentage of people living in rural areas, and a shortage of funds for services and treatments.

As a result, many people die prematurely from causes that are often easily and inexpensively prevented or treated. For example, in Sub-Saharan Africa:

In 2015, the average life expectancy at birth was 60 years compared to a world average of 72 years.[1]
In 2013, there were 510 maternal deaths per 100,000 live births compared to 16 such deaths in developed countries.[2]
In 2015, out of every thousand children, 86 died before they reach the age of five. This compares to 6 child deaths per 1,000 in developed countries.[3]
HIV/AIDS killed 1.6 million people in 2013 – 75% of all HIV/AIDS deaths in the world that year – although the survival rate for people with HIV/AIDS has gone up dramatically in the past few years because of the availability of antiretroviral drugs.[4]

Clearly, the number of preventable deaths in Sub-Saharan Africa and some other developing countries remains far too high. However, there are a lot fewer of them than there were just 15 years ago. A significant reason for this is the United Nations Millennium Development Goal Program that has helped many countries to reduce premature deaths by 50% or more.[5]

This program began in 2000 and ended in 2015. It was replaced by the UN Sustainable Development Goal Program which began in 2016 and will continue through 2030.[6] The new program has ambitious goals to reduce these mortality rates much further. Below, I briefly describe a healthcare project that could serve as a model for reducing mortality in the years ahead.

A few years ago, I conducted research on a community healthcare initiative in Kenya coordinated by the National Cooperative Business Association (NCBA), a US-based organization that provides international development assistance.

Five main things struck me about this program:

Community health workers, selected by their fellow villagers, received training to address basic health needs. As a result, scarce health professionals served as secondary resources rather than primary ones for local healthcare.
There was an emphasis on self-reliance at the village level, both in terms of healthcare planning and implementation.
The program operated at a very low cost per village resident.
Village initiatives were designed to be sustainable after NCBA staff left.
In just a few years, the program expanded to include several thousand villages and millions of local residents.

This kind of community-based healthcare model has the potential to save millions of lives in Sub-Saharan Africa and in other regions of the world between now and 2030 – especially if it is promoted through the UN Sustainable Development Goal Program, international health assistance programs, and healthcare ministries in developing countries.

If you’d like to learn more about lessons from the community healthcare in Kenya, [pdf-embedder url=”https://thecooperativesociety.org/wp-content/uploads/2020/02/12212-the-first-mile-community-based-health-cooperatives-.pdf” title=”Click Here”]

[1]https://data.worldbank.org/region/Sub-saharan-africa; https://data.worldbank.org/indicator/SP.DYN.LE00.IN

[2]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[3]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[4]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[5]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[6] http://www.undp.org/content/undp/en/home/sustainable-development-goals.html