Episode 2: Development & the COVID 19 Pandemic

We are back!

In this episode, Noaman and Safa reflect on the emergence, spread, political economy and impact of the COVID 19 pandemic on development work.

Transcript

Safa: We are back recording. It's been a month since we released our first episode. Thanks to everyone who tuned in and helped amplify. I am back with Noaman Ali. Hi Noaman!

Noaman: Hi Safa, how are you?

Safa: Good. How are you?

Noaman: Not bad, not bad. Glad to be here again.

Safa: Excellent. We're happy to be back and have a chance to speak about some of these issues in light of rethinking development and the political economy of development. And we were thinking: what should we talk about this time? And the overall umbrella theme of the pandemic - of the last two years and its implications for the way we work and the way we live - that's what we're going to go for. How do you feel about that Noaman?

Noaman: It is a daunting subject, because there's just so many aspects to it. But let's see if we can work our way through it.

Safa: Yeah, so true. So many layers, we will try to attack one by one some of the key elements and of course, bring it back to how it's impacted development work, try to draw the threads there as well. So today, you know, we're in October 2021, it's almost been two years. And we're in a bit of a strange place where I would say some countries, a few European countries, they're kind of in like a post pandemic context where they've removed all public health measures, they don't even wear masks indoors. And it's this weird thing of they're kind of back to normal. Whereas I would say probably the majority of the world and other countries are still in the thick of a crisis and a global health emergency. So how do you feel about that juxtaposition right now Noaman?

Noaman: It is true that a lot of third world countries or global south countries are still in the throes of it - mainly because they haven't received the vaccine at the same time. And I was just talking to a friend who lives in Colombia, and he was talking about how they just lifted their lock down, they had one of the world's most stringent lock downs. But that didn't really - it didn't seem to be in and of itself effective, especially if you're looking at it from the perspective of poor people or from working class people. They were being really affected and impacted so badly by the pandemic. So they just got out of a lockdown, almost as if, you know, it doesn't really matter anymore. And many global south countries are also getting out of it. So the disease has definitely not stopped in many of these places. But it seems like people are tired of these kinds of stringent measures. And they also just don't have that kind of vaccine coverage that countries in the global north have.

Safa: Yeah, exactly. These are things we'll definitely get into. This all started to get more serious around December 2019, January 2020. And last season, I interviewed Haroon Akram-Lodhi. One thing that came up in our discussion with him was about the emergence of the virus and its implications for how we understand and deal with our relationship with the environment as well. And I remember in that conversation, he spoke about zoonotic diseases, and I'm by far not an expert in this at all. But there's a quote from that interview that I thought we can start with. And he said that: "wherever the virus originated, the terms and conditions by which it jumped the species barrier and started to infect humans was a result of the way in which marginalized communities have to try and construct viable livelihoods under conditions of their ongoing marginalization. And this then forces those communities into adopting livelihood strategies, which facilitate the spread of zoonotic diseases." So what do you think of that Noaman?

Noaman: Yeah, and Haroon has this very brief but very dense article about this that I think is worth reading, I think in the Journal of Peasant Studies. And there's been work done by other critical scholars like Rob Wallace and Mike Davis, who are also looking at these kinds of issues. And the point that Haroon is making there is that there's these broader political economic conditions under which people live, they have to make their livelihoods. And that makes them have to, in many ways, encroach into what we might call the wilderness. And that's where all of these kind of diseases exist or are developing because viruses or pathogens like bacteria, or even fungi, they evolve, they develop, and let's just part of what happens. But generally, as Rob Wallace says, there's these immune firebreaks. There's these systems - not really systems, but just things that exist in our bodies or in the environment, which helps to stem the spread of disease. And two things he mentions are first, genetic diversity, and the other is distance, actually. So if you have genetic diversity, you know, just maybe randomly, some people might be more - some people or some individuals may be more resistant to a new disease than others. But when we tamp down on that, I'll get to that in a second, then, when you enforce genetic uniformity, you might be getting rid of naturally existing diversity, which ends up giving us like this natural firebreak, immune firebreak that he's talking about. The other thing is, as we encroach on spaces of wilderness, we reduce the distance between us and these wild pathogens. And we reduce the distance that they have to travel to jump that species barrier to become, you know, the kind of zoonotic human specific diseases that we're dealing with. And what we're talking about with this encroachment is maybe two or three different things. The first thing is industrial farming. And what industrial farming is talking about, is these massive farms, which have genetically uniform chickens, or genetically uniform pigs, sometimes genetically uniform cows, because you're trying to produce milk from them. And meat, of course. And as I said that genetic uniformity gets rid of these immune firebreaks. It gets rid of the natural diversity that exists amongst populations, which can enable some people or some individuals to be more resistant to disease. But why are we pursuing industrial farming? Why are we pursuing that model? It's because of these compulsions from a capitalist economic system, which is driven towards profit. And a lot of poor countries or a lot of poor people don't have any option but to participate in industrial farming. The other thing that industrial farming often ends up looking like is not simply amongst animals, but it's like chopping down forests, in places like Malaysia, etc, wild existing forests so that you can instead grow plantations of say palm so that then you can produce palm oil. Again, these palm plantations are genetically uniform, they're monocultures. Which is not good just for the existence of that crop. For example, bananas - bananas are all the same across the world, pretty much. That means that when there's a disease, it spreads so fast, and it can wipe out the entire banana stock. In fact, a lot of banana, if you read articles about banana, which I do for some reason, you'll find that the banana industry is actually in crisis because of these kinds of diseases. But what that also means is you're reducing the space between the wilderness and humans. The third thing is maybe what we might call a quote unquote, poaching. Right? When when we say there's people on the margins of, say, the formal economy in third world countries, who then have to go into forests, or into jungles, and hunt wildlife, and then bring that back for these quote unquote, exotic markets or exotic consumption. Sometimes you hunt that you bring it back, and then you grow it, you know, we might grow like civets or other kind of wild animals, in conditions that increasingly resemble industrial farming, intensive farming. And so we end up, you know, in this kind of global north frame, or in this kind of like moralistic frame that's often talked about, you know, oh, it's those people, they eat this weird kind of food, or it's those people and they have wet markets, they're not responsible around these things. But the point that Haroon is making is, first of all, a lot of these things are not culturally abnormal or whatever. That's not the problem. The problem is that the way these things are being consumed and produced is reducing these immune firebreaks. And it's enabling the jumping - and that's happening as a consequence of these economic processes that are profit seeking and driving people into certain forms of livelihood. So that was a long way to explain something that I think Haroon could probably explain far more

Safa: That was very helpful. Yeah, I think there's this distinction between agri-business and agri-culture, right. And how, as you said so well, the emergence of this happened within a very specific political economic context. And have we been able to learn anything from that, you know, take any lessons from that. But now that it did emerge, we can also speak to the spread of it in terms of what that says about the world we live in, the ways in we're connected, the ways in which how something that emerges in one area can very quickly and rapidly become a crisis for all of us. That also speaks to and connects to the economic system that we're in in some ways. What do you think Noaman?

Noaman: Yeah, absolutely. That too, right. So one thing is production. And then the other thing, I guess is part of production is circulation, like how do you circulate goods? How do you circulate commodities? And the way we're doing it - not we, it's not like you and I own businesses. But the way that the dominant system organizes that stuff is through what we might call global supply chains or global production networks, which means that, you know, any kind of product that you have isn't necessarily simply produced in one country, all of its components may be produced in different places, wherever it's most efficient. Wherever the unit labor costs are the cheapest to produce that thing. There's a scholar named Intan Suwandi, who talks about this. But also Kim Moody has written about these global supply chains. And wherever it's cheapest, or wherever it's more labor efficient to produce these things, that's where those things are being produced, and then they may be assembled somewhere. But what that means is there's increasing interconnection and spread of people, goods, services, which in and of itself is not necessarily a bad thing. But the way that it's done at this breakneck pace with people, you know, for example, truckers who are pressured to meet certain quotas to work, you know, sometimes without sleep, so that they can just make a living, or they can continue to have their jobs. Or people working on ships, in these kind of closely contained units. who are transporting this stuff. Those are also places where then you can imagine a disease like COVID-19, or any other disease, impacting people more severely, because they don't often get a chance to rest in good ways and build up their own immunities. But then just generally, like even then, people flying from one place to the other constantly, which is also a question of global carbon footprint and stuff like that. But those interconnections and the way that these global supply chains work, they work on a just in time principle, that is something that we can point to as facilitating the spread. And maybe not so much that, you know, in the past, the absence of this degree of interconnection has not necessarily prevented the spread of disease. So in 1918/ 1919, with the Spanish - the so called Spanish Flu, that still went all over the world, part of which had to do with World War One and the way that colonial political economies span the globe. But it might have been a bit slower than what we have right now, which is like just in time, right? The very next day, that disease can show up in a place that it didn't start in. And so again, it's not necessarily - the point isn't that global interconnections and interactions and interchange is bad, but it's just the way that it's organized, the way that it's hectic, the way that it's done, that can help facilitate the spread of diseases.

Safa: Yeah, and the other side of this being in so many ways, the movement of goods are permitted more so than the movement of people, right? And what that also tells us about our values, and the ways that we structure our societies, or we think about our relationships with one another, and our borders, and all of that. But maybe rather than getting to that conversation, we can go to how public health reacted, right. So we had the emergence of this virus, eventually it began to spread, it reached the level of a pandemic, a global pandemic. And all over the world, public health agencies and workers began to issue advice and policies around this. And there's been so many conversations over the past two years about the privilege of being in a place where you actually can adhere to physical distancing recommendations, or have the privilege of working from home rather than that absolutely not being an option in your job, having access to supplies and water, soap, masks - all these things that maybe in the global north is just something that we're all used to and we don't question, but in so many other countries, it's not a viable public health strategy at all. It just does not fit into the context of lives and livelihoods and communities.

Noaman: Yeah, I mean, I got an anecdote around this. So when COVID first hit, I was in Pakistan, and I was doing some work in some low income communities, marginalized groups. And at that point, a lot of people were like, we're losing our jobs immediately - because there's a lot of precarious work in obviously in the global north as well, but definitely in the global south, most people are employed in precarious conditions. They might lose their job at any time, but generally, there's some level of like, okay, as long as the economy is going better or worse, at least I got this, you know, gig that I have. I might be a cleaner, I might be a janitor, I might be a sanitation worker, and I might get fired anytime. But generally, there's a need for that. But with when the COVID thing hit, the factories all shut down in Lahore, for example, where I was living. And also in Karachi, many of the factories went down to basically not operating at all or operating at very, very, very small thing. So millions, actually, of workers probably got laid off at that time. But aside from that, just other kinds of workers were also getting laid off. And you know, the average kind of person in the world doesn't have a bank account, they don't have savings. And the average worker, obviously, in global south countries don't have savings. So when you pursue that, that kind of "lock everything down immediately" kind of strategy, you are putting millions of people out of work. And without the necessary kind of social security or social safety nets, where literally, it's a question of am I gonna be able to feed my family this week, or next week? So one thing we started to do with some students and activists was to collect some funds and use that money to buy some rations and distribute that in the neighbourhood. And when w were doing this, the disease was still new, so we didn't realize that, you know, being outside is not as much of a risk as being inside and all of those things. So outside there was this, you know, this like crowd of women, and it's important to understand that most people who came to collect the rations were women, and what that means around masculinity and notions of that, and misogyny and patriarchy, but that's a different conversation. But there's all these women standing outside and they were just kind of crowding to try and get you know, the thing and we're like, just just line up, just line up and have, you know, two or three feet between you at least if not six feet, you guys know that there's a disease going on, right? And this one woman said to me: Look, we know there's a disease going around, we're not stupid. She didn't say we're not stupid, but you could tell in her eyes that, that that's what she was saying. She's like: we know there's a disease going around. But hunger affects us more immediately. So in that moment, it was humbling, because it's like that hunger was not my issue, but it is an issue for so many people. So how and why does lockdown become the preferred strategy? The preferred intervention? Almost the only intervention that many people can think about? You know, if you look at World Health Organization documents, they are not saying that that's should be the first thing you do, or that should be the generalized thing that you do. But both in the global south and the global north, it kind of becomes the norm. Whereas we probably should have been looking at testing, tracing and containing - but that has its own issues like, can you actually supply the tests? Can you actually test millions of people, you know, almost on a daily basis? Do you have the infrastructure necessary to trace when one person gets the disease, figure out who their social contacts are? That's actually something we can do in Pakistan, and actually, to some degree did, thanks to previous experience with polio stuff. And then once you've traced things, can you contain people? Can you contain a disease, whether it's at the neighbourhood level or at the city level or whatever? Those those things, raise their own questions. In the global north I think the question is: why testing tracing and containment wasn't done, because they probably have the money and the resources to at least set that up, or they had time to set it up. But that doesn't seem to be the preferred strategy. But that's a different question. But the point is that who those kinds of public health interventions affect - both in the global north and the global south. Because it is one thing to be like lockdowns, that's a discussion we can have and should have. But the other thing is also just the public health systems and hospital systems in not just global south countries, but even the global north countries, and the way they've been weakened. In Pakistan, one thing that came up - and it came up in India later, not later, also around the same time, but it became very acute in India was - in Pakistan, if you're reading the news stories, especially around like April and May of 2020, when rich people - rich people are always being affected by this disease, and you know, Dr Yogan Pillay who works for the Clinton Health Access Initiative in South Africa, and he used to work for the government of South Africa as an official in their Public Health department. And I interviewed him on my podcast, and he explained that in South Africa anyway, this was a disease that was brought to South Africa by rich people who traveled to like the Alps in Italy or something. And then it spread to working class areas where you know, it just - in South Africa, it mutated also, and it became quite a devastating disease in South Africa. And I would say it's probably similar in India, Pakistan it's a slightly different question, who brought it in or how it got in, probably multiple sources. But in any case, what happened in Pakistan was these private hospitals were filling up. And that became this immense crisis in the media. It was like, oh, private hospitals don't have beds, private hospitals don't have supplies. But the public hospitals did have beds, public hospitals did have supplies. But none of the rich people wanted to go to those public hospitals. And of course, some public hospitals are better than others. So those public hospitals were getting filled up. They have better reputations, they have more cutting edge staff, etc. But what does it say - I think it's an indictment on those rich people and their relationship to the public health systems in these countries, where there is literally a crisis where people were like: we would rather get treated privately at home, then go to a public hospital. What does it say about the level of care and health that you have left for the vast majority of people who have no option to go to private hospitals, no option to hire doctors to come visit them, or to hire oxygen canisters for themselves at home or all of those things, who have no choice but to go to public hospitals? And I think that that's something really worth thinking about.

Safa: Yeah, absolutely. And also, we see that over the past few months in terms of access to vaccines, like there's the medical tourism aspect of folks who can afford it being able to fly to other countries and maybe illegally or in other ways, just sourcing and paying for vaccines so that they can access it - because otherwise they would not have any access to it in their home countries, in the health system of their home countries. So, when you put it in those words, it's really a stark reality of wow, what kind of healthcare system have we created, that this is the reality that we're living in right now, especially seen through the context of a pandemic. I remember last year, I interviewed Kaveh Zahedi, who works in the Asia Pacific region. And he was saying in that conversation that even before the pandemic, everyone knew that investment in social protection in the region was extremely low, I think he had quoted it was about 3.7% of the GDP in the Asia Pacific region, whereas globally, the average is around 11% of the GDP. And what that meant was that even before the pandemic, even if just somebody got sick, or became unemployed, or pregnant, or a natural disaster, that they would immediately be pulled back or put in a situation of poverty, where they have absolutely no access to social safety nets to help them cope. And COVID just exasperated that, right. It was just another pressure that made everything so much worse. So in terms of the response of global health, of course, there's some development agencies and actors who are part of that response. And in some ways, many have tried to really advocate for and create policies around increasing, strengthening investment in social protection in countries so that this reality could be addressed in some way.

Noaman: Yeah, this is actually where we can start talking about the development sector a little bit more pointedly, and especially public health development organizations and NGOs. I think one thing that's happened over the last 10/ 20 years in public health is the dominance of Bill Gates, literally just one man, one oligarch, Bill and Melinda Gates Foundation, who've made public health, I guess, their core thing. And the fact that like, Bill and Melinda Gates are like one of the main funders of the World Health Organization. Like this is supposed to be an international body, an international public body that is funded by governments, but really a huge chunk of its funding comes from a private philanthropist, quote, unquote - I would say private, you know, capitalist oligarchy, actually. And how much do his concerns and his perspectives on development get to direct a public health agenda? One consequence of this, and it's not just Bill Gates in particular, but it's also just the way that public health has been approached for a long time by by global north agencies, is what you can call a vertical approach versus a horizontal approach. And a horizontal approach, and I'm drawing on some scholars' work here whose names I forget, I'm sorry, I'm drawing a blank - but you know, a lot of critical public health people will tell you this. A horizontal approach is about can we build resilient systems of public health and health care at the base, at the grassroots, which is not just about intervening when something goes bad, but also about having a constant check in with people, making sure that they're living healthy lives, that they're getting basic nutrients, that they're getting basic exercise, that they're getting these basic things, which would help with immunity, help with living healthy lives, and God forbid, in case some pathogen does break out, then instead of like, some centralized body sitting in a capitol, trying to figure out what are we going to do now, you've got this network of health at the grassroots level, which is able to intervene to make interventions where people have trust in their health care workers. And you can contrast that with a kind of vertical approach, which is often looking at more technical interventions, for example, vaccines. Now, I'm not saying vaccines are bad - by no means. But if you look at a disease, like Polio, for example, and the Gates Foundation has been very active in Pakistan, in terms of funding response to polio, and trying to eradicate polio through this technical intervention of vaccination, which is not bad, but in a lot of neighbourhoods, there's just like: you guys don't care about our health when it comes to anything else. We don't have a functioning healthcare system. But you know, people show up at my door saying, we have a Polio vaccine for you. And that's the most important thing and we're just kind of like, is it really? That gives rise to a lot of vaccine conspiracy things here as well, and just a reluctance around people for why they don't want to get a vaccine, it has a lot to do with the way that they - do they trust government or is government trustworthy? And here I have colleagues, Sameen Mohsen Ali has worked on this, Anushka Ataullahjan has worked on this as well in the context of Pakistan, where they're looking at people's engagement with the state and government and what kind of trust is is there? Whereas with Polio, you know, another intervention that you could make to make sure that you're preventing Polio is to have functioning sewerage systems, to have sewage systems where the water you drink is separate from and is treated and is clean and it's separate from the water that carries your waist. A lot of the diseases that we get in Pakistan - dysentery, for example, which is a symptom of underlying conditions. Like 10s of 1000s of children die from dysentery in Pakistan every year, 10s of 1000s. And what would solve that is functioning sewerage systems. But the Gates Foundation does not - explicitly does not work on that. Or if it does, it's on like very technical interventions and sewage systems, as opposed to saying, let's fix that. Why? Because building sewerage infrastructure is a political problem. It's not merely a thing of like, oh, let's figure out a vaccine, which is a technical solution to actually a broader issue of public health and whether or not people are living healthy lives and in healthy infrastructures around them. So you've got this distortion in public health, which is really towards these like, oh, let's build self cleaning toilets. It's like, okay, that's cool. But we need a sewage system man. And then we're not even getting into the question of how Bill Gates and these private philanthropists, who are capitalists, who are oligarchs, who are invested in pharmaceutical companies, are invested in monopolies of intellectual property around health, not just vaccines, but other pharmaceuticals. That's a whole other conversation, but just this like orientation of public health towards technical interventions, and technical solutions, as opposed to these horizontal networks of resilience, as opposed to these infrastructures of health and safety that exist in the global north, but are not allowed to exist in the global south.

Safa: Yeah, definitely. And, you know, one of the main issues has been access to vaccines and the vaccine apartheid that we've seen over the past few months - definitely, it's in the interest of global public health, not just one country, but globally, that as many people as possible get vaccinated as quickly as possible, right. And the inequality we've seen in terms of access to vaccine distribution is really laying bare the political economy side of it. And we have of course, COVAXS as one initiative. But it has not been enough, by far. We have the battles over intellectual property and the rights of countries to be able to produce vaccines, all of this happening, and really the consequence of it being the lives of many, many people being at stake or the death of many, many people.

Noaman: Yeah, I mean, I'm not sure that it is necessarily in the interests of pharmaceutical corporations that are located in the global north, for people everywhere in the world to get vaccinated as soon as possible. And the reason for that might be very cynical thinking, but I don't think it's at all conspiratorial, I think it's it's actually very rational. And I think they've said things like this themselves. Look, if in the United Kingdom, there's a new variant, than in South Africa there's a new variant, than in India there's a new variant, which we now call the Delta variant and I think we all understand it to be very, very, very virulent compared to the other variants. That means that the more this disease evolves, the more there's these reserves of human guinea pigs, basically, that is what people in the third world are, frankly, where this disease can evolve, this disease can take on new characteristics, and then that can, you know, act as a threat to people in the first world, which means that every year you're going to have to get this booster shot. It's in the interest of pharmaceutical companies for COVID to become an endemic disease, rather than to have pursued from the outset a zero COVID policy. Because if you are somehow able to eradicate the disease, then you know, we are not going to be selling booster shots. Year after year, we have this business model where we can sell booster shots, for example, which you do with the flu virus, although flu is not necessarily the most profitable vaccine, actually, there could also be research into developing a universal flu vaccine and there is research. But that research has also been held back for a long time, because if you just develop a universal flu vaccine, and you get rid of that, then again, you can't sell booster shots. But anyway, making sure that COVID is an endemic disease and one that's always on people's minds, and that there's these reserves of human guinea pigs in the Third World, a billion people in India billion, you know, billion people in the African subcontinent, whatever, who cares, as long as this disease is able to serve as this threat and governments are saying, Okay, let's get booster shots, - then these corporations have an interest in producing booster shots every year. So you know, I'm not sure that it is in the interest of everybody that the vaccine get, you know - and once everybody in the global north is vaccinated, as you know, right now, things are very much getting back to normal, people are very much secure in the knowledge that: oh, I'm vaccinated, probably 80 to 90% of people that I'm going to be in this restaurant or club with are vaccinated. So who cares what's happening in the Third World? Unless you know, there's a headline about a new variant then okay, I'm gonna go get my booster shot. That's cool. Yeah. So I don't know - it's cynical, but I do think that that is a real thing that we're contending with.

Safa: I see what you're saying - that could be the motivations behind this. But thinking of vaccine distribution, we can also tie it back to what you touched on a bit earlier in terms of supply chains, and just the whole infrastructure of global distribution of goods. You know, I used to work in a shipping company. And the whole infrastructure of ordering a container, filling it up , having it shipped, putting it on a boat, then it gets a truck and then goes - like this whole infrastructure, it's quite vulnerable. And that one domino effect can really effect other things. So as we've seen over the past few months / a year - with labor shortages, with lock downs, with new rules around hygiene and all of that there's been such a disruption in global supply chains, which eventually leads to having an impact on the prices of goods, on global markets. That's another element of this that we see happening where you might think of: oh, it's just like a shortage of containers, or we have to wait longer - that actually can have much starker consequences in terms of significant impact on the economy and prices and people's livelihoods.

Noaman: Yeah, I mean, that's the thing about - first of all, it's interesting, I didn't know you work for a shipping company. In some ways, It sounds like a very, very fascinating experience, but also very difficult and stressful.

Safa: Yeah, it's very stressful. I think most people don't last long in that business.

Noaman: Wow, so I think we should just do a podcast on that, like, what does global shipping look like? And what does it have to do with development? But I mean, this is a question of political economy of development that we've been discussing, right? You have these globalized networks of commodity chains, as you said - and when that ship got stuck in the Suez Canal, for example, right, that like cost the global economy like a billion dollars a day, minimally. But there's a deeper question of like, where goods are being produced, how they're getting to other places? Those are not random questions,. There is a structure of sorts to the global economy, where global north countries dominate high tech and high value sectors of production. And they outsource low tech and low value sectors of production to the Third World, for example, Pakistan has this massive textile industry where we're just producing cheap clothes for the world. Bangladesh is also one of these countries - there may be slightly higher tech things being produced in countries like Indonesia. Again, China, why is their industrial farming so concentrated in certain provinces of China is, again, this logic of what role is it playing in a global division of labor as a country. And when you start thinking about health products, and vaccines, with that logic, again, it's one thing to be producing like low value masks, for example, face masks. The interesting thing is we've outsourced a lot of that production to China, for example. And then when the supply chains are interrupted, you're unable to get those masks in time to the global north, also, because we don't believe in having reserve stocks of these things. Because, you know, it will cost money to store them. Therefore, we're gonna keep ordering them just in time from China or from other places. So there, there's a low value, the low tech sectors. But the vaccine development and production is dominated by global north countries. That's a high tech, high value part of that. You know, China's stepping into that - they're doing their own thing. Cuba is a very interesting example of a country which is poor, but which has an incredible biotech sector. That's a different question. By and large, this kind of biotech stuff is dominated by these global north rich countries, who have almost deliberately through control of not just intellectual property, I mean, it's important to understand that intellectual property is just one part of the thing. The other part of it is factories, actual production, having that technology located in global south countries. Most of them do not have their own capacity to produce vaccines. This is a complicated process, but it's dominated by global north countries. And something that's very revealing is Angela Merkel, who's the chancellor in Germany, you know, at some point, she slipped and she said: the reason we allowed India to have vaccine production is so that they can supply those vaccines to us at cheap rates. And if they're not going to do that, well, you know, wagging her finger at India saying: maybe we should make sure that Indians have, you know, priority access to the vaccine rather than the European countries that we're supposed to be contracting to export them to. Right? So even that slip of tongue where she's like, we allowed India to have this production. It's like, global north countries, monopolized technology - there's a monopoly of technology. And that is a relationship that we should understand as - you know, we've been talking about vaccine apartheid, as if it's simply a problem of access to vaccines. It's not. We should call it vaccine imperialism, where it is actually a relationship of where things are being produced, where things are being consumed, how they're being spread around. And it's not just in vaccines that we're not allowed to have high tech, high value production. It's in just about every aspect of things, unless it is under the very direct supervision of a global north multinational corporation, this stuff is not being produced in global south countries. And the assumption is that we're going to buy the expensive stuff from global north countries, and that they're going to buy the cheap stuff from us. And that is obviously racist. It obviously perpetuates certain apartheid conditions. But fundamentally what that is, is a relationship of imperialism, when you understand imperialism not simply as global north countries bombing global south countries, but really about controlling their economics, which is what we talked about last time, neocolonialism. So understand vaccine apartheid is a consequence of neocolonial relations and imperialist relations on a global scale.

Safa: Mm hmm. Yeah, that framing is so important - vaccine imperialism. And we see also some countries like hoarding vaccines, and then they become expired at the same time where people in other countries would, would have benefited from them, right. So whether by design, intentional, inefficiency, and just the violence of that system, where some people have so much that it gets expired, and other people don't have any.

Noaman: But then here's my question to you then Safa - like what, we've been discussing the political economy of this for a while, we touched on the development sector a little bit thinking about Gates Foundation, and a lot of public health initiatives. But more broadly, how has the development sector reacted to this? And what role does it have to play in addressing these kinds of inequities? What do you think about this stuff?

Safa: Yeah, I mean, thinking about the last year and a half or so and everyone I've interviewed on the previous seasons, maybe it can be broken down into three main areas. One is like the impact on issues, right - as long as COVID is such a central part of our lives, all programs and policies have to kind of be thought through in terms of what is the effect of that in light of the pandemic or considering the current context that we're all living in. So whether that's on public health issues, education issues, social protection issues, whatever it is that organizations were planning before, had to kind of be redesigned and rethought in light of, okay, how can this in some way address the issues that we're seeing, because of the pandemic, or be better adapted to the current reality that we're living in? So that kind of reprogramming happening rapidly and even till today, right, it's still an ongoing issue. The other thing was, I guess, the methods and the tools. With the reality that some development actors or professionals and organizations having the option of working remotely or being forced to work remotely, it kind of created this new dynamic where now people could travel less. And so they had to maybe rely more on partners who are based in the country or in the community, or find partners who were based in the community if before they didn't have those relationships. And that shift that took place in terms of how are we going to rethink, re-plan the way that we deliver services, in light of the fact that maybe a lot of the staff members we have won't be traveling. And also the shift to kind of this virtual reality of you know everything being zoom meetings and all that, how does that impact the way we connect with each other, like there's less international conferences that are in person - and of course, they can be kind of put into a virtual format, but it still has consequences for the way people are able to relate to each other and understand each other and be aware of issues. So just like the methods and tools also started changing. And just generally the lifestyles, right. Before, if practitioners were really used to being mobile, now it's been less of a possibility. So in all these ways, there's been shifts. And I think also one other thing, based on talking to people and just observations over the last few months or the year and a half is that mental health has kind of become much more of an important issue or an acknowledged issue for at least some organizations, right, not everyone. And mental health on both sides, on the side of your staff members, your colleagues, their mental health, and just mental health globally as an issue that should be addressed through development programming. So these are the things that come to mind. I'm sure there's so many other things I may be missing, but it's impacted basically everything in terms of what are we addressing? How are we addressing them? And what does that all mean for the way that our work can be effective or successful or reach the most people or, you know, have the results that we aim to have?

Noaman: You know, I want to pick on the first thing that you said, which is about that all issues are now refracted through the lens of COVID. And in some ways, you know, it's important. I think, over the last year and a half, unfortunately, about 5 million people or close to, you know, over 4 million people have died across the world as a consequence of COVID. So obviously, it is important. But one thing that was worrying, for example, when public health systems oriented everything toward COVID. It's not that the other diseases stopped either, although some of them might have been helped by the social, distancing, etc. But like, every year, millions of people die from tuberculosis, for example, every year, as I said, 10s of 1000s of children are dying in Pakistan from dysentery. But public health systems then got oriented towards COVID and away from that. And then in that same vein, if you're saying that social protection and just health, education, all of these things are refracted through COVID, does it detract or is it being done in a way that is additive - that actually complements things that are happening? Or is it like, oh, actually, now we have to do this, because it's, it's the thing that's on everyone's mind?

Safa: Yeah, actually, that's a good point. You're right. I remember I interviewed someone who was like a Manager at the Global Fund to Fight AIDS, Tuberculosis and Malaria. And she was definitely saying that, yes, COVID, it's something that we have to address. But it's so important for us to not forget our priorities in terms of addressing and supporting and continue to work on our programs around AIDS, Tuberculosis and Malaria. So, yeah, I think there's been that balance that organizations and colleagues have had to strike between how can we continue to show up for the issues that we're mandated to and that we've historically been addressing, versus the need to address the realities of the context of living in the pandemic? And also, I think this is where funding comes in, right? If you're being funded suddenly to run a COVID program, and your funder is telling you, okay, now you have to pivot , like you have to address this, then what room do you have to kind of push back on that or be able to do multiple priorities - hold multiple priorities in the same moment. Also on leadership, like visionary leadership, if you have a group of colleagues who are trying to make it work so that they can continue to address the original prior issues that they had been historically addressing, and at the same time find a way to address COVID issues as well. I don't have the perfect answer for that. I don't know what every organization has had to do or think through in terms of the choices they're making. But you're right, there's been maybe a risk of overlooking other issues that can be very deadly, can be very, very important, can have stark consequences on the lives of communities. It's a great question.

Noaman: And what about - so then the other thing you talked about was methods and tools, rather, and even lifestyles about how people are engaging? You know, you said a lot of international travel conferences, etc, have been stemmed. But I think one thing that perhaps you've also discussed with other people in your podcast is how a lot of times the kind of agendas, operations of development agencies are kind of directed by people and organizations located in the global north, almost to a sense that like, there's this feeling that people on the ground cannot operate without, like constant supervision or intervention. And so is there some kind of reflection about the need to develop resiliency and greater capacity? I'm sure this conversation is happening all the time. But has that changed or been accelerated as a consequence of the lack of ability to travel etc? Which, by the way, again, is also a question of like, why is so much travel necessary in the first place? And it's also reminding me of this thing that I think James Verbinski who's with Doctors Without Borders was talking about, how in some states that they're working in, they realize that there's so much this idea that, you know, these aid workers are just going to come and do things, but then that takes away from like, the power of government agencies, which have the scale that aid workers or NGOs don't have? And has there been any attention paid to like, Okay, how do we build the resiliency of the state of governments to have capacity to do these things as opposed to simply relying on NGO workers or aid workers?

Safa: Yeah, yeah, I think over the last year and a half, in terms of the interviews I've done with people, the word localization has come up much more than ever before, right and this, this idea that, oh, we need to localize, we need to as much as possible be able to redesign and reformat the way we work so that actual implementation and ownership is by colleagues and partners who are in the country and that we have like a much more minimal administrative kind of role. But there are controversies around that in terms of this idea that we need to capacitate local actors, you know, they need training, they need technical knowledge. And it comes from a perspective of superiority, right, of thinking that, Oh, if we don't train them, they will not be capable to do what we want them to do, right.

Noaman: And I guess it's also a question of like, to what extent do these methods and tools enable global north interests and agendas to continue to dominate, you know, what's happening at the local level, so that now I don't even have to go to that country in order to dictate the agenda can just do it over zoom, as long as they control the funding?

Safa: The funding is key, right? Like, okay, you're giving me this funding, and you want me to take the lead on this. But to what extent do I really have autonomy to do it in my own way, or the way that I think is best versus the agenda or the plan that you have in mind? Right? So it's a it's a stark reality, I think, to a large extent, still, whoever the funder is they have the final say, if they think that oh, the priority should be let's do like an education program on how to wash your hands, then then local colleagues are forced to follow that, right.

Noaman: Yes, and that's - I think that goes back to the thing I was saying earlier about, like, literally, there's something called WASH, right? WASH is an acronym for stuff like how to better wash your hands and boil water and stuff like that. But it doesn't really talk about how do you build sewage infrastructures? Like, give us money for that? But it's like, no, there's no money for that. But there's money for teaching people how to wash their hands.

Safa: Yeah, like WASH is water, sanitation, hygiene. And you're probably right, like, a lot of the initiatives around it are not the structural ones of let's improve our sewage systems, but more the individual behaviour change type programming, you know.

Noaman: And that kind of of ties right back into our conversation last time about decolonization and how thats seen rather than a structural problem, and what role can actual development workers play in addressing those structural issues, it just becomes about individual performance, and about projecting a certain image of sensitivity or whatever. But it really reduces it down to like individuals, as opposed to the question of structures.

Safa: And like, how we define our goals and how we define success, right? I do want to say - I think some people listening might feel like, oh, you know, I do great work, my colleagues do great work, we've had such a difficult two years, this is, you know, maybe not a fair analysis on your part and stuff like that. But I do want to stress that we're not trying to take away from the hard work and efforts of individual folks everyday working in the sector, right. I think that sometimes some of the comments we get like, oh, you know, in our organization, we work so hard - which of course is true and so much respect to those people. But overall, we see this trend that programs and initiatives are more based around behavioural change type things rather than structural changes that address the root causes, rather than just the effects or symptoms of the reality of the systems we all live in right now.

Noaman : Yeah, and you know, without a doubt, for example, especially healthcare workers over the last two years have worked very hard. There's no doubt about that. And in conditions that have been very, far more threatening to them, and it's not just been helped healthcare workers, it's also other workers in the development sector, aid workers, etc. So it's not a criticism on what people as individuals are doing. It's actually a criticism of the system in which they're doing things, right. Like if you're focused on simply on curative medicines and the entire approach of the system is like, let's give people pills, as opposed to okay, let's actually focus on building people's immunity through like, through nutritional diversity through constant care and exercise and making sure people have the ability to live healthy lives. Which then we have to ask questions about like, what are the wages people are getting? What are their sources of income? What are their conditions at work? You know, health is about all of those things. But it's the system that makes it simply about, oh, we got to cure somebody who is sick. And in that same way the issue isn't, again, people are doing a lot of good work. That's not really the question. But the question is, are we being honest with ourselves about the nature of the work that we're doing, or rather about the nature of the systems in which we are working so hard. If we could be working just as hard in a different kind of system, which had different aims, different agendas, had a different orientation? How much more meaningful and how much more transformative could our work be? I think that's a question that really, you and I are trying to ask. It's not to diss on or to, you know, simply attack people - as it is, we need to rethink development, and we need to rethink what it actually means.

Safa: Yeah, and thinking of the pandemic context, like everything we've been talking about, in so many ways, it's been so devastating. There's so much grief around it, is kind of been a global traumatic experience on so many levels. But, you know, through these type of conversations and reflecting on these issues, can we hopefully learn from this, right? Are there things that we can learn to change the way we view each other, view our work, the way we operate? Some thing that comes out of this that can hopefully be seen in a positive light or have a have a positive consequence? Right?

Noaman: Yeah, and I think that reflection has to begin, at least for me, it's to understand that, I mean again, I work in academia, but I don't think I need to have any illusions about academia being anything other than, on one hand, if it's a private university, it is to some degree a business, even if it's a nonprofit. And on the other hand, is about training people who are just going to go and become more or less creative slash critical workers, but nevertheless docile enough that they're not questioning the system overall Like that is ultimately what academia is about. But in the same way, understanding that development, you know, as we said, at the end of the day, I think is really operating in a context of imperialism, where the agenda, the direction is set by by the First World for what the Third World ought to be doing and how it's ought to be doing that. And if that's the case, that is something that we really need to rethink and start reorienting.

Safa: Yeah, and I think overall, today, we've kind of talked about public health response, development organizational response, but throughout all this, we see the hand of governments, right, like the the response of governments and the power of government and leaders and those who really are in a position or have been in the last two years to really control and shape and direct and impact the experiences we've all had, whether it's in our sectors, in our organizations, in our families, you know?

Noaman: Yes, so is there something to be said about governments and state?

Safa: Yeah, I mean, if we're talking about vaccine imperialism, and we're talking about how aid is political and all the reasons behind why interventions are maybe not as, what is the word here....

Noaman: Democratic?

Safa: Yeah, democratic or whatever word you want to put in there. But I think what we're trying to say is that there are things we can track and trace and speak to and name that have implications for the reality of our sector and the work that we do. And just overall the world, the state of affairs.

Noaman: No, absolutely. So my colleague, Luke Melchiorre who is in Colombia, I think I opened by by referring to him but not by name. So Luke and I are working on a project actually, which is about understanding governments and states as being influenced by oligarchies and oligarchy is a term that refers to the rule of the rich elite, the few. And we can counterpose that to an actual democracy. So the way we think of democracy now is like, Oh, do vote in elections every three or four years. And that is, you know, a lot of what many NGOs are also focused on that, like on governance issues and stuff like that. But the actual meaning of democracy is rule of the people and rule of the majority and rule of the poor majority. Iss the poor majority, the working classes, the poor peasants of the world, are they actually in charge of the direction and orientation of the state? And our argument is no, they're not. It is actually these oligarchies who are in charge of the direction and orientation of the state. And to some extent, it's really a question of how much they concede to the democracy. So there's a constant struggle between oligarchy and democracy in these states, but that has impacted the COVID-19 response. And we really need to think about states - the way they're structured, the way they're not at the end of the day actual democracies. To understand that people don't have popular sovereignty in how things are handled, which is ultimately the reason, as you said, and we can name it. It's the rule of capitalist oligarchs, of imperialist oligarchs that is determining so much morbidity, mortality, and it was doing that long before COVID, COVID just broke so many things open for us to see.

Safa: Mm hmm. Yeah. 100%. I'm on the same page - I think thinking about the audience, sometimes we get responses of oh, well, then, you know, tell us what is the perfect ideal system like, you know, we have those type of reactions out there of people be like, well, then you try to be the President, like, you see if you can do a better job, stuff like that. What do you have to say to those folks?

Noaman: I think we need to begin imagining alternatives, where it's not about being a President, A President is not somebody who has absolute power, right? First of all, it's always going to be some rich man, probably, and maybe in some instances, a rich woman. And then we can all applaud the fact that it's a woman instead of a man, but doesn't matter. The question is not who is in power? The question is who has power? And power is in the hands of corporations, it is in the hands of these oligarchs. It's in the hands of capitalist elites, landed elites, they're the people who have power. And they're the ones who ultimately determine the agenda. So even if I become the President of a country, which I don't know if I want to do that, like I could be in power without having power. And understanding that distinction is so important. You know, we've talked about this, what would development mean, if we talk about it seriously as the transfer of power from these oligarchs, to the popular majority? What kind of institutions? What kind of organizations, what kind of education? What kind of training do we need to do that? And hey, guess what, that is not the kind of education training and institutions that rich people, oligarchs, capitalist, landed elites want to exist. They just want cogs in a machine. They don't want people who are thinking about ruling their own lives and ruling the country or ruling the world. So it's not that there's an ideal system to propose - any system is going to have mistakes, any system is going to have errors and problems. That's fine. The question is, how are those errors and problems dealt with, in whose interests are those errors and problems dealt with? And what we've seen with COVID, and the response to COVID, is that that problem has been dealt with in the interests of the rich and the elite, at the expense of the poor majority of the world. That is true of any country. Yes, in India, everybody started getting affected, rich and poor, like, however, the poor were far more affected, and far more obliterated and had far less access to resources and access. I'm saying that as somebody whose family members have died in India as a consequence of COVID. But I also understand that there's a class dimension to it, my family members are relatively privileged, quite privileged compared to the vast majority of Indian people who are discriminated against on basis of class, caste, and other statuses - gender, obviously. But the response has not been in the interest of the poor. So it's not up to me to tell you what an ideal system is. But it is to say that we need to change certain structures, so that whatever system operates after that, it's not going to be ideal. Nothing's going to be ideal. But it's a question of how we deal with errors, problems and mistakes in whose interest - that's the thing.

Safa: Yeah, yeah. And I think that making this space to have this conversation - if I think back on the first person that I interviewed three years ago, or four years ago or something, that first person, one of the main things that I took away from that conversation was that she was saying: Safa over the last, like, whatever, 20 years I've been in this organization, I don't have time to think about these issues, like I am kept so busy, my days are so full, like I'm so into the minutiae of my everyday things that I don't have the mental space to question what I'm doing anymore, you know?

Noaman: Yeah, and I think one of the most, you know, this guy, this scholar named Steven Lukes who talks about power. And he says, one of the main forms in which power operates at the ideological level, like, it's not simply telling you what to think, which is part of what people do, but it's really to make you believe that there is no alternative. And one way to do that is just to like overwhelm people with so much of the minutiae of work that you don't have time to even think about an alternative. So, it's important to have these kinds of spaces, I think, and this podcast is an important part of it. The question is, how does that translate? And at some point, people are gonna have to, like, stop. They're gonna have to stop the busy work, they're gonna have to stop the things they're doing, put a brake on it, and really think about which road they're on. And I don't know how that happens or where that happens. Because it's not simply about having conversations - conversations are fine, but it has to be about changing our actions in a way that's meaningful.

Safa: Yep, in that person's example, they decided to take early retirement. So basically, they decided to stop working And that was kind of their final straw of saying, okay, like I need to come out of this cycle. And hopefully that will allow me to just be in a different context where I can think in the way that I want to - not just be so overwhelmed, as you say all the time. So everyone will have a different answer to this. But looking at the time, I think we've gone over the time we had for today. But thank you so much Noaman - is there anything you'd like to say as a way to wrap up?

Noaman: No, I think everything's in there. But I will say thank you Safa. Once again, for a stimulating conversation. I had fun, although the topic we're on is not fun at all. And of course, it's grave. But I think there's got to be ways that we can think of it creatively and differently. So yeah, thank you.

Safa:Thank you. Yeah. And thank you to our listeners. Thank you for listening in. Feel free to you know, send us a message on social media. Let us know what you thought. And we'll be back again next month with our third episode, but until then, take care. Stay in touch and we'll we'll talk to you soon. Bye bye.

Noaman: Bye bye.