« Meet the world’s most powerful doctor: Bill Gates
The software mogul’s sway over the World Health Organization spurs criticism about misplaced priorities and undue influence.
Some billionaires are satisfied with buying themselves an island. Bill Gates got a United Nations health agency in Geneva.
Over the past decade, the world’s richest man has become the World Health Organization’s second biggest donor, second only to the United States and just above the United Kingdom. This largesse gives him outsized influence over its agenda, one that could grow as the U.S. and the U.K. threaten to cut funding if the agency doesn’t make a better investment case.
The result, say his critics, is that Gates’ priorities have become the WHO’s. Rather than focusing on strengthening health care in poor countries — that would help, in their view, to contain future outbreaks like the Ebola epidemic — the agency spends a disproportionate amount of its resources on projects with the measurable outcomes Gates prefers, such as the effort to eradicate polio.
Concerns about the software billionaire’s sway — roughly a quarter of WHO’s budget goes toward polio eradication — has led to an effort to rein him in. But he remains a force to be reckoned with, as WHO prepares to elect one of three finalists to lead the organization.
“All of the candidates are going to have to ally with him in some way,” said Sophie Harman, associate professor of international politics at Queen Mary University of London. “You can’t ignore him.”
Evidence of Gates’ unprecedented influence abounds in ways subtle and showy.
Already a decade ago, when Gates started throwing money into malaria eradication, top officials — including the chief of the WHO’s malaria program — raised concerns that the foundation was distorting research priorities. “The term often used was ‘monopolistic philanthropy’, the idea that Gates was taking his approach to computers and applying it to the Gates Foundation,” said a source close to the WHO board.
The billionaire was the first private individual to keynote WHO’s general assembly of member countries, and academics have coined a term for his sway in global health: the Bill Chill. Few people dare to openly criticize what he does. Most of 16 people interviewed on the topic would only do so on the condition of anonymity.
“He is treated liked a head of state, not only at the WHO, but also at the G20,” a Geneva-based NGO representative said, calling Gates one of the most influential men in global health.
The member country delegates POLITICO spoke to did not voice particular concern over Gates’ influence and were confident he is well intentioned.
However, his sway has NGOs and academics worried. Some health advocates fear that because the Gates Foundation’s money comes from investments in big business, it could serve as a Trojan horse for corporate interests to undermine WHO’s role in setting standards and shaping health policies.
Others simply fear the U.N. body relies too much on Gates’ money, and that the entrepreneur could one day change his mind and move it elsewhere.
Gates and his foundation team have heard the criticism, but they are convinced that the impact of their work and money is positive.
“It’s always a fair question to ask whether a large philanthropy has a disproportionate influence,” said Bryan Callahan, deputy director for executive engagement at the Bill and Melinda Gates Foundation. “When it comes to the priorities that the foundation has identified and that we choose to invest in, we hope that we are helping to create an enabling environment,” he said.
Steve Landry, the Gates Foundation’s director of multilateral partnerships, said the foundation provides “significant funds” to program teams that then decide how to use them best.
Strings attached
The Gates Foundation has pumped more than $2.4 billion into the WHO since 2000, as countries have grown reluctant to put more of their own money into the agency, especially after the 2008 global financial crisis.
Dues paid by member states now account for less than a quarter of WHO’s $4.5 billion biennial budget. The rest comes from what governments, Gates, other foundations and companies volunteer to chip in. Since these funds are usually earmarked for specific projects or diseases, WHO can’t freely decide how to use them.
Polio eradication is by far WHO’s best-funded program, with at least $6 billion allocated to it between 2013 and 2019, in great part because around 60 percent of the Gates Foundation’s contributions are earmarked for the cause. Gates wants tangible results, and wiping out a crippling disease like polio would be one.
But the focus on polio has effectively left WHO begging for funding for other programs, particularly to prop up poor countries’ health systems before the next epidemic hits.
The Ebola crisis of 2014, which killed 11,000 people in West Africa, was a particularly bruising experience for WHO. An emergency program drawn up in the wake of the epidemic has so far received just around 60 percent of the $485 million needed for 2016-2017.
Outgoing WHO boss Margaret Chan has also had to scale back her attempt to get countries to increase mandatory contributions for the first time in a decade. Chan initially hoped for a 10 percent hike, but WHO will end up asking for just 3 percent more this month after some countries objected.
That makes the Gates Foundation’s input all the more important. “They come with a checkbook, and with some smart ideas,” said Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations.
Most of the Gates Foundation’s influence in the WHO is very discreet, she said, adding that it can also decide to take initiatives outside of the organization, as it did with GAVI, which helps the poorest countries buy vaccines in bulk at a discount, or with a recently launched Coalition for Epidemic Preparedness Innovations, an alliance to develop vaccines for emerging infectious diseases.
But the foundation’s focus on delivering vaccines and medicines, rather than on building resilient health systems, has drawn criticism. And some NGOs worry it may be too close to industry.
In January, 30 health advocacy groups penned an open letter to WHO’s executive board protesting against making the Gates Foundation an official partner of the agency because its revenue comes from investments in companies that are at odds with public health goals, such as Coca-Cola.
The Gates Foundation says it operates as a separate entity from the trust, thanks to a “strict firewall,” and that it remains independent from its investments, which strictly exclude the tobacco, alcohol or arms industries.
Fencing off big money
Worries about the growing role of private money led member nations to agree, after several years of negotiations, on a new policy governing how it engages with entities such as private foundations, companies and NGOs. It is currently being rolled out across the agency.
Despite the criticism, WHO’s board granted the Gates Foundation « official relations » status. In practice, several sources said it does not change much to the relations WHO already had with the foundation.
Gaudenz Silberschmidt, WHO’s director for partnerships, said the new status is based on a three-year collaboration plan: “That means we have a solid planning and we and member states know what we are doing with them.”
The U.N. body also changed four years ago the way its budget is approved, to ensure member countries set its priorities. That means Gates can only put money into projects the 194 members support; the foundation cannot pitch a new one out of the blue and ask WHO to work on it right away just because it is providing the money.
These changes have calmed some criticism of its growing influence over the health body, Silberschmidt and two sources close to the WHO board said.
The foundation also seems to have got the message. Its representatives meet five to six times a year with other major donors to discuss the WHO’s priorities, and how it can support them, Landry said.
Two representatives of major donor countries confirmed the foundation’s envoys had been very cooperative in recent years. “They’re much more inclusive. They bring in other stakeholders, talk to member states to really try to build consensus,” said one delegate.
With the best intentions
Gates’ influence over the WHO was called into question once again during the race to succeed Chan as its director general.
The final three candidates include Sania Nishtar, a cardiologist from Pakistan who has pledged to take the agency “back to its former glory”; David Nabarro, a British physician and former U.N. special envoy for Ebola; and Tedros Adhanom Ghebreyesus, who has served as health minister and foreign minister in the Ethiopian government.
Tedros, who like many in Ethiopia goes by his first name, is supported by the African Union. He has promised to reform the organization to better deal with crises like Ebola and to push for universal access to health care all over the world.
Last year, a French diplomat suggested that Gates also supports Tedros, having funded health programs in his country when he was health minister. Several foundation officials have denied this, saying that the foundation cannot take a position given that it is not a voting member country and thus has to remain neutral.
The new WHO boss will be selected by the member countries who have paid their membership fees on May 23, at an annual meeting in Geneva.
Still, most country representatives who agreed to speak anonymously on the topic said they were not particularly concerned with the Gates Foundation’s influence on WHO.
“I don’t think they have any bad intentions. They are just such a big player that as immediately as they put money down they can disrupt things,” said one Geneva-based diplomat.
“As far as I can tell, people are really happy with anyone who is giving money,” said another.
One big unknown is what will happen with the foundation’s money once it meets its target of eradicating polio, which started in the late 1980s and now appears to be nearing its goal. Chan has warned that if the polio money dries up in 2019, the global health body will be on the lookout for even more money.
The Gates Foundation’s Landry said his colleagues were working with WHO and its polio team on a “transition plan” to ensure the programs currently funded by the polio effort don’t run into trouble once the money stops flowing. WHO is due to present a report on it to member countries in May.
“The foundation’s impact on the WHO is enormous,” said Garrett, of the Council on Foreign Relations. “If they weren’t there, if they walked away with their money, the deleterious impact would be profound, and everyone is all too aware of that.” »
– By NATALIE HUET AND CARMEN PAUN (5 avril 2017)
« Bien qu’elle doive l’essentiel de sa fortune à la pensée sociologique et politique, la notion de solidarité a une origine juridique. Elle a d’abord désigné (dans le code civil de 1804) une technique du droit de la responsabilité utilisée en cas de pluralité de créanciers (solidarité active) ou de débiteurs (solidarité passive) d’une même obligation.
C’est seulement à la fin du XIXe siècle qu’elle a acquis un sens juridique nouveau : celui d’organisation collective permettant de faire face aux risques liés au machinisme industriel, et de faire peser sur ceux qui de fait les créent une responsabilité objective, indépendante de toute faute.
Ont ainsi été institués des régimes de solidarité que Jean-Jacques Dupeyroux a justement décrits comme des « pots communs (…) où l’on cotise selon ses ressources et où l’on puise selon ses besoins (1) ». Parce qu’elle ne se laisse jamais dissoudre dans un pur calcul d’intérêt, la solidarité est un facteur de résistance, pour le meilleur et pour le pire, à l’empire du marché. Lui donner force juridique permet de limiter l’extension de la compétition économique à tous les domaines de la vie.
C’est sur le plan national que la solidarité a acquis la plus grande portée. Le code de la Sécurité sociale (1945) affirme ainsi que « l’organisation de la Sécurité sociale est fondée sur le principe de solidarité nationale ».
A ce principe correspond une citoyenneté sociale, distincte de la citoyenneté politique, qui repose sur trois piliers : la sécurité sociale, les services publics et les libertés collectives garanties par le droit du travail (liberté syndicale, négociation collective et droit de grève).
Cette citoyenneté sociale, qui ne procède pas d’un droit du sang ou du sol, unit tous ceux qui contribuent à la solidarité nationale par leurs impôts et cotisations et bénéficient de celle-ci en tant qu’assurés sociaux et usagers des services publics.
La solidarité nationale n’est pas exclusive. Elle admet en son sein l’expression de solidarités plus étroites qu’on peut qualifier de « solidarités civiles » — fondées sur le volontariat et gérées par des organismes à but non lucratif, comme les associations, les syndicats ou les mutuelles —, sans oublier les solidarités familiales. Toutes s’exercent sous l’égide de la solidarité nationale, qui les coordonne et que tout à la fois elles prolongent et soutiennent. Les liens entre ces cercles de solidarité sont multiples ; on ne peut donc en modifier un sans affecter tous les autres. Aucun système de sécurité sociale ne résisterait longtemps, par exemple, à une disparition des solidarités familiales. Il suffit pour le comprendre de convertir en heures de salaire le travail invisible que représentent les soins prodigués dans ce contexte aux personnes malades ou âgées.
Cible privilégiée des néolibéraux
Ainsi définie, la solidarité se distingue aussi bien de l’assurance que de la charité.
A la différence de l’assurance privée, qui s’appuie sur un calcul actuariel des risques (par une méthode statistique), un régime de solidarité repose sur l’appartenance à une communauté, qu’elle soit nationale, professionnelle ou familiale.
Les membres de cette communauté qui sont à un moment donné les plus fortunés, ou les moins exposés au risque, contribuent davantage que les moins fortunés ou les plus exposés, mais tous ont les mêmes droits.
A la différence de la charité (ou de son avatar contemporain, le care), la solidarité ne divise donc pas le monde entre ceux qui donnent et ceux qui reçoivent : tous doivent contribuer au régime selon leurs capacités, et tous ont le droit d’en bénéficier selon leurs besoins.
Expression de l’égale dignité des êtres humains, l’organisation de la solidarité est un frein à l’extension de la logique marchande à toutes les activités humaines. C’est pourquoi elle est depuis trente ans la cible privilégiée des politiques néolibérales.
L’érosion des solidarités nationales est la manifestation la plus visible de cette remise en cause.
L’attaque, frontale en ce qui concerne les services publics, a été moins brutale dans le cas de la sécurité sociale, même si, dès 1994, la Banque mondiale avait clairement fixé aux systèmes de retraite un nouveau cap : convertir les cotisations en valeurs mobilières abondant les marchés financiers.
En Europe, où l’attachement des populations à la sécurité sociale est fort, la réalisation de ce programme a suivi une voie indirecte.
Plutôt que de s’en prendre directement à ces régimes, on a sapé leurs bases financières, en rompant le lien entre le devoir d’y contribuer et le droit d’en bénéficier. »
– Solidarité : ni charité ni assurance, mais l’égale dignité (humaine)
« Who pays WHO? As this compelling POLITICO piece notes, ‘Over the past decade, the world’s richest man has become the World Health Organization’s second biggest donor, second only to the United States and just above the United Kingdom. This largesse gives him outsized influence over its agenda. The result, say his critics, is that Gates’ priorities have become the WHO’s. » The article unpacks what some of those « priorities » are, and what that means for us:
Some billionaires are satisfied with buying themselves an island. Bill Gates got a United Nations health agency in Geneva.
The billionaire was the first private individual to keynote WHO’s general assembly of member countries, and academics have coined a term for his sway in global health: the Bill Chill. Few people dare to openly criticize what he does. Most of 16 people interviewed on the topic would only do so on the condition of anonymity. ‘He is treated liked a head of state, not only at the WHO, but also at the G20,’ a Geneva-based NGO representative said, calling Gates one of the most influential men in global health.
The Gates Foundation has pumped more than $2.4 billion into the WHO since 2000, as countries have grown reluctant to put more of their own money into the agency, especially after the 2008 global financial crisis. Dues paid by member states now account for less than a quarter of WHO’s $4.5 billion biennial budget.
‘The foundation’s impact on the WHO is enormous,’ said Garrett, of the Council on Foreign Relations. ‘If they weren’t there, if they walked away with their money, the deleterious impact would be profound, and everyone is all too aware of that.’
Some health advocates fear that because the Gates Foundation’s money comes from investments in big business, it could serve as a Trojan horse for corporate interests to undermine WHO’s role in setting standards and shaping health policies.
But the foundation’s focus on delivering vaccines and medicines, rather than on building resilient health systems, has drawn criticism. And some NGOs worry it may be too close to industry.
In January, 30 health advocacy groups penned an open letter to WHO’s executive board protesting against making the Gates Foundation an official partner of the agency because its revenue comes from investments in companies that are at odds with public health goals, such as Coca-Cola. Despite the criticism, WHO’s board granted the Gates Foundation ‘official relations’ status.
Gates’ influence over the WHO was called into question once again during the race to succeed Chan as its director general. Last year, a French diplomat suggested that Gates supported Tedros Adhanom Ghebreyesus, having funded health programs in his country when he was health minister. The final three candidates included Sania Nishtar, David Nabarro, and Tedros. Perhaps inevitably, Tedros won, duly elected on May 23 2020. » – Politico.
Gates has recently pushed for an even more draconian lockdown on the world’s economy: « Despite urging from public health experts, some states and counties haven’t shut down completely », the billionaire noted.
« In some states, beaches are still open; in others, restaurants still serve sit-down meals. This is a recipe for disaster. The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere. Until the case numbers start to go down across America — which could take 10 weeks or more — no one can continue business as usual or relax the shutdown. »
As MarketWatch reported, « Gates, who boasts a net worth of $103.4 billion, according to Forbes (making him the second wealthiest man in the world behind Amazon’s Jeff Bezos) has been one of the most vocal critics of the U.S. response to the COVID-19 pandemic which has ravaged the domestic economy and brought most of the world’s business and personal activity to a screeching halt. In a March 31 op-ed in the Washington Post, the tech luminary advised more stringent closures to mitigate the spread of the deadly viral outbreak, saying ‘shutdown anywhere means shutdown everywhere’. »
The Bill & Melinda Gates Foundation was also one of the main organisers of ‘Event 201’, a remarkable gathering of the world’s major business elites, together with the World Economic Forum (Davos), Johnson & Johnson, NBCUniversal, Lufthansa Group Airlines, and UPS, that met last October to plan for a global pandemic (the pandemic they picked, coincidentally, was coronavirus, which subsequently broke out several weeks later in China).
There are many concerns with Gates’ approach: one is that he understands diseases almost entirely in terms of technology, and vaccines – i.e., lucrative, left brain solutions to holistic, socially-embedded right brain realities.
This myopia is partly ideological – like many billionaires, he has a visceral dislike of anything that resembles « socialism », i.e. that recognises the deep social, relational aspects to wellbeing. Gates also clearly thinks in a peculiarly linear, technological, instrumentalist way, which as McGilchrist has shown, can be absolutely disastrous when applied to complex, reverberative situations, such as social health.
He also obsessively believes that the solution to the problems generated by science and technology is more science and technology. As Alain de Botton acutely observed in his examination of how news stories operate: « The news takes us through these terrible cycles of fear – constant fear, fear, fear, FEAR. And then of course the odd hope – and the hope is centred always around science and technology, so the new iPhone, the new pills for curing Alzheimers – always the idea that over the horizon there is some cure to the problems of life, the problems of existence. »
This is exactly the mindset of Gates: utterly limited, utterly fixated « around science and technology ». In a recent TED talk, this showed very clearly: « But in fact, we can build a really good response system », he noted, speaking of any future global response to a pandemic. « We have the benefits of all the science and technology that we talk about here. We’ve got cell phones to get information from the public and get information out to them. We have satellite maps where we can see where people are and where they’re moving. » I.e., Apple, Microsoft, and Google are the technological Messiahs that will save us, and the billionaire class who own them, and who relentlessly track and isolate us.
Indeed, just last month it was reported that « representatives from major technology companies — including Amazon, Google, and Facebook — met with officials at Downing Street, the residence of U.K. prime minister Boris Johnson » to discuss how to respond to the coronavirus outbreak in the UK. While « in Germany, politicians have come to a cross-party agreement to launch a smartphone app similar to the one pioneered in Singapore to help trace infections, despite public unease over digital surveillance.”
In Wuhan, « Chinese authorities harnessed big data to deploy facial recognition systems that detect high temperatures in crowds, track population movement using smartphone data, and create new artificial intelligence models for identifying people wearing masks. The government has encouraged citizens to monitor neighbors and report those suspected of carrying the virus.
In mid-March, the Washington Post reported that the US government was in talks with Facebook, Google, and other Silicon Valley companies about how geolocation information collected from smartphones could be used to map the spread of COVID-19 and determine if people were self-quarantining. »
These policies all seem to be following in line with the model set out by the Gates-sponsored World Economic Forum ‘Event 201’ last year, outlining how the world should respond to a coronavirus. « Donors, international financing institutions, global funds and philanthropies », it resolved, « must increase funding for the poorest and most vulnerable countries through development assistance”.
The key word in this statement is « society », which doesn’t appear once. For the super-rich, problems and systems should be managed by « international financing institutions » and billionaire « philanthropists ». It’s effectively a strategy to push out the public sector and the role of democratic governments – other than as an aid to channel the policies and dictates of the high and mighty. As the Politico piece noted, « the foundation’s focus is on delivering vaccines and medicines, rather than on building resilient health systems » – that is to say, it ends up profoundly weakening and ideologically infecting the actual social systems that can prevent and manage disease.
« We need a type of private/public collaboration that we have not generally had », observed Christopher Elias, also from the Bill Gates Foundation, at the Event. « During a severe pandemic, public sector efforts to control the outbreak are likely to become overwhelmed. Their efforts are chronically under-funded and lack sustained support. Global business leaders should play a far more dynamic role as advocates with a stake in stronger pandemic preparedness. »
That Gates has so much say over a world Health Organisation, which in turn has so much control over our response to pandemics, is deeply concerning. »
« Saving lives in the pandemic will also save the economy in the long run
If you’ve listened to President Trump or his aides in recent weeks, you might think we have to choose between what’s optimal for public health and what’s optimal for the economy. We can save lives, or maximize gross domestic product.
But if you listen to economists, you’ll learn that this is a false choice. Prematurely reopening businesses, schools and public gatherings — as Trump has agitated to do — would be worse for long-run economic growth than requiring them to remain closed until the virus is contained.
Last week, Trump and his National Economic Council director, Larry Kudlow, complained that the “cure” to this pandemic — that is, our collective economic coma — might “be worse than the disease.” Right-wing news organizations echoed this complaint, sometimes appallingly implying that Grandpa should be sacrificed to juice GDP.
After widespread pushback from public health experts, Trump gave in, and on Sunday extended social distancing guidance through the end of April. Still, he appeared to want credit for making the supposedly bold choice to set aside U.S. economic interests (and by implication, his political interests) to save lives.
In fact, there’s near-unanimity among economists that the best way to limit economic damage would be to listen to the public health experts’ advice about how to limit infections — including by continued dramatic social distancing measures.
This should make sense.
If the virus is not contained, customers will be afraid to shop, travel and dine out, even without mandatory lockdowns. Or, as Harvard economics professor Lawrence H. Summers wrote in The Post recently: “It is an elementary confusion to believe that lost growth and lost jobs are primarily a consequence of social distancing measures rather than the pandemic itself.”
In other words, the demand-side shock would continue, even without forced business closures. So, too, would the supply-side shock. After all, Americans won’t be able to work if they’re sick. They definitely won’t be able to work if they’re dead.
Funny thing about our economy, that: Until the robots take over, we still need healthy workers to produce stuff.
Don’t take my word for it.
In a recent University of Chicago IGM Economic Experts Panel survey, 80 percent agreed that “Abandoning severe lockdowns at a time when the likelihood of a resurgence in infections remains high will lead to greater total economic damage than sustaining the lockdowns to eliminate the resurgence risk.” Not a single economist surveyed disagreed with the statement; remaining respondents instead said they were “uncertain.”
A bipartisan group of high-profile economists and former economic policymakers likewise signed onto a recent letter reading in part: “Saving lives and saving the economy are not in conflict right now; we will hasten the return to robust economic activity by taking steps to stem the spread of the virus and save lives.”
These conclusions are informed by both theoretical models and historical data.
Theoretical work by Martin Eichenbaum and Sergio Rebelo (of Northwestern University) and Mathias Trabandt (of Freie Universitat Berlin) finds that, in the short term, there does appear to be a trade-off between economic activity and health outcomes. That is, the containment measures required to limit the spread of the coronavirus would result in a sharp initial recession. But over the long run, an optimal containment strategy would reduce economic costs, largely because it preserves the lives of workers needed to keep the economy running. »
« On peut ainsi estimer que la PFI a mis en place un système qui remet fondamentalement en cause les principes fondamentaux au cœur de la mission de service public :
le principe du financement public par le biais de l’impôt ;
le principe de leur propriété publique ;
le principe de la gratuité de la santé publique (dans le cas britannique).
Le cas de la PFI souligne à l’envi les dysfonctionnements créés par les politiques qui ont progressivement rogné les prérogatives et les marges de manœuvre financières de l’Etat. La PFI montre les dangers de la cession de services publics à des entreprises privées et de leur soumission aux lois du marché.
Les considérations d’équité et de justice sociale constituent les principes directeurs des services publics, or ce sont deux notions dont le marché s’accommode très mal. La notion de service public assure à tous les citoyens des services, quelle que soit leur situation économique.
La mission de service public hospitalier aux mains de l’Etat garantit ce principe de manière fondamentale, car seul le public peut décider d’opérer, de soigner en prenant en compte les notions d’équité et de justice sociale.
Seul le public peut imposer l’accès au soin de tous, y compris des personnes qui ne sont pas solvables.
Tourner le dos à ces principes essentiels du service public revient à saper les fondements mêmes du Welfare State britannique, mis en œuvre par le gouvernement travailliste de Clement Attlee à partir de 1945. »
– Printanière Variation en C(apitalo-néo-libéralisme) Mineur
« Comment la gauche s’est-elle faite la championne de la défaite, l’incarnation de la loose, une grande congrégation de perdants ? Comment cette notion s’est-elle évidée, aux yeux d’une majorité des corps électoraux, à commencer par ses franges les plus jeunes, des idéaux de bien commun et d’intérêt général, de progrès comme de justice sociale, de solidarité et d’équité, d’émancipation non seulement physique et matérielle mais culturelle, morale et intellectuelle ?
Née dans la seconde moitié des années 1980 et la première des années 1990, l’enfance de cette génération fut rythmée par les victoires de la gauche, deuxième du nom. De la France aux États-Unis, du Royaume-Uni à l’Allemagne, une « troisième voie » d’inspiration sociale-démocrate laissait espérer une conciliation entre la libération des forces économiques et la juste répartition des fruits d’une croissance devenue mondiale. Comment et pourquoi ce nouveau corpus idéologique et, avec lui, les nouvelles stratégies de conquête et d’exercice du pouvoir ont-ils conduit à saper durablement non seulement l’assise électorale, mais la crédibilité même des discours de gauche ? »
– Renouveler & Ré-Inventer la Gauche : Enjeux & Défis (pour les Nouvelles & Jeunes Generations)
« Assez tôt dans l’épidémie, la Chine a mis en place une politique de tests généralisés de la température corporelle des individus à l’aide de thermomètres infrarouges, jusqu’à arrêter systématiquement les voitures pour de tels tests. Certes, cela n’est pas très précis : on rate les porteurs asymptomatiques ou les individus qui ont fait baisser leur température avec des médicaments, alors qu’on attrape dans son filet les individus qui ont la fièvre pour d’autres raisons que le Covid-19. Mais cela permet un premier tri. En parallèle, toute la population des foyers de contagion est sommée de porter des masques et de se laver les mains très régulièrement.
Les individus potentiellement positifs, du fait de leurs symptômes ou de leurs contacts avec des malades, sont dépistés. Les tests de dépistage sont réalisés en quatre heures, pendant lesquelles les personnes dépistées doivent attendre leurs résultats.
En l’absence des tests biologiques de dépistage (il y a des cas de pénurie) ou en complément, on réalise des scanners rapides, qui permettent de mettre en évidence les opacités pulmonaires qui sont considérés comme des signes cliniques de la maladie. Chaque machine de scanner en effectue jusqu’à 200 par jour (5 à 10 minutes par examen).
À Wuhan, il existe plus de 1800 équipes d’épidémiologistes (avec un minimum de cinq personnes par équipe), qui sont occupées à plein temps à tracer les contacts des personnes positives. Selon la région, 1 à 5 % des contacts identifiés sont ensuite eux-mêmes dépistés positifs au virus, et on recommence l’enquête de traçage des contacts avec elles et eux. Chaque fois qu’un agrégat (cluster) est identifié, on ferme les écoles, théâtres et restaurants, on confine les personnes-contacts.
Seule la métropole de Wuhan, où est née l’épidémie, est placée en confinement total.
La durée moyenne entre les premiers symptômes et l’hospitalisation/l’isolement est prodigieusement réduite, d’environ 15 jours au début de l’épidémie à 2 jours, ce qui permet de réduire le potentiel contaminateur d’une personne malade.
Dans son interview par le New York Times, Bruce Aylward raconte que les hôpitaux vus par l’équipe de l’OMS sont équipés massivement en respirateurs artificiels et en machines ECMO, qui permettent une oxygénation du sang lorsque les poumons n’y parviennent plus.
Les experts invités sont stupéfaits, les hôpitaux semblent mieux équipés que des centres spécialisés en Suisse ou à Berlin.
La conclusion du rapport de l’OMS est sans appel :
« Ces mesures [prises en Chine] sont les seules à l’heure actuelle qui ont prouvé qu’elles pouvaient interrompre ou minimiser les chaînes de transmission chez les humains.
Au fondement de ces mesures est la surveillance extrêmement proactive, afin de détecter immédiatement les cas, de procéder à des diagnostics très rapides et à un isolement immédiat des patients positifs, au traçage rigoureux et à la mise en quarantaine des contacts proches. »
Le rapport insiste aussi sur l’importance de la compréhension et l’acceptation de ces mesures par la population. »
– « Que pouvait-on savoir et prévoir de l’actuelle pandémie » ?
Lectures supplémentaires / complémentaires :
- Genieys, W. & Hassenteufel, P. (2012). Qui gouverne les politiques publiques : Par-delà la sociologie des élites. Gouvernement et action publique, vol. 1(2), 89-115.
- Du Gay, P. & Scott, A. (2011). Transformation de l’État ou changement de régime ? De quelques confusions en théorie et sociologie de l’État. Revue française de sociologie, vol. 52(3), 537-557.
- Boutillier, S. (2013). La crise de 1929 ou la leçon non apprise de l’histoire. Marché et organisations, 19(3), 13-30.
- La révolution commence-t-elle par le local ? Expérimentations communales et dilemmes stratégiques : « Éditorial. La révolution commence-t-elle par le local ? Expérimentations communales et dilemmes stratégiques », Mouvements, 2020/1 (n° 101), p. 7-11.
- Laville, J. (2015). Changement social et économie solidaire : les événements dans le processus de recherche. Nouvelle revue de psychosociologie, 19(1), 181-194.
- Petits arrangements avec la race dans les organisations internationales (1945-2019) : Geoffray, M. (2020). Mettre la peur à distance par la fabrique collective de la réflexivité. Critique internationale, 86(1), 141-164.
- Chamayou, G. (2015). Dans la tête de la NSA: Une histoire philosophique du renseignement américain. Revue du Crieur, 1(1), 20-39.
- Boussaguet, L., Jacquot, S. & Ravinet, P. (2019). Dictionnaire des politiques publiques: 5e édition entièrement revue et corrigée. Presses de Sciences Po.
Les 50 Nuances de Dave 