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bloated, inefficient health-care system

Racist policies that have endured since the days of colonization and slavery left Indigenous and Black Americans especially vulnerable

decades-long process of shredding the nation’s social safety net

same social-media platforms that sowed partisanship and misinformation during the 2014 Ebola outbreak in Africa and the 2016 U.S. election became vectors for conspiracy theories

the COVID‑19 debacle has also touched—and implicated—nearly every other facet of American society: its shortsighted leadership, its disregard for expertise, its racial inequities, its social-media culture, and its fealty to a dangerous strain of individualism.

SARS‑CoV‑2 is neither as lethal as some other coronaviruses, such as SARS and MERS, nor as contagious as measles. Deadlier pathogens almost certainly exist. Wild animals harbor an estimated 40,000 unknown viruses, a quarter of which could potentially jump into humans. How will the U.S. fare when “we can’t even deal with a starter pandemic?,”

The U.S. cannot prepare for these inevitable crises if it returns to normal, as many of its people ache to do. Normal led to this. Normal was a world ever more prone to a pandemic but ever less ready for one. To avert another catastrophe, the U.S. needs to grapple with all the ways normal failed us

Many conservationists jump on epidemics as opportunities to ban the wildlife trade or the eating of “bush meat,” an exoticized term for “game,” but few diseases have emerged through either route. Carlson said the biggest factors behind spillovers are land-use change and climate change, both of which are hard to control. Our species has relentlessly expanded into previously wild spaces. Through intensive agriculture, habitat destruction, and rising temperatures, we have uprooted the planet’s animals, forcing them into new and narrower ranges that are on our own doorsteps. Humanity has squeezed the world’s wildlife in a crushing grip—and viruses have come bursting out.

This year, the world’s coronavirus experts—and there still aren’t many—had to postpone their triennial conference in the Netherlands because SARS‑CoV‑2 made flying too risky.

In 2003, China covered up the early spread of SARS, allowing the new disease to gain a foothold, and in 2020, history repeated itself. The Chinese government downplayed the possibility that SARS‑CoV‑2 was spreading among humans, and only confirmed as much on January 20, after millions had traveled around the country for the lunar new year. Doctors who tried to raise the alarm were censured and threatened. One, Li Wenliang, later died of COVID‑19. The World Health Organization initially parroted China’s line and did not declare a public-health emergency of international concern until January 30. By then, an estimated 10,000 people in 20 countries had been infected, and the virus was spreading fast.

Even after warnings reached the U.S., they fell on the wrong ears. Since before his election, Trump has cavalierly dismissed expertise and evidence. He filled his administration with inexperienced newcomers, while depicting career civil servants as part of a “deep state.” In 2018, he dismantled an office that had been assembled specifically to prepare for nascent pandemics. American intelligence agencies warned about the coronavirus threat in January, but Trump habitually disregards intelligence briefings. The secretary of health and human services, Alex Azar, offered similar counsel, and was twice ignored.

“By early February, we should have triggered a series of actions, precisely zero of which were taken.”

Travel bans make intuitive sense, because travel obviously enables the spread of a virus. But in practice, travel bans are woefully inefficient at restricting either travel or viruses. They prompt people to seek indirect routes via third-party countries, or to deliberately hide their symptoms. They are often porous: Trump’s included numerous exceptions, and allowed tens of thousands of people to enter from China. Ironically, they create travel: When Trump later announced a ban on flights from continental Europe, a surge of travelers packed America’s airports in a rush to beat the incoming restrictions. Travel bans may sometimes work for remote island nations, but in general they can only delay the spread of an epidemic—not stop it.

countries “rely on bans to the exclusion of the things they actually need to do—testing, tracing, building up the health system,”

genetic evidence shows that the specific viruses that triggered the first big outbreaks, in Washington State, didn’t land until mid-February. The country could have used that time to prepare. Instead, Trump, who had spent his entire presidency learning that he could say whatever he wanted without consequence, assured Americans that “the coronavirus is very much under control,” and “like a miracle, it will disappear.” With impunity, Trump lied. With impunity, the virus spread.

it found a nation through which it could spread easily, without being detected

sluggish response by a government denuded of expertise

In response to the global energy crisis of the 1970s, architects made structures more energy-efficient by sealing them off from outdoor air, reducing ventilation rates. Pollutants and pathogens built up indoors, “ushering in the era of ‘sick buildings,’ ” says Joseph Allen, who studies environmental health at Harvard’s T. H. Chan School of Public Health. Energy efficiency is a pillar of modern climate policy, but there are ways to achieve it without sacrificing well-being. “We lost our way over the years and stopped designing buildings for people,”

As of early July, one in every 1,450 Black Americans had died from COVID‑19—a rate more than twice that of white Americans. That figure is both tragic and wholly expected given the mountain of medical disadvantages that Black people face

The indoor spaces in which Americans spend 87 percent of their time became staging grounds for super-spreading events. One study showed that the odds of catching the virus from an infected person are roughly 19 times higher indoors than in open air. Shielded from the elements and among crowds clustered in prolonged proximity, the coronavirus ran rampant in the conference rooms of a Boston hotel, the cabins of the Diamond Princess cruise ship, and a church hall in Washington State where a choir practiced for just a few hours.

Between harsher punishments doled out in the War on Drugs and a tough-on-crime mindset that prizes retribution over rehabilitation, America’s incarcerated population has swelled sevenfold since the 1970s, to about 2.3 million. The U.S. imprisons five to 18 times more people per capita than other Western democracies. Many American prisons are packed beyond capacity, making social distancing impossible. Soap is often scarce. Inevitably, the coronavirus ran amok. By June, two American prisons each accounted for more cases than all of New Zealand. One, Marion Correctional Institution, in Ohio, had more than 2,000 cases among inmates despite having a capacity of 1,500.

America’s nursing homes and long-term-care facilities house less than 1 percent of its people, but as of mid-June, they accounted for 40 percent of its coronavirus deaths. More than 50,000 residents and staff have died. At least 250,000 more have been infected. These grim figures are a reflection not just of the greater harms that COVID‑19 inflicts upon elderly physiology, but also of the care the elderly receive. Before the pandemic, three in four nursing homes were understaffed, and four in five had recently been cited for failures in infection control. The Trump administration’s policies have exacerbated the problem by reducing the influx of immigrants, who make up a quarter of long-term caregivers.

the Department of Health and Human Services paused nursing-home inspections in March, passing the buck to the states. Some nursing homes avoided the virus because their owners immediately stopped visitations, or paid caregivers to live on-site. But in others, staff stopped working, scared about infecting their charges or becoming infected themselves. In some cases, residents had to be evacuated because no one showed up to care for them.

its problematic attitude toward health: “Get hospitals ready and wait for sick people to show,” as Sheila Davis, the CEO of the nonprofit Partners in Health, puts it. “Especially in the beginning, we catered our entire [COVID‑19] response to the 20 percent of people who required hospitalization, rather than preventing transmission in the community.” The latter is the job of the public-health system, which prevents sickness in populations instead of merely treating it in individuals. That system pairs uneasily with a national temperament that views health as a matter of personal responsibility rather than a collective good.

“As public health did its job, it became a target” of budget cuts,

Today, the U.S. spends just 2.5 percent of its gigantic health-care budget on public health. Underfunded health departments were already struggling to deal with opioid addiction, climbing obesity rates, contaminated water, and easily preventable diseases. Last year saw the most measles cases since 1992. In 2018, the U.S. had 115,000 cases of syphilis and 580,000 cases of gonorrhea—numbers not seen in almost three decades. It has 1.7 million cases of chlamydia, the highest number ever recorded.

In May, Maryland Governor Larry Hogan asserted that his state would soon have enough people to trace 10,000 contacts every day. Last year, as Ebola tore through the Democratic Republic of Congo—a country with a quarter of Maryland’s wealth and an active war zone—local health workers and the WHO traced twice as many people.

Compared with the average wealthy nation, America spends nearly twice as much of its national wealth on health care, about a quarter of which is wasted on inefficient care, unnecessary treatments, and administrative chicanery. The U.S. gets little bang for its exorbitant buck. It has the lowest life-expectancy rate of comparable countries, the highest rates of chronic disease, and the fewest doctors per person. This profit-driven system has scant incentive to invest in spare beds, stockpiled supplies, peacetime drills, and layered contingency plans—the essence of pandemic preparedness. America’s hospitals have been pruned and stretched by market forces to run close to full capacity, with little ability to adapt in a crisis.

Sabeti’s lab developed a diagnostic test in mid-January and sent it to colleagues in Nigeria, Sierra Leone, and Senegal. “We had working diagnostics in those countries well before we did in any U.S. states,”

American hospitals operate on a just-in-time economy. They acquire the goods they need in the moment through labyrinthine supply chains that wrap around the world in tangled lines, from countries with cheap labor to richer nations like the U.S. The lines are invisible until they snap. About half of the world’s face masks, for example, are made in China, some of them in Hubei province. When that region became the pandemic epicenter, the mask supply shriveled just as global demand spiked. The Trump administration turned to a larder of medical supplies called the Strategic National Stockpile, only to find that the 100 million respirators and masks that had been dispersed during the 2009 flu pandemic were never replaced. Just 13 million respirators were left.

The supply of nasopharyngeal swabs that are used in every diagnostic test also ran low, because one of the largest manufacturers is based in Lombardy, Italy—initially the COVID‑19 capital of Europe. About 40 percent of critical-care drugs, including antibiotics and painkillers, became scarce because they depend on manufacturing lines that begin in China and India. Once a vaccine is ready, there might not be enough vials to put it in, because of the long-running global shortage of medical-grade glass—literally, a bottle-neck bottleneck.

As usual, health care was a matter of capitalism and connections. In New York, rich hospitals bought their way out of their protective-equipment shortfall, while neighbors in poorer, more diverse parts of the city rationed their supplies.

A study showed that the U.S. could have averted 36,000 COVID‑19 deaths if leaders had enacted social-distancing measures just a week earlier. But better late than never: By collectively reducing the spread of the virus, America flattened the curve. Ventilators didn’t run out, as they had in parts of Italy. Hospitals had time to add extra beds.

the indiscriminate lockdown was necessary only because America’s leaders wasted months of prep time. Deploying this blunt policy instrument came at enormous cost. Unemployment rose to 14.7 percent, the highest level since record-keeping began, in 1948. More than 26 million people lost their jobs, a catastrophe in a country that—uniquely and absurdly—ties health care to employment

In the middle of the greatest health and economic crises in generations, millions of Americans have found themselves disconnected from medical care and impoverished. They join the millions who have always lived that way.

Elderly people, already pushed to the fringes of society, were treated as acceptable losses. Women were more likely to lose jobs than men, and also shouldered extra burdens of child care and domestic work, while facing rising rates of domestic violence. In half of the states, people with dementia and intellectual disabilities faced policies that threatened to deny them access to lifesaving ventilators. Thousands of people endured months of COVID‑19 symptoms that resembled those of chronic postviral illnesses, only to be told that their devastating symptoms were in their head. Latinos were three times as likely to be infected as white people. Asian Americans faced racist abuse. Far from being a “great equalizer,” the pandemic fell unevenly upon the U.S., taking advantage of injustices that had been brewing throughout the nation’s history.

Of the 3.1 million Americans who still cannot afford health insurance in states where Medicaid has not been expanded, more than half are people of color, and 30 percent are Black.* This is no accident. In the decades after the Civil War, the white leaders of former slave states deliberately withheld health care from Black Americans, apportioning medicine more according to the logic of Jim Crow than Hippocrates. They built hospitals away from Black communities, segregated Black patients into separate wings, and blocked Black students from medical school. In the 20th century, they helped construct America’s system of private, employer-based insurance, which has kept many Black people from receiving adequate medical treatment. They fought every attempt to improve Black people’s access to health care, from the creation of Medicare and Medicaid in the ’60s to the passage of the Affordable Care Act in 2010.

A number of former slave states also have among the lowest investments in public health, the lowest quality of medical care, the highest proportions of Black citizens, and the greatest racial divides in health outcomes

“We’re designed for discrete disasters” like mass shootings, traffic pileups, and hurricanes, says Esther Choo, an emergency physician at Oregon Health and Science University. The COVID‑19 pandemic is not a discrete disaster. It is a 50-state catastrophe that will likely continue at least until a vaccine is ready.

Native Americans were similarly vulnerable. A third of the people in the Navajo Nation can’t easily wash their hands, because they’ve been embroiled in long-running negotiations over the rights to the water on their own lands. Those with water must contend with runoff from uranium mines. Most live in cramped multigenerational homes, far from the few hospitals that service a 17-million-acre reservation. As of mid-May, the Navajo Nation had higher rates of COVID‑19 infections than any U.S. state.

Americans often misperceive historical inequities as personal failures

the largely unregulated, social-media-based communications infrastructure of the 21st century almost ensures that misinformation will proliferate fast. “In every outbreak throughout the existence of social media, from Zika to Ebola, conspiratorial communities immediately spread their content about how it’s all caused by some government or pharmaceutical company or Bill Gates,”

Rumors coursed through online platforms that are designed to keep users engaged, even if that means feeding them content that is polarizing or untrue. In a national crisis, when people need to act in concert, this is calamitous. “The social internet as a system is broken,” DiResta told me, and its faults are readily abused.

Like pandemics, infodemics quickly become uncontrollable unless caught early.

In 2016, when DiResta spoke with a CDC team about the threat of misinformation, “their response was: ‘ That’s interesting, but that’s just stuff that happens on the internet.’ ”

The WHO, the CDC, and the U.S. surgeon general urged people not to wear masks, hoping to preserve the limited stocks for health-care workers. These messages were offered without nuance or acknowledgement of uncertainty, so when they were reversed—the virus is worse than the flu; wear masks—the changes seemed like befuddling flip-flops.

Drawn to novelty, journalists gave oxygen to fringe anti-lockdown protests while most Americans quietly stayed home. They wrote up every incremental scientific claim, even those that hadn’t been verified or peer-reviewed.

By tying career advancement to the publishing of papers, academia already creates incentives for scientists to do attention-grabbing but irreproducible work. The pandemic strengthened those incentives by prompting a rush of panicked research and promising ambitious scientists global attention.

In March, a small and severely flawed French study suggested that the antimalarial drug hydroxychloroquine could treat COVID‑19. Published in a minor journal, it likely would have been ignored a decade ago. But in 2020, it wended its way to Donald Trump via a chain of credulity that included Fox News, Elon Musk, and Dr. Oz. Trump spent months touting the drug as a miracle cure despite mounting evidence to the contrary, causing shortages for people who actually needed it to treat lupus and rheumatoid arthritis. The hydroxychloroquine story was muddied even further by a study published in a top medical journal, The Lancet, that claimed the drug was not effective and was potentially harmful. The paper relied on suspect data from a small analytics company called Surgisphere, and was retracted in June.**

Science famously self-corrects. But during the pandemic, the same urgent pace that has produced valuable knowledge at record speed has also sent sloppy claims around the world before anyone could even raise a skeptical eyebrow.

No one should be shocked that a liar who has made almost 20,000 false or misleading claims during his presidency would lie about whether the U.S. had the pandemic under control; that a racist who gave birth to birtherism would do little to stop a virus that was disproportionately killing Black people; that a xenophobe who presided over the creation of new immigrant-detention centers would order meatpacking plants with a substantial immigrant workforce to remain open; that a cruel man devoid of empathy would fail to calm fearful citizens; that a narcissist who cannot stand to be upstaged would refuse to tap the deep well of experts at his disposal; that a scion of nepotism would hand control of a shadow coronavirus task force to his unqualified son-in-law; that an armchair polymath would claim to have a “natural ability” at medicine and display it by wondering out loud about the curative potential of injecting disinfectant; that an egotist incapable of admitting failure would try to distract from his greatest one by blaming China, defunding the WHO, and promoting miracle drugs; or that a president who has been shielded by his party from any shred of accountability would say, when asked about the lack of testing, “I don’t take any responsibility at all.”

Trump is a comorbidity of the COVID‑19 pandemic. He isn’t solely responsible for America’s fiasco, but he is central to it. A pandemic demands the coordinated efforts of dozens of agencies. “In the best circumstances, it’s hard to make the bureaucracy move quickly,” Ron Klain said. “It moves if the president stands on a table and says, ‘Move quickly.’ But it really doesn’t move if he’s sitting at his desk saying it’s not a big deal.”

everyday Americans did more than the White House. By voluntarily agreeing to months of social distancing, they bought the country time, at substantial cost to their financial and mental well-being. Their sacrifice came with an implicit social contract—that the government would use the valuable time to mobilize an extraordinary, energetic effort to suppress the virus, as did the likes of Germany and Singapore. But the government did not, to the bafflement of health experts. “There are instances in history where humanity has really moved mountains to defeat infectious diseases,” says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “It’s appalling that we in the U.S. have not summoned that energy around COVID‑19.”

People suffered all the debilitating effects of a lockdown with few of the benefits. Most states felt compelled to reopen without accruing enough tests or contact tracers. In April and May, the nation was stuck on a terrible plateau, averaging 20,000 to 30,000 new cases every day. In June, the plateau again became an upward slope, soaring to record-breaking heights.

It is no coincidence that other powerful nations that elected populist leaders—Brazil, Russia, India, and the United Kingdom—also fumbled their response to COVID‑19. “When you have people elected based on undermining trust in the government, what happens when trust is what you need the most?”

the United States underperformed across the board, and its errors compounded. The dearth of tests allowed unconfirmed cases to create still more cases, which flooded the hospitals, which ran out of masks, which are necessary to limit the virus’s spread. Twitter amplified Trump’s misleading messages, which raised fear and anxiety among people, which led them to spend more time scouring for information on Twitter.

The virus was never beaten in the spring, but many people, including Trump, pretended that it was. Every state reopened to varying degrees, and many subsequently saw record numbers of cases. After Arizona’s cases started climbing sharply at the end of May, Cara Christ, the director of the state’s health-services department, said, “We are not going to be able to stop the spread. And so we can’t stop living as well.” The virus may beg to differ.

The long wait for a vaccine will likely culminate in a predictable way: Many Americans will refuse to get it, and among those who want it, the most vulnerable will be last in line.

It is almost unheard-of for a public-health measure to go from zero to majority acceptance in less than half a year. But pandemics are rare situations when “people are desperate for guidelines and rules,” says Zoë McLaren, a health-policy professor at the University of Maryland at Baltimore County. The closest analogy is pregnancy, she says, which is “a time when women’s lives are changing, and they can absorb a ton of information. A pandemic is similar: People are actually paying attention, and learning.”

As the economy nose-dived, the health-care system ailed, and the government fumbled, belief in American exceptionalism declined. “Times of big social disruption call into question things we thought were normal and standard,” Redbird told me. “If our institutions fail us here, in what ways are they failing elsewhere?” And whom are they failing the most?

It is hard to stare directly at the biggest problems of our age. Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. We have no choice, though, but to grapple with them. It is now abundantly clear what happens when global disasters collide with historical negligence.

America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.

The cost of living in Lagos is also very high, which means that home ownership is the exception for Lagosians rather than the rule. The majority of renters live in extremely close quarters, in a kind of private proximity that mirrors the density of public life.

In my city, grimy currency notes go from hand to hand throughout the course of everyday life. People sweat on one another in transit. Communal toilets, kitchens and bathrooms are typical in low-income neighbourhoods, and can be shared by as many as 40 people in one building. In the poorest neighbourhoods, sanitation is non-existent because neither piped water nor sewage management systems are available.

even if we wanted to, we simply don’t have the space to socially distance from one another

there are other threats more real and more immediate than a respiratory infection which has so far tended to kill old people in faraway places most of us will only ever see on TV. The idea of social distancing is not just alien to us, it is impossible for social and economic reasons too. Cities such as Lagos are kept alive by the kind of interpersonal interaction that the global north is currently discouraging or criminalising.

In Lagos, about six million people live on incomes earned largely on a daily basis

For such people, the possibility of catching a previously unheard-of illness is a far less dangerous one than the knowledge that not having anything to eat is always a sunrise away.

If rape and torture are not enough to deter people from leaving home every day to try to make some money to survive, a novel coronavirus outbreak is not likely to succeed either

In Nigeria, it won’t matter whether we get 20,000 cases all at once or over the course of a few months; with fewer than 500 ventilators for a population of 200 million,

In all likelihood, the social expectation that female relatives will care for the sick and dying will hold sway in this outbreak, which means that in the immediate term, girls and women may be at disproportionate risk of infection and re-infection. Still, as 80% of coronavirus patients report mild to moderate symptoms,

The failures of the government have been mitigated by the fact that we are socialised to see to the wellbeing of our communities and their members; this has been a workable solution until now.

a reality that is extremely widespread across Africa: people survive difficulty by coming together as communities of care, not pulling apart in a retreat into individualism. 

It’s time for us Africans to start thinking about solutions that are not based on the legitimate fears of other nations, but on our own established realities.

it is particularly worrying how far the coronavirus is spreading within the political elite in countries where many senior politicians are over 60, making them especially at risk. In Burkina Faso, a country that has experienced more than its fair share of instability in recent years—and which is currently struggling against an insurgency—the ministers of foreign affairs, education, the interior, and mines have all tested positive.

In Nigeria, one of the most economically and politically important countries on the continent, Abba Kyari, the chief of staff to 77-year-old President Muhammadu Buhari, has come down with the disease. Although media outlets have reported that Buhari tested negative, this has not stopped damaging rumors that the often ill president has been incapacitated from circulating in Twitter.

The world should also be paying close attention to Iran, where media censorship has obscured the extent of the crisis. So far, two vice presidents and three cabinet officials are known to have gotten the virus. It is also estimated that 10 percent of parliament and many prominent figures within the Islamic Revolutionary Guard Corps are sick—including a senior advisor to the 80-year-old supreme leader, Ayatollah Ali Khamenei, raising questions about his health.

A leadership crisis is just one of the potential sources of political instability the coronavirus could spark. Others include the risk of popular unrest and the debt crises that will soon engulf many countries around the world. Along with the fact that some of the main providers of foreign aid are now preoccupied with their own financial crises, there is a serious risk that politically and economically weak states will face a perfect storm of elite deaths, debt, mass unemployment, and social unrest

In countries where poverty is widespread, health systems are weak, and the cost of food is high, citizens are already under intense financial pressure. Despite earning the least, those who live in slum areas around capital cities often have to pay more for access to water and food than those who have valuable properties in the city centers. While the cramped conditions of slum living make it implausible to self-isolate, limited and inconsistent income make it impossible to buy in bulk—or to stay home for weeks on end without working and risk starvation. For many of the poorest people in the world, hunger is just a few days away

Already, there have been sporadic incidents of unrest in a number of countries, including prison protests in Italy. Meanwhile, heavy-handed efforts to enforce the curfew threaten to further erode public confidence in the government and the security forces. There are reports of widespread human rights abuses being committed in Kenya and South Africa, where the police have been using water cannons and rubber bullets to enforce the lockdown.

Unless the deferral of debt goes hand in hand with debt cancellation and long-term rescheduling, the end of the coronavirus crisis could be followed by a series of economic collapses across the developing world. In turn, this will undermine the ability of governments to provide affordable fuel and food, further increasing the risk of public unrest.

Civil wars, political instability, and poverty kill millions of people every year. These deaths rarely elicit the kind of comprehensive media coverage that COVID-19 has received, but they are no less important. It is possible to prevent the worst political consequences of the coronavirus but only if governments and institutions act now. Wealthy nations must increase their aid budgets rather than cut them, and international organizations must anticipate and work to avoid political crises more proactively than ever before. That is the only way to collectively survive the present in a way that does not undermine the future.

AGRA, initiated in 2006, heralded a new campaign to bring the kind of input-intensive agriculture to Africa that had failed to take hold on the continent when the first Green Revolution swept through much of Asia and Latin America in the 1960s and 1970s.

AGRA worked with governments to speed the development of high-yield commercial seeds designed for Africa’s wide range of soils and climates and to facilitate the delivery to farmers of those seeds and the inorganic fertilizers that would make them grow.

Many warned that it was seeking to impose Western technologies inappropriate for the continent’s soils, farmers and food systems. Some decried the lack of consultation with African farmers on the nature of the interventions.9 Others pointed out the serious flaws in the first Green Revolution: water supplies depleted and contaminated with chemical runoff; farmers indebted due to high input costs while yields declined after their initial increases; and the loss of crop and diet diversity as Green Revolution crops took over the countryside

African farm groups like the Alliance for Food Sovereignty in Africa (AFSA) also warned of the loss of food sovereignty, the ability of communities and nations to freely choose how they wanted to feed themselves, as large commercial firms could come to dominate local markets backed by new government policies designed to ensure market access.

Evidence would suggest that the main beneficiaries are likely not the poorest or most food-insecure farmers but rather a growing number of medium-scale farmers who have access to more land and are already integrated into commercial networks. Only a fraction of such farmers come up from the ranks of smallholders; many are new investors in farming from urban elites. One study showed that a tiny fraction of smallholders is likely to become commercial farmers.18

These data suggest that Green Revolution programs have not produced a productivity boom through intensification but rather an extensification onto new lands. The promotion of extensification is a serious contradiction for Green Revolution proponents. The explicit goal of “sustainable intensification” is to minimize pressure on land and water resources while limiting further greenhouse gas emissions. To the extent Green Revolution programs are encouraging extensification, they are at odds with national and donor government commitments to mitigate climate change. Depending on individual countries’ land endowments, extensification can be a serious problem. Rwanda, for example, is densely populated and does not have vast tracts of uncultivated arable land.

One of the negative consequences of the Green Revolution focus on maize and other commodity crops is the declining importance of nutritious and climate-resilient crops like millet and sorghum, which have been key components in healthy diets. These are rarely supported by African governments or AGRA; meanwhile, input subsidies and supports for maize and other favored crops provide incentives for farmers to decrease the cultivation of their own crop varieties

Cassava, a key staple in Nigeria, Mozambique, Uganda, Tanzania and many other AGRA countries, saw a 6% decline in yields. Overall, roots and tubers, which include nutritious crops such as sweet potatoes, experienced a 7% decline in yields. Groundnuts, another critical staple source of protein in many countries, saw an alarming 23% drop in yields.

The Staple Crop Index shows that Rwanda’s apparent success in maize has come at the expense of more comprehensive food crop productivity.

The total number of undernourished in AGRA’s 13 countries has increased from 100.5 million to 131.3 million, a 30% increase, from before AGRA to 2018. Only Ethiopia, Ghana and Mali report a significant decline in the absolute number of chronically hungry residents

Only one country, Ethiopia, shows anything resembling the combination of yield growth and hunger reduction Green Revolution proponents promised, with a 73% increase in productivity and a 29% decrease in the number of hungry. Note, however, that neither of these is on track to meet AGRA’s goal of doubling productivity (100% increase) and halving the number of hungry (which would be a 50% decrease). Ghana is the only other AGRA country that shows decent productivity growth with some decrease in hunger. Malawi achieved relatively strong yield growth but only a small reduction in undernourishment.

AGRA seems to be feeding Africa’s worrisome trend toward locking in path dependency on input-intensive agriculture, much to the detriment of smallholder farmers

Unlike industrial-scale farmers in developed countries, their path has not yet been determined; there remain opportunities to chart paths different from the high-input agriculture model promoted by AGRA.

Agroecology is one of the systems giving farmers the kinds of innovation they need, farming with nature to promote the soil-building practices that Green Revolution practices often undermine. Building on farmers’ knowledge of local conditions and food cultures, multiple food crops are grown in the same field. Compost, manure and biofertilizers — not fossil-fuel-based fertilizer — are used to nourish fields. Biological pest control decreases pesticide use. Researchers work with farmers to improve the productivity of their seeds rather than replacing them with commercial varieties farmers need to buy every year and douse with fertilizer to make them grow.25 AFSA has documented the effectiveness of agroecology, now widely promoted among its member organizations as a key step toward food sovereignty.26 Such initiatives also achieve productivity increases more impressive than those achieved by Green Revolution programs. One University of Essex study surveyed nearly 300 large ecological agriculture projects across more than 50 poor countries and documented an average 79% increase in productivity with decreasing costs and rising incomes.27 Such results far surpass those of the Green Revolution.

It is time for international donors and African governments to change course, to shift their agricultural development funding toward the kinds of low-input sustainable farming that many small-scale farmers in Africa are pioneering under the banner of agroecology. With substantial support, like that provided to Green Revolution programs, agroecology can be Africa’s food future

every state and society faces serious challenges. The difference lies in whether the underlying structures are healthy enough to effectively respond to those challenges. Viewed in this light, it’s less the arrival of the massive earthquake than whether the damaged infrastructure is rebuilt; not the crushing battlefield defeat, but whether competent new recruits and materiel can be found to replace what’s lost; not the feckless, no-clothes-having emperor, but whether the political system can either effectively work around him or remove him from power altogether. Successful states and societies are resilient when faced with even serious challenges. Falling empires are not.

it’s far more likely that the real meat of the issue will be found in a tax code full of sweetheart deals for the ultra-wealthy, the slashed budgets of county public health offices, the lead-contaminated water supplies. And that’s to say nothing of the decades of pointless, self-perpetuating, and almost undiscussed imperial wars that produce no victories but plenty of expenditures in blood and treasure, and a great deal of justified ill will.

Historians will look back at some enormous disaster, either ongoing now or in the decades or centuries to come, and say that it was just the icing on the cake. The foundation had already been laid long before then, in the text of legislation nobody bothered reading, in local elections nobody was following, in speeches nobody thought were important enough to comment on, in a thousand tiny disasters that amounted to a thousand little cuts on the body politic.

The pull of the past is strong. The mental frameworks through which we understand the world are durable, far more so than its actual fabric. The new falls into the old, square pegs into round holes no matter how poor the fit, simply because the round holes are what we have available.

the Christian democratic ideology can be characterized in terms of three core principles: a morally tinged conception of the “natural order” as a harmonious and organically integrated society; a remedial conception of the welfare state as a way to protect social unity and stability from the threat of radical takeover; and a conception of democratic practice as a constant process of compromise and reconciliation between conflicting social interests.

This approach is justified with reference to another classically Christian democratic idea: that everyone should contribute to the best of their ability to the well-being of society as a whole. While this involves some measure of socioeconomic redistribution, it steers clear of the more radical idea that society should aspire to some form of substantive—as well as formal—equality.

Biden has a similar view of the Democratic Party’s role in the contemporary United States. Given the way in which the Republican Party has been transformed under the leadership of Trump, Biden seems to think it’s now the role of the Democrats to reunite the whole nation under the banner of its traditional moral and political principles of inclusiveness and civility.

In contrast to Sanders’s advocacy for universalist welfare entitlement programs such as “Medicare for All” and free public college tuition, Biden thinks that the role of state intervention in the economy should be focused on the protection of socially disadvantaged groups

the deeply conservative dimension to Biden’s promise to “heal” the divisions that cut across American society—one that is reminiscent of European Christian democracy’s historic emphasis on the values of “national unity” and “restoration” of the social order in the aftermath of World War II

the logic of the Christian democratic parties in Europe that supported welfare-state policies in the aftermath of World War II as explicitly anti-revolutionary measures.

throughout the 1950s and ’60s, it was Christian democrats—not social democrats—who pushed forward many policies incentivizing homeownership for the working classes in both Germany and Italy

Biden’s approach to such law-and-order questions again parallels the thinking of Christian democratic parties in Europe. For instance, during the 1960s and ’70s, both Italian and German Christian democrats took a very firm stance against the so-called “Red Terrorism” of far-left revolutionary groups such as the Brigate Rosse and Baader-Meinhof—in some cases going as far as reviving extraordinary criminal justice procedures that hadn’t been used since the end of the fascist and national-socialist regimes. These measures were justified precisely as a compromise between the far-right’s demands for a complete suspension of the democratic order and the center-left’s calls for a more lenient approach.

Although Biden is a devout Catholic (one who has apparently been wearing a rosary under his sleeve since the death of his son Beau in 2015), he remains firmly within the American tradition of secularism, which posits a strict “wall of separation” between politics and religion. Europe’s Christian democracy, by contrast, is partly rooted in an attempt to directly translate principles of Catholic social doctrine into a democratic political platform. In this sense, Biden is a distinctly Americanized version of this European strand of political conservatism.

Christian democrats succeeded in keeping both the far-left and the far-right out of power for several decades after the end of World War II precisely on the basis of a coalition that united social elites, the urban middle classes, and the rural poor against the perceived threat of radical takeover

if he is indeed elected, Biden is likely to be far more open to political influence than either Clinton or Sanders would have been as president. His presidency would likely leave ample space for the two main factions within the Democratic Party—the Clintonian liberal wing and Sanders’s democratic socialist one—to continue shaping policy in important ways, even though neither is likely to get all of what they want. In this sense, the result wouldn’t be very much unlike the constant struggle for compromise between the center-right and the center-left wings of continental European Christian democratic parties during their period of political hegemony in the postwar years.

As the prospect of both fascist resurgence and communist revolution began to wane in postwar continental Europe, Christian democracy lost its way, falling prey to widespread clientelism and corruption. Ultimately, this is what brought down the Italian democrazia cristiana at the beginning of the 1990s and has also weakened the German Christian Democratic Union and other continental European Christian democratic parties’ political identities ever since. Seen in this light, Biden might succeed in defeating both Sanders and Trump. But his presidency would probably end up being rather weak and aimless, without doing much to address the United States’ deeper social and political problems.

There was no other reason for having such a referendum; it was purely an internal Tory party affair

The circumstances of the 2016 referendum, its nature, and its consequences, have multiple causes that jointly led to the stupefying mess in the country and its political and constitutional order that we are now in. The Eurosceptics made good use of these other factors

the policy from 2010 of austerity and the resulting large and rapid increase in inequality, which affected some areas of the country and economy much more drastically than others

a series of bad mistakes and misjudgements by David Cameron and Ed Miliband, the leaders of the two main parties

the quality of MPs after decades in the EU. Membership of the EU brought a degree of general consistency and equilibrium to the economies and states of the member nations, even taking into account the misguided austerity policies after 2010 in the UK itself. This has lessened the temperature of political debate in the UK, premised as it is (unlike most other EU countries) on a deeply adversarial style of politics. Before joining the EEC the UK was a theatre of intense struggles between left and right, socialism and capitalism, managements and unions, a pervasive 'us and them' mentality infecting every major decision.That moderated, with a more temperate tone entering politics in the period between the end of Thatcher and the post-2010 coalition. But as a result, politics became somewhat less attractive to energetic, clever and ambitious people, with the result that - with some extremely honourable exceptions - the general quality of MPs is not nearly what it was.

Banal careerism, the unchallenged sway of the party whips, unthinking sound-bite ideas as the staple of political discourse, the fact that literally hundreds of MPs in the Tory party can support a profoundly unfit person such as Boris Johnson in the office of prime minister - this is a mark of serious decline in quality of those elected to the legislature.

the innate fragility and dysfunction of the UK's outdated and ramshackle constitutional order. The uncodified constitution - 'a series of understandings that no-one understands' - is very convenient for any party that commands a majority in the House of Commons, because they can do whatever they like, always getting their agenda enacted and controlling the business of the House of Commons itself.

no separation of powers between the legislature (parliament) and executive (the government - meaning, the cabinet and prime minister)

Instead of holding the government to account, therefore, parliament is in effect the creature of the government, and does what the government wants.

"elective tyranny"

The clique controls the executive, the executive controls parliament, parliament is absolute in its powers: The clique is the tail that wags the entire dog.

when people of lower quality, less integrity, less intelligence and less honour populate these offices of state, danger looms. And that danger has burst upon us in the form of Brexit.

One of the major scandals of the 2016 referendum is that its outcome has never been debated in parliament. The question, 'Shall we take the advice of 37% of the electorate to take an enormous, uncosted, unplanned and unpredictable step?' has never been debated and voted upon in our sovereign state body.

our hopelessly undemocratic first past the post electoral system lies at the rotten core of these arrangements. It disenfranchises the majority of voters, turning them off politics. It puts majorities into the House of Commons on minorities of the popular vote. It entrenches two-party politics, in which elections produce one-party government by turns - with the foregoing 'elective tyranny' resulting. It is a mess, and reform is urgently needed.

there is a huge clean-up operation required in our political and constitutional order, in addition to addressing the serious inequalities and injustices in our economy and society

We in the UK have skated on very thin political and constitutional ice for a long time; the wealth and prestige of empire, the nostalgic dream it left behind, the self-deceptions and illusions of those who could not see how good a future was developing for us as a leading nation in Europe, made us unaware of the danger. We have fallen through that ice, and the bitterly cold waters we now flounder in must at last wake us up.

Despite testing far less than its neighbors, Somalia has the highest death toll in East Africa. On April 17 and 18, 72 people were tested, out of which 55 were confirmed positive, a staggering 76 percent infection rate. Since this revelation, the Somali government has stopped sharing the numbers of people tested with the public.

Anecdotal accounts of COVID-19 symptoms and a spike in burials abound. “There is extraordinary community transmission. Infections and deaths are out of control,” explained a Mogadishu doctor on the condition of anonymity. “And why visit a hospital if they can’t treat you?” Somalia’s health infrastructure is mere scaffolding: scarce public hospitals struggling with a lack of equipment, unaccredited doctors in private facilities offering unaffordable services, and medication that is as low-grade as it is scarce.

Somalia’s best-equipped medical institution, Erdogan Hospital in Mogadishu, was shut down in April after 3 of its doctors were infected. Martini Hospital—kitted with 76 beds—is the only medical facility in the whole country designated to treat the infected

Answers to this acute health crisis lie in part with the government’s 2020 budget, which allocated $9.4 million for health spending, a mere 2 percent of the national budget. A whopping $146.8 million was reserved for security institutions—a telling indication of a cash-strapped state facing widespread security threats.

The group heralded the disease as divine punishment for the treatment of Muslims globally. Weaponizing the disease, al-Shabab ushered in Ramadan with an attempted vehicle-borne explosive attack at a military base on the first full day of the holy month.

Like the virus, al-Shabab transcends national borders and presents risks not only to Somalia but to its pandemic-weakened neighbors, particularly Kenya, which has weathered violent attacks from the group for years. Born out of a power vacuum itself, al-Shabab will capitalize on lapses in states’ security apparatus as governments redirect resources from preempting terror attacks to enforcing curfews

risks reversing critical security gains

Kenya’s northeastern towns lying on its border with Somalia have been particularly vulnerable to devastating al-Shabab attacks. In response to the illegal smuggling of people and goods from both Somalia and Ethiopia, Kenyan security authorities have recently ramped up aerial surveillance along its borders, in part, to curtail cross-border infection. Ethiopia’s health minister announced last week that 13 of its new cases were imported via illegal migration from Djibouti and Somalia

More than 80 percent of global trade passes through the Gulf of Aden

the resurgence of piracy can be expected

For more than a year now, the central government has been embroiled in a rancorous fight with two of its federal states. This being an election year, the fledgling Somali state finds itself at a critical juncture. It remains to be seen whether federal elections will be postponed, following in the footsteps of neighboring Ethiopia.

The disappearance of remittances—a lifeline for millions on the continent and estimated at $1.4 to $2 billion annually in Somalia alone—makes the situation all the more desperate. These critical cash flows have dried up as a global recession sets in and incomes of workers in the diaspora shrink.

harrowing statistics from across Europe show that Somali communities have been disproportionately affected by COVID-19. In Sweden, Somalis are dying from the virus at “an astonishing high rate” according to the BMJ despite accounting for only 0.69 percent of the population. The World Bank is calling on governments to designate remittance companies as an essential service, a crucial step to easing restrictions on these financial flows.

The populations most at risk in Somalia are those living in the densely populated camps scattered across the country. More than 2.5 million internally displaced people live in these cramped conditions, already weakened by malnutrition and compromised immune systems, and with limited access to clean water, soap, or bathrooms.

According to the World Food Programme, the number of food-insecure people in East Africa is projected to reach up to 43 million in the next few months—more than double what it is now—sparking fears of conflict over scarce resources.

The specter of drought and famine, alongside the unforgiving plague of locusts that has ravaged crops in recent months

deadly flash floods

will force more people to move, compounding the internal displacement crisis and heightening intercommunal tensions  even as it spreads the disease further

Border closures across the region have throttled migration flows, making it ever harder for people to escape conflict or starvation. This will simply force migration into the shadows, opening up avenues for human trafficking and exploitation. Irregular movement of refugees has already been observed across the Horn of Africa’s highly porous borders.

During  Friday prayers at Mogadishu’s Marwazi mosque on April 10, armed forces tried to forcibly disperse a congregation of worshippers without notice. A massive demonstration broke out, and shoulder-to-shoulder prayers continue across the country today

Riots swept the streets of Mogadishu again on April 24 in response to the fatal shooting of two innocent civilians by police as they tried to enforce a curfew. Ramadan, replete with nightly rounds of public taraweeh prayers, is likely to catalyze disease spread in the absence of clear communication with communities and Islamic leaders.

The virus demands self-sufficiency. Countries are forced to make do with their own systems, however broken.

government’s restrictions on press freedom and access to information about the novel coronavirus to the detriment of its own people

As has often been the case in the disaster-prone country, it will be up to grassroots community groups, the private sector, and members of the diaspora to mobilize en masse to contain the crisis.

Two officials at the Ministry of Health have already been arrested on corruption allegations related to COVID-19 response donations, denting public confidence.

With domestic flights suspended, it is all the more critical to invest in hospital and testing capacity across the country. This cannot be achieved without genuine collaboration between the federal government and its constituent member states.