Review of The Monster at Our Door: the Global Threat of Avian Flu by Mike Davis
In 2003, SARS raised the specter of a global pandemic the likes of which the world hadn't seen since influenza swept the world and killed 100 million in 1918. While SARS was defeated in short order, new diseases took its place. Fortunately, these too have been vanquished. Swine flu, the newcomer presented by the media as the disease that would live up to all the deadly promise of SARS, has so far killed fewer people than the plain old flu.
Does this mean we're off the hook?
Far from it. In his excellent 2004 book The Monster at our Door: The Global Threat of Avian Flu, Mike Davis examines the industrialization of agriculture and other structural features of capitalism that make a catastrophic pandemic almost inevitable in the near future. Such a pandemic could kill as many as a billion people.
Davis shows that the relationship between man and farm animal exists on a wholly different scale than in the past. Driven by competition and an increased demand for meat in the third world, where proletarianization has forced hundreds off millions off the land and into cities, capitalist firms have implemented the most remarkable centralization of meat production. Gone are the days of the small farm with a few hundred animals. For instance, "in Western Arkansas and northern Georgia, more than 1 billion chickens are slaughtered annually." "One swine megafarm in Milford Valley, Utah, reputedly produces more sewage than the city of Los Angeles" (page 84). Packing together so many animals means diseases have exponentially more chances to mutate and gain an ineradicable foothold. So it was that Swine flu probably originated in a Mexican hog farm operated by Smithfield Foods, the world's largest pork processor.
The concentration of farm animals is not the only danger. These animals are transported further and more often than ever before, a practice which "expands the radius of potential infection." Increased use of antibiotics and vaccines may also increase selection for hardier strains of viruses and bacteria (page 91). Thus, "researchers told Science that swine influenza's sudden burst of mutational energy has probably been stimulated by parallel changes in herd size, interstate transport of hogs, and vaccination practice" (90).
Changes in human population density and transportation habits mirror changes to livestock and poultry production. (Indeed, under capitalism human beings are simply commodities like anything else; we are bought and sold for use in production, with our lives organized so as to keep our costs down). If the 1918 influenza pandemic that killed 100 million people had its origins, at least in part, in the trenches of the Western Front, imagine what diseases might be fostered by the slums of the third world. Slums house (to use the term loosely) a billion of the world's people, Davis points out. Dharavi, a slum in Mumbai, has 571,000 inhabitants per square kilometer. Delhi has a slum with the density of 300,000 per square kilometer. Kibera, a slum of Nairobi, has a density of 200,000 people per square kilometer. Cite-Soleil, a slum of the now earthquake-flattened Port-Au-Prince, had a density of 180,000 people per square kilometer (page 154). In Hong Kong, SARS possibly spread because of an apartment building's faulty sewage system. Imagine, then, the possibilities for the spread of disease in slums where the sewage systems are not faulty, but non-existent (pages 72-73). (In Dharavi there is one toilet for every 1,400 people.) Ironically, affluence as much as poverty contributes to the transmission of diseases. Corporate scumbags and yuppie travelers flying around the world are capable of spreading disease from one continent to another in a matter of hours.
It might be argued that advances in medical science can match, step for step, the evolution of deadly infecious diseases. Here Davis has more bad news. First, the pharmaceutical industry has put profits in front of people -- the only possibility in capitalism -- and virtually abandoned producing vaccines. Davis presents two reasons for this. First, companies have been found liable for the inevitable side effects of their vaccines, so in the 1970s there was a "rush" to get away from vaccines (page 41). Moreover, vaccines and antibiotics just aren't profitable: "products that actually cure or prevent diseases, like vaccines and antibiotics, are less profitable, so infectious disease has largely become an orphan market. As industry analysts point out, worldwide sales for all vaccines produce less revenue than Pfizer's income from a single anticholesterol medication." Thus, while in 1976 there were thirty-seven companies in the U.S. producing flu vaccines, by 2004 there were only two (one of which maintained a criminally unsanitary vaccine production facility) (pages 140, 143). Davis also notes that pharmaceutical companies spend nearly three times as much on marketing as they do on research. This isn't a "conspiracy" or "callousness" on the part of pharmaceutical companies, it is simply the nature of the capitalist mode of production: any enterprise that does not seek out the highest profits inevitably disappears under the crush of competition.
If capitalist medicine offers little hope, can we at least rely on the state and its health officials? Again, Davis paints a bleak picture. In the first instance, the countries in which SARS and deadly influenza strains have appeared are quick to deny that there is any problem. This has been especially true of Thailand and China, but even Canada is guilty as well (page 94). Such a response is the only option open to the state, which is really nothing but the defender of national capital. Its only course of action is to protect the sales of the local capitalists producing diseased chickens, the local capitalists reliant on tourism, etc., even if this means allowing a small outbreak to turn into a full-fledged pandemic. Some governments find ways to use these outbreaks to the advantage of the big capitalists who finance them. In Thailand, for instance, the government forced a chicken culling that devastated small farmers but exempted the largest producers, leaving them free to take over more of the market. Other countries are blase about the dangers of influenza. In the U.S., more money was devoted to abstinence education than to the development of an avian influenza vaccine (page 128). The U.S. government also made it clear that in the event of an avian flu pandemic, it would first distribute Tamiflu to its imperial legions occupying Iraq and Afghanistan (page 146). Even more troubling is that the U.S. only ordered two million doses of Tamiflu, rather than the 100 million recommended by experts (pages 144-145). Other states are no better. India, for instance, spends eight times as much of its budget on defense as it does health (page 157). In Africa, fully one million more health workers are needed to ensure even basic care (page 157). And so on, and so on.
These are the main points of Davis's book. He very capably lays out the case against the current scale of industrial agriculture and states' inability to confront incipient pandemics, a course of action which would harm the profits of their capitalists and draw resources from military endeavors and the other criminal enterprises of the state. Whether the next would-be pandemic fizzles out and fades from memory, as SARS did and now Swine Flu seems destined to do, Davis's book will remain relevant, for a catastrophic pandemic is virtually assured by the capitalist mode of production.