Commentary No. 23, Sept. 1, 1999
"Whose Health Do We Preserve?"
Once upon a time, someone invented DDT, a miracle spray that killed pests, and thereby increased agricultural output. A famous book by Rachel Carson, Silent Spring, published in 1962, argued persuasively that DDT had entered a long food chain, killing many other animals than the so-called pests, and threatening humans themselves. This book began the long campaign against the use of DDT, which is nearing its culmination point, a United Nations treaty that would ban all use after a date still being debated.
The issue of DDT was originally presented as health vs. profits, the health both of the biosphere and of humans. And in this debate health ultimately won in the political arena. As well it should! But now it turns out there is another issue. DDT, it seems, is the most effective, cheap method of controlling the anopheles mosquito that spreads malaria. And malaria is a major cause of premature death in all countries with tropical regions. These countries are by and large poor countries as well, so they need not only an effective but an inexpensive mode of combating malaria. Two of these countries currently using DDT to control malaria are China and India, which just by themselves represent 50% of the world's populations. They and others are opposing a UN ban and suggesting instead some limited use of DDT for these purposes.
According to the New York Times, this is opposing environmentalists and public health advocates, in which neither side represents primarily the interest of profit-seekers. I would say, the real issue is: whose health do we preserve? George Bernard Shaw once quipped that a people suffering from colonial rule was like persons with a broken arm: there was nothing else they could think about until the arm was mended. But once mended, the really serious problems would then have to be faced. Analogously, a world suffering from capitalism is one in which its distortions govern all our thoughts. But once mended, we shall have to face up to even harder and more important problem s, like priorities in health concerns. We are getting a foretaste of the issue now.
This problem is of course exacerbated by the realities of the polarization of the capitalist world. In the countries of the North, which are relatively wealthy, and which are largely in zones of temperate climate, malaria is not a serious issue. But the environment and food poisoning are serious issues. It is clear that the vices of using DDT far outweigh any virtues in such countries. But in the countries of the South, poor, and mostly tropical, malaria is a major concern, and it is not at all clear that in these countries the vices of DDT outweigh the virtues of its use.
Now, we would all be relieved if some clever scientists found a way to square the circle, say by inventing another equally cheap way of combating malaria that would permit the elimination of the use of DDT everywhere. But so far, no one has done this. Furthermore, as in most of these issues, the scientists are of course finding it difficult to measure the exact amount of damage that is done by one or another decision (how many human lives are spared by eliminating DDT from the food chain? how many human lives are saved using DDT to fight malaria?). Since it is difficult to measure, different scientists have come up with different calculations.
There is a second matter about which people differ, this time not the scientists but the politicians (and their voters). The issue is money. If China and India were to renounce the use of DDT in favor of some other more expensive (but for the sake of argument equally efficacious) mode of combating malaria, who should pay for it? the people of China and India, people in the "North", or people everywhere? This is a moral question and a political one. But it is not a minor one.
What we see in the short run is a very unfortunate split among persons usually on the same side: environmentalists who are usually fighting persons primarily oriented to profit-making and so-called efficient production, and public health advocates who are usually fighting persons primarily oriented to profit-making and so-called efficient production. The environmentalists and the public health advocates are in this case fighting each other, with a strong overlay of a North-South split.
In the long run, what is at issue is whether we can arrive at a "substantively rational" decision in this matter (and indeed in all others). What would such a decision be? Well, of course, one isn't sure in advance. The process would involve carefully weighing the interests of persons in different parts of the world (at the moment, primarily North and South, to simplify) and persons in different generational strata (the young, those of working age, the elderly, and those yet unborn). There is no perfect allocation of resources, but there are clearly some that are fairer than others and which we might consider optimal. They require balancing scientific data (and inferences) with political claims and administrative practicalities. The more egalitarian the distribution of world income, the more likely that existing and/or future potential imbalances would play a lesser role in the arguments, explicit or implicit.
How we might resolve such issues in a not yet existing truly post-capitalist world remains to be seen. What we need to do as long as we're in the real existing capitalist world-economy is first of all to get the debate onto the table and into wide public discussion, and secondly to recognize that whatever we do ought not to have the consequence of expanding still further the gap between the haves and have-nots of this world, between the rich and the poor, the North and the South, the privileged and those who are oppressed. The use of DDT is in itself an important issue, but it is the tip of a very large iceberg. How we handle this debate therefore can be a sign of how we are ready to handle the vaster issues before us.
Get the issue out of the backrooms of world diplomacy and even out of the backrooms of the specialists. And let such an issue open up the larger ones of the world we hope to construct as the existing world-system begins to crumble.
Immanuel Wallerstein
[Copyright by Immanuel Wallerstein. All rights reserved. Permission is granted to download, forward electronically or e-mail to others and to post this text on non-commercial community Internet sites, provided the essay remains intact and the copyright note is displayed. To translate this text, publish it in printed and/or other forms, including commercial Internet sites and excerpts, contact the author at iwaller@binghamton.edu; fax: 1-607-777-4315.
These commentaries, published twice monthly, are intended to be reflections on the contemporary world scene, as seen
from the perspective not of the immediate headlines but of the long term.]
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