Empowering the vulnerable communities in the war against Covid-19

Jayati Ghosh, the Executive Secretary of the International Development Economics Association, explained that under a pandemic, the health of the richest depends on the health of the poorest. She wrote:

“Pandemics like Covid-19, alarming and destructive as they are, can serve a useful purpose if they remind everyone of the critical importance of public health. When a contagious disease strikes, even a society’s most protected elites must worry about the health of neglected populations. Those who have advocated privatization and cost-cutting measures that deny health care to the most vulnerable now know that they did so at their own peril. A society’s overall health depends on the health of its poorest people.”

Indeed, Covid-19 has made many realize that the health of one is the health of all. In line with this, the response of most governments to the Covid-19 threat is to lock down whole communities to protect each community from the spread of the virus. At the same time, governments have rushed to rebuild their respective public health-care systems, most of which were in varying states of neglect and stagnation due to the past neo-liberal policy of leaving everything to the market. This is why outside of China, the countries that have successfully managed or contained the virus spread are those with good existing public health-care systems such as Cuba, New Zealand, South Korea, Thailand and Vietnam.

However, the wholesale program of isolating communities from each other has resulted in the devastating paralysis of the economy and the consequent collapse of businesses, livelihoods and jobs in virtually all countries. For the vulnerable segments of society, the health-economic crisis has also been transformed into a food-hunger-survival crisis for many families. To save people’s lives, the Philippines and other countries paired the lockdown measure with a program of social amelioration and relief good distribution.

However, the question is: how long can a financially-strapped government sustain a program of relief distribution, wage subsidy and other forms of assistance? Congress has been pushing for new trillion-peso stimulus packages to rev up the economy, revive businesses and create jobs. In response to these Congressional initiatives, both the DOF and Neda have cautioned the legislators that the government is now in the red and that not enough funds can be sourced further from new borrowings. There are virtually none from the BOC and BIR, whose collections have gone down dramatically.

So how can the most vulnerable segments of society survive in a flattened economy amidst a deepening fiscal crisis facing the government?

Earlier, we wrote that the government should tweak its “Build, Build, Build” program away from the costly big-ticket infra projects in favor of labor-intensive low-cost community rebuilding and infra development projects in the most depressed and vulnerable communities. We also wrote that the government, given the natural timidity of big private investors to invest today and the collapse of the global and national markets, should be the lead job creator and employer in Covid times.

The point is that the government has no choice but to manage a Keynesian-style piloting of the economy. But can it do this without fleshing out a clear development framework? Can it be Keynesian while pushing at the same time for neo-liberal policy measures such as opening up the economy to FDIs through generous fiscal incentives at a time when FDI flows are slowing down worldwide? And what can the government do in addressing the survival needs of the vulnerable segments of society now that funds are drying up?

This author is proposing another policy approach: transform the vulnerable communities as partners in waging the war against Covid-19. They should stop being passive receivers of amelioration assistance. They should be developed and treated as partners in the war against the pandemic. The transformation can happen as follows:

1.  Build up community awareness, knowledge and skills in combating the spread of the virus and in building up community wellness. The community here covers all members of the community, families and government and non-government organizations existing in the community. Organized communities with enlightened leaders are in the best position to initiate and institutionalize preventive measures against Covid-19 and other infectious diseases such as social distancing and good practices in sanitation, health and water management.

2.  Use the Covid-19 crisis to institutionalize and build up the primary health-care system, the necessary base nationwide for the successful implementation of a universal health-care system, as successfully illustrated by the experiences of Cuba, Thailand and Vietnam. The building up of the primary health-care system requires the establishment of a clinic and health facilities as well as the hiring of needed health personnel.

However, the role of a primary health-care system is a complex one. The WHO’s Alma-Ata Declaration of 1978 explains it as follows: “Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self reliance and self-determination.” It addresses the “health problems in the community, providing promotive, preventive, curative and rehabilitative services.”

But in addition, the system also involves the “promotion of food supply and proper nutrition” as well as coordination in relation to “aspects of national and community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, communications and other sectors.” In short, community wellness in Covid times should be developed around the idea of a well-functioning system of primary health-care system, which addresses the community health, economic and livelihood concerns in a holistic manner.

3.  Revive livelihoods and jobs at the community level without violating the rules on management of the spread of the virus such as social distancing and wearing of safety masks. Here the role of social dialogue, consultations and problem-solving at the community level is critical. Very often the informal workers and commnuity-based micro and solo enterprises are ignored or forgotten in existing and proposed stimulus packages. One explanation is that many informal workers have livelihoods that are not registered and are not counted under the MSME business grouping. These include the home-based workers, street vendors, jeepney/tricycle drivers, service workers contacted through the barangay or cellular communication, informal construction workers, and so on.

As to the micro and family businesses, they are usually cited as the justification for the stimulus packages. However, experience shows that these businesses, which constitute almost a million, are usually left out in national policy formulation on government assistance to distressed businesses. The government is understandably comfortable talking on the details of stimulus packages with the big industry associations and established business chambers.

The challenge then is for the government, at the national and local levels, to work out stimulus plans involving the most vulnerable or weakest in the MSME cluster. One way of approaching this is for government officials to find out the situation at the community level and talk directly to the people. During the ECQ in Metro Manila, some visionary mayors like Vico Sotto did just that, by going around various communities and working out practical solutions on maintaining livelihoods by consulting and talking directly to those affected by the ECQ.

In the end, organized, disciplined and empowered communities are better partners and allies for the government compared to docile and vision-less quarantined communities.


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