The precarity of the global 99%

What The Global Fund's decision to cancel next year's funding round means for victims of Aids, TB an

In Europe and the US there is a lot of talk of austerity these days. But elsewhere in the world, the financial realities of our age of insecurity are leading not to belt-tightening but to malnutrition and disease. And things look set to get a lot worse yet.

This week's unprecedented announcement by The Global Fund to Fight Aids, TB and Malaria to cancel its next funding round is a case in point. It reveals just how precarious daily life has become for the global 99 per cent: those whose very health, as much as their job security, is pegged to the rise and fall of the money markets.

The Global Fund has for years been one of the most important fronts in the battle to beat back HIV/Aids. It has helped put 3.2 million people on anti-retroviral therapy (ARVs). But it has been running on empty for a year now, since securing just $10 billion -- half of what it hoped for -- during a major funding replenishment a year ago. Some countries also recently cut their pledges owing to concerns about the way the Global Fund is operated.

Ten billion dollars sounds like peanuts in comparison to the bank bailouts we have gotten used to in recent years -- it's about the same amount that Goldman Sachs has cheerfully set aside in bonuses again this year.

But it was the minimum figure that the Global Fund required from rich countries to sustain the many medical programmes it supports around the world. And with those countries failing to meet even downsized pledges in October, the Global Fund concluded this week, after a heated and difficult board meeting in Accra, Ghana, that it had no choice but cut the funding lifeline.

Instead, it has put in place an emergency '"transition mechanism" to safeguard the most needy, but this is no more than a tin roof over the heads of some in a rapidly worsening storm. The fact is that sooner or later people are going to be kicked off existing treatment programmes: this is already happening in Swaziland, which recently decided to forego Global Fund support and, as a result, has simply run out of drugs.

The Global Fund's apparent demise could hardly come at a more crucial time. The last couple of years had seen greater optimism in the battle against Aids. Thanks to internationally funded programmes, the number of people on ARVs had increased by 20 per cent since 2009, and many had begun looking forward to a generation free of HIV. "We have an historical opportunity now with treatment as prevention to push back against HIV," Marius Trosied, a doctor with Médecins Sans Frontières told me just a few weeks ago. But such claims require solid revenue streams to back them up. It is now far from clear how even the 7.7 million people the Global Fund claims to have already "saved" will fare in the years to come.

South Africa and Kenya have already been told they are ineligible to apply for funds this year, despite both only having treatment coverage rates of around 50 per cent.

And in Malawi, which had ambitious plans to scale up treatment provision, the question now is all about how best to manage a treatment scale-down. That is global health speak for a process of triage to determine who lives and who dies.

The root problem is not just the banking and financial crisis, says David McCoy, a public health specialist at UCL: "What is happening to the Global Fund ought to concentrate the minds and efforts of public health workers all across the world on the need to change the broader social and economic institutions within which our fragile health programmes are located."

McCoy is right: the precarity of individuals is ultimately a function of the precarity of the institutions that sustain them. That is as true in Europe and the US -- where we are seeing jobs lost, services cut, and shops boarded up along our highstreets because our institutions and systems of government do not protect us equally from the vicissitudes of the market -- as it is in global health. But of course the two are related, and some individuals are more vulnerable than others.

So when life-saving organizations like South Africa's Treatment Action Campaign declare that, because rich countries now feel they can afford to give less, they too may be forced to shutter up the premises next year, then we have to recognise that the politics of austerity we are going through has not even begun to be properly costed. This is the real lesson of the Global Fund's demise and it will require much more than simply getting wealthy donors back on board to address it.

Simon Reid-Henry is a lecturer at Queen Mary, University of London

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Meet Anne Marie Waters - the Ukip politician too extreme for Nigel Farage

In January 2016, Waters launched Pegida UK with former EDL frontman Steven Yaxley-Lennon (aka Tommy Robinson). 

There are few people in British political life who can be attacked from the left by Nigel Farage. Yet that is where Anne Marie Waters has found herself. And by the end of September she could well be the new leader of Ukip, a party almost synonymous with its beer-swilling, chain-smoking former leader.

Waters’s political journey is a curious one. She started out on the political left, but like Oswald Mosley before her, has since veered dramatically to the right. That, however, is where the similarities end. Waters is Irish, agnostic, a lesbian and a self-proclaimed feminist.

But it is her politics – rather than who she is – that have caused a stir among Ukip’s old guard. Former leader Paul Nuttall has said that her views make him “uncomfortable” while Farage has claimed Ukip is “finished” if, under her leadership, it becomes an anti-Islam party.

In her rhetoric, Waters echoes groups such as the English Defence League (EDL) and Britain First. She has called Islam “evil” and her leadership manifesto claims that the religion has turned Britain into a “fearful and censorious society”. Waters wants the banning of the burqa, the closure of all sharia councils and a temporary freeze on all immigration.

She started life in Dublin before moving to Germany in her teens to work as an au pair. Waters also lived in the Netherlands before returning to Britain to study journalism at Nottingham Trent University, graduating in 2003. She subsequently gained a second degree in law. It was then, she says, that she first learnt about Islam, which she claims treats women “like absolute dirt”. Now 39, Waters is a full-time campaigner who lives in Essex with her two dogs and her partner who is an accountant.

Waters’s first spell of serious activism was with the campaign group One Law for All, a secularist organisation fronted by the Iranian feminist and human rights activist Maryam Namazie. Waters resigned in November 2013 after four years with the organisation. According to Namazie, Waters left due to political disagreements over whether the group should collaborate with members of far-right groups.

In April 2014, Waters founded Sharia Watch UK and, in January 2016, she launched Pegida UK with former EDL frontman Steven Yaxley-Lennon (aka Tommy Robinson). The group was established as a British chapter of the German-based organisation and was set up to counter what it called the “Islamisation of our countries”. By the summer of 2016, it had petered out.

Waters twice stood unsuccessfully to become a Labour parliamentary candidate. Today, she says she could not back Labour due to its “betrayal of women” and “betrayal of the country” over Islam. After joining Ukip in 2014, she first ran for political office in the Lambeth council election, where she finished in ninth place. At the 2015 general election, Waters stood as the party’s candidate in Lewisham East, finishing third with 9.1 per cent of the vote. She was chosen to stand again in the 2016 London Assembly elections but was deselected after her role in Pegida UK became public. Waters was also prevented from standing in Lewisham East at the 2017 general election after Ukip’s then-leader Nuttall publicly intervened.

The current favourite of the 11 candidates standing to succeed Nuttall is deputy leader Peter Whittle, with Waters in second. Some had hoped the party’s top brass would ban her from standing but last week its national executive approved her campaign.

Due to an expected low turnout, the leadership contest is unpredictable. Last November, Nuttall was elected with just 9,622 votes. More than 1,000 new members reportedly joined Ukip in a two-week period earlier this year, prompting fears of far-right entryism.

Mike Hookem MEP has resigned as Ukip’s deputy whip over Waters’ candidacy, saying he would not “turn a blind eye” to extremism. By contrast, chief whip, MEP Stuart Agnew, is a supporter and has likened her to Joan of Arc. Waters is also working closely on her campaign with Jack Buckby, a former BNP activist and one of the few candidates to run against Labour in the by-election for Jo Cox’s former seat of Batley and Spen. Robinson is another backer.

Peculiarly for someone running to be the leader of a party, Waters does not appear to relish public attention. “I’m not a limelight person,” she recently told the Times. “I don’t like being phoned all the time.”

The journalist Jamie Bartlett, who was invited to the initial launch of Pegida UK in Luton in 2015, said of Waters: “She failed to remember the date of the demo. Her head lolled, her words were slurred, and she appeared to almost fall asleep while Tommy [Robinson] was speaking. After 10 minutes it all ground to an uneasy halt.”

In an age when authenticity is everything, it would be a mistake to underestimate yet another unconventional politician. But perhaps British Muslims shouldn’t panic about Anne Marie Waters just yet.

James Bloodworth is editor of Left Foot Forward

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear