By James Thompson

Hypocrisy or diplomacy

Certainly all rational people understand that the current negotiations between Cuba and the USA are complex and progress will not be smooth.

One way to smooth the negotiations would be to remove the element of hypocrisy constantly being hammered by the US negotiators.

One impediment to progress is the demand by the US for Cuba to improve their stance on “human rights.”

The US negotiators should consider this biblical passage before making demands on Cuba:

John 8:7

And as they continued to ask him, he stood up and said to them, “Let him who is without sin among you be the first to throw a stone at her.”

They also might want to consider this old saying “People who live in glass houses should not throw stones.”

The US negotiators have reached the apex of hypocrisy when they demand that Cuba improve its human rights record.

Cuba has never unleashed nuclear weapons on foreign or domestic metropolises such as the US did to Nagasaki and Hiroshima.

Cuba has never firebombed a city such as was done to Dresden, Germany.

Cuba has never bombed foreign countries throughout the world such as the US has done in Latin America, Africa, Europe, the Middle East and Asia.

Cuba has never committed genocide against foreign or domestic populations such as the US has done to Native Americans, African Americans and Latinos in the USA and to the peoples of Latin America, Africa, the Middle East, and Asia. Cuba has never supported the Israeli government’s oppression and slaughter of Palestinian people. Cuba did not support and fought against apartheid in South Africa while the US stood firmly behind the fascists in South Africa.

Cuba has never maintained foreign military bases such as Guantánamo in which people are unjustly detained, and tortured. The word “hypocrisy” is not sufficient to describe the travesty of the US demands for Cuba to improve its human rights record while the US is violating human rights on Cuban soil.

Cuba has never placed economic sanctions and/or embargoes on a foreign country which resulted in that country’s people’s economic deprivation and misery.

Cuba does not have a history of supporting Nazis and fascists such as the US has done in the Ukraine and many other places in the world.

Cuba does not have a history of barbaric foreign policies of “regime change” of democratically elected governments in foreign countries such as the US has done in Grenada, Panama, Cuba, Venezuela, Yugoslavia, all socialist countries and all anti-imperialist countries around the world.

Cuba has never allowed its police force to murder with impunity young people of African descent.

Cuba has never supported terrorist organizations within its own country who have bombed the airliners of foreign countries such as was done to the airliner carrying the Cuban fencing team in a flight from Venezuela to Cuba. Cuba has never supported perpetrators of terrorism such as Luis Posada Carriles. Mr. Carriles remains free in the USA today even though it is well documented that he has murdered many Cubans.

The US negotiators have not budged in their stubborn adherence to Cuba remaining on the US list of “state sponsors of terrorism.” If the US negotiators want to negotiate in good faith, they must insist that the USA be placed on the US list of “state sponsors of terrorism.”

By BRADLEY KLAPPER and MICHAEL WEISSENSTEIN
Published: Yesterday
http://m.apnews.com/ap/db_289563/contentdetail.htm?contentguid=2tmFgO4G

HAVANA (AP) – The United States and Cuba closed two days of historic talks in Havana with some progress toward restoring diplomatic ties after a half-century of estrangement, but sharp differences over the role of human rights in their new relationship.

“As a central element of our policy, we pressed the Cuban government for improved human rights conditions, including freedom of expression,” said Roberta Jacobson, the top U.S. diplomat for Latin America and most senior American official to visit the island country in more than three decades. In Spanish, however, her statement said the U.S. “pressured” Cuba on the issue.

“Cuba has never responded to pressure,” Josefina Vidal, Cuba’s top diplomat for U.S. affairs, responded.

The comments by Jacobson and Vidal reflected longstanding positions of their governments and it wasn’t immediately clear whether the issue, which has previously blocked closer U.S.-Cuban relations, would pose a threat to the new diplomatic process.

Yet it laid bare the pressures each side faces at home – the U.S., from Republican leaders in Congress and powerful Cuban-American groups and Cuba, from hardliners deeply concerned that rapprochement could undermine the communist system founded by Fidel Castro.

In the first face-to-face talks since last month’s declaration of detente, the two countries laid out a detailed agenda for re-establishing full diplomatic relations. Further talks were planned.

Jacobson hailed a morning session as “positive and productive,” focusing on the mechanics of converting interest sections into full-fledged embassies headed by ambassadors. But she also spoke of “profound differences” separating the two governments and said embassies by themselves would not mean normalized ties.

“We have to overcome more than 50 years of a relationship that was not based on confidence or trust,” Jacobson told reporters.

Along with human rights, Cuba outlined other obstacles in the relationship. Vidal demanded that Cuba be taken off the U.S. list of state sponsors of terrorism. However, she praised Obama for easing the U.S. trade embargo and urging the U.S. Congress to lift it entirely.

“It was a first meeting. This is a process,” Vidal said. In the next weeks, she said, the U.S. and Cuba will schedule a second round of talks, which may or may not be the time to finalize an agreement.

Issues on Thursday’s agenda included ending caps on staff, limits on diplomats’ movements and, in the case of the U.S. building, removing guard posts and other Cuban structures along the perimeter.

Earlier, the two countries disputed whether human rights had even been discussed at all. Jacobson said the U.S. raised it in the morning meeting; Vidal said it had not come up.

Gustavo Machin, Cuba’s deputy chief of North American affairs, later said the delegations spent time in an afternoon session discussing U.S. human rights problems – a reference to recent police killings of black men in Missouri and New York. Cuban state media said the Cuban delegation also complained about the detention of prisoners at the U.S. base in Guantanamo Bay.

A U.S. official said the difference in Jacobson’s statements was unintentional and that the English version – that the U.S “pressed the Cuban government for improved human rights conditions, including freedom of expression” – reflected the delegation’s position.

The U.S. and Cuba also talked about human trafficking, environmental protection, American rules to allow greater telecommunications exports to Cuba and how to coordinate responses to oil spills or Ebola outbreaks.

The need for at least one future round of talks could set back U.S. hopes of reopening the embassies before April’s Summit of the Americas, which Obama and Castro are expected to attend.

Still, after so many years of mutual suspicion, each side stressed the importance of the collegial atmosphere in Havana that included long working lunches and a dinner together.

“Look at my face,” Machin said, smiling. “It reflects the spirit in which we’ve been talking up ’til now.”

© 2015 The Associated Press. All Rights Reserved.

William Blum

Official website of the author, historian, and U.S. foreign policy critic.

The Anti-Empire Report #136

By William Blum – Published January 20th, 2015

138

Murdering journalists … them and us

After Paris, condemnation of religious fanaticism is at its height. I’d guess that even many progressives fantasize about wringing the necks of jihadists, bashing into their heads some thoughts about the intellect, about satire, humor, freedom of speech. We’re talking here, after all, about young men raised in France, not Saudi Arabia.

Where has all this Islamic fundamentalism come from in this modern age? Most of it comes – trained, armed, financed, indoctrinated – from Afghanistan, Iraq, Libya, and Syria. During various periods from the 1970s to the present, these four countries had been the most secular, modern, educated, welfare states in the Middle East region. And what had happened to these secular, modern, educated, welfare states?

In the 1980s, the United States overthrew the Afghan government that was progressive, with full rights for women, believe it or not   , leading to the creation of the Taliban and their taking power.

In the 2000s, the United States overthrew the Iraqi government, destroying not only the secular state, but the civilized state as well, leaving a failed state.

In 2011, the United States and its NATO military machine overthrew the secular Libyan government of Muammar Gaddafi, leaving behind a lawless state and unleashing many hundreds of jihadists and tons of weaponry across the Middle East.

And for the past few years the United States has been engaged in overthrowing the secular Syrian government of Bashar al-Assad. This, along with the US occupation of Iraq having triggered widespread Sunni-Shia warfare, led to the creation of The Islamic State with all its beheadings and other charming practices.

However, despite it all, the world was made safe for capitalism, imperialism, anti-communism, oil, Israel, and jihadists. God is Great!

Starting with the Cold War, and with the above interventions building upon that, we have 70 years of American foreign policy, without which – as Russian/American writer Andre Vltchek has observed – “almost all Muslim countries, including Iran, Egypt and Indonesia, would now most likely be socialist, under a group of very moderate and mostly secular leaders”.   Even the ultra-oppressive Saudi Arabia – without Washington’s protection – would probably be a very different place.

On January 11, Paris was the site of a March of National Unity in honor of the magazine Charlie Hebdo, whose journalists had been assassinated by terrorists. The march was rather touching, but it was also an orgy of Western hypocrisy, with the French TV broadcasters and the assembled crowd extolling without end the NATO world’s reverence for journalists and freedom of speech; an ocean of signs declaring Je suis Charlie … Nous Sommes Tous Charlie; and flaunting giant pencils, as if pencils – not bombs, invasions, overthrows, torture, and drone attacks – have been the West’s weapons of choice in the Middle East during the past century.

No reference was made to the fact that the American military, in the course of its wars in recent decades in the Middle East and elsewhere, had been responsible for the deliberate deaths of dozens of journalists. In Iraq, among other incidents, see Wikileaks’ 2007 video of the cold-blooded murder of two Reuters journalists; the 2003 US air-to-surface missile attack on the offices of Al Jazeera in Baghdad that left three journalists dead and four wounded; and the American firing on Baghdad’s Hotel Palestine the same year that killed two foreign cameramen.

Moreover, on October 8, 2001, the second day of the US bombing of Afghanistan, the transmitters for the Taliban government’s Radio Shari were bombed and shortly after this the US bombed some 20 regional radio sites. US Defense Secretary Donald Rumsfeld defended the targeting of these facilities, saying: “Naturally, they cannot be considered to be free media outlets. They are mouthpieces of the Taliban and those harboring terrorists.”

And in Yugoslavia, in 1999, during the infamous 78-day bombing of a country which posed no threat at all to the United States or any other country, state-owned Radio Television Serbia (RTS) was targeted because it was broadcasting things which the United States and NATO did not like (like how much horror the bombing was causing). The bombs took the lives of many of the station’s staff, and both legs of one of the survivors, which had to be amputated to free him from the wreckage.

I present here some views on Charlie Hebdo sent to me by a friend in Paris who has long had a close familiarity with the publication and its staff:

“On international politics Charlie Hebdo was neoconservative. It supported every single NATO intervention from Yugoslavia to the present. They were anti-Muslim, anti-Hamas (or any Palestinian organization), anti-Russian, anti-Cuban (with the exception of one cartoonist), anti-Hugo Chávez, anti-Iran, anti-Syria, pro-Pussy Riot, pro-Kiev … Do I need to continue?

“Strangely enough, the magazine was considered to be ‘leftist’. It’s difficult for me to criticize them now because they weren’t ‘bad people’, just a bunch of funny cartoonists, yes, but intellectual freewheelers without any particular agenda and who actually didn’t give a fuck about any form of ‘correctness’ – political, religious, or whatever; just having fun and trying to sell a ‘subversive’ magazine (with the notable exception of the former editor, Philippe Val, who is, I think, a true-blooded neocon).”

Dumb and Dumber

Remember Arseniy Yatsenuk? The Ukrainian whom US State Department officials adopted as one of their own in early 2014 and guided into the position of Prime Minister so he could lead the Ukrainian Forces of Good against Russia in the new Cold War?

In an interview on German television on January 7, 2015 Yatsenuk allowed the following words to cross his lips: “We all remember well the Soviet invasion of Ukraine and Germany. We will not allow that, and nobody has the right to rewrite the results of World War Two”.

The Ukrainian Forces of Good, it should be kept in mind, also include several neo-Nazis in high government positions and many more partaking in the fight against Ukrainian pro-Russians in the south-east of the country. Last June, Yatsenuk referred to these pro-Russians as “sub-humans”   , directly equivalent to the Nazi term “untermenschen”.

So the next time you shake your head at some stupid remark made by a member of the US government, try to find some consolation in the thought that high American officials are not necessarily the dumbest, except of course in their choice of who is worthy of being one of the empire’s partners.

The type of rally held in Paris this month to condemn an act of terror by jihadists could as well have been held for the victims of Odessa in Ukraine last May. The same neo-Nazi types referred to above took time off from parading around with their swastika-like symbols and calling for the death of Russians, Communists and Jews, and burned down a trade-union building in Odessa, killing scores of people and sending hundreds to hospital; many of the victims were beaten or shot when they tried to flee the flames and smoke; ambulances were blocked from reaching the wounded … Try and find a single American mainstream media entity that has made even a slightly serious attempt to capture the horror. You would have to go to the Russian station in Washington, DC, RT.com, search “Odessa fire” for many stories, images and videos. Also see the Wikipedia entry on the 2 May 2014 Odessa clashes.

If the American people were forced to watch, listen, and read all the stories of neo-Nazi behavior in Ukraine the past few years, I think they – yes, even the American people and their less-than-intellectual Congressional representatives – would start to wonder why their government was so closely allied with such people. The United States may even go to war with Russia on the side of such people.

L’Occident n’est pas Charlie pour Odessa. Il n’y a pas de défilé à Paris pour Odessa.

Some thoughts about this thing called ideology

Norman Finkelstein, the fiery American critic of Israel, was interviewed recently by Paul Jay on The Real News Network. Finkelstein related how he had been a Maoist in his youth and had been devastated by the exposure and downfall of the Gang of Four in 1976 in China. “It came out there was just an awful lot of corruption. The people who we thought were absolutely selfless were very self-absorbed. And it was clear. The overthrow of the Gang of Four had huge popular support.”

Many other Maoists were torn apart by the event. “Everything was overthrown overnight, the whole Maoist system, which we thought [were] new socialist men, they all believed in putting self second, fighting self. And then overnight the whole thing was reversed.”

“You know, many people think it was McCarthy that destroyed the Communist Party,” Finkelstein continued. “That’s absolutely not true. You know, when you were a communist back then, you had the inner strength to withstand McCarthyism, because it was the cause. What destroyed the Communist Party was Khrushchev’s speech,” a reference to Soviet premier Nikita Khrushchev’s 1956 exposure of the crimes of Joseph Stalin and his dictatorial rule.

Although I was old enough, and interested enough, to be influenced by the Chinese and Russian revolutions, I was not. I remained an admirer of capitalism and a good loyal anti-communist. It was the war in Vietnam that was my Gang of Four and my Nikita Khrushchev. Day after day during 1964 and early 1965 I followed the news carefully, catching up on the day’s statistics of American firepower, bombing sorties, and body counts. I was filled with patriotic pride at our massive power to shape history. Words like those of Winston Churchill, upon America’s entry into the Second World War, came easily to mind again – “England would live; Britain would live; the Commonwealth of Nations would live.” Then, one day – a day like any other day – it suddenly and inexplicably hit me. In those villages with the strange names there were people under those falling bombs, people running in total desperation from that god-awful machine-gun strafing.

This pattern took hold. The news reports would stir in me a self-righteous satisfaction that we were teaching those damn commies that they couldn’t get away with whatever it was they were trying to get away with. The very next moment I would be struck by a wave of repulsion at the horror of it all. Eventually, the repulsion won out over the patriotic pride, never to go back to where I had been; but dooming me to experience the despair of American foreign policy again and again, decade after decade.

The human brain is an amazing organ. It keeps working 24 hours a day, 7 days a week, and 52 weeks a year, from before you leave the womb, right up until the day you find nationalism. And that day can come very early. Here’s a recent headline from the Washington Post: “In the United States the brainwashing starts in kindergarten.”

Oh, my mistake. It actually said “In N. Korea the brainwashing starts in kindergarten.”

Let Cuba Live! The Devil’s List of what the United States has done to Cuba

On May 31, 1999, a lawsuit for $181 billion in wrongful death, personal injury, and economic damages was filed in a Havana court against the government of the United States. It was subsequently filed with the United Nations. Since that time its fate is somewhat of a mystery.

The lawsuit covered the 40 years since the country’s 1959 revolution and described, in considerable detail taken from personal testimony of victims, US acts of aggression against Cuba; specifying, often by name, date, and particular circumstances, each person known to have been killed or seriously wounded. In all, 3,478 people were killed and an additional 2,099 seriously injured. (These figures do not include the many indirect victims of Washington’s economic pressures and blockade, which caused difficulties in obtaining medicine and food, in addition to creating other hardships.)

The case was, in legal terms, very narrowly drawn. It was for the wrongful death of individuals, on behalf of their survivors, and for personal injuries to those who survived serious wounds, on their own behalf. No unsuccessful American attacks were deemed relevant, and consequently there was no testimony regarding the many hundreds of unsuccessful assassination attempts against Cuban President Fidel Castro and other high officials, or even of bombings in which no one was killed or injured. Damages to crops, livestock, or the Cuban economy in general were also excluded, so there was no testimony about the introduction into the island of swine fever or tobacco mold.

However, those aspects of Washington’s chemical and biological warfare waged against Cuba that involved human victims were described in detail, most significantly the creation of an epidemic of hemorrhagic dengue fever in 1981, during which some 340,000 people were infected and 116,000 hospitalized; this in a country which had never before experienced a single case of the disease. In the end, 158 people, including 101 children, died.   That only 158 people died, out of some 116,000 who were hospitalized, was an eloquent testimony to the remarkable Cuban public health sector.

The complaint describes the campaign of air and naval attacks against Cuba that commenced in October 1959, when US president Dwight Eisenhower approved a program that included bombings of sugar mills, the burning of sugar fields, machine-gun attacks on Havana, even on passenger trains.

Another section of the complaint described the armed terrorist groups, los banditos, who ravaged the island for five years, from 1960 to 1965, when the last group was located and defeated. These bands terrorized small farmers, torturing and killing those considered (often erroneously) active supporters of the Revolution; men, women, and children. Several young volunteer literacy-campaign teachers were among the victims of the bandits.

There was also of course the notorious Bay of Pigs invasion, in April 1961. Although the entire incident lasted less than 72 hours, 176 Cubans were killed and 300 more wounded, 50 of them permanently disabled.

The complaint also described the unending campaign of major acts of sabotage and terrorism that included the bombing of ships and planes as well as stores and offices. The most horrific example of sabotage was of course the 1976 bombing of a Cubana airliner off Barbados in which all 73 people on board were killed. There were as well as the murder of Cuban diplomats and officials around the world, including one such murder on the streets of New York City in 1980. This campaign continued to the 1990s, with the murders of Cuban policemen, soldiers, and sailors in 1992 and 1994, and the 1997 hotel bombing campaign, which took the life of a foreigner; the bombing campaign was aimed at discouraging tourism and led to the sending of Cuban intelligence officers to the US in an attempt to put an end to the bombings; from their ranks rose the Cuban Five.

To the above can be added the many acts of financial extortion, violence and sabotage carried out by the United States and its agents in the 16 years since the lawsuit was filed. In sum total, the deep-seated injury and trauma inflicted upon on the Cuban people can be regarded as the island’s own 9-11.

By A. Shaw

Today, in 2015, there must be at least 5000 brands of anarchism. Some of these brands attack the proletariat from the Left and others from Right. Leftwing anarchism was the first ideological current that substituted intrigue, splitting of sects, and rampant sectarianism for political struggle.

Leftwing anarchism abstains from political struggle, but wallows in sectarianism.

Now, 120 years after Engels’ death, Bakunin’s brand of anarchism, with certain minor modifications, still exemplifies leftwing anarchism.

THE MAIN EVIL

“As for Bakunin, the state is the main evil, nothing must be done which can maintain the existence of any state, whether it be a republic, a monarchy or whatever it may be,” Engels writes in a Jan.1872 letter to Theodor Cuno.

To anarchism, the form of the state — that is, “a republic, a monarchy or whatever it may be” — does not alter the evil character of the state. Moreover, to anarchism, the content of the state — that is, whether it be a slaveholding state, a feudalist state, bourgeois state, or proletarian state — does not alter the evil character of the state.

The state is evil, the anarchist insists. Case closed.

The regime in the USA has a democratic form, and bourgeois content. The regime in Saudi Arabia has monarchical form and bourgeois content. The government of North Korea has monarchical form and proletarian content. The government of Cuba has democratic form [based on multi-candidate elections — not multi-party elections – at the municipal level] and a proletarian content.

Form reveals HOW state power is exercised and is often laid out in the constitution of the state.

Content tells us WHO or what social class chiefly exercises state power and for whom is power chiefly exercised.

The anarchist condemns the state as the “main evil” whatever its form and content, so nothing must be done to maintain or defend the existence of any state.

Anarchism and Marxism agree that the state is the organized power of one class for oppressing or holding down another, as Marx and Engels argue in the Communist Manifesto.

In others words, the principle function of a state, regardless of form, is oppression. Again, this is common ground between Marxism and anarchism.

In ancient Greece, the so-called master class oppressed the class of slaves, using the slaveholding state as an instrument of oppression whether the regime’s form was democratic or undemocratic. During the feudalist era, the landowners oppressed peasants, using the feudalist state. In bourgeois society, the capitalist class oppresses or holds down the working class, using the bourgeois state, no matter how democratic is the form of the state. In a socialist society, the working class uses the proletarian state, which may be either democratic or undemocratic to hold down the bourgeoisie ousted from power by revolution.

Of course, communism, which follows socialism by hundreds of years, gradually makes the state superfluous. Classes based on relations to the means of production and income disparities begin to die out. The state, which oppresses classes, withers away as these classes fade away.

COMPLETE ABSTENTION

Engels writes “Hence therefore complete abstention from all politics. To perpetrate a political action, and especially to take part in an election, would be a betrayal of principle …  To preach that the workers should in all circumstances abstain from politics is to drive them into the arms of the priests or the bourgeois republicans.”

The principle, above, to which Engels refers is the anarchist principle of political abstention. This is the benchmark principle of anarchism.

In the mid-term U.S. elections of 2014, the abstention of the working and middle classes reached astounding proportions and bourgeois reactionaries grew more powerful in the bourgeois state which oppresses other classes.

Engels calls the Left anarchist a swindler when the Left anarchist urges workers to drop out of the political struggle.

Engels says something like you can fool workers sometimes but not all of the time, here “But the mass of the workers will never allow themselves to be persuaded that the public affairs of their country are not also their own affairs; they are by nature political and whoever tries to make out to them that they should leave politics alone will in the end get left in the lurch.”

If anarchist identity is determined by political inactivity rather than anarchist consciousness and theory, then anarchism may be the largest tendency within the U.S. working class.

THE MECHANICS OF THE ANARCHIST SWINDLE

Let’s assume a race between candidate A and candidate B for some office.

Let’s further assume you support candidate A.

There are two ways you can help candidate A:

(1) give support directly to candidate A or

(2) block support going to candidate B

No. (1) — that is, give support directly to candidate A  — is the politics of participation

No. (2) — that is, block support going to candidate B  –  is the politics of abstention

Let’s assume you argue that you are evenhanded between candidate A and B because you urge voters and operatives not to support either candidate.

Say a constituency votes 90% for a candidate like B [e.g., like in some African American districts] and 10% for a candidate like A.

If the leftwing anarchist persuades voters and volunteers to abstain, candidate B will suffer a blow nine times harder than his opponent.

That is not evenhanded. That is two-faced.

HEAP ABUSE UPON THE STATE

What does the anarchist do while he abstains from politics?

“The thing to do is to conduct propaganda, heap abuse upon the state, organize until all workers are won over …,” Engels says about the anarchist.

In other words, the anarchist talks as he waits.

When it comes to conducting propaganda against the state, many anarchists are phenomenal. Many of them have a knack.

When either the ruling bourgeoisie [e.g., USA] or the ruling proletariat [e.g., Cuba] exercises state power in the wrong way, anarchists have a knack of finding out what happened and making propaganda about the transgression.

A presupposition of anarchist propaganda is: If there were no state, then state power could not be exercised in the wrong way.

AUTHORITY

According to Engels, anarchist society will not tolerate authority.

“In this society there will above all be no authority, for authority = state = an absolute evil. (How these people propose to run a factory, work a railway or steer a ship without having in the last resort one deciding will, without a unified direction, they do not indeed tell us.) The authority of the majority over the minority also ceases. Every individual and every community is autonomous, but as to how a society, even of only two people, is possible unless each gives up some of his autonomy, Bakunin again remains silent,” Engels writes.

Apparently, anarchists believe the state is the main evil or the absolute evil because the state has more authority than other institutions.

So, “every individual and every community is autonomous.” This proposition has generated thousands of intrigues, splits, and savage sectarianism within the anarchist movement.

“Every individual … is autonomous.” is a favorite proposition of rightwing anarchism.

“Even if this authority is voluntarily bestowed it must cease simply because it is authority,” Engels observes

CONCLUSIONS

Anarchists want to abolish the state today. Marxists are willing to wait hundreds of years for the state to wither away.

Both anarchists and Marxists believe the state, even in a democratic form, is an instrument by which one class oppresses another.

Anarchists want to abstain from the struggle for power. Marxists struggle for power.

Anarchists say nasty things about the ruling class whether it is bourgeois or proletariat. Marxists truthfully defend the proletarian state.

Anarchists are intolerant of authority. Marxists greatly uses authority, especially during socialism, the stage of development between capitalism and communism.

“Here you have in brief the main points of the swindle,” Engel writes.

By swindle, Engels means anarchism.

AfricaFocus Bulletin
January 21, 2015 (150121)
(Reposted from sources cited below)

Editor’s Note

Media coverage of the Ebola epidemic, which took a sharp downward
turn after a handful of patients in the United States recovered, has
faded even further into the background as the battle against the
epidemic has begun to succeed in the most-affected countries. But
those on the front lines warn that complacency could easily allow
the still-present virus to hold out and even expand. And although
there are clear lessons to be learned, there are also unanswered
questions, most notably about international will to implement the
imperative of sustainable health systems for the future.

For a version of this Bulletin in html format, more suitable for
printing, go to http://www.africafocus.org/docs15/who1501.php, and
click on “format for print or mobile.”

To share this on Facebook, click on
https://www.facebook.com/sharer/sharer.php?u=http://www.africafocus.org/docs15/who1501.php

A 14-part report from the World Health Organization provides a rich
analysis of lessons learned and of measures needed for ending the
epidemic this year. But it also leaves many questions unanswered,
and some unasked. In particular, it does not address the fundamental
question of the failure of international agencies as well as
national governments to invest in sustainable health systems, a
factor that everyone agrees was a fundamental cause of vulnerability
(see “Sierra Leone: Losing Out” at
http://www.africafocus.org/docs15/sl1501.php).
And, while the UN and the United States have joined in calls for the
IMF to cancel debts of the most-affected countries, to assist in
their recovery, this proposal has not yet been acted on.

Among many valuable lessons covered in the WHO report is the
essential role of community involvement in changing behaviors to
block transmission channels for the virus (such as safe as well as
culturally appropriate burial practices). Another is the success of
several West African countries (Nigeria, Senegal, and Mali) in
implementing rapid response to the threat, with isolation,
treatment, and case tracking.

This AfricaFocus Bulletin contains excerpts from the last chapter of
the report, focused on what needs to be done in 2015. The full
report (http://www.who.int/csr/disease/ebola/en/) is essential
reading for anyone seeking a deeper analysis than in the sparse
ongoing news coverage. It includes chapters analyzing the evolution
of the epidemic in Liberia, Sierra Leone, and Guinea, as well as the
contrasting case of successful containment in the Democratic
Republic of the Congo.

Among the key questions posed but left unanswered by the WHO report
is the sharp differential in survival rates with treatment in
developed countries versus treatment in the most-affected countries.
As the report notes, this is a practical as well as an ethical
question, since people will not go to treatment centers unless they
have some hope of survival.

The ethics of this is clear, as stressed by Paul Farmer in a recent
op-ed in the Washington Post. Everyone deserves the same standard
care known to be effective in developed countries. Evidence from
several treatment centers in the affected countries shows this must
include intravenous as well as oral rehydration, as well as other
elements of “supportive care.” The unanswered question is whether
the implicit double standard will be abandoned, and adequate
resources allocated by the international community to implement
standard care both in the response in 2015 and in future epidemics.

Paul Farmer, “The secret to curing West Africa from Ebola is no
secret at all,” Washington Post, Jan 16, 2015
http://tinyurl.com/m4j6tk2
Survival rates from Ebola are high when people receive supportive
care that has been standard for cases of Ebola in rich countries and
foreign medical workers airlifted out. “What we need — what we’ve
always needed — to improve survival in West Africa is the capacity
to safely deliver excellent supportive care.”

Peter Piot in BBC article, Jan 21 “My concern is that when [the
Ebola outbreak] is over we will just forget about it. We need to be
better prepared and we need to invest in vaccines and treatment.
It’s like a fire brigade – you don’t start to set up a fire brigade
when some house is on fire.”
http://www.bbc.com/news/business-30907630

For a set of general talking points and previous AfricaFocus
Bulletins on health issues, visit
http://www.africafocus.org/intro-health.php

++++++++++++++++++++++end editor’s note+++++++++++++++++

Ebola response: What needs to happen in 2015

[Excerpts: full text available at
http://www.who.int/csr/disease/ebola/en/]

…

The four biggest lessons from 2014

First, countries with weak health systems and few basic public
health infrastructures in place cannot withstand sudden shocks,
whether these come from a changing climate or a runaway virus. Under
the weight of Ebola, health systems in Guinea, Liberia and Sierra
Leone collapsed. People stopped receiving — or stopped seeking —
health care for other diseases, like malaria, that cause more deaths
yearly than Ebola.

In turn, the severity of the disease, compounded by fear within and
beyond the affected countries, caused schools, markets, businesses,
airline and shipping routes, and borders to close. Tourism shut
down, further deepening the blow to struggling economies. What began
as a health crisis snowballed into a humanitarian, social, economic
and security crisis. In a world of radically increased
interdependence, the consequences were felt globally.

The evolution of the crisis underscored a point often made by WHO:
fair and inclusive health systems are a bedrock of social stability,
resilience and economic health. Failure to invest in these
fundamental infrastructures leaves countries with no backbone to
stand up under the weight of the shocks that this century is
delivering with unprecedented frequency.

Second, preparedness, including a high level of vigilance for
imported cases and a readiness to treat the first confirmed case as
a national emergency, made a night-and-day difference. Countries
like Nigeria, Senegal and Mali that had good surveillance and
laboratory support in place and took swift action were able to
defeat the virus before it gained a foothold.

Third, no single control intervention is, all by itself,
sufficiently powerful to bring an Ebola epidemic of this size and
complexity under control. All control measures must work together
seamlessly and in unison. If one measure is weak, others will
suffer.

Aggressive contact tracing will not stop transmission if contacts
are left in the community for several days while test results are
awaited. Good treatment may encourage more patients to seek medical
care, but will not stop community-wide transmission in the absence
of rapid case detection and safe burials. In turn, the powers of
rapid case detection and rapid diagnostic confirmation are
diminished in the absence of facilities for prompt isolation. As
long as transmission occurs in the community, medical staff
following strict protocols for infection prevention and control in
clinics will be only partially protected.

Finally, community engagement is the one factor that underlies the
success of all other control measures. It is the linchpin for
successful control. Contact tracing, early reporting of symptoms,
adherence to recommended protective measures, and safe burials are
critically dependent on a cooperative community. Having sufficient
facilities and staff in place is not enough. In several areas,
communities continued to hide patients in homes and bury bodies
secretly even when sufficient treatment beds and burial teams were
available. Experience also showed that quarantines will be violated
or dissolve into violence if affected communities are given no
incentives to comply.

An epidemic with two causes

The persistence of infections throughout 2014 had two causes. The
first was a lethal, tenacious and unforgiving virus. The second was
the fear and misunderstanding that fuelled high-risk behaviours. As
long as these high-risk beliefs and behaviours continue, the virus
will have an endless source of opportunities to exploit, blunting
the power of control measures and deepening its grip. Like the
populations in the three countries, the virus will remain constantly
on the move.

Getting to zero means fencing the virus into a shrinking number of
places where all transmission chains are known and aggressively
attacked until they break. It also means working within the existing
context of cultural beliefs and practices and not against them. As
culture always wins, it needs to be embraced, not aggravated, as WHO
aimed to do with its protocol on safe and dignified burials.

A more strategic emergency response

As the new year began, a revised response that builds on accumulated
experiences was mapped out by WHO. This new response plan adopts
what has been shown to work but also sets out new strategies
designed to seize all opportunities for getting the number of cases
down to zero.

Community resistance must be tackled by all outbreak responders with
the greatest urgency. Concrete guidance on ways of doing this is
likely to emerge from an analysis of Sierra Leone’s Western Area
Surge, which included several strategies for engaging communities
and responding to their concerns. As was learned during 2014,
community leaders, including religious leaders as well as tribal
chiefs, can play an especially persuasive role in reducing high-risk
behaviours.

Apart from low levels of community understanding and cooperation,
contact tracing is considered the weakest of all control measures.
Its poor performance likewise needs to be addressed with the
greatest urgency. For example, in Guinea, which has the most
reliable data, only around 30% of newly identified cases appear on
contact lists. In all three countries, the number of registered
contacts for confirmed cases is too low. In Sierra Leone, some lists
of contacts include family members only, and no one from the wider
community.

As the year evolved, outbreak responders learned the importance of
tailoring response strategies to match distinct needs at district
and sub-district levels. An understanding of transmission dynamics
at the local level usually reveals which control measures are
working effectively and which ones need improvement. Doing so
requires better district-level data and, above all, better
coordination. The outbreaks will not be contained by a host of
vertical programmes operating independently. Again, all control
measures must work seamlessly and in unison.

At year end, as cases flared up in new areas or moved from urban to
rural settings, a clear need emerged for rapid response teams and
for agile and flexible strategies that can change direction — and
location — quickly. In WHO’s assessment, all three countries now
have sufficient numbers of treatment beds and burial teams, but
these are not always located where they are most needed. As was also
learned during 2014, transporting patients over long distances for
treatment does not work, either for families and communities or in
terms of its impact on transmission.

As long as logistical problems persist, community confidence in the
response will remain low. People cannot be expected to do as they
are told if the effort leaves them visibly worse off — quarantined
without food, sleeping in the same room with a corpse for days —
instead of better off. These problems are compounded by poor road
systems and weak telecommunications in all three countries. In
Liberia, for example, health officials in rural areas are lucky if
they have an hour or two of internet connectivity per week. This
weakness defeats rapid communication of suspected cases, test
results and calls for help, thus ensuring that response efforts
continue to run behind a virus that seizes every opportunity to
infect more people.

A decentralized strategy — and an ethical imperative

As the response decentralizes to the subnational level, fully
functional emergency operations centres, with local government
health teams integrated and playing a leadership role, must be
established in each county, district and prefecture in the three
countries. These centres will drive the step-change in field
epidemiology capacity needed to achieve high-quality surveillance,
rapid and complete case-finding, and comprehensive contact tracing
— the fundamental requirements for getting to zero.

A decentralized response also demands urgent attention to well-known
gaps and failures in collecting, collating, managing and rapidly
sharing information on cases, laboratory results and contacts.
Understanding and tackling the drivers of transmission in each area
call for enhanced case investigation and analytical epidemiology.
Tools for collecting and sharing this information need to be
standardized and put into routine use by governments and their
partners.

Another major problem is the unacceptably large difference in case
fatality rates between people who receive care in affected countries
(71%) and foreign medical staff (26%) who were evacuated for
specialized treatment in well-resourced countries. Getting case
fatality down in affected countries is an ethical imperative.

Innovation needs to be encouraged, publicized, tested and funnelled
into control strategies whenever appropriate. Mali used medical
students with training in epidemiology to rapidly increase the
number of contact tracers. Guinea drew on its corps of young and
talented doctors to strengthen its outbreak response, with training
provided by WHO epidemiologists. These staff know the country and
its culture best. They will still be there long after foreign
medical teams leave.

In Sierra Leone, the government-run Hastings Ebola Treatment Centre,
a 123-bed facility entirely operated by local staff, has defied
statistics elsewhere in the country with its survival rates. Six out
of every 10 patients treated there make a full recovery. As noted by
an infection control specialist working on the wards, the only
patients that cannot be saved are those who wait too long to seek
care. After noting that Ebola virus disease has some similarities
with cholera, staff at the facility made intravenous administration
of replacement fluids a mainstay of the routine treatment protocol.

The pattern of transmission seen throughout 2014 makes a final
conclusion obvious: cross-border coordination is essential. Given
West Africa’s exceptionally mobile populations, no country can get
cases down to zero as long as transmission is ongoing in its
neighbours.

Prevent outbreaks in unaffected countries

With the increasing number of cases and infected prefectures in
Guinea, the risk of new importations to neighbouring countries is
also growing. In terms of preparedness, the most urgent need is for
active surveillance in the areas bordering Mali, Senegal, Guinea-
Bissau and Cote d’Ivoire, through the deployment of additional human
and material resources, and the introduction of standard performance
monitoring and reporting on a weekly basis.

Improvements in contact tracing and monitoring in the second phase
of the response provide an opportunity to substantially enhance the
efficacy of exit screening. Doing so further reduces the risk of new
Ebola exportations from affected areas. As contact tracing improves,
lists of active contacts could be systematically shared with border
and airport authorities to link this information with exit
screening.

Get health systems functioning again — on a more resilient footing

Much debate has focused on the importance of strengthening health
systems, which were weak before the outbreaks started and then
collapsed under their weight. In large parts of all three countries,
health services have disintegrated to the point that essential care
is either unavailable or not sought because of fear of Ebola
contagion.

As some have argued, cases will decrease fastest when a well-
functioning health system is in place. That argument also points to
the need to restore public confidence — which was never high — in
the public health system. Targeted drug-delivery campaigns that
aimed to treat and prevent malaria were well-received by the public
and are a step in the right direction, but much more needs to be
done.

Although virtually no good systems for civil registration and vital
statistics are still functioning in the three countries, indirect
evidence suggests that childhood deaths from malaria have eclipsed
Ebola deaths. Liberia, for example, had around 3500 malaria cases
each month prior to the outbreak, with around half of these cases,
mainly young children, dying. An immediate strengthening of health
systems could reduce these and many other deaths, while also
restoring confidence that health facilities can protect health and
heal disease.

Others argue that efforts must stay sharply focused on outbreak
containment. As this argument goes, response capacity is limited and
must not be distracted. This argument favours a step-wise approach
that initially concentrates on strengthening those health system
capacities, like surveillance and laboratory services, that can have
a direct impact on outbreak containment.

For its part, WHO sees a need to change past thinking about the way
health systems are structured. As the Ebola epidemic has shown,
capacities to detect emerging and epidemic-prone diseases early and
mount an adequate response need to be an integral part of a well-
functioning health system. Outbreak-related capacities should not be
regarded as a luxury or added as an afterthought. Otherwise, the
security of all health services is placed in jeopardy.

Step up research

Research aimed at introducing new medical products needs to continue
at its current accelerated pace. Executives in the R&D-based
pharmaceutical industry have expressed their view that all candidate
vaccines must be pursued “until they fail”. They have further agreed
that the world must never again be taken by surprise, left to
confront a lethal disease with no modern control tools in hand.

New tools will likely be needed to get to zero. For example,
vaccines to protect health care workers may make it easier to
increase the numbers of foreign and national medical staff. Better
therapies — and improved prospects of survival — may encourage
more patients to promptly seek medical care, greatly increasing
their prospects of survival.

…

Mine every success story

Operational research is needed to understand why some areas have
stopped or dramatically reduced transmission while others, including
some in the same vicinity and with similar population profiles,
remain hotspots of intense transmission.

Did the striking and robust declines in Lofa County, Liberia, and
Kailahun and Kenema districts in Sierra Leone occur because
devastated populations learned first-hand which behaviours carried a
high risk and changed them? Or can the declines be attributed to
simultaneous and seamless implementation of the full package of
control measures, as happened in Lofa country? Answers to these
questions will help refine control strategies.

Research is also needed to determine how areas that have achieved
zero transmission can be protected from re-reinfection. Some success
stories look real and robust, but these are only pockets of low or
zero transmission in a broad cloak of contamination.

At every opportunity, strategies devised for the emergency response
should be made to work to build basic health capacities as well.
Some success stories can serve as models.

Liberia demonstrated how quickly the quality of data and reporting
can improve, thus strongly supporting the strategic targeting of
control measures at district and sub-district levels.

Sierra Leone showed how laboratory services can be strengthened and
expanded, reducing waiting times for test results close to what is
seen in countries with advanced health systems while also supporting
the better clinical management of cases.

Each and every survivor is also a success story. In an effort to
fight the stigma that so often haunts these people, many treatment
centres hold celebratory ceremonies when survivors are released from
treatment. Each is given a certificate as proof that they pose no
risk to families or communities.

Get the incentives — and support — right

Both foreign and domestic medical staff have worked in the shadows
of death, placing their lives at risk to save the lives of others.
In many places, these staff also risked losing their standing in
communities, given the fear and stigma attached to anything or
anyone associated with Ebola.

These people deserve to be honoured and respected. They also deserve
to be paid on time and given safe places to work. Timely and
appropriate payment to national staff remains problematic. More
studies are currently under way to identify the circumstances under
which health care workers continue to get infected.

Special efforts are also needed to improve safety at private health
facilities, in pharmacies, and among traditional healers, as
evidence suggests the risk of transmission is highest in these
settings. The number of hospitals that remain closed or virtually
empty supports the conclusion that doctors and nurses are most
likely getting infected while treating patients in community
settings.

Incentives also need to be in place to ensure that foreign medical
teams stay in countries long enough to understand conditions,
including political and social as well as operational issues, and
pass on this knowledge to replacement staff. Towards the end of the
year, WHO ensured that its field coordinators stayed in countries
for several months.

The “post-Ebola syndrome”

Given the fear and stigma associated with Ebola, people who survive
the disease, especially women and orphaned children, need
psychosocial support and counselling services as well as material
support. They may need medical support as well. A number of symptoms
have been documented in what is increasingly recognized as a “post-
Ebola syndrome”.

Efforts are now under way to understand why these symptoms persist,
how they can best be managed, whether they are caused by the
disease, and whether they might be linked to treatment or the heavy
use of disinfectants. WHO staff have developed an assessment tool
that is being used to investigate these issues further.

Maintain unwavering commitment at national and international levels

Media coverage of the Ebola crisis peaked in August, when two
American missionaries and a British nurse became infected in West
Africa and were medically evacuated for treatment in their home
countries. Coverage increased dramatically in October, when the USA
and Spain confirmed their first locally transmitted cases.

…

Although the situation in Liberia at year end, especially in
Monrovia, looked promising, optimism must remain cautious. As
experiences in Guinea made clear, this is a virus that can go into
hiding for some weeks, only to return again with a vengeance. In
Liberia, as caseloads declined, evidence of complacency and “Ebola
fatigue” rapidly appeared in some populations even though
transmission continued.

The three countries will continue to need international support for
some time to come, whether in the form of direct support for
response measures or assistance in rebuilding their health services.
Countries and the international community must brace themselves for
the long-haul.

One overarching question hangs in the air. The virus has
demonstrated its tenacity time and time again. Will national and
international control efforts show an equally tenacious staying
power?

*****************************************************

AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with a
particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.

AfricaFocus Bulletin can be reached at africafocus@igc.org. Please
write to this address to subscribe or unsubscribe to the bulletin,
or to suggest material for inclusion. For more information about
reposted material, please contact directly the original source
mentioned. For a full archive and other resources, see
http://www.africafocus.org

Statement from the Ministry of Public Health