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Send in the Clowns

Global guidelines become necessary when problems cross borders. 

by Dr. Ruwantissa Abeyratne in Montreal

But where are the clowns?

There ought to be clowns.

Quick send in the clowns

~ From the song “Send in the Clowns” by Stephen Sondheim

The song “Send in the Clowns,” is not about clowns at all.  It is a song from a musical called “a Little Night Music” in which clowns are a metaphor for a tragicomic moment in a play when things are disintegrating, and someone comes up with a few jokes to veer the audience from the disarray and chaos.   We are at a juncture when things are seemingly falling apart.  We need a few jokes to take our minds off what’s going on.  

One of the definitions of a “joke” given by the Merriam-Webster Dictionary is “the humorous or ridiculous element in something” and it is in this context that this article is presented. This is hardly the time for us to see the humorous and ridiculous side of things as the 20th of January heralds both an auspicious day and the beginning of an era of hope when the 46th President of the United States is sworn in, bringing with it the promise of global cooperation and sensibility. 

 Now that vaccinations have arrived, it is seemingly ridiculous that we cannot agree globally on how they are to be administered. Reuters report that the Director General of the World Health Organization Tedros Adhanom Ghebreyesus has issued a serious warning that the world is on the brink of “catastrophic moral failure” in sharing COVID-19 vaccines. He “urges is urging countries and manufacturers to spread doses more fairly around the world”. According to the Head of WHO, the prospects for equitable distribution which were at “serious risk” just as its COVAX vaccine-sharing scheme meant to start distributing inoculations next month.  Dr. Ghebreyesus criticized the “me first” attitude reflected by many countries through 44 bilateral agreements signed in 2020 and 12 such agreements already signed in January this year.

Added to this fiasco is the feckless ambivalence of economic, political, medical and health policies adopted by various countries that leave citizens as well as health care workers and teachers bewildered.  Just one example is the Public Charge Rule adopted by the United States.  As Medha D. Makhlouf & Jasmine Sandhu write in The Northwestern University Law Review, “On February 24, 2020, just as the Trump Administration began taking significant action to prepare for an outbreak of COVID-19 in the United States, it also began implementing its new public charge rule. Public charge is an immigration law that restricts the admission of certain noncitizens based on the likelihood that they will become dependent on the government for support. A major effect of the new rule is to chill noncitizens from enrolling in public benefits, including Medicaid, out of fear of negative immigration consequences. These chilling effects have persisted during the pandemic. When noncitizens are afraid to (1) seek treatment or testing for COVID-19 or (2) access public benefits in order to comply with stay-at home guidance, it impedes efforts to slow the spread of COVID-19, contributing to the strain on the health care system”.

Another measure that calls into question the sensibility of governance is the lifting of travel bans when the pandemic has taken full control of global health. During the previous administration, as of 26 January, The United States rescinded entry bans imposed because of the coronavirus pandemic on most non-US citizens arriving from Brazil, the United Kingdom, and all European Union countries. Fortunately, the incoming President has decided to rescind this policy.

Closer home to the author, The Quebec Government’s decision to open schools 11 days into a planned 18 day school closure has been criticized by experts as being too dangerous.  CTV News of Montreal reports: “Now infectious disease experts say the next few weeks will be critical in getting the virus under control—and that Jan. 11 is too soon to reopen schools in particular”. Michael Levy, an environmental health specialist, is reported to have said: “If we do it now, with the numbers so high, it's not going to work, and the numbers are just going to go up and up and up”.

Global guidelines become necessary when problems cross borders.  In such instances, there should be one policy be it on travel, social intercourse, quarantine or healthcare. On 2 April 2020, The United Nations General Assembly adopted a Resolution co-sponsored by 188 member States titled ‘Global Solidarity to Fight the Coronavirus Disease 2019 (COVID-19)’. The aim of the Resolution was to seek global cooperation and multilateralism for intensified international cooperation to defeat the pandemic that is causing severe disruption to societies and economies. The Resolution follows the third Sustainable Development Goal (of the 17 such goals) – “ensuring healthy lives and promoting the well-being at all ages is essential to sustainable development” - which the United Nations adopted as the Goal of the Month for April 2020.  Among the requests in the Resolution of the international community was a plea to ensure full respect for human rights on the basis that there was no place for any form of discrimination, racism and xenophobia in the response to the pandemic. According to Antonio Gutteres, Secretary General of the United Nations, the COVID-19 crisis is “the most challenging crisis we have faced since the Second World War” .

On 20 April 2020 The United Nations adopted Resolution 74/270 which inter alia, calls for intensified international cooperation to contain, mitigate and defeat the pandemic, including by exchanging information, scientific knowledge, and best practices and by applying the relevant guidelines recommended by the World Health Organization.  The Resolution renews its commitment to help people and societies in special situations, especially the weakest and most vulnerable, and recognizes that many Governments have offered their assistance and support to others in a spirit of solidarity and mutual support. While reaffirming its full commitment to the decade of action and delivery for sustainable development, and in this regard underlines the need for the United Nations system to work as one to support all Governments, The United Nations expressed optimism that the unprecedented crisis caused by the COVID-19 pandemic can be mitigated and successfully reversed through leadership and sustained global cooperation and solidarity.  Finally, the Resolution calls upon the United Nations system, under the leadership of the Secretary-General, to work with all relevant actors in order to mobilize a coordinated global response to the pandemic and its adverse social, economic, and financial impact on all societies.

This does not seem to be happening.

In the absence of international cooperation and the prevalence of the “me first” attitude, we have, as citizenry, to appreciate what we have and help each other irrespective of individual State policy.   As Sarah McAfee of the Centre for Health Progress wrote on 4 January 2021, “If there is one positive outcome from 2020, it is the knowledge that we can do extraordinary things together. We can mobilize trillions of dollars. We can develop a vaccine for a novel virus in record time. We can make bold policy changes--at the Capitol, in our states, in our workplaces, in our schools, in our communities, and everywhere else quickly, to suit the needs of the people and the demands of the time. And even when our leaders and government fail us, we can come together to take care of each other”.

As the song goes: “But where are the clowns? Quick, send in the clowns. Don't bother they're here”.

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