The Capitol takeover in early January put American conspiracy theorists on the world stage. Though conspiracy theories have a long history in the United States — on topics ranging from JFK’s assassination to 9/11 — they have never been as widespread or as dangerous as they are today. Most notable among this sector is the shadowy far-right movement known as QAnon, which combines centuries-old anti-Semitic tropes with ideas of a global pedophilic cabal linked to the Clintons. Conspiracy theorists like QAnon have been arguing recently that the coronavirus pandemic is a hoax (or a “plandemic”) and that masks and vaccines are part of a secret plan to control the population. Though absurd, these ideas have severe consequences and threaten countless people.
Yet vaccine skepticism goes beyond fringe ideas promoted by the Far Right. Even before the pandemic, there was an “anti-vaxxer” movement that held generally liberal views and that promoted “natural health” practices — some legitimately linked to better health, like organic eating and yoga, others completely spurious, like homeopathic medicine. It included figures like Joseph Mercola, a multimillionaire who built his fortune on vitamin supplements, and Robert F. Kennedy Jr., son of RFK and environmental advocate. This sector is generally white and well off. They are more likely to send their children to private schools and to live in exclusive neighborhoods. Troublingly, however, despite the difference in social compositions, there is evidence that the ideas of the anti-vaxx sector are merging with those of QAnon and the Far Right.
But there other sectors whose skepticism should not be dismissed as based on pseudoscience or conspiratorial ideas. Several surveys have shown that people of color are less likely to have confidence in Covid-19 vaccines because of their legitimate anger toward and mistrust of the American medical system. African Americans and Latinos have historically suffered neglect, mistreatment, and outright abuse by the health care industry. Among oppressed communities, vaccine reluctance is the logical outcome of a health care system that time and again has failed to meet their needs and those of the majority of the population. When official science continually puts forward inadequate solutions, dismisses the input of those most affected, and acts as a dutiful servant for big business, a lack of trust is the obvious result.
To understand how science has failed to live up to its promise, we must examine how science functions in society. The Biden White House says, “America deserves a response to the Covid-19 pandemic that is driven by science, data and public health — not politics.” The statement fits well with liberal ideology. “Scientists must rise above politics,” as a 2019 Nature editorial put it. But contrary to this liberal worldview, politics cannot be separated from either science, data, or public health. It is politics — or more specifically, political, social, and economic interests — that determines what problems science investigates and what solutions are proposed, accepted, and rejected. For socialists, the key questions are what set of politics and whose interest guide the development of science.
The dialectical biologists Richard Levins and Richard Lewontin made the critical observation that
science reflects the conditions of its production and the viewpoints of its producers or owners. The agenda of science, the recruitment and training of some and the exclusion of others from being scientists, the strategies of research, the physical instruments of investigation, the intellectual framework in which problems are formulated and results interpreted, the criteria for a successful solution to a problem, and the conditions of application of scientific results are all very much a product of the history of the sciences and associated technologies and of the societies that form and own them. The pattern of knowledge and ignorance in science is not dictated by nature but is structured by interest and belief.[efn_note]Richard C. Lewontin and Richard Levins, “Ten Propositions on Science and Antiscience,” in Biology under the Influence: Dialectical Essays on the Ecology, Agriculture, and Health (New York: Monthly Review Press, 2007), 90.[/efn_note]
This is why, in spite of its advances, capitalist science has been so often incapable of preventing health crises. The CDC — ostensibly an agency run by scientists — declared masks to be unnecessary for more than a month after the coronavirus outbreak. Today, the same agency says it is “safe” to reopen schools without teachers or students fully vaccinated. And it’s hardly the first time that official science has put forward “solutions,” that later proved disastrous for public health. Despite initial assurances of safety by scientists, the burning of coal , prescription opioids, and nuclear energy all led to major health emergencies in the past century. It is not a matter of a few bad scientists. When science is so heavily influenced by the pressures of capitalism and the profit motive, such catastrophes are inevitable.
In the imperialist era, science has been one of the primary tools for the central countries to dominate the globe. New military, surveillance, and communications technologies are used to subjugate the semicolonial world and plunder its resources. After the emergence of Sars-CoV-2, the development of a vaccine — ostensibly a “global public good” — took on major geopolitical implications. Contracts between vaccine manufacturers and the world’s wealthiest nations replicated patterns of dependency for the peripheral countries. Israel has been widely lauded for vaccinating more than half its people — but has refused to deliver more than a scant number of vaccines to Palestinians in the West Bank and Gaza, leaving the residents of these territories to die.
According to Oxfam, nine out of 10 residents of the poorest nations will miss out on the vaccine in 2021, as the vast majority of Pfizer and Moderna vaccines are destined for the U.S. and other imperialist countries. As Nina DeMeo writes, “Rich countries with only 14 percent of the world’s population have bought up 53 percent of the eight most promising vaccines.” Canada has secured a supply sufficient to vaccinate its population four times over. Not only have the richest nations hoarded the vaccines for themselves, but they have often prevented poorer nations from accessing the science and technology used in vaccine development. Initiatives to pool technology and knowledge across borders for the development of Covid-19 vaccines were widely supported by nations of the Global South. But the United States and the United Kingdom effectively killed these initiatives by refusing to take part, since doing so would encroach on the pharmaceutical giants’ intellectual property.
How can we explain governments’ lack of preparedness for a pandemic of this scale? Only by pointing to the inextricable link between science and politics. Ecological Marxists Rob Wallace and Mike Davis have sounded the alarm for years over the threat of zoonotic diseases, which emerge directly from deforestation, factory farming, and other ecocidal practices. Yet these practices all continued with little concern from the establishment, even in the face of several outbreaks this century. When an industry is so immensely profitable, science rarely stands in the way.
In the face of science’s inadequacies, bourgeois ideology offers two lines of critique. One is to dismiss science’s objective basis and progressive potential. This is the postmodernist critique. The other, a liberal critique, claims that the progressive manifestations of science (medicine, material comforts, renewable energy) can be uncoupled from its oppressive manifestations (instruments of war, environmental degradation, factory farming) without overturning the capitalist system.
But Marxists understand that under capitalism the two sides of science cannot be separated. That’s because capitalist science has a dual nature, both contributing to human misery and offering liberatory possibilities for longer, healthier lives, such as through new vaccines and virological research. In the first half of the 20th century, victory in the world wars required not only more deadly armaments and new military strategies but the development of new medical treatments, including vaccines against infectious diseases to minimize troop losses. World War I, for example, saw the creation of blood banks for the first time. Penicillin was first used in the interwar period. Chloroquine was administered as a malaria treatment during World War II. A polio vaccine emerged shortly after.
The dual nature of science is perfectly evident in the United States’ so-called health care industry. The for-profit system leaves millions of people in the U.S. indebted each year, keeps millions more sick, and provide unequal care for people of color. Treatments and medicine are commodities; for those who can afford it, medical treatment is as advanced as it is in any other country.
These contradictions have become even more apparent in the Covid pandemic, in which over 450,000 Americans have already perished. This figure will surely rise significantly with the arrival of a new, more infectious strain of the virus. The staggering death toll, higher than in any other country, highlights the extreme injustices and inefficiencies of health care in the U.S. In Covid deaths per 100,000 people, the world’s richest country ranks first among the larger countries. This is taking place in a country that spends more on healthcare than any other — equivalent to 17 percent of GDP.
This criminal neglect of public health has hit communities of color especially hard. Black, Latino, and Indigenous people are all more likely to be hospitalized, and they are two to three times more likely to die of the disease than their white counterparts. In Washington, DC, for example, Black residents represent less than half of the city’s population but account for 75 percent of Covid-19 deaths. It’s no secret why these disparities exist. Across the United States, Black people and other people of color suffer from higher rates of comorbidities like heart disease. They are more likely to live in crowded housing and to be exposed to air pollution. They work more often in essential industries, where remote work is out of the question. They are more likely to be uninsured or underinsured, and they suffer inferior care in hospitals. In a nationally reported case, Dr. Susan Moore, a Black family physician, complained of racially motivated neglect in the Indianapolis hospital where she was being treated for Covid-19. She died two weeks after being sent home.
But these facts do not constitute a failure in the eyes of the health care industry, since the same pandemic has meant unprecedented profits. This is particularly true for vaccine manufacturers, which have secured multibillion-dollar contracts and stand to earn tens of billions more in sales. Pfizer alone has already secured over $4 billion in contracts with the federal government. The investment bank Morgan Stanley estimates that Pfizer will earn $19 billion from vaccine sales in 2021. Moderna, the second corporation to be approved for vaccine production, saw share prices increase by 700 percent in the past year. While hospitals have suffered because patients are putting off “elective” medical treatments during the pandemic, insurance companies have also seen profits rise dramatically for the same reason.
The fact that tens of millions die around the world each year from a lack of affordable medicine is not a concern for Big Pharma. Instead, the industry is driven by pursuing so-called blockbuster drugs, that is, drugs that bring in $1 billion or more in annual revenue. Meanwhile, if drugs or vaccines are deemed unprofitable, they simply aren’t developed. Mike Davis notes,
Of the 18 largest pharmaceutical companies, 15 have totally abandoned the field [of antivirals and vaccines]. Heart medicines, addictive tranquilizers and treatments for male impotence are profit leaders, not the defenses against hospital infections, emergent diseases and traditional tropical killers. A universal vaccine for influenza — that is to say, a vaccine that targets the immutable parts of the virus’s surface proteins — has been a possibility for decades but never a profitable priority.[efn_note]Mike Davis, “Who Gets Forgotten in a Pandemic,” The Nation, March 13, 2020.[/efn_note]
This means that knowledge of vital medicine simply does not advance. In this way, writes Davis, Big Pharma has become “a fetter on the medical revolution and scientific revolution.”
Further, the commoditized health care industry ignores the social causes of disease. Official science has nothing to say about overcrowded apartments caused by realty speculation. It says nothing about the prison system, which places thousands of Black and Latino people in the closest possible quarters. It will never advocate shutting down nonessential businesses while protecting workers’ salaries and benefits. These areas are better left to the “policy advocates,” says science, even though these steps would have drastically reduced infections and deaths — far more effectively than a vaccine.
Only in this context can we understand the puzzle of why tens of millions of Americans say they do not want to be vaccinated. When it is clear to most people that the health care industry does not exist to protect their health but rather to increase shareholder value, mistrust toward the industry is the logical outcome. Indeed, according to Gallup, more than six in 10 Americans say the U.S. health care system is in “crisis” or suffers from “major” problems. In the same poll, 49 percent of respondents said they had a “very negative” or “somewhat negative” attitude toward the pharmaceutical industry.
The transparently profit-oriented health care system led many to turn away from scientific medicine altogether. One of the primary expressions of this was the conspiratorial anti-vaccine movement that arose in the late 1990s after the publication of a paper in the Lancet by British ex-doctor Andrew Wakefield linking the MMR vaccine to autism. The paper lacked evidence, and the Lancet later retracted it. But the claim caught on among conspiracy circles and continues to turn up in social media groups and Internet forums. This anti-vaxx movement fit well with liberal ideas about “self-care.” Rather than challenging the for-profit health care industry as a whole, it called for individual abstention from vaccines. Just as liberalism in general has no answer for capitalist brutality and inhumanity, liberal responses to the health crisis are equally impotent.
More recently, sectors of the Right have taken up the anti-vaxx banner. This is consistent with the populist distrust of the establishment, promoted by Trump and others, but it also reflects a general rejection of science in conservative circles. Science for this sector undermines obscurantist religious teachings, challenging, for example, the “natural” basis for women’s subjugation.
Trump’s pronouncements downplaying the virus and its effects played no small role either. Trump, of course, was motivated by the need to keep businesses open and maintain capital accumulation. To do this, he had to sow seeds of doubt about the danger of the virus. So for months, he promoted hydroxychloroquine as a simple and available treatment and refused to wear a mask. Anti-mask and anti-vaxx demonstrations now take place regularly around the country, from the liberal cities of Los Angeles and Santa Cruz to conservative strongholds like Arizona and Florida. Anti-vaxxers went so far as to temporarily shut down LA’s largest vaccination site at Dodger Stadium.
According to some polls, as many as 40 percent of Americans say they are unlikely to accept the current Covid-19 vaccines. Among these, 20 percent say they definitely will not accept them.
This mistrust is apparently highest among sectors who are already most vulnerable to infection. Anecdotal reports from various sources point to large numbers of health care workers refusing the vaccine. A poll conducted by the Kaiser Family Foundation shows that 23 percent of workers in the sector are “vaccine hesitant.” At the hospitals in New York City’s Mount Sinai Health System, only somewhere between 25 and 65 percent of their health care staff plan to be vaccinated. In Ohio, only 40 percent of nursing home workers are accepting the vaccine. In long-term care facilities, the lowest paid workers show the most vaccine reluctance.
People of color are also more hesitant to accept the coronavirus vaccine. Recent polls show that only 42 percent of African Americans are willing to be vaccinated, although this is up from 32 percent last September. Latinos show somewhat greater trust in the vaccine, but still just 36 percent say they will “definitely” get the vaccine if offered at no cost, compared with 46 percent of white respondents.
It should not be startling given the disparities affecting people of color in the health care system. More than seven in 10 Black people reported that the “health care system treats people unfairly based on their race or ethnic background” “very often” or “somewhat often,” according to a Kaiser Family Foundation/Undefeated poll. Only four in 10 whites said the same. While 55 percent of white respondents said they trust the health care system to “do what is right for you or your community almost all or most of the time,” just 44 percent of Black respondents said the same. Unequal care — along with the daily stress of discrimination and hyperexploitation — is considered a primary factor behind the significantly higher rates of death during childbirth for Black mothers.
But the mistrust of the medical establishment does not stem only from inadequate and inferior care. People of color have been subject to the most horrific forms of medical experimentation, often without their knowledge. In the most famous case, hundreds of Black people in Tuskegee, Alabama, were deliberately left to suffer from syphilis while treatments existed, ostensibly in order to study the long-term effects of the disease. Nurses kept registries of the men in the study and distributed their names to local clinics to explicitly prevent the men from receiving treatment.
The Tuskegee case is not isolated. As Stephen and Hillary Rose note in their important work Genes, Cells, and Brains, the U.S. Atomic Energy Commission deliberately exposed native Alaskan people — alongside learning-disabled children, pregnant women, prisoners, and psychiatric patients — to radiation for over three decades beginning in the 1940s. Working in Guatemala, the U.S. Health Service infected hundreds of Guatemalan prisoners with syphilis by bringing infected sex workers into prisons. A recent investigation found that during World War II, the Department of Defense deliberately exposed tens of thousands of Black, Puerto Rican, and Japanese American soldiers to chemical agents such as mustard gas. These are not just phenomena of the past. Last year, migrant women in U.S. detention centers reported being unknowingly sterilized by doctors. These cases have justifiably undermined trust in both science and medicine.
The for-profit health care industry, which fails to offer real health solutions, fuels anti-vaccine attitudes. When it is clear to so many that science and health care do not provide for the well-being of the majority, a rejection of these institutions is predictable. Some people will respond in a progressive way, seeing that science and health care, once the profit motive is removed, could be radically transformed. Others will be entirely retrograde, turning against modern medicine altogether. It is our responsibility therefore to challenge anti-vaxx ideas without ignoring the criminal actions of the pharmaceutical and health care industries. We must fight for universal health care, a national health service, and vaccine development under public control.
It is already evident that the private sector is unnecessary. After all, while private vaccine manufacturers are securing multibillion-dollar contracts and taking in record-breaking revenue, the vaccines produced by Pfizer and Moderna rely on science and technology made possible by public funding. The mRNA modification technology used in both vaccines was in fact first developed by the National Institutes of Health and by scientists working at the University of Pennsylvania. Only afterward was it acquired by private corporations and put toward creating a Covid-19 vaccine.
A democratization of science and health care systems must not be restricted to the specialists employed by multinational corporations and elite academic institutions. It must take into account the knowledge of its practitioners and the public. Nurses and other frontline health care workers are the ones who know best how to care for patients. But hospital bureaucracies routinely ignore their opinions on crucial issues, from PPE to safe staffing practices. It is no wonder that many nurses themselves have become skeptical of the solutions put forward by the health care conglomerates. As one Florida pediatrician put it, “Even people who want to weigh the pros versus cons — we’re not being able to do that because of the lack of data and transparency.” Frontline workers and the public must have access to the full range of data accessible to the scientists, corporate executives, and state agencies if we want them to support vaccination efforts.
Anti-science attitudes can be combated by democratizing science and putting science in the service of the majority. We can build on the model of Science for the People, a grassroots organization built in the 1970s, which campaigned against ecological destruction, war, racism and sexism and sought to involve people of all social classes and educational backgrounds, not just scientists, in the development and communication of science. But to truly rescue science, it must be brought under public control and made part of a planned economy, that is to say, a socialist society. Only then can the full possibilities of science be unlocked. We will marvel at what we can do.