PSI is facing the most acute crisis its members have ever been confronted with. Health workers represent about 12% of the infected population globally, and the death toll is unbearable.

Unpreparedness of health systems, including understaffing, gruelling long working hours, and lack of personal protective equipment (PPE) are exposing health workers to fatal hazards that also undermine the capacity of the health systems to respond to the emergency.

A chronic shortage of ventilators, ICU beds, reanimation beds, testing kits, laboratories and biologists is impeding the chances to save lives and will worsen already perilous working conditions for health staff.

Moreover, years of privatisation of health facilities have put even more pressure on public health systems, until (some) governments decided to compel private providers to join the public hospitals in their response to the emergency.

At this stage, the trade union movement should focus on the immediate emergency response:

1. Use all means to provide PPE to all workers exposed to high risk of contagion (healthcare, elder care, home care, transport, ambulance, police, firefighters, prisons and detention facilities, including refugees and migration camps, shop assistants and cashiers, workers in essential production, etc.). To achieve this, unions must urge governments to adopt public industrial policies that include local factories to convert to the production of these goods. This policies should also address the need to produce ventilators, test kits and all equipment and devices necessary to allow the health sector to work efficiently.

2. Increase the number of ICU beds. This means that we need to demand that governments also provide private hospitals and clinics without any exception and not for profit as a public health measure in order to respond to the needs of the population.

3. Recruit, train and equip nurses and doctors to alleviate the workload on current hospital staff and reduce the risk of contagion.

4. Suspend the patents of medications that prove to be necessary for the treatment of COVID 19. Create a consortium/agency at global level, under the WHO, to coordinate the research for a vaccine and avoid commercial exploitation.

5. Impose the closure of all non-essential manufacturing and commercial activities.

6. Ask governments to support workers and family income, including informal workers of all kind, and ensure paid leave. Similarly, provide support for childcare to all workers who must continue working. In PSI we believe that there must be a collective response of states to a global emergency with the injection of resources to support family and small business income, and that the private sector must contribute according to government guidelines.

7. Engage with government development agencies and IFIs to ensure the injection of adequate resources, without conditionalities, to support the emergency in developing countries, including the supply to all of clean water and soap for handwashing.

8. Urge the international community to provide an urgent, inclusive and rights-based solution to migrants in detention, those trapped at the borders and the refugees, asylum seekers, migrants and displaced persons living in camps. Besides the human rights and humanitarian situation, which we are concerned about as trade unions, there is the high risk that concentration of thousands of people in restricted areas without access to healthcare services and clean water and sanitation can turn into a public health catastrophe of unimaginable scale.

Measures are needed to deal with issues arising from the economic fallout of the health crisis. The situation was made worse by the lack of preparedness and by the changes to the global economic system over the last 30 years. The ensuing deep economic shock has the potential to create much hardship for working people and usher in another cycle of austerity. We must prepare now to shape the economic response.

This will be the moment to say that there is a global emergency that needs to be funded, and rapid and radical measures must be adopted if we are to avoid the crippling austerity, social dislocation and right-wing political extremism that followed the global financial crisis (GFC). The workers are already making sacrifices and small business is also suffering – it’s time for those who have profited from the system to pay back now and immediately contribute to fixing the mess they have created. Issues might include:

1. Introduction of debt relief and debt restructuring for the most vulnerable economies so that they are not forced to face currency and repayment crises at the same time as they are trying to deal with the health and economic crisis.

2. Changes to the global debt bailout system to ensure that orderly debt restructuring can occur, when necessary, that shares the burden between the creditors and debtors and does not undermine economic growth or exacerbate social crises.

3. Remove legislative debt and expenditure caps, as is the case in Europe and Brazil.

4. Demand that loans provided to countries (from the World Bank, the IMF, regional development banks or private creditors) do not contain liberalising conditionalities such as labour market liberalisation, privatisation or tax breaks for the most wealthy.

5. Implement wealth taxes to ensure those who have stockpiled wealth in the lead-up to the crisis now contribute.

6. Increase rates of corporate taxes to 50% for those making excess profits i.e. above 5%. At a time when companies are failing, public services are under-funded, and workers are making sacrifices, those companies which are making excess profits have a moral and economic obligation to contribute to the recovery. Unlike other taxes or levies, a tax on excess profits cannot make struggling businesses more vulnerable as they are only levied on profits already generated, and at excess levels. Struggling companies would pay no more tax but would benefit from the fiscal stimulus provided by ensuring excess profits are immediately redirected to fiscal stimulus.

7. Introduce a digital services tax immediately so that those tech companies which have made massive profits, previously avoided tax and stockpiled cash in tax havens (and are now making even more profit because of the confinement, i.e. Netflix, Amazon, etc.) pay their fair share immediately. Many countries wanted to introduce such taxes but were persuaded to wait until the outcomes of the OECD BEPS process. The BEPS process is now not able to provide a credible proposal, and certainly not in the timeframe required for urgent fiscal repair. All countries should be urged to introduce them immediately as a revenue raising tool.

8. No financial bailout measures should be made to any company that does not provide a public CBCR (country by country report), nor any that operates through tax havens. The response to the GFC and the recent tax giveaways in the USA show that without these measures many companies will redirect these benefits to shareholders, directors and management and not use them to protect employment and employees’ conditions.

In the long term there is a need to deeply rethink the global economic system, including the production system and the role of global supply chains, which failed in this crisis. We should also reconsider the role of government in industrial policies, including the need for domestic productions of goods that are essential to ensure the public interest and wellbeing. Reconsidering the role of public services and investing in public health systems, public education, clean water, sanitation and social protection is crucial. This will mean defending the argument that the current system of financial governance and oversized power of MNCs must end.

This is why we believe that we need to change the discourse right now.

This is why we believe that we need to change the discourse right now.

We don’t want health workers who save lives to be called heroes. They are not heroes! They are professionals who claim and deserve respect, dignity, the right to be protected and recognition of decent wages and working conditions.

We want to make clear once and for all who are the profiteers and how the rules of the game must be changed if we are to avoid disasters in the future and if we are to really work for a better and more just world for all.

Not understanding this under the circumstances is not only a mistake, it is irresponsible. We already missed the opportunity in 2008. We cannot miss this one.

As Pope Francis said, “we thought we could be safe in an ill world”. And the global crisis generated by COVID-19 shows we are not and cannot be safe on a sick planet.

We must mirror the many policies governments are forced to take now to help us deal with the climate crisis. A narrow focus on jobs and corporate-driven transition is sure to doom humanity to systemic crisis and system failure.

Nobody can now claim that rapid changes in policies are impossible or that future crises can be best dealt with by markets. But people can ignore the warnings and return to business as usual. Our job is to ensure this does not happen. It is to ensure that the current suffering is not in vain and use the warnings we now have to convince people we must build a radical new economy and develop policies that put people and the planet over profit.