In “Love in the Time of Cholera,” Gabriel Garcia Marquez imagines an enduring love triangle between two passionate people — Florentino and Fermina — and a punctilious doctor, Juvenal Urbino, whom Fermina is persuaded by her father to marry. Trained as a physician in Paris, Dr. Urbino is a national hero for having saved the Colombian port where the story is set (based loosely on Cartagena and nearby Barranquilla) from recurrent cholera epidemics.
“When [Urbino] returned to his country,” writes Marquez, “and smelled the stench of the market while he was still out at sea and saw the rats in the sewers and the children rolling naked in the puddles on the streets, he not only understood how the tragedy had occurred but was certain that it would be repeated at any moment.”
In cities all over the world in the late 19th century, men like Juvenal Urbino were fighting the same battle, struggling to persuade city governments and urban elites to take the essential measures necessary to limit the spread of cholera. In Western Europe, these battles were won after 1892, the year of the last great cholera outbreak there, in Hamburg. In Latin America, the struggle was much more protracted.
“Dr. Urbino wanted to make the place sanitary, he wanted a slaughterhouse built somewhere else and a covered market. But even the most complaisant of his notable friends pitied his illusory passion. That is how they were: they spent their lives proclaiming their proud origins, the historic merits of the city, the value of its relics, its heroism, its beauty, but they were blind to the decay of the years.” Marquez’s leitmotif — “that the symptoms of love were the same as those of cholera” — seems almost to suggest that the Colombians could not quite distinguish between plague and passion.
Latin America has had an exceptionally bad time of it since the first Covid-19 case was confirmed in Sao Paulo on Feb. 26 last year. Rank the world’s countries by deaths per million, and only a few Eastern European countries look worse. But the Latin American excess mortality figures are especially shocking. Overall, US mortality since January last year has been about 18% above normal, according to estimates by the Financial Times. For the UK, the figure is about the same (17%). But for Brazil it is 34%.
For Western commentators accustomed to heaping opprobrium on the Brazilian president, Jair Bolsonaro, this confirms the view that he is like former US President Donald Trump or UK Prime Minister Boris Johnson, only worse. But the theory that populist leaders are responsible for high Covid deaths begins to look less compelling when you realize that the excess mortality rates for a number of other South American states are even worse: Peru leads (123%), followed by Ecuador (67%), Bolivia (56%) and Mexico (55%). There is a political story here, but it is not the familiar one in which madcap right-wing populists excel at exposing their own people to the virus.
As Marquez’s famous novel implies, there is nothing new about Latin America’s rough ride through this pandemic. When the Spanish influenza swept the world in 1918-19, the mortality rates in Guatemala (39 per thousand) and Mexico (20.6) were among the highest in the world, according to the estimates published by Niall Johnson and Juergen Mueller in 2002. Only in Africa, Indonesia and the South Pacific islands were the rates higher. By comparison, they estimate the mortality rate for the US at 6.5 per thousand.
Similarly, in the 1957-58 Asian flu pandemic — which was in some ways closer to Covid in its global impact than the much worse 1918-19 episode — Chile, Colombia, El Salvador, Mexico, Panama and Venezuela all had mortality rates significantly above the global average, according to research led by Cecile Viboud.
So how do we explain this? My first foreign trip in 16 months was to Mexico City last week. It is a city I’ve had a crush on since I first visited it 40 years ago, as a callow 17-year-old on a gap-year adventure loosely based on Jack Kerouac’s travels in “On the Road.” And although the city has grown explosively since then, it has not lost its charm.
There is a verdant, overgrown quality to the center of the city. The stormy mountain weather in summer keeps the air surprisingly clear. And the cuisine remains irresistible to me, not least the inspired madness of chicken in chocolate sauce (mole). Is there a better aperitif than mezcal?
Yet you can see as you walk the streets why pandemics hit Latin America so hard. On the one hand, the populations of Central and South America are older on average than those of most developing countries. Whereas the median age in Africa is 19.7 years and in Southern Asia 27.6, according the United Nations, in Latin America and the Caribbean it is 31. People are also much more likely to be obese than in South Asia or Africa. The age-standardized prevalence of obesity among adults in Mexico is 28.9, not far behind the US (36.2). In India the figure is 3.9, in Nigeria 8.9. On the other hand, Latin America has significantly patchier health-care coverage than most developing countries with comparably old and unhealthy populations.
All over the world, it is now clear, Covid kills the poor more than the rich, and darker skinned people more than lighter skinned people. Latin America, with its high levels of inequality — where poverty often correlates with skin pigmentation — has therefore presented the disease with a lot of vulnerable people in many big and crowded cities.
Finally, vaccination in Latin America is pretty much a mess. In the US more than half the population has now been vaccinated; in both the UK and Canada it is 59%. The figures in Latin America are far lower: 22% in Argentina and Brazil, 18% in Mexico — not much ahead of India (13%). Even where vaccination has gone well (Chile: 57%), the Chinese vaccines they have relied on have proved to have much lower efficacy than the vaccines produced by Moderna and Pfizer/BioNTech.
But these differences should not be regarded as God-given. To explain them, you need to look at the region’s politics. To say that the problem is populist leaders is too simplistic. True, Brazil has a right-wing populist president and Mexico a left-wing populist.
But in Peru it is Congress that wields the power, so much so that it has brought down three of the country’s last four presidents, including Martin Vizcarra, who was impeached twice in 2020 and finally forced to resign despite an approval rating above 50%. In Ecuador, too, President Lenin Moreno did not conform to the populist stereotype last year, and in last month’s presidential election he was replaced by a center-right candidate, pro-market banker Guillermo Lasso. In Bolivia, the pandemic struck after the populist President Evo Morales had been ousted from power.
In any case, even the populists have very little in common when you compare their pandemic responses. Mexican President Andres Manuel Lopez Obrador, known by the abbreviation AMLO, may be a man of the people, but he has done remarkably little to protect Mexicans from either the virus or its economic effects. Unlike in Brazil, there has been almost no fiscal support for the Mexican economy. As the rest of the world commits itself to a “net zero” future of reduced reliance on fossil fuels, AMLO remains strangely preoccupied with restoring the dominance of the state-owned oil producer, Pemex, over the country’s energy sector.
By contrast, Bolsonaro has been forced by the Brazilian Congress to blow out the deficit while at the same time expressing views on Covid that make Trump look like Anthony Fauci. Last week saw large-scale protests against Bolsonaro in numerous cities. His chances of re-election have been further hurt by the return to political life of the former president, Luiz Inacio Lula da Silva, whose criminal conviction for corruption was recently overturned. Yet while 54% of Brazilians see Bolsonaro’s handling of the pandemic as bad or awful, according to a March 17 Datafolha poll, his approval remains well above the single digits that presaged the impeachments of previous presidents Dilma Rousseff and Fernando Collor.
Wherever you look closely, you see how complex Latin American politics really is. In most cases, populist presidents have to reckon with powerful parliamentary bodies, in which vested interests are well entrenched; more or less independent judiciaries and central banks; not to mention independent media companies.
The real political problem in Latin America is that the elites in most countries have proved — over the 200 years since they gained their independence from Spain and Portugal — remarkably reluctant or simply unable to address the problems of the lower classes.
The recurrent pattern is, after prolonged periods of paralysis, for a far-left alternative to present itself and tear everything down, leaving nearly everyone even poorer. That is what happened in once-rich Venezuela under Hugo Chavez and Nicolas Maduro. It might conceivably be Peru’s fate, if left-wing firebrand Pedro Castillo beats his right-wing rival, Keiko Fujimori, in Sunday’s run-off election for the presidency. (It is going to be close.) During his campaign, Castillo has threatened (at times and not consistently) to redraft the constitution, bring key mining and energy sectors under direct state control, and abandon free trade.
Typically for a Latin American election, Castillo has the support of rural voters in the interior, indigenous Peruvians, younger progressives, hardened Marxists and organized labor — including Peru’s powerful teachers union. Fujimori’s base is concentrated in the metropolitan Lima area, and is educated and urban. She also polls very strongly with older voters, practicing Catholics and the wealthy. The fact that she is the daughter of Alberto Fujimori, the imprisoned former dictator, and served as his first lady in the 1990s does not seem be considered disqualifying by such voters.
Sometimes the illiberal right wins, sometimes the radical left. In the latter case, eventually, the right is restored to power and sets about turning back the clock. Then, rinse and repeat.
Typical of the dysfunction is Chile, South America’s most successful economy since the reforms of the 1980s, where a great deal of energy is soon to be consumed by the writing of a new constitution, which I suspect won’t actually do much for poorer Chileans. Latin American states love new constitutions, but these seldom address the real issues of inequality and often send countries disastrously off course (see Venezuela). Why are the Chileans changing their constitution, despite the fact that it has worked rather well? Because the last one originated under the dictatorship of Augusto Pinochet — and because a wave of protest, beginning before the pandemic, sapped the strength of the center-right government of Sebastian Pinera.
Yet as I walked the streets of Mexico City last weekend, a question kept popping into my head. All of this may long have been true of Latin America. But is it finally starting to be true of the US too? A decade ago, in a book titled “Civilization,” I tried to show why the variants of European settlement in the Americas after around 1500 had produced such different outcomes in North, Central and South America, emphasizing the very different approaches to land distribution that distinguished British colonialism from Spanish and Portuguese. Whereas the initial land grab by the conquistadores and early settlers ultimately established very small property-owning elites with vast tracts of territory, in North America land continued to be distributed in relatively small parcels as new settlers arrived.
The question I asked toward the end of the book, however, was whether the US was beginning in some ways to resemble Latin American countries — not just because of large-scale immigration from south of the Rio Grande, but because American inequality and US institutions were turning Latin.
This same question has prompted a brilliant essay on “The Brazilianization of the World” by Alex Hochuli in the latest issue of the journal American Affairs. Because of the pandemic, he argues, “hollowed-out state capacities, political confusion, cronyism, conspiratorial thinking and trust deficits have exposed the crumbling legitimacy that now makes rich and powerful states look like banana republics.”
We have reached “the End of the End of History.”
Far from the world converging on Francis Fukuyama’s idea of liberal democratic capitalism, we risk converging on the Latin American fever dream: “The only people satisfied with their situation are financial elites and venal politicians. Everyone complains, but everyone shrugs their shoulders. This slow degradation of society is not so much a runaway train, but more of a jittery rollercoaster, occasionally holding out promise of ascent, yet never breaking free from the tracks.” (If that reminds you of Marquez’s Colombia, you’ve been paying attention.)
It seems to me, however, that Hochuli is not describing a phenomenon you would encounter in continental Europe or indeed in Canada. It is the US he is really talking about. And the pathologies he identifies are not peculiar to Brazil. A better framing, I think, would be the LatAmization of the US. For all his invective against immigrants from Central America, Trump was in many ways a very Latin American figure, with strong caudillo instincts, even if his attempt at an autogolpe, or self-coup, on Jan. 6 was a fiasco.
How far this process can be reversed will depend on whether our own Dr. Urbinos — people willing to learn the real lessons of last year’s disastrous mishandling of Covid — outnumber those who, to paraphrase Marquez, spend their lives proclaiming their proud origins, the historic merits of the country, the value of its relics, its heroism, its beauty, but are blind to the decay of the years.
In Marquez’s Colombia, “the symptoms of love were the same as those of cholera.” In America today, I wonder if the symptoms of Covid are, in a similar way, akin to those of a morbid, suffocating patriotism.