I'm new to the concept of anarchism, at least as a vision of society that actually has had thought put into it, so my apologies if this question seems stupid of self centered.
Risking losing context as I ask this, I'm curious about how advanced medicines like insulin (things that aren't small molecules, require rDNA, multinational logistics, supply chains and quality assurance, etc) would work and be distributed. What about advanced medical devices like insulin pumps, subcutaneous glucose monitors, etc?
I know there are some types of anarchist who would say those things wouldn't be needed without industrialization (im not going to gratify that take with a reaponse), but I suspect most still recognize the need for things like this, since millions of people would die without them.
I guess the root of my question is what the motivation would even be for someone to work on projects like that. Type 1 diabetics make up ~0.1% of the population at the highest, and a major hurdle from my perspective would be getting people to work on something needed by so small a population, but requiring such intensive resources to produce. And especially in any kind of transition period, I find it basically impossible to imagine the able bodied revolutionary actually giving a shit whether people like me live to see the "after."
I've done some looking and it seems like broadly, the attitudes range from "you'd make it yourself and its okay because you'd have time to if all your basic needs are met" to "well surely someone would do it altruistically." I also found a few people who just said "people die, get over it," and "the real problem is you should've died when you were 7 but we played god," but I have to assume (hope?) that such ideas are fringe. I'm hoping especially to hear from someone who actually understands why insulin (and pumps and CGMs and all that) are complicated, hard things that probably won't get made purely by volunteer labor at the huge scale needed. Like, it's not one of those things you can whip up at a local pharmacy, its far too complex for that.
I guess in all, I like the idea of a society without hierarchy, where self determination and community engagement become the de facto environment...but from my admittedly novice perspective, it sure doesn't feel like much thought has been given to how those of us with extremely short expiration dates should stability evaporate actually survive the transition.
Over the last week that I've been reading and thinking about this, I keep coming back to the inherent (though hopefully temporary) loss of stability that comes with any revolution. In that kind of scenario, I just...die. Along with millions like me. Either from supply chains failing during transition, or my own bullet because I'm staring down the barrel of an agonizing final week that ends with me dehydrated, starving, vomiting blood and gasping for air. From here it's really hard to see a place for me in an anarchist future.
Sorry, I recognize thats a little dark. But its something im finding myself having to think about more and more as collapse seems to draw ever closer.
Just hoping anyone has insights to share. And if i respond in the comments and i seem a little forceful, I promise I'm not trying to be a dick, its just that this is kind of existential for me, so I am probably going to be prone to pushing back or really pressing on certain aspects. If im being rude, please dont hesitate to tell me and I'll try to reframe to avoid that. It's neither the goal nor the intended process.
These type of questions are always based in the unrealistic assumption that an anarchist society would have to start from scratch and have none of the existing knowledge and production facilities.
So, no, it wouldn't be a major issue in the short to medium term as keeping these facilities running is not all that complicated. Existing worker-owned cooperatives run on anarchists principles have long proven that they can handle complex supply-chain logistics.
You could argue that in the long run some of the existing infrastructure would not be kept up as current systems depend on various forms of exploitation, and for some industrial sectors like mining that could indeed become a problem, but pharmaceuticals are actually not all that complicated to produce with modern biotechnological means. And the research focus would probably shift towards production methods that are easier to replicate, something today's pharmaceutical companies have little incentives to do as they don't want to make it too easy for Indian generica producers to copy their products.
And last but not least, very few modern Anarchists advocate for a single hugely destructive "revolution", knowing full well the risks that come with that and how historically such revolutions have always just replaced the oppressors but not altered the system of oppression significantly. The idea is rather a more gradual replacement of power structures bottom up starting with municipalities and so on.
That said, it is very likely that regardless of what Anarchists wish to do for a less destructive transition, a system collapse will happen due to the current inherent capitalist contradictions, climate change and the physical limits of our planet, and Anarchist will be left trying to pick up the shards, mutual aid style. So the question for you should be rather how you can prepare for this likely eventuality and not some imagined hypothetical scenario where Anarchists cause a world revolution.
Sorry, I'm going to do the annoying blockquote thing just because your split this up so nicely into chunks for me to digest and respond to.
I'm actually not trying to make that assumption here, although I should have been clearer. My response to annother commenter goes more into depth on what I'm talking about (or at least tries to, my thoughts are being updated in real time).
I mean, for certain drugs and certain definitions of "that complicated," I guess kinda? But producing it at scale, in sterile conditions, at extremely specific titrations, and moving it with a cold chain to where it's needed...that's fairly specific work that isn't particularly glamorous or sometimes even healthy. Certainly, things could be done to make those things easier (bring back trains), but like...at the end of the day, you're still farming and processing genetically modified bacteria with precision. It might not be rocket science, but it's not easy. The only project I'm aware of working on making insulin something easily produced in a distributed way has been over a decade without more than a few micrograms made. And that's without the burden of patent encumberance (they tried with just human insulin, not the newer stuff we use for better quality of life), that's just "getting this to work at pharmacy scale."
That's good to know. Building parallel tools for getting things done avoids another fear I have, which is instability. Being dependent on a system (not necessarily this system, but a lot of moving pieces have to work to keep me alive) just means death if there's too long of a break.
I'm going to be honest, this feels like trying to turn it around on me, and I don't super appreciate that, but I'm going to read it charitably anyway because text is bad at conveying those things and I'm probably wrong.
Anyway, I do have a plan. I've had to think about it a lot this past year especially, but even before then, this isn't something I suspect any diabetic has avoided thinking about. If either of those scenarios happen in the near to medium future, the answer is the same. Hold out as long as I can doing what I can to create a survivable environment for the people I'm surrounded by, and then as soon as I'm out of ways to get insulin, eat a bullet. Having dipped my toe into the shallow end of dying from that twice before, it's not worth it to continue that for several days before going out.
Sorry, I promise, I'm not trying to be combative, it's just that I'm sure there's about to be a big change, good or bad, and I'm gonna be real, right now I need a picture of a future better than this that still has me in it. And the more I refine my picture of what that world might look like, the more I realize that my existence is predicated on a lot of incentives that currently lean in the direction of keeping me alive. With new rules (or no rules), you have to wonder if the calculus still works out on the keeping you alive side. Especially when the process of doing that is so energy intensive, polluting and moralized.