This has been a long time in writing – I started 2 weeks ago, and have been pulled into a maelstrom of COVID-19 preparation in the interim. Glad to have a brief pause to get some ink on paper (bytes on screen?).
As the COVID-19 pandemic started up, this article from China caught my eye – amidst the stories of heroic efforts from health care workers and citizens withstanding quarantine, a report on how those already disadvantaged by poverty & disability were more markedly impacted by the measures taken to slow the spread of COVID-19 infections.
This is not a surprise.
But while it is not a surprise, it is important to keep in mind as the COVID-19 pandemic spreads across the world. Through the lens of equity that global health employs, we can already predict that the impact on LMICs & on underserved populations within HICs will be disproportionate; that when there is scarcity, that which is desired will flow most to those who have rather than those who need; and that when there is discord, people on the margins of society will be those who are discarded.
The pandemic strikes at a time where the world still wrestles with the legacy of colonialism, in global health just as much as outside of it. Advocates for equity already struggled to obtain support for development and global health, in part due to politicians lambasting “foreign aid” to the point where the American public’s perception of how much development aid our country provides is a) imprecise and b) inaccurate (28% of US budget mean estimate; true amount, <1%). Solidarity will be a challenge in the months to come, at a time when our own hospital systems will be stressed to the limit – we need to push for continued support to groups like the WHO that provide support across the world. More importantly, after the pandemic ends, we will need to incessantly voice the simple idea that public health cuts across the world as a whole – strong health systems in China, New Mexico, and Congo protect those populations but also all of us. The dean of our school of public health has voiced this well across many forum, including a recent blog post of his own.
The pandemic spreads because of the social distance across and within countries; inequity is the ally of infection. Our work as advocates for health equity will be to help bridge that distance when the flood recedes, so that the next tsunami finds us better prepared across all countries & across all strata of society.