Whose Right to Health? Holding Up a Mirror to Global Health’s Inequities
by Lazenya Weekes-Richemond
Our resident blogger Lazenya discusses the political intricacies that hinder certain groups in accessing good health globally.
Media from Unsplash
Today on International Human Rights Day, I question: is health a human right? Do we all have an equal right to good health? These questions have been on my mind as we approach the two-year mark of the COVID pandemic. The health of a nation is the wealth of a nation, however the pandemic has exposed deep health inequalities within and between countries globally.
COVID-19 has disproportionately affected ethnic minority groups in developed countries. In the U.K., people of Black ethnicity have the highest diagnosis rates, while white British people had the lowest rates. A staggering 25% of patients requiring intensive care support are of Black or Asian background and a recent report found the mortality risk from COVID-19 among ethnic minority groups is twice that of white British patients after potential confounding factors such as age, sex, income, education, housing tenure, and area deprivation have been taken into account.
America shows a similar picture with health inequalities across racial lines. American Indians are nearly twice as likely to contract COVID, have a three-fold hospital rate and two-fold death rate compared to white Americans. People of African descent have a nearly three-fold rate of hospitalisation and nearly double the death rate compared to white Americans. As of November 2021, 25% of coronavirus cases in the U.S. were among people of Hispanic or Latino origin, and 11% of cases were among non-Hispanic Blacks. The pandemic has forced us to question: whose life is worth more? Do certain ethnicities have less of a right to health than others?
The differences in COVID mortality rates between ethnicities have been compounded with the vaccine inequity between High Income Countries (HICs) and Low- and Middle-Income Countries (LMICs). We have watched this year as the vaccine roll out has been concentrated in HICs. To date, only 6% of low-income countries have been vaccinated. In India, which had a major surge in cases over the summer, 44% of the population is yet to receive their first vaccination. A majority of health workers in LMICs - 70% of whom are women - have still not been vaccinated, meanwhile the U.K. has started giving booster shots to over 40s and all adults are set to be offered a booster by the end of January. Some have argued that vaccine hesitancy is the reason for low vaccination rates in LMICs, however a study has shown it is actually a lack of access to vaccines contributing to the low uptake.
Women continue to bear the brunt of the pandemic, experiencing increased caregiver responsibilities, loss of income and increased violence. The overwhelming majority of the health workforce globally are women, yet COVID-19 task forces globally had only 24% representation from women and women are less protected against COVID-19 than their male counterparts due to PPE being designed for men.
The pandemic has exposed the dark reality that health is political. Health should be a fundamental human right however nationality, ethnicity, the ability to pay for healthcare and even gender affects one’s realisation of good health. The World Health Assembly recently voted on the need for a Pandemic Treaty to strengthen future pandemic prevention, preparedness and response. This treaty, along with the Memorandum of Understanding between Women in Global Health and WHO present a unique opportunity to centre women’s rights and ensure women have a seat around key decision making tables to advocate for gender equity in health.
Taken from The Politics of Pandemics, The Economist (by Andrea Ucini)
In an increasingly globalised world and with countries reopening their borders, none of us are safe until all of us are safe. At the UN General Assembly in September, Chad’s president Mahamat Idriss Déby Itno stated “the virus doesn’t know continents, borders, even less nationalities or social statuses. The countries and regions that aren’t vaccinated will be a source of propagating and developing new variants of the virus.” Less than two months after his speech, the new highly infectious Omicron variant first detected by South African scientists in late November resulted in the U.K. placing numerous Southern and Western African countries on the red travel list while Canada, Australia, Belgium and other HICs who now have cases of the variant remain open for travel to the U.K.
High Income Countries such as the U.K. have pledged to donate 1.4 billion COVID vaccines to LMICs, however the World Health Organization has only seen less than 20% of these. Despite this, the U.K. disposed of 600,000 vaccines after they expired earlier this year. South Africa’s president Cyril Ramaphosa addressed the UN General Assembly: “It is a great concern that the global community has not sustained the principles of solidarity and cooperation in securing equitable access to COVID-19 vaccines. It is an indictment on humanity that more than 82% of the world’s vaccine doses have been acquired by wealthy countries, while less than 1% has gone to low-income countries.”
The African Union (AU) actively attempted to buy vaccines to vaccinate at least 60% of Africa, however the AU Special Envoy for COVID-19 noted in a recent WHO briefing, "vaccine manufacturers knew very well that they never gave Africa proper access. They knew supplies were restricted, there was no production. But they have a moral responsibility to ensure others had access. It's very sad." Dr Tedros, WHO Director-General, pens it very well: “it makes no sense to give boosters to healthy adults, or to vaccinate children, when health workers, older people and other high-risk groups around the world are still waiting for their first dose……This is a scandal that must stop now.”
The U.K. Health Secretary Sajid Javid admits the new “variant is a reminder for all of us that this pandemic is far from over.” As we celebrate International Human Rights Day, I urge the U.K. and other HICs to stop playing politics with people’s lives and actively demonstrate that health is a fundamental human right. Access to life-saving vaccines, diagnostics and therapeutics is a human right. No life is worth more than the other. As we close out another tumultuous year for global health, I look forward to seeing more ethical leadership and global solidarity like Switzerland who recently made millions of vaccines available to LMICs through the COVAX initiative. It is time for us to end this vaccine apartheid, start redressing health inequities and live up to the Sustainable Development Goal promise to ‘leave no one behind’.