COVID-19 has increased the neglect of disabled people. Photo credit: BigstockDEHRADUN, India / OXFORD, UK March 24th (IPS) – 2020 will be remembered as the year that changed the world as COVID-19 spared no country, community and person. As the pandemic continues into 2021, it is recognized that some groups are harder hit than others, not just by the virus itself, but also by the socio-economic inequalities and access inequalities exacerbated by global shutdowns. All over the world, countries and organizations are trying to better rebuild and eliminate inequalities.
António Guterres, Secretary General of the United Nations, stressed that we have ignored inequality for too long and put the poor at greater risk during the pandemic.
Studies in the UK confirm this: people in affluent areas are 50 times less likely to die from COVID-19, while black people and disabled people are four and three times more likely to die from COVID-19, respectively.
A third of 18- to 24-year-olds have lost their job – twice as many as adults of working age. The disproportionate effects on women include restricted reproductive health rights; increased unpaid care responsibilities; more domestic violence; and a record decline in women leaving the workforce. Together, these trends threaten global equity and inclusion gains.
India is an example of the challenges and inequalities so many low and middle income countries are facing during the pandemic. India’s poor are hardest hit by the disease itself to the economic and social ramifications of national lockdowns.
Numerous migrants walked hundreds of kilometers to their villages and showed examples of how people in the informal sector have lost their jobs, their livelihoods and their homes. Public and private health institutions have tried to support COVID-19 patients, but reports have questioned the accessibility and equity of services to the poor. In economic terms, experts expect that millions of people in India will be impoverished as a result of the pandemic.
For global health in a broader sense, the pandemic has threatened to reverse the advances made in recent decades, highlighting how we have neglected calls for health systems to strengthen in recent years. However, we see opportunities and demands for better reconstruction. The global health community must first ask, “What’s wrong with global health?” Therefore we avoid these systemic problems and build a more inclusive world.
The reality is that before 2020 in global health, many things went wrong. To date, we have seen certain groups forgotten in the global health space. For example, only 0.5% of international development funding goes to programs for the inclusion of people with disabilities. Even less of this goes directly to global health, even though people with disabilities make up 15% of the world’s population. COVID-19 has increased the neglect of disabled people.
For example, India’s COVID-19 tracker, the Aarogya Setu app, public health guidelines and testing sites have remained inaccessible to disabled people. During lockdowns, disabled people also had difficulty gaining access to essential food, information, medicines and supplies.
We propose three ways to address access inequalities in global health:
Under-represented and marginalized groups need better, more authentic representation. Global health organizations must constantly wonder who is not represented or reached in their programs and actively take action to remedy this. Involving advocates and activists from the start will address the needs of vulnerable populations and promote acceptance, inclusion and belonging.
Global health needs better, timely, factual, and accessible communication. Creating accessible and acceptable communication strategies and messages that are used to reach even the most remote areas is key to ensuring that global health connects everyone.
Act in solidarity. Governments, civil society and international organizations need to come together to distribute resources proportionally as needed. Distributive justice can ensure greater security for all – be it health, income, or employment – which ultimately affects our collective ability to weather disasters such as pandemics.
COVID-19 was a pivotal moment and offers a unique opportunity to rebuild a better, fairer and healthier world. Without an explicit focus on inequality, however, we risk leaving out those whom global health has forgotten despite our moral obligation and duty to protect.
In 2020 we showed that anything is possible with political will, dedicated funding and global action. In 2021, we need a paradigm shift in our approach to global health to capture those who need it most. We need to apply what we have learned from collective action on COVID-19 to the greatest challenge facing our society: inequality. In addressing this, we ensure that global health is truly accessible to all.
Shubha Nagesh is a doctor and global health advisor based in Dehradun, India. It strives to make children’s disabilities a global health priority.
Sara Rotenberg is a Rhodes Fellow and DPhil student in the Nuffield Department of Primary Care Health Sciences at Oxford University.
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