Tlaleng Mofokeng, UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

As the demands of the pandemic have evolved, from the initial scramble for masks and ventilators to the ongoing struggle to purchase vaccines — one that, predictably, the most affluent states have dominated despite the urgent need in many developing countries — there has been a great deal of discussion on how to ensure an equitable recovery. Quite rightly, much of this has focused on the wide gaps between richer and poorer nations. Yet it is just as important to ensure that similar disparities do not emerge within countries between more and less privileged groups.

From early on in the pandemic, it was clear that Black people, minorities, indigenous peoples and other racially and religiously persecuted groups were significantly more exposed to the threat of COVID-19 and greatly impacted by it. For them, however, the health crisis did not begin with the virus. Within the Global South, and deeply rooted in historical oppression, coloniality, systemic racism and structural discrimination, countries have less favourable health systems and face disparities and inequities to access the determinants of health. It is in this context that those populations in particular are affected by higher rates of infant mortality to lower life expectancy, from greater exposure to communicable disease like tuberculosis to a heavier burden of mental illness. Every stage of their lives has been characterized by disproportionately poorer health outcomes. The situation is especially acute for women, people with disabilities and LGBTQ+ and gender diverse persons, who often experience intersectional discrimination on account of their identity.

These disparities are not going away on their own. We are far away from a scenario of an equitable, global vaccine rollout that successfully reaches the many communities usually excluded from underlying determinants of health such as clean water and sanitation, let alone medical care. However, without this, of course, there is no guaranteed end in sight to the pandemic. Looking beyond our immediate predicament, there are broader lessons to be learned. Otherwise, for populations in the Global South, Black people, minorities, indigenous peoples and other discriminated groups, the crisis will simply continue in other forms – exposing them, as before, to disproportionate levels of death, disease and mental illness.

We now know that many factors can contribute to better protection from COVID-19, from effective hygiene and social distancing to safer working conditions. Though often described as ‘behaviours’, these are grounded in rights and needs – adequate housing, healthy occupational and environmental conditions, labour protections, equitable health systems – that are simply unattainable for many. Unless a rights-based approach is employed for communities forced to the margins, living in crowded apartments in low-income neighbourhoods or informal settlements without sanitation, these issues will remain long after the pandemic has ended.

The crisis of COVID-19 may be unprecedented, but the inequalities it has compounded have been with us for generations. The scale of the challenge we now face and the universal threat it poses demand much more than charity: to emerge from this catastrophe stronger, we need transformative change. This means, first and foremost, to address coloniality, an end to discrimination, inequality and other underlying conditions that have long undermined the health and security of minorities, indigenous peoples and other neglected groups. We need to fully embrace all human rights.


Photo: Ethnic minority health works gather with police and fire crews outside a hospital in London, UK, to ‘Clap for Carers’ as a sign of gratitude for the services of essential workers during the COVID-19 pandemic. Credit: Avpics / Alamy Stock Photo.