Karl Marx wrote that ‘the history of all hitherto existing society is the history of class struggle’. To many people the idea of class struggle seems archaic and belonging firmly to the 20th century. An equally 20th century idea is that of living through a deadly pandemic – a scenario that has for most of us only been conveyed through history books, and a scenario in which we have collectively been thrust by the once-in-a-century unprecedented COVID-19 pandemic. This current pandemic is exposing the problems within our current economic and social systems, and most importantly exposes the fragility of the human right to health. It turns out that the emperor is naked.
Inequalities in access to healthcare between Global North and Global South countries have, rightfully, long been the focus of conversation surrounding global health. Soon after the WHO declared a public health emergency of international concern (PHEIC), the Director General, Dr Tedros, pointed out that this virus could be most lethal and dangerous for countries with weaker health systems, largely (though not uniquely) corresponding to the Global South. Beyond ‘developing’ and conflict-heavy countries with weaker health systems, the current pandemic has exposed the health inequalities that exist within the Global North as well. In many Global North countries, in the years after the crashing down of the neoliberal order, austerity (to varying degrees) has been the go-to policy with public sector jobs being cut, and many people being thrust into unemployment and even poverty. This has had many consequences on health (both mental and physical) and has caused many of our countries to be woefully underprepared for something as catastrophic as a pandemic.
In recent weeks, governments have been calling on ‘essential workers’ and their skills. Many people across the world have been applauding their healthcare staff from their windows, balconies, living rooms and their palaces. We have, rightfully, been supporting ‘essential workers’, but what does that mean when essential workers have been devalued for years within our societies? When many of the people we have elected have been the ones to systematically cut funding for healthcare and the minimum wage is still not necessarily a living one. Many essential workers are in low-paying jobs, and additionally many essential jobs are traditionally feminised roles such as caring professions and domestic and service jobs. This exacerbates already exiting inequalities where they exist.
One of the most effective ways to slow the spread of infectious disease is through social – also called physical – distancing measures such as working from home, staying at home as much as possible, and avoiding close physical contact with other people not part of one’s household. However, for many people, many of whom economically disadvantaged and/or marginalised, this is nearly impossible, increasing the burden of mortality for this group. For many these people working from home is impossible because of the nature of their jobs, staying at home would mean a loss of income and livelihood, and there is a lack of paid sick leave and no (affordable) available childcare.
But beyond income inequality and depletion of resources for many of our health services and the low-wage nature of many essential jobs,, there are other vulnerable groups who will be suffering from increased difficulty in accessing healthcare during the pandemic. An example of this are the homeless who will not have the opportunity to social distance in the same way those with a home do, and who will often not be able to access quality healthcare as easily. Another example of a vulnerable group who might experience more difficulty are prisoners. Prisons are often not adept at containing major infectious disease epidemics. Thirdly, immigrants and refugees who are currently living in dire conditions in camps and settlements, particularly as these people will likely live in crowded places with poor sanitation and more difficulty to access healthcare. Beyond the elderly and those with underlying conditions, there are so many other people who might be particularly at risk in this time. Many of whom have been neglected by society, but all of whom are particularly at risk of having their human rights abused.
This global pandemic has shown us that, even though health is a human right, it is only as viable and attainable as the strength of our health systems and our care for the most vulnerable in society are.
Health is a human right as recognised in the Universal Declaration of Human Rights. The decade of systematic cuts to our health systems and the secondary effects of austerity of thousands of people working in precarity and dealing with failing living standards have caused us to be woefully unprepared for a catastrophic event like this. This global pandemic has shown us that, even though health is a human right, it is only as viable and attainable as the strength of our health systems and our care for the most vulnerable in society are. In a world where the rich are able to self-isolate in mansions or second homes, and get access to tests even when others can’t, it seems difficult not to imagine there might be an aspect of class strife involved. It seems clear that we won’t be able to return to normal after the pandemic is over. The shaky foundations our systems are built on are not likely to survive in tact after this. It is then up to us to decide what’s next and to prepare for the next pandemic – which will come – in more comprehensive ways such as defending the right to healthcare, increasing its access, funding our health systems, implementing fairer labour policies, and redistributing wealth. We must applaud our essential workers, but we must also not forget them when this pandemic is over and they ask for more than just verbal appreciation. We, after all, are only as strong as the weakest link and at the moment the tower is crumbling.