Barriers to Health for World’s Poor Exposed by Africa’s Conflict and Crisis

Seventy-five years ago, in the ashes of World War Two and the unprecedented human suffering it caused, nations laid out a way to build “the foundation of freedom, justice and peace in the world.”

The principle of fundamental rights of everyone, everywhere was captured in the Universal Declaration of Human Rights, which was adopted in 1948. The World Health Organization was founded the same year. Its Constitution enshrines health as “one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”

On the 75th anniversaries of these monumental milestones, we should be celebrating the great strides made in advancing human rights and improving many vital health indicators.

But as 2023 ends, the world is embroiled again in war and crisis. Conflicts in Gaza, Israel, Ethiopia, Sudan, Ukraine, Russia and Myanmar and beyond have caused unimaginable pain, despite repeated calls to respect International Humanitarian Law. Populations have struggled with the aftermath of earthquakes, floods and droughts made worse by the climate crisis.

Health facilities and workers have been among the casualties of such crises, and far too many people have needlessly died or suffered catastrophic physical harm.

Bloody images on our screens are the tip of the iceberg of denial of the universal right to health.

The anguish we see induces deep shock and anger. And yet these blood-soaked images are just the tip of an iceberg when it comes to even more pervasive infringements on the right to health for hundreds of millions.

For when acute crises end, the underlying exclusion and discrimination concealed below remain. Addressing these preventable rights violations requires world leaders, and others wielding power and responsibility, to take seriously their duty to respect, protect and fulfil human rights.

Civilians bear the brunt, and inevitably, it is the poorest, and those enduring discrimination, who suffer most. Poverty, discrimination and other factors make people more vulnerable to disasters – and they make societies more likely to ignite in violence.

To end conflict, and build communities to be better prepared for and protected from disaster, we must tackle systemic poverty, marginalization, and discrimination, and dismantle the economic and political structures upholding them.

This requires prioritizing the most vulnerable by promoting peace, preventing poverty and protecting those at greatest risk.

Poverty and inequity lead to violent societies.

And yet as the world’s wealth soars to unprecedented heights, so do structural inequalities.

In 2022, the wealthiest 10% of the world’s population controlled a staggering 76% of total global wealth; the poorest half controlled just 2%. The affluent have disproportionate influence on how our economies and societies are governed.

COVID-19 cast these disparities into sharp relief. The UN Global Crisis Response Group reports that 60% of workers have lower incomes than before the pandemic. Yet, it was these very individuals who were instrumental in sustaining us through that crisis. Their economic struggles make a mockery of the gratitude they are owed.

According to the latest World Inequality Report, the fight against global poverty suffered a serious reverse due to COVID-19. In 2020 global extreme poverty rose by 8.4% from 2019, with over 70 million more people pushed into extreme poverty. The world’s poorest lost twice as much income as the richest, and global inequality rose for the first time in decades.

Poverty and inequalities of such towering proportions not only harm individuals; they profoundly undermine social harmony and peace. This is not a landscape anyone would want to live in, or offer to future generations.

But we don’t have to. A more sound, human rights-based approach to our societies, economies and the pursuit of peace can leverage policies to turn this situation around.

Governments can take actions that shelter people from the sudden shocks that rock societies, be they caused by economic failure, earthquakes, climate-caused calamities, conflicts or pandemics.

Because we know when the dust settles on any acute crisis, the suffering of the most at-risk remains: the World Bank estimates that by 2030, 46% of the world’s poor will live in areas characterized as fragile or conflict affected. Food insecurity is twice as prevalent in these areas.

Human rights must guide investment decisions to reduce the risks of crises. Rights must be placed at the center of conflict prevention, response and resolution. Societies built on human rights are most likely to maintain peaceful relations and avoid escalation of conflict.

Investing in health is not a luxury but a necessity to our mutual survival.

At the dawn of a new year, as we call for peace and the protection of human rights and health, we also urge a radical recommitment to ending poverty.

The WHO Council on the Economics of Health for All has pointed out a stark contradiction: “although at least 140 countries recognize health as a human right somewhere in their constitution, only four countries to date mention how to finance it.”

We must view health not as a cost, nor a luxury that only those who can afford benefit from. Health must be seen as a crucial investment in the well-being of humanity. A just economy promotes equality, invests in healthcare, and ensures equitable distribution of resources.

All national economic, fiscal, monetary, investment and business decisions should be viewed, and managed, through the lens of health and human rights.

In this sense, addressing poverty, prioritizing peace, investing in education, ensuring fair wages, and eliminating all forms of discrimination are imperative steps to realizing the right to health for all, and building a just and peaceful society.

The prescription for humanity is clear: it is time to stop putting wealth before health. It is only by sheltering the world’s most at risk from poverty, crisis and inequality can we build lasting peace, prosperity and health for all.

Dr Tedros Adhanom Ghebreyesus is the Director-General of the World Health Organization and Mr Volker Türk is the United Nations High Commissioner for Human Rights.

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