The study, released Monday ahead of G20 meetings later this month in Johannesburg, South Africa, shows that unequal access to housing, health care, education and employment puts millions more people at risk of disease.
The report released by UNAIDS – the global agency dedicated to ending AIDS and HIV infection – reveals that inequalities not only worsen the spread and impact, but also undermine the global capacity to prevent and respond to epidemics.
Breaking the inequality-pandemic cycle: building real health security in the era of globalization, calls for a fundamental shift in what we mean by “health security.”
Vicious circle
New data shows that pandemics increase inequality, fueling a cycle visible not only in the aftermath of COVID-19, but also for AIDS, Ebola, influenza, mpox and beyond.
Co-chaired by Nobel laureate Joseph E. Stiglitz, former First Lady of Namibia Monica Geingos and eminent epidemiologist Professor Sir Michael Marmot, the Global Council on Inequality, AIDS and Pandemics – which conducted the research – draws a stark conclusion: pandemics and inequalities are locked in a vicious cycle, each fueling the other in ways that threaten global stability and progress.
“Inequalities are not inevitable. It is a political and dangerous choice that threatens the health of all“, said Ms. Geingos. “Leaders can break the inequality-pandemic cycle by implementing the proven policy solutions contained in the Council’s recommendations.”
Global inequality exacerbates risks
Studies reviewed by the Council reveal that unequal access to housing, education, employment and health protection has created conditions in which COVID-19, AIDS, Ebola and Mpox spread faster and hit hardest.
For example, people living in informal settlements in African cities were found to have higher HIV prevalence than those living in formal housing. In England, crowded housing was associated with higher mortality from COVID-19.
In Brazil, people without basic education were several times more likely to die from COVID-19 than those who completed primary school.
The Mathare slum in Nairobi houses 500,000 people over 5 square kilometers.
Between countries, global inequalities exacerbate shared risks. Low-income countries have faced repeated barriers to accessing vaccines, medicines and emergency funding, leaving outbreaks uncontrolled and prolonging global disruption.
“The evidence is unequivocal,” Professor Marmot said. “If we reduce inequality, through decent housing, fair work, quality education and social protection, we reduce the risk of a pandemic at its roots. »
Towards real health security
UNAIDS Executive Director Winnie Byanyima said the findings come at a pivotal time as the G20 meets under South Africa’s presidency.
“This report shows why leaders must urgently tackle the inequalities that fuel pandemics, and it shows them how they can do it,” Ms. Byanyima said.
Pensioner Xhane Grodani who lives with her husband in Tirana, Albania, receives her third COVID-19 vaccination at a clinic in the capital.
“Reducing inequalities within and between countries will enable everyone to live better, fairer and more secure lives,” she added.
The report aligns with the G20 South African theme of “Solidarity, Equality, Sustainability”, emphasizing that achieving true health security will depend on economic justice and social equity as much as vaccines or laboratories.
The Global Council defines four key actions to break the “inequality-pandemic cycle”:
- Remove financial barriers to ensure all countries have the fiscal space to tackle inequality.
- Invest in the social determinants of health, such as housing, nutrition, education and employment, to reduce vulnerability to disease.
- Ensure equitable access to pandemic-related technologies by treating research and innovation as global public goods and promoting regional production.
- Strengthen multi-sectoral community-led responses by integrating pandemic preparedness into local systems and ensuring broad participation of government, civil society and science.
