Русский | Español
13 May 2021
As both a doctor and the United Nations’ High Commissioner for Human Rights, I am pleased to join you in this discussion of how research can contribute to a healthier world for vulnerable populations.
This is a topic as important as it is vast. Today, I will raise two points I find fundamental, especially in the context of COVID-19. Equality of access to health services, goods and facilities, including vaccines; and the need for disaggregated data to tailor appropriate and specific policies, during the pandemic and beyond.
First and foremost: health is a right.
One that is indispensable for the exercise of many others and necessary for living in dignity.
COVID-19 has made its realisation even more urgent.
The crisis has shown us that for anyone to be safe everyone has to be.
Access to health services and vaccines must be in accordance with principles of equality and non-discrimination.
The pandemic has demonstrated the importance of strong and universal public health systems, with quality care available, accessible and affordable to all, without discrimination and irrespective of anyone’s ability to pay.
Universal health coverage must be a fundamental priority.
The case for it has never been stronger nor the stakes higher.
Healthy societies are the key to unlocking sustainable development, and poor health outcomes severely restrict their capacity to flourish and build resilience.
The 2030 Agenda for Sustainable Development clearly affirms this link. Moreover, target 3.8 specifically commits governments to achieving universal health coverage. That includes “financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines.”
However, that this is not yet the case.
COVID-19 has laid bare the profound inequality pandemic affecting our societies, including when it comes to both access and spending on health care.
The virus and its impacts have fed into and exacerbated fault lines built on discrimination and deep, intersecting and structural inequalities. These are clear gaps in human rights protection.
In every region of the world, people who were already most vulnerable, those whose voices have been historically and systematically silenced, have been more likely to die of COVID-19, and have been hit the hardest by its socio-economic consequences.
Women and girls, indigenous peoples, people of African descent, LGBTI people, migrants, people with disabilities, and those deprived of their liberty, among others. People who have been left behind – and are being pushed further behind.
To recover better from this crisis, it is clear to me that we must prioritise systems that realise the rights to social protection and to health to all. That includes resources and funding.
And that the principles of equality and non-discrimination must also be respected in accessing vaccines, regardless of migration status.
National vaccination plans must be made public and accessible, in consultation with civil society and affected communities prior to implementation.
It is deeply concerning, however, to see how historical inequities, both within and between countries, are repeating themselves.
Vaccines have sadly become the new frontier in the struggle for equality, demonstrating that the gap between rich and poor remains as wide as ever.
With several vaccines licensed by national regulatory bodies around the world, more than 1.1 billion doses of vaccines have been administered globally so far. However, more than 80% of these have been administered in high- and upper-middle-income countries, while only 0.3% have been administered in low-income countries.
This approach not only runs counter to the cooperation necessary for an effective, human rights-based global response.
It is also inefficient in the context of a global pandemic, which has made it clear that there is only one way out of this crisis.
A collective one.
The absence of vaccination in massive parts of the world represents a direct threat to all.
We need global solidarity and concerted political action to ensure that vaccines are affordable, accessible and available to everyone, everywhere.
The Human Rights Council has been actively discussing how to ensure their equitable and timely access.
The United States’ support for the proposal to temporarily suspend IP protections applicable to COVID-19 vaccines is an encouraging example of international solidarity. I look forward to a timely WTO Council decision that would contribute to the expansion of local production, thereby increasing COVAX capacity to serve the billions of people who are being left behind in terms of access to COVID-19 vaccines.
At the same time, help cannot wait.
We must also urgently increase current funding for manufacturing and vaccines.
The COVAX mechanism is an inspiring example. Worldwide, it has already delivered over 59 million doses to 122 participants.
In all its forms, the promotion of public health is crucial.
And health, as we know, is more than the absence of a disease.
Socioeconomic determinants of health, such as poverty, inequality, discrimination, nationality, migration status, and access to safe food, clean water, and a non-toxic environment have been major reasons why millions of people suffer from poor health. To make matters worse, this is often compounded by a lack of access to good quality health care and services.
In this past year, we have been painfully reminded of how outbreaks of communicable diseases can severely affect those who were already in vulnerable situations.
But these profound inequalities in healthcare were not an invention of the current pandemic.
More than half the people alive today have little or no access to live-saving services such as prenatal care and basic treatment for malaria, tuberculosis or HIV-AIDS.
Countless more are affected by pollution and other preventable environmental harms, which disproportionately affect people and groups in vulnerable situations.
Migrants and their families often face a range of additional obstacles in accessing health services. And for women and girls, sexual and reproductive health care remains a challenge, particularly for those in vulnerable situations.
This injustice undermines the future not only for individuals, but also for entire countries and regions.
It is of the utmost importance to invest in studies that look at how the social determinants of health affect the poor and most vulnerable. I would also highlight the need for in-depth research on how issues such as nutrition, access to water and sanitation, air pollution, housing conditions and other inequalities have influenced the impact of the pandemic on these groups.
I encourage countries to share studies and best practices related to the influence of the social determinants of health on the impact of the pandemic on the most vulnerable groups.
For research to deliver to the most vulnerable I would emphasize two important points. One is diversity, in both research teams and objects. The other is increased data disaggregation as I mentioned earlier.
The restrictions necessary to combat COVID-19 pose a considerable obstacle to data collection on discrimination and other human rights challenges aggravated by the pandemic. However, it is
essential that it continues in a timely way. As many of the groups most impacted by COVID-19 were already experiencing higher levels of discrimination, such data is key to mitigate such adverse effects of the pandemic.
Data collection needs to be maintained and scaled up to fully inform human rights-based responses to the crisis.
My office has supported the UN Crisis Management Team to collect data on the human rights impact of the pandemic. Working together with other UN agencies, including the World Health Organization (WHO), we have developed ten indicators for measuring whether the UN and States’ responses to the pandemic are consistent with international human rights standards and address key concerns.
Moreover, COVID-19 pandemic is creating a massive setback in the realization the Sustainable Development Goals and exacerbating global inequalities, including on data.
While 9 out of 10 countries can report internationally comparable data on SDG global health indicators, much of it predates the crisis. Moreover, the vast majority of national statistical systems from low- and lower-middle-income have suffered funding cuts.
Seventy-three countries have expressed the need for external support in addressing data challenges associated with COVID-19. If these needs are not filled, they will have a lasting effect on countries’ ability to produce timely and disaggregated data for many SDG indicators, potentially jeopardizing rights-based recovery in many countries.
The international statistical community and donors should urgently provide support to national systems most in need. In addition, new partnerships must be forged to restore trust in data and statistics, which have been weakened by the speed and reach of misinformation and disinformation.
My office continues to strengthen institutional linkages and collaboration between National Human Rights Institutions (NHRIs), National Statistical Offices (NSOs), and national statistical systems.
Such partnerships are increasingly seen in countries applying the
Human Rights-Based Approach to Data, demonstrating how data can be produced putting people at the centre and following international human rights and statistical standards.
"Leaving no-one behind" is not an empty slogan: it is an action plan. The discrimination that holds back millions of people, often denying them access to quality health care, is deeply unjust, illegal and damaging to everyone.
COVID-19 has provided us with a powerful demonstration of the value of human rights, one rarely ever seen.
We must not close our eyes to it.
It is time to look at the world in a different way.
To look for political and economic systems that are more just, inclusive and sustainable.
To ensure all people can benefit from scientific progress and participate in evidence-based decision-making.
And to finally recognize the urgency of protecting the planet, the best way to protect human health and wellbeing, including from pandemics.
Many of the last epidemics and pandemics – SARS, MERS, COVID-19 and others – are, after all, the result of animal-to-human zoonosis, which is made more likely by environmental degradation and biodiversity loss.
Better understanding the ways human health depends on the health of our environment can help us recover better. Recover into more resilient societies that are better prepared to face other looming or existing crises.
As the UN Secretary-General has said, this is a make-or break year to confront the climate emergency, an overarching threat to human rights and to us all.
The damage that climate change could inflict is far greater than even COVID-19 – and over a much longer period. In terms of deaths; economic damage and extreme poverty; social tensions and violence; displacement; and the potential impact on conflict and profound underdevelopment.
We can avert this. But we need to move fast.
We have to learn the lessons of COVID-19 – and apply them to climate action and to all our recovery efforts. These lessons include our new understanding of the ways in which human rights gaps act as conduits and multipliers of disasters.
And our grasp that only human rights based policies can combat crises that impact the entire globe.
This is how we recover better.