Global inequalities are prolonging current pandemics such as HIV/Aids and making the world more vulnerable to future outbreaks, warns a new report by an expert panel convened by the UN Programme on HIV/Aids (UNAids).
The Global Council on Inequality, Aids and Pandemics on Monday called for debt restructuring for distressed countries to help break the vicious cycle between pandemics and inequality. It urged countries facing pandemics, including HIV/Aids, to scrap austerity measures, saying they made things worse by degrading public health systems and deepening inequality.
“When efforts to stabilise pandemic-hit economies are paid for through high interest on debts and through austerity measures, they starve health, education and social protection systems.
“Societies then become less resilient and more vulnerable to disease outbreaks. Breaking this cycle requires enabling all countries to have the fiscal space to invest in health security,” said Nobel Prize-winning economist Joseph Stiglitz, who co-chaired the council.
The report comes as SA prepares to host the G20 leaders summit later this month, on a continent in which many nations are grappling with high debt servicing costs and dwindling foreign aid.
Many Western governments are reducing bilateral support as they increase defence spending, while the Trump administration has slashed foreign aid and withdrawn support from a wide range of global health organisations, such as the Global Fund to fight HIV/Aids, tuberculosis and malaria.
An estimated 60% of tax revenue collected by Sub-Saharan African countries is spent on servicing debt, said Stiglitz.
High levels of inequality increase the risk of disease outbreaks becoming pandemics and make pandemics more deadly and longer lasting, warns the report.
“The evidence is unequivocal. If we reduce inequalities — including through decent housing, fair work, quality education and social protection — we reduce pandemic risk at its roots. Actions to tackle inequality are not ‘nice to have’; they are essential to pandemic preparedness and response,” said council co-chair Michael Marmot, executive director of the Institute of Health Equity.
The council was established by UNAids executive director Winnie Byanyima in 2023 to advocate for policies to tackle the inequalities that fuel disease outbreaks.
“The report shows why leaders urgently need to tackle the inequalities that drive pandemics, and it shows them how they can do this,” she said.
It recommends treating medicines and other technology needed to respond to a pandemic as “public goods” and waiving the intellectual property rights on these products to ensure wide access. It also calls for resources to be invested in regional production capabilities.
Such measures would ensure Africa was spared the “vaccine apartheid” it endured during the Covid-19 pandemic, which saw the continent at the back of the line when shots were in short supply, said Byanyima.
Implementing universal health coverage, as the SA government seeks to do with National Health Insurance, was key to tackling inequalities within countries and ensuring they were better positioned to respond to pandemics, she said.
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