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By Jeffrey Braithwaite and Wendy Nicklin Monday. Jun 15, 2020

Health inequalities, COVID-19, Black Lives Matter Featured

On either side of the Atlantic, the US Black Lives Matter protests over the death of George Floyd, and the calls for a UK enquiry into the disproportionate death rate from the COVID-19 infection of black, Asian and minority ethnic (BAME) groups, are energising communities and fair-minded folk globally. In point of fact, no-one in any country should be complacent about health inequalities and human rights.


Racism is systemic, and the social determinants of health – those economic, social, education, living and working conditions that affect healthcare and health status – lead to disparities in just about everything – life opportunities, wealth and income, social mobility, life expectancy and the distribution and exercise of power.


We write while the pandemic is at its peak in many countries and there are very concerning signs that the next wave might be underway in others. All the while equality campaigns, rallies and protests are occurring in many towns and cities.    


The rapidity of the spread of concerns, demonstrations and advocacy for a better world has been astonishing. We believe that every crisis affords opportunity: opportunity for change, opportunity for improvement, opportunity to build, or rebuild; or conversely, one can choose to ignore these opportunities.


We have only been witnessing and personally experiencing the COVID-19 threat to our health, as individuals and as populations, and all of the restrictions that have accompanied this vicious virus, for a few months – so this is early days.  Yet already, we can all see in this locked-down world how people can sincerely display empathy, and reach out via the internet, video-meetings or social media to colleagues, friends, and those in need.


Indeed, many people have been moved to show concern for others in this strange new world – but that is not enough.  The pandemic has also brought into the sharpest of focus that the BAME community is truly being impacted in a more severe way – due to many factors, some of which are outlined in Public Health England’s report on COVID-19 deaths, identifying major inequalities, with mortality risk significantly higher among BAME groups.   


Exacerbating the situation, the impact on mental health is immense given the changes in our lifestyles and rising levels of anxiety and depression that have been brought on by the virus.  Our lives are being transformed and many of us feel powerless to control what is happening.  As the stress levels rise, due to unemployment, the economic downturn, levels of social restrictions, and the switch of education and work to the home, it is not surprising that many people are close to their breaking point.  


It was clear as these responses to the pandemic progressed, it would only take an additional stressor, a catalyst, for the bonfire to be lit. The death of George Floyd was that trigger for many people – to reignite the reality of unacceptable racism faced around the world.


The Mission of ISQua is to inspire and drive improvements in health, and to promote the safety and quality of healthcare worldwide.  The Board of ISQua has a clear strategy and many initiatives underway to realise this mission.


Our commitment is to work with people and institutions across the world, whether from low-, middle- or high-income countries. Our role is to contribute to the reduction in health inequalities and improve the quality of care for all – and to support initiatives such as #blacklivesmatter, and help level the playing field for BAME groups in all health and social matters. We wish to strongly affirm this support, and recognise the principles of equality, health for all and healthcare as a human right, and to support universal access and quality care for everyone, no matter their circumstances.  These principles permeate all our activities and initiatives.


We are not the first to note that, with all this change, and the high levels of concern being expressed, that the world is at an inflection point in history. Together, we have a unique opportunity to heed this clarion call for a better world.  Together, we can work to turn the situation around.  This state-of-affairs which we have allowed to fester – infused with racism, income inequalities, and social inequities, and which has in reality been known for decades – needs to change.


The result might be a radical transformation, with change occurring almost before we know it. Or it might unfold as a tortuous journey, with every gain hard won, and manifest as merely incremental improvements over decades. Either way, change for good will require our unrelenting commitment and collective efforts.  As we march ahead together, it behooves each and everyone of us to reflect on these issues, and take deliberate steps to contribute to the solutions – as individuals, in small groups, as institutions, across whole populations, and internationally.


So, while right now the US and UK seem to be the major flashpoints, the imperative for equality is relevant to the people of every country and also between countries across every continent.   We do indeed have an opportunity.  While hurt and inequality will continue, protests will be held, and calls for inquiries made, and while more individuals are destined to suffer negative consequences, a window for progress has opened. ISQua commits to playing its part.


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