Coronavirus has amplified inequities that exist in the health system

Dr. Craig Spencer works in an emergency department in charge of its global health programme and is on the board of directors of Médecins Sans Frontières (Doctors Without Borders). We interviewed Dr. Spencer as part of our #PassTheMic series. Here’s some of what he had to say.

We’re not safe until this virus is controlled everywhere, whether it’s in Alabama or Burundi.

I recognize that for us in the US, the acute focus needs to be on our preparation and saving lives here. But we also need to recognize that could potentially have negative impacts elsewhere. For example, with export restrictions on personal protective equipment or by undermining global organisations that are going to be best suited to coordinate a response, like the World Health Organization.

All that does is make it more difficult for us to lead an effective response that’s going to ultimately save lives everywhere.

Even here in the US, if we had a coordinated response, it would be so much more efficient than if it were New York State vying for personal protective equipment against New Mexico. We’ve highlighted the unfortunate deleterious impacts that hoarding and stockpiling has had here in the US, making things less available and more expensive.

We’re now seeing that amplified on a global scale. The problem is that Côte d’Ivoire is not going to be able to pay a premium for surgical masks and respirators like Colorado might be able to.

Local preparation is key, but a global response is needed

It’s important to recognise that preparation is key locally, but also think about how it’s going to be done on a global scale. Because again, without a global response, one part of this world can be safe, while the rest is not.

Likewise, we all know what’s going to happen when a vaccine gets made: it’s going to go to wealthy individuals and wealthy places.

The problem is, even if we make a vaccine, we’re not going to be able to scale this up at enough of a speed to even protect everyone in the US. So how are we going to think about that from an equity standpoint in making sure that people who need it most, regardless of where they’re at, and regardless of their ability to pay, are able to access it?

It may be that a vaccine would be better for elderly patients in long-term care facilities in low- or middle-income countries, rather than a healthy 35-year-old in New Jersey. But how are we going to have any type of mechanism or accountability or organisation to make sure that happens? That’s going to be a huge challenge.

The need for empathy

In thinking of the immediate next steps to prioritise, empathy is a big one. Recognition from people in wealthy countries that this is not just an issue in their country.

I can’t help but imagine that after this, there’s going to be some type of permanent and hopefully sustained change in the consciousness of who we are together.

What’s needed is an understanding that if the virus was devastating here, it’s going to be more devastating in places where it’s not just a lack of PPE that’s an issue — it’s a lack of basic things like gloves and running water.

The risk of not having a global response is that we’ll end up having hot spots of the virus all across this country and across every continent that will likely move in waves and will come back to our shores repeatedly.

If we don’t stop this at the global level — as long as it’s in Peru or Rwanda — it’s a threat to us here. We can’t close ourselves off, especially if we’re so focused and concerned about the economy.

However, I’ve been heartened by the fact that there has been a focus on this hitting more vulnerable communities. I’m starting to hear people talk about how coronavirus has amplified inequities that exist in the health system in our country and across the world.

In fact, I’ve heard it to such an extent that I can’t help but imagine that after this, there’s going to be some type of permanent and hopefully sustained change in the consciousness of who we are together. As well as an understanding of why it’s important, not just from a humanitarian point of view, but also in terms of protecting ourselves and our loved ones, to ensure that we’re elevating and amplifying the needs of people who are most marginalised in our societies.

These excerpts from the interview were edited for length and clarity.

Hear more from experts in our #PassTheMic campaign, where global health experts take over celebrities’ social media channels to share the data, facts, and science we need to know to end COVID-19. Follow us on Instagram, Facebook, and Twitter for more.

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