By Sharon Atieno
To promote anti-racist strategies and actions that will reduce barriers to health and well-being facing communities on the basis of race, ethnicity, tribe, caste, gender identity or expression, sex, ability, class, geography or religion, a new O’Neill-Lancet Commission on Racism, Structural Discrimination and Global Health has been formed.
The unveiling of the Commission which will be made up of about 20 experts from across the globe took place on the sidelines of the 77th session of the United Nations General Assembly in New York.
The three-year Commission is founded on the recognition that racism creates and maintains unjust and avoidable health inequities worldwide as observed during the COVID-19 pandemic where socio-economic inequalities, systemic racism and structural discrimination influenced access to quality treatment and care.
“The COVID-19 pandemic has dramatically highlighted the urgency of addressing racism directly when it comes to health,” said Dr. Tlaleng Mofokeng, Commission co-chair, and United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
“It has also raised critical questions about the continuing colonial relationships undergirding global health efforts. Now is the time to confront this reality and accept that too little progress has been achieved to reduce discrimination in health.”
The announcement of the Commission comes on the heels of Dr. Mofokeng presenting her report on “Racism and the right to health” to the United Nations General Assembly on October 20.
The report highlights how, “rooted in colonialism, slavery and other historical power imbalances, racism continues to manifest itself in poor and preventable health outcomes worldwide, such as glaring disparities in maternal mortality and morbidity, and higher risk levels of communicable and non-communicable diseases.”
The report documents varied ways in which racism impacts health, including language barriers, residential segregation that distances some populations from key health services, and structural racism in areas like education that ultimately lead to poorer health outcomes for some populations.
The Commission will go beyond simply documenting these disparities, as that is insufficient for understanding the connections between race, ethnicity, structural discrimination, and global health.
“It is too easy to see race, rather than racism, as a driver of poor health outcomes and to dismiss these as the products of particular historical contexts,” said Dr. Ngozi Erondu, Commission co-chair and senior scholar, O’Neill Institute for National and Global Health Law. “That narrow view misses both the local and international causes of racial inequities.”
The Commission will also investigate specific outcomes seen across countries and consult communities to understand their causes and impact. For example, it is well-documented that in many countries around the world, maternal mortality rates are rooted in both gender and racial injustices. In the United Kingdom of Great Britain and Northern Ireland, for example, Black women are four times more likely, and Asian women twice as likely, to die in childbirth than White women. In Brazil, women of African descent are approximately five times more likely to die in childbirth than White women. The Commission will further impact these outcomes and examine their transnational implications.
Recognizing that global health financing and foreign aid between colonial powers and formerly colonized regions are shaped by the legacy of these relationships, the Commission will also set out to examine and challenge current global health governance systems and structures.
“We’ve known for some time now that racism leads to increased rates of sickness and death,” added Dr. Erondu. “Our aim with this Commission is to not only further document and unpack these realities on a global level, but most importantly help promote meaningful change. And we’re doing this by bringing together individuals who are not only experts in their respective fields, but who have experienced racism and structural discrimination and fight against it for their communities.”
To achieve its goals, the Commission has set out four charges which include diagnosing the problem of racism in health globally. This will be achieved by reviewing existing national and cross-national evidence on racism in health in a global context. The Commission will then describe the effects of racial and ethnic discrimination and its intersections on health at a national and international level.
It has also set out to identify best practices and actionable anti-racist strategies through activities such as holding consultations with people who have lived experiences of structural discrimination in health, to discover how racist structures in select countries were addressed to close health equity gaps.
Additionally, it will compile a report of its findings, highlighting the strategies, tactics, and actionable lessons that other countries can use to develop anti-racist approaches in the sphere of health policy and service delivery to ensure equitable and just health outcomes.
Further, the Commission will disseminate its findings widely to the public, to ensure that the anti-racist strategies and actionable lessons produced are used and contribute a body of knowledge to augment efforts to decolonize global health.
“Now is the time for the public health and human rights communities to come together to recognize the ways that racism, structural discrimination, and the long-lasting impacts and remnants of colonialism and oppression shape our health and well-being,” said Dr. Mofokeng. “This Commission will help bring new voices to the table that can share learnings and solutions across borders to address these issues with the level of attention and urgency they deserve.”