The study, released Monday ahead of the G20 meetings later this month in Johannesburg, South Africa, shows that unequal access to housing, healthcare, education and employment leaves millions more exposed to disease.
The report presented by UNAIDS – the world body’s agency dedicated to ending AIDS and HIV infection – finds that inequality is not only worsening the spread and impact, but is also undermining the global capacity to prevent and respond to outbreaks.
Breaking the inequality-pandemic cycle: building true health security In a global era, It requires a fundamental change in what we understand by “health security.”
Vicious circle
New data shows that pandemics increase inequality, fueling a cycle that is visible not only after COVID-19, but also in the case of AIDS, Ebola, flu, mpox and beyond.
Co-chaired by Nobel Laureate Joseph E. Stiglitz, former First Lady of Namibia Monica Geingos and leading epidemiologist Professor Sir Michael Marmot, the World Council on Inequality, AIDS and Pandemics – which carried out the research – reaches a stark conclusion: pandemics and inequality are trapped in a vicious cycle, each feeding the other in ways that threaten global stability and progress.
“Inequality is not inevitable. It is a political and dangerous choice that threatens everyone’s health.“said Ms. Geingos. “Leaders can break the cycle of inequality and pandemic by implementing the policy solutions tested in the Council’s recommendations.”
Global inequalities exacerbate risks
Studies reviewed by the Council reveal that unequal access to housing, education, employment and health protection created conditions in which COVID-19, AIDS, Ebola and Mpox spread faster and hit harder.
For example, people living in informal settlements in African cities were found to have a higher prevalence of HIV than those living in formal housing. In England, housing overcrowding was associated with higher mortality from COVID-19.
In Brazil, people without basic education were several times more likely to die from COVID-19 than those who finished primary school.
The Mathare slum in Nairobi is home to 500,000 people within a 5 square kilometer radius.
Between countries, global inequalities exacerbate shared risks. Low-income countries have faced repeated obstacles to accessing vaccines, medicines and emergency financing, leaving outbreaks uncontrolled and prolonging global disruption.
“The evidence is unequivocal,” said Professor Marmot. “If we reduce inequalities, through decent housing, fair work, quality education and social protection, we reduce the risk of pandemic from its roots.”
Towards true health security
UNAIDS Executive Director Winnie Byanyima said the findings come at a crucial time as the G20 meets under South Africa’s presidency.
“This report shows why leaders urgently need to address the inequalities driving pandemics, and shows them how they can do so,” Ms Byanyima said.
Pensioner Xhane Grodani, who lives with her husband in Tirana, Albania, receives her third COVID-19 vaccine at a clinic in the capital.
“Reducing inequalities within and between countries will allow for a better, fairer and safer life for all,” he added.
The report aligns with South Africa’s G20 theme: “Solidarity, Equality, Sustainability,” highlighting that achieving genuine health security will depend as much on economic justice and social equity as it does on vaccines or laboratories.
The Global Council outlines four key actions to break the “inequality-pandemic cycle”:
- Remove financial barriers to ensure all countries have the fiscal space to address inequality.
- Invest in the social determinants of health, such as housing, nutrition, education and employment, to reduce vulnerability to disease.
- Guarantee equitable access to technologies related to the pandemic by treating research and innovation as global public goods and promoting regional production.
- Strengthen community-led multi-sector responses by embedding pandemic preparedness into local systems and ensuring broad participation across government, civil society and science.
