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I hope you are all managing all right in your personal and professional lives during this very difficult situation, which is disrupting the lives of billions of people on this planet.
We now have a clearer view of how even the richest and most powerful countries were totally unprepared to cope with such a pandemic -- despite long-standing warnings by medical experts that a serious one was inevitable. Well over 4 million people have now been infected, and well over a quarter of a million people have died. Economies are being devastated. The numbers are rising relentlessly, and will almost certainly continue to do so, with the spread of COVID-19 among the less developed countries in the South still in its early stages.
While the virus itself does not discriminate, its uneven impacts have laid bare the man-made social and economic inequalities on which it feeds. The overall impact on lives and economies is clearly catastrophic, but predictably enough the data is now starting to show that the poorest and most marginalized – those people suffering the biggest human rights deficits -- are being affected worst of all.
A number of lessons are already becoming clear, including that neglecting the economic and social rights of parts of the population in the end rebounds on everyone else. How well we learn those lessons will go a long way towards determining the scale and duration of this particular pandemic. It should also help us be better prepared to prevent or contain future pandemics, including ones potentially more deadly than COVID-19.
We should also, as a matter of urgency, apply those lessons to other looming and predictable crises that require global solidarity, such as climate change.
We are now entering an even more complicated period, with some countries beginning to open up again after lock-downs, while others are tragically seeing their infection and death rates starting to soar for the first time. Second and even third waves of COVID-19 are likely to occur in different places at different times with different degrees of severity.
All of this is complicated by the fact that we still know relatively little about how COVID-19 functions, how it will develop, and what sort of time-frame we are looking at before it is brought under control.
How each country handles its own specific situation will affect not only its own population, but potentially the rest of us as well. This is a test of individual leadership, but also of global leadership and cooperation. I will return to this issue of leadership later.
As a former doctor and health minister, as well as a former head of state and current High Commissioner for Human Rights, I am acutely aware of how complex it is to find the right balance. Governments have to cope with handling the medical situation as effectively as they can, while also trying to save their economies from collapsing, with all the additional devastating effects this will have – is already having -- on their populations. Going forward, major human rights challenges will continue to be inextricably interwoven with the medical and economic ones.
Coming out of lock-downs
Today, I would like to focus on some specific human rights issues relating to the lifting of lock-downs, as more and more countries follow this route, several of them taking their first tentative steps over the past few days, with others following in the coming weeks and months.
If an affected country comes out of lock-down too hastily, there is a danger that a second wave, costing many more lives, will be triggered sooner and more destructively than would otherwise be the case. As economies and societies transition towards more normal functioning, we must recognise that every measure to revive workplaces, education and mobility, every effort to improve our social lives, may carry a risk.
If the re-opening of societies is mishandled, all the huge sacrifices made during the initial lock-down will have been for nothing. However, the damage to individuals and to economies, will not just be retained -- it will be significantly amplified.
First and foremost,have the health criteria been met?
The WHO has clearly outlined the need for transmission to be controlled, and for health system capacities to be in place to detect, test, isolate and treat every case, and to trace every contact.
A few countries and territories applied the advice on testing, tracing, treating and isolating from the outset, and it is no coincidence that those who did have managed to contain the spread of the disease better than some of those who did not. The Republic of Korea, New Zealand and Germany are just three countries from three different regions that have been praised for taking courageous, prompt and effective measures to handle the pandemic as it began to emerge on their territory. We can also learn lessons from how two of those three countries have already faced a resurgence of COVID-19 – hopefully on a controllable scale – since beginning to relax their lock-downs and emergency measures.
Have special measures been introduced to address vulnerable locations?
There is ample evidence that people living together in certain locations face heightened risks. Plans to lift lockdowns need to pay special attention to these.
For example, before coming out of lock-downs, are steps in place to test residents and staff of care homes, psychiatric institutions, and drug treatment centres, and to monitor and report health data from such locations? And are there plans in place to ensure isolation and specialised treatment for all those who may become exposed to COVID-19 in the future? The neglect of elderly people in care homes in some countries during the first wave of the pandemic has been horrifying.
Have similar measures been taken for people in detention? For migrants, for internally displaced people and refugees in camps or settlements? Plans to lift lockdowns should aIso include measures to reduce overcrowding in such locations.
Special measures are also needed in high-density residential areas such as urban slums, and other areas without adequate water, sanitation or healthcare facilities. Mobile testing facilities need to be available in such areas, as do mobile dispensers providing free water, and soap or sanitizer. Collecting and monitoring of health data is essential here as well, to ensure new outbreaks are spotted early.
The ability to adopt certain measures is of course to some extent dictated by the wealth of the country concerned. But it is in the interest of the richest to help the poorest – both within and between countries -- as COVID-19 will fester and thrive in the most deprived areas, and in due course will inevitably spread back into the richer ones.
Are targeted measures in place for people at high risk?
What appears to be good for the social and economic welfare of the overall population may significantly increase the risks for some parts of that same population. There is, for example, already substantial data in some countries showing that the pandemic is having a disproportionate impact on racial and ethnic minorities, and on migrant workers. People with disabilities, and people with existing underlying health issues, are at heightened risk due to the prevalence of other risk factors. Some indigenous peoples face extreme risks.
Plans to lift lockdowns should include specific measures to address groups such as these. Again, monitoring and reporting -- using disaggregated data -- will be key to identifying disproportionate impacts on particular groups. Other specific steps that need to be taken to safeguard at-risk groups include prioritized testing, and provision of easily accessible health care – and in some cases specialized care.
Never before has it been so starkly clear that it is important for all of us that no one is left out of social protection schemes. And in some countries such schemes barely exist.
Poor countries urgently need support from the international community – including debt relief – to help them redirect their spending towards key areas, including access to water and food, health care, employment and social protection for those particularly affected by the crisis.
Nevertheless, many African countries have already been doing a lot with what they have. Some, especially those with experience of previous epidemics including HIV/AIDs and Ebola, have quickly put in place measures to prevent the spread of COVID-19. And many have been providing at least some economic and food assistance to vulnerable groups, or provided cash transfers. Some have also instituted economic stimuli to enable the private sector to keep functioning. Countries adopting one or more such measures include the DRC, Ethiopia, Guinea Bissau, Kenya, Niger, Senegal, South Africa, Sudan, The Gambia and Zimbabwe.
Very different approaches will be needed for certain vulnerable groups in different parts of the world. In the global South, for example, older people tend to be looked after by their families, rather than placed in care homes. This has both advantages and disadvantages, but the measures to protect them need to be adapted accordingly.
Data has been emerging showing frightening increases in domestic gender-based violence. In some countries the extent of the problem is not clear. However others, including Spain, Portugal and France, have introduced specific innovative measures to enable women and girls to alert the authorities to their plight.
This crisis has also revealed deep-seated bias, with misinformation and hate speech directed at various groups, including migrants, minorities, and LGBTI people. Our responses need to protect people who face such abuse, including by ensuring that privacy is protected when digital tracing technologies are deployed.
Have steps been taken to ensure workers are protected?
When lifting lockdowns, those without stable incomes, those not able to work remotely, and all those in essential jobs – which is not just health workers -- will face the highest risks. It is finally starting to be noticed that disproportionate numbers of essential workers are migrants, and that most of them, despite being “essential” are often very poorly paid.
Measures to protect such workers should include ensuring those with jobs involving contact with many people have appropriate protective equipment, such as masks, sanitizer and shielding materials. Clear rules are needed to provide protection for workers and members of the public. And all forms of public transport must be made as safe as possible.
Various countries are adopting these types of measures. Do they also have mechanisms in place to learn from each others’ successes and failures, and to change course if necessary? During the first wave, several countries did seem to react to the experiences of other countries, and others did not, or waited too long – with in some cases catastrophic consequences.
For countries coming out of lockdown, as well as those that have not yet experienced the full force of the pandemic, flexibility and responsiveness will be crucial, with the ability to adapt policies quickly in response to local surges in contagion or other adverse consequences.
Is the population engaged on the way forward?
People have a right to accurate information about the pandemic. They also have a right to be involved in the decisions that affect their lives, including how to lift emergency measures. When drawing up plans to lift lockdowns, states should consult badly affected communities and groups -- as well as those on the pandemic front-lines, such as health workers, public transport workers, and people working in the food manufacturing and distribution sectors.
Participation builds greater trust in the authorities and better compliance with measures to restrict contagion, and it is important to recognize that freedom of expression, like other human rights, is a crucial component of public health.
As a former politician, I know how difficult it can be for national leaders and ruling parties to take politics out of the equation. But this pandemic will not be contained by politics or ideologies, or by a purely economic focus. It will be contained by careful, sensitive, science-guided policymaking, and by responsible, humane leadership.
Letting politics or economics drive the response at the expense of health and human rights will cost lives and do even more damage in both the short and long terms. Such approaches are simply not sustainable. And they will not be sustainable in the future either. We will not be able simply to return to the “normal” economy, and other parts of the pre-COVID-19 status quo, when the pandemic is over. That should be the most important lesson learned from this crisis.
Balancing the economic imperatives with the health and human rights imperatives during the COVID-19 pandemic is going to be one of the most delicate, daunting and defining experiences for all leaders and all governments. Their place in history will be decided by how well or how badly they perform over the coming months. If their response is based on the interests of a particular elite – causing the disease to flare up again in other less privileged or marginalized communities -- it will rebound on everyone.