Coronavirus is killing black Americans at six times the rate at which it is killing white Americans. But this is not because there is anything uniquely innate in blacks that makes them less able to withstand the viral assault. Health experts tell us that the reason for this racial disparity in infection and death rates is that “This is an outward manifestation of structural racism where African Americans are at an increased risk,” said Mother Jones magazine about two weeks ago. In other words, a long history of racial discrimination has produced poverty, crumbling of black neighbourhoods in major United States metropolitan cities, police brutality and incarceration of young black men on minor charges and for longer jail terms than Whites. It has also meant that more blacks work odd jobs such as serving fast-foods, shelving commodities in groceries, delivering post and serving at gas stations, all of which, in the age of Covid-19 and the physical distancing measures effected by states to fight it, have been considered essential occupations, to keep America running during lock down. But these occupations disproportionally expose them to coronavirus infections.
Above all, this long history of marginalisation, governance deficit and wealth disparities have become more fundamental formations of chronic health conditions in African-Americans, from hypertension to diabetes to lung disease, than anything else. It is these conditions that form a fertile ground for coronavirus to create serious damage to the lungs. It is these circumstances and the history underpinning them that makes the subsequent Acute Respiratory Distress Syndrome (ARDS) more deadly for black Americans. Meanwhile, black people in southern US live in states that have not expanded public health insurance system known as Medicaid, leaving blacks with limited or without coverage at all. And people without insurance in the US are less likely to report to the nearest healthcare centre when they experience Covid-19 symptoms, for they would get hit with a hefty medical bill they would have no capacity to pay.
I report this US situation simply to illustrate how Covid-19 infections and deaths are likely to show similar disparities in many African countries, where socio-economic disparities have become increasingly acute over the past 40 years of the so-called market liberalisation. That opening up of African markets to ‘globalisation’ has seen major foreign corporations, along with their local political and legal facilitators and the local parasitic capitalists, have moved much of Africa’s wealth away from Africans and into the hands of foreign corporations and into the hands of the local petty bourgeoisie class that arranges and expedites this foreign economic onslaught, leaving a gaping hole in the basic services that would have guarded Africans against any health emergencies. In essence, local African corruption and greed have met the global lust for Africa’s natural resources, oil and minerals, land and rivers, cheap labour with a colonised mind to boot, to create a deadly marriage of extraction that has left African landscape laid open to disease.
This has created gross inequality in Africa’s health-care systems, such that although coronavirus does not discriminate on the basis of class and political power, it will still be the most politically and economically marginalised who will suffer the most should it start spreading its wings in Africa full circle the way global experts are insisting it will. A health system that is gutted of its workforce and the resources necessary for an equitable national response to a health emergency of the Covid-19 magnitude is one that is likely to manifest disparities in infection and death rates that draw a clear line between wealth and poverty. Will the racial disparities that have been seen in the US and the inability of the US healthcare system to respond equitably to a national health crisis manifest itself in Africa due to economic disparities, despite the absence of a racial factor? If such disparity should come to pass, revealing the impact of power and wealth on the one hand and poverty on the other, it will be a classic proof that this disease only sees wealth and poverty in Africa, the same way it only sees the colour of skin in America.
The only caveat that one must add in the case of Africa is that Covid-19 deaths will not just follow wealth disparities, but also the unequal application of the emergency response measures against the virus, as the wealthy elite also wield political power that will most likely grant them preferential treatment in the use of the meagre health resources available, now that there is no way for them to run to foreign hospitals, as they have been doing in normal circumstances.
With the infection rates gathering momentum in Africa and the whole world pointing to Africa, predicting that its less effective health systems and Africa being home to a higher burden of underlying health conditions will cause the black continent to be more vulnerable, it is even more worrying to picture poor, post-war and politically fragile African countries like Sudan, Congo, South Sudan or Central African Republic. There, it seems, the landscape lays open to the virus.
Overcrowded and unplanned urban settlements that lack basic services and with crumbly hygiene, subsistence industries that just can’t be closed down without risking the lives of people who work in them, poor rural areas without access to healthcare and millions upon millions of refugees and internally displaced persons squeezed together into unworkable spaces, all make Africa seems like the continent has stretched her arms out to welcome Covid-19. And then there is the economy that hardly employs anyone formally, a large and growing gap between a vast impoverished population and a small group of politically-connected who live nicely and get the best healthcare by virtue of the warped system that only looks at how much money people have, not how sick they are.
Looking to the future, the question now is how much longer can Africans go on ignoring or learning to live with these disparities and still expect their countries’ health systems to come to their rescue when emergencies emerge? Do we adhere to these unworkable isolation measures that have been put in place as the only panacea, pretend it is natural that some of us will have access to quality healthcare, should they get afflicted by this disease, and others don’t? Or can we use the inequities to which Covid-19 has exposed to stand together for equitable systems? It is my conviction that anything short of civic solidarity spells death.
What measures can civic activists, public health workers and all people who uphold values of fairness embark upon in readiness to call out these long-established inequities that decide who dies of Covid-19 or the next epidemic or pandemic and who lives?
The author is a professor of anthropology at Maxwell School of Citizenship and Public Affairs, Syracuse University.