Rethinking solidarity towards equity in global health: African views

Area of Science:

• Global Health
• Bioethics
• Public Health Policy

Background:

• The COVID-19 pandemic highlighted global inequities in health technology access, with stark disparities in vaccination rates between high-income and low-income countries.
• Vaccine nationalism and self-interest hindered an effective global response, contributing to the emergence of new variants and underscoring the need for international cooperation.
• The World Health Organization's (WHO) Solidarity Call to Action aimed for equitable access but faced significant challenges in implementation.

Purpose of the Study:

• To propose an enhanced conceptualization of solidarity as a foundational ethical framework for global health.
• To argue that a relational understanding of solidarity, drawing on African philosophical perspectives, is essential for addressing systemic global health inequities.
• To identify pathways for creatively responding to global health risks and ensuring equitable access to essential healthcare for all.

Main Methods:

• Conceptual analysis of solidarity, drawing on African relational views of personhood and morality.
• Critique of traditional, transient, and voluntary approaches to solidarity in global health.
• Development of a framework for a more systematic and permanent approach to global health equity.

Main Results:

• Appeals to solidarity have often failed due to an inadequate conceptualization that treats it as a voluntary, transient act rather than a core moral principle.
• An ethical framework grounded in relationality and the recognition of interconnectedness offers a more robust foundation for global health solidarity.
• Rethinking solidarity as a central aspect of moral behavior within an interdependent world is key to achieving systematic and permanent solutions to global health inequities.

Conclusions:

• Solidarity, when understood through a lens of relationality and interdependence, can provide a powerful ethical framework for achieving global health equity.
• Moving beyond a superficial understanding of solidarity is necessary to systematically address systemic inequities in access to health technologies.
• Embracing a robust, ethically grounded concept of solidarity is vital for creating a more just and equitable global health landscape.