COVID-19 Op-ed

Justice in the time of Covid-19: Actualizing Pragmatic Solidarity in Global Health Responses

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Justin Francis Bionat

Graduate of the APMA programme 2018 Cohort , MA
Human Rights and Democratisation, of the Institute of Human Rights and Peace
Studies, Mahidol University. He has been working on youth, sexual and
reproductive health and rights (SRHR), and LGBTIQ

Covid-19 highlights the need for a paradigm shift that does
not distinguish the “us” and “them”, the “affluent” and “poor”, and the
“developed” and “underdeveloped”. A nexus between global health and human
rights has to be established. The current global health situation caused by
CoVid-19 calls for all to take a rights-based approach.Development and human
rights scholars have suggested a paradigm shift necessary in matters of
global health focusing on justice and pragmatic solidarity (Gostin and Dhai,
2014; Farmer and Gastineau, 2009). The right to health should be the basis of
all states’ commitments in ensuring the well-being of everybody (citizen or
non-citizen.)Disparities in accessing healthcare reflect a burden of disease
shouldered by states that have little capacity to provide tenable solutions.
Global health justice entails shared responsibility between the global south
and the global north (Gostin and Dhai, 2014) and collaborative solutions
between nations (West-Oram and Buyx 2016).Pragmatic solidarity (Farmer and
Gastineau, 2009) encourages the rapid deployment of tools and resources to
improve the health and well-being of affected populations. It is recognized
that human rights abuses in health stem from structural violence affecting
different populations. These health injustices originate from a weak health
system violating key aspects to the right to health, being an inclusive,
non-discriminatory right (OHCHR & WHO.)With respect to justice, the
concept of global health brings to the fore the importance of country
contexts and concerns that national security should not upend the state’s
commitment to protecting human rights. However, the reality of global health
is that the success of local and regional health responses is reliant on a
larger movement of global health justice (West-Oram & Buyx,
2016).Global health responds to epidemics like Ebola, Tuberculosis, and HIV,
which had spread easily due to globalization, including migration, conflict
and displacement, decolonization, and industrialization. Covid-19, as it
seems, is no different—posing threats to both national and human
securities.This new proposed agenda places the provision of services at the
core while advocating for societal transformation in the prioritization of
health and rights by governments. Pragmatic solidarity begins by finding
shared solutions to address key development issues (i.e. the strengthening of
health infrastructures and systems of care) as it attains global health
justice.The pragmatic solidarity is observable in the “ASEAN Post-2015 Health
Development Agenda” developed by the ASEAN health ministers meeting (AHMM).
These health strategic measures maximises health system potentials of the
ASEAN member states. ASEAN would be instrumental to this proposed paradigm
when it actively contributes to strengthen collaborations on global health
with other countries and development partners, especially with the current
CoVid-19 pandemic. In addition, the ASEAN health sector has also bolstered
its response to CoVid-19 anchored on a Joint Statement during the ASEAN plus
three health ministers meeting in 2019. This response is hinged on ASEAN
member states sharing timely information and technical knowledge.The ongoing
Covid-19 pandemic reminds us that marginalization and vulnerability increases
during pandemics because systems are disrupted. Therefore, the marriage of
global health justice and pragmatic solidarity is essential. The immediate
solutions can be seen when governments are responsive to immediate testing,
treatment, care and support for those afflicted by CoVid-19. Medium term
solutions can enable policy changes that improve failed health approaches and
prepare for yet another health emergency. The longer term solutions would
include increase in healthcare financing, creation of sustainability
measures, and research for scale-up.The shared responsibility to global
health exercised by states will achieve this paradigm shift centered on
pragmatic solidarity and vital to the realization of health human rights.
Only then pandemics like Covid-19 can be treated and prevented in the

  1. ASEAN Post-2015 Health Development Agenda, endorsed by the ten
    ASEAN member states. Available here:
  2. Ministers of Health of ASEAN Member States (AMS), “Joint Statement
    of the 8th ASEAN-Plus Three Health Ministers Meeting, 2019 Siem Reap,
    Cambodia. Available here:
  3. Farmer, P., and Gastineau, N., 2009. Rethinking Health and Human
    Rights: Time for a Paradigm Shift. In: Goodale, M., ed. 2009. Human
    Rights: An Anthropological Reader
    . Blackwell Publishing. West
    Sussex, United Kingdom.
  4. Gostin, L.O., and Dhai, A.,
    2014. Global Health Justice: A Perspective from the Global South on a
    Framework Convention on Global Health. In: Teays, W., Gordon, J.S., and
    Renteln, A.D., ed., 2014. Global Bioethics and Human Rights
    Contemporary Issues
    . Rowman & Littlefield. Maryland,
    United States of America. pp.319-328.
  5. Lock, M. and
    Nguyen, V.K., 2018. An Anthropology of Biomedicine.
    2nd John Wiley & Sons, Inc. New
    Jersey, USA.
  6. OHCHR and WHO, “The Right to Health”. Fact
    Sheet No. 31. Available here:
  7. West-Oram, P. G. N., & Buyx, A.
    (2016). Global Health Solidarity. Public Health Ethics,

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