A/HRC/45/44 drug protocols – namely, be equally invested in their own survival – to gain access to lifesaving medicines.39 51. State responses to the COVID-19 pandemic must also balance other existential threats to their population. In Africa and Latin America, several States where the informal economy is of primary importance locked down in step with wealthier Western countries, despite the likelihood of malnutrition and starvation. In Haiti, the COVID-19 pandemic has not had a per capita impact anywhere near that of cholera, which infected nearly 1 million people and killed 10,000 after being brought in by United Nations peacekeepers. The cumulative consequences of the said cholera outbreak and the 2010 earthquake have left the State poorly positioned to cope with the added challenges posed by COVID-19.40 C. Race as the through line 52. An analysis of systemic racism reveals how bias is embedded in practices and policies that structure operations, industries, economies and mindsets. Historically, systemic racism was used to rationalize colonialism and trade and trafficking in enslaved Africans by embedding justifications throughout the societal fabric. Enslavers and colonizers developed elaborate social, economic and moral justifications, constructing whiteness as a valued commodity, a site of superiority and unquestioned moral authority. The social construct of race was normalized everywhere. These practices, and the trade in enslaved Africans, are some of the earliest existing examples of globalization and global cooperation; indeed, today’s global economy is founded on trafficking in persons and on the enslavement and exploitation of people of African descent. Although modern laws prohibit enslavement, trafficking and racism, legacy mindsets persist and relevant analogues abound. In the course of the COVID-19 pandemic, the global response and the aftermath, these mindsets are still apparent, as is their deep connection to historical exploitation, including in the area of medical and scientific research. Some people of African descent in the diaspora refer to this as the line connecting 1619 to COVID-19. 1. Medical abuse and exploitation in the name of scientific innovation 53. In addition to the exploitation of bodies, labour, land and resources for economic gain, people of African descent have experienced significant legalized exploitation in the name of scientific innovation and progress. This has included medical exploitation and experimentation, the display of Black bodies for public spectacle, the development of surgical techniques using people of African descent as test subjects, dissection, and the infecting and re-infecting of people of African descent to study illness and disease, including radiation sickness and sexually transmitted infections.41 Scientists engaged in eugenics and experimentation sought to “prove” that people of African descent were of a lesser species, and often conducted research on persons lacking effective capacity to consent, including children, and enslaved or incarcerated persons.42 54. Examples of this abound. Perhaps the most well-known is the Tuskegee syphilis study, the counter-example underlying ethics protocols in human experimentation today. From 1932 to 1972, African Americans were injected with syphilis and deliberately left untreated to study the nature and progression of the disease. In Belgium, people of African descent were used several times to populate “human zoos”, most recently in 2002 (A/HRC/42/59/Add.1, para. 10). Sara Baartman, known as the “Venus Hottentot”, was forcibly removed from modern-day South Africa, enslaved, subjected to sexual assault and exploitation (including “experimental” impregnation) and publicly displayed in Europe, for 39 40 41 42 12 See for example Paul Farmer et al., Community-based treatment of advanced HIV disease: introducing DOT-HAART (directly observed therapy with highly active antiretroviral therapy), Bulletin of the World Health Organization, vol. 79, No. 12 (2001). See for example Sandra Wisner and Beatrice Lindstrom, “COVID-19 brings renewed urgency to remedies for cholera in Haiti”, Al Jazeera, 22 May 2020. See Harriet A. Washington, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (New York, Random House, Inc., 2006). Ibid.