A/HRC/45/44 14. Systemic racism is at the heart of this persistent reality. Structural racial discrimination exacerbates inequality in access to health care and treatment, leading to racial disparities in health outcomes and a higher rate of mortality and morbidity for people of African descent. The Durban Declaration recognized that social biases and discrimination prevailing in public and private institutions continued to create barriers for people of African descent, including in the realization of human rights. States must recognize the specificity of needs in particular communities, or risk deprioritizing people of African descent as a matter of law and policy. A. Race as the through line connecting COVID-19, police impunity and global protests 15. Importantly, a taxonomy, or classification system, may hide the racialized impact of certain policy decisions. The COVID-19 pandemic is not exclusively a public health issue where policy decisions fail to prioritize scientific conclusions, but also reflects racialized priorities. Police violence against Black bodies is not exclusively a policing issue where widespread impunity, misconduct and brutality exist within an enabling environment where racialized misconduct persists. To pretend otherwise is to disregard the racialized through line that consistently lowers expectations and worsens outcomes along racial lines. The parallel operation of systemic racism in multiple sectors reflects the historical development of interlocking systems that have exploited, rather than protected, people of African descent. 16. Historically, classification priorities have a dramatic impact on outcomes. The COVID-19 pandemic is no exception. Neglecting race has led to critical failures in the production of knowledge relating to the pandemic, including in scientific fields and despite racially-determined outcomes. Structural discrimination has exacerbated inequality in access to health care and treatment, leading to racial disparities in health outcomes and a higher rate of mortality and morbidity for people of African descent. Most States, however, have failed to consider the social determinants of health.10 Failure to appreciate the risks that Afrodescendent populations face has facilitated racial disparities in the pandemic. 1. Foreseeable risks specific to people of African descent 17. Even before the outbreak of COVID-19, scientists had suggested that a pandemic would disproportionately affect people of African descent. Racial disparities in exposure, susceptibility, access to health care, and perceptions of discrimination were key factors in the influenza A (H1N1) pandemic.11 Contrary to popular belief, susceptibility to and the severity of COVID-19 are not wholly attributable to an individual’s health. Public health experts note that underlying health conditions (“comorbidities”) do not adequately explain the racial disparities seen in COVID-19 infection.12 Susceptibility to COVID-19 relies on the foreseeable and “pernicious effects of adverse social determinants of health, and the absence of privilege that does not allow a reprieve from work without dire consequences for a person’s sustenance, does not allow safe practices, and does not even allow for 6-foot distancing.”13 Universal health care may have mitigated racial disparities in some States. 18. The disproportionate representation of people of African descent in service industries is a source of risk and vulnerability. Widespread quarantining, distancing and mask mandates 10 11 12 13 See Public Health England, Disparities in the risk and outcomes of COVID-19 (2020). See Supriya Kumar et al., “The impact of workplace policies and other social factors on self-reported influenza-like illness incidence during the 2009 H1N1 pandemic”, American Journal of Public Health, vol. 102, no. 1 (January 2012), p. 34; Sandra Crouse Quinn et al., “Racial disparities in exposure, susceptibility, and access to health care in the US H1N1 influenza pandemic”, American Journal of Public Health, vol. 101, No. 2 (2011), p. 285; and Philip Blumenshine, et al., “Pandemic influenza planning in the United States from a health disparities perspective”, Emerging Infectious Diseases, vol. 14, No. 5 (2008), p. 709. See Richard Oppel et al., “The Fullest Look Yet at the Racial Inequity of Coronavirus”, New York Times, 5 July 2020. Clyde W. Yancy, “COVID-19 and African Americans”, Journal of the American Medical Association, 15 April 2020. 5