“Violence” in its general sense and use is meant to communicate an image of physicality. However, as maintained by John Galtung in this sense it is “avoidable impairment of fundamental human needs or human life, which lowers the actual degree to which someone is able to meet their needs below that which would otherwise be possible.” Structural violence transpires when there are individuals placed in unfavorable circumstances due to legal, economic, political or cultural structures. Because of their deep-rooted and long-standing nature, these inequalities are generally viewed as “ordinary” simply because it’s how things have always been according to Deborah D. Winter and Dana C. Leighton.
The notion of structural violence is synonymous with that of social injustice and the system of oppression. Forms of structural violence are inequality in the access to political power, legal standing and specifically during a public health crisis, healthcare, education, food, and resources in general. When analyzing the effects of structural violence, it is greater in our society’s poorest communities. Structural violence has proven to be a major determinant of not only disease distribution but the outcome as well.
From a medical/ public health perspective, it is important to note that although there are incredibly well-established modes of intervention, we must acknowledge the fact that in our principal model of health care there is a monumental flaw. Medical and health services are overarchingly presented and vended as commodities. Because of this commodified nature, only those with the means to purchase them will the services be readily available to. Hence why in today’s times with the outbreak of the coronavirus we have celebrities coming out and testing positive irrespective of having no prior symptoms.
This is what makes elements such as nationalized health insurance, along with assured food security, primary education, and clean water vital because now they are viewed as rights as opposed to commodities. Without these economic and social assurances, structural violence is preserved and sustained.As history would attest to, with the spread of a disease, particularly infectious ones, an opportunity for global cooperation is fostered, even between competitors.
This was evident during the Cold War when American and Soviets leaders and scientists united in the generation of a vaccine to combat polio. Also, outbreaks of influenza, Zika, and Ebola within the years have triggered progress internationally regarding the reinforcement of global ability to properly intercept epidemics and pandemics.
A substantial innovation was the 2014 introduction of the Global Health Security Agenda, which has united 67 national bodies for the improvement of discovery and response to outbreaks of infectious diseases. Moreover, entities such as the World Health Organization have released recommendations to ensure the security of global health, for example, one World Health report titled “A safer future: global public health security in the 21st century”, which enlists the following recommendations:
- full implementation of the revised International Health Regulations (IHR 2005) by all countries;
- global cooperation in surveillance and outbreak alert and response;
- open sharing of knowledge, technologies and materials, including viruses and other laboratory samples, necessary to optimize secure global public health;
- global responsibility for capacity building within the public health infrastructure of all countries;
- cross-sector collaboration within governments; and
- increased global and national resources for training, surveillance, laboratory capacity, response networks, and prevention campaigns.
Given the ease that infectious diseases rapidly travel intercontinental, there is a demand, for global cooperation to successfully contain and provide adequate treatment. Most recently, the spread of COVID-19 has brought to the forefront the abilities of leaders to put aside differences and come together on one cause.
In the words of Dr. Margaret Chan, former Director-General of WHO, ‘Given today’s universal vulnerability to these threats, better security calls for global solidarity, international public health security is both a collective aspiration and a mutual responsibility. The new watchwords are diplomacy, cooperation, transparency, and preparedness.’ Prior to public health threats of any sort evolving into devastation, cooperation internally is paramount to not only recognizing these threats but also mitigating their potential effects and damages to global health.
