Pandemic Survival May Depend on Where You Live

Almost 60 per cent of the population in Mumbai, India lives in slums or informal settlements.

A new global report warns that inequality is increasing the world’s vulnerability to pandemics, making them more deadly, more costly, and longer lasting – and that where you live could determine how badly you are affected.

Released on Monday ahead of the G20 meetings later this month in Johannesburg, South Africa, the study shows that unequal access to housing, healthcare, education, and employment leaves millions more exposed to disease.

The report, launched by UNAIDS – the UN agency dedicated to ending AIDS and HIV infection – finds that inequality not only worsens the spread and impact of pandemics but also undermines global capacity to prevent and respond to outbreaks.

Vicious cycle

Titled Breaking the Inequality–Pandemic Cycle: Building True Health Security in a Global Age, the report calls for a fundamental shift in what “health security” means.

The new data shows pandemics increase inequality, fuelling a cycle evident not only in the aftermath of COVID-19 but also in AIDS, Ebola, influenza, mpox, and other outbreaks.

Co-chaired by Nobel Laureate Joseph E. Stiglitz, former First Lady of Namibia Monica Geingos, and leading epidemiologist Professor Sir Michael Marmot, the Global Council on Inequality, AIDS and Pandemics – which carried out the research – reached a stark conclusion: pandemics and inequality are locked in a vicious cycle, each feeding the other in ways that threaten global stability and progress.

“Inequality is not inevitable. It is a political choice, and a dangerous one that threatens everyone’s health,” said Ms Geingos. “Leaders can break the inequality–pandemic cycle by applying the proven policy solutions in the Council’s recommendations.”

Global inequalities exacerbate risks

Studies reviewed by the Council reveal that unequal access to housing, education, employment, and health protection created conditions in which COVID-19, AIDS, Ebola, and mpox spread faster and hit harder.

For instance, people living in informal settlements in African cities were found to have higher HIV prevalence than those in formal housing. In England, overcrowded housing was associated with higher COVID-19 mortality.

In Brazil, people without basic education were several times more likely to die from COVID-19 than those completing elementary school.

Between countries, global inequalities have worsened shared risks. Low-income nations have faced repeated barriers to accessing vaccines, medicines, and emergency financing, leaving outbreaks uncontrolled and prolonging global disruption.

“The evidence is unequivocal,” said Professor Marmot. “If we reduce inequalities through decent housing, fair work, quality education, and social protection, we reduce pandemic risk at its roots.”

Towards true health security

UNAIDS Executive Director Winnie Byanyima said the findings come at a pivotal moment as the G20 meets under South Africa’s presidency.

“This report shows why leaders urgently need to tackle the inequalities that drive pandemics, and it shows them how they can do this,” Ms Byanyima said.

“Reducing inequalities within and between countries will enable a better, fairer, and safer life for everyone,” she added.

The report aligns with South Africa’s G20 theme of “Solidarity, Equality, Sustainability”, highlighting that achieving genuine health security will depend as much on economic justice and social equity as on vaccines or laboratories.