Tony Joakim Sandset1, Kristin Heggen1, Eivind Engebretsen2. 1. Centre for Sustainable Healthcare Education, University of Oslo, Box 0316 Oslo, Norway. 2. Faculty of Medicine, University of Oslo, Box 0316 Oslo, Norway. Electronic address: eivind.engebretsen@medisin.uio.no.
Richard Horton provides us with an important comment on the ongoing COVID-19 pandemic. By refracting the ongoing pandemic through the scholarship of the anthropologist and physician Didier Fassin, Horton alerts us to the fact that COVID-19 is much more than a global health crisis: it is a crisis of life itself.We agree. However, we would also argue that the ongoing pandemic sheds light on the need for equitable and sustainable politics. If the COVID-19 crisis is a crisis of life, then what is needed is a sustainable politics of life, not just health. Horton, through Fassin, contrasts “the rising legitimacy of those who have a biologically defined disease with the declining legitimacy of lives lived in a particular social setting”, such as poverty. He further argues that “the physical has prevailed over the political” in health care, thus reducing our ability to understand life as political. Nevertheless, data show that COVID-19 is driven to a large degree by social and economic inequalities, rendering “the furthest behind” the most vulnerable.3, 4If we are to take the UNs Sustainable Development Goals (SDGs) seriously, health can no longer be reduced to a purely biomedical concept. The SDGs urge us to acknowledge the social determinants of health and to understand health in the broadest of contexts. We cannot model our way out of the COVID-19 crisis because we cannot model our way out of the social inequalities that drive COVID-19 and other diseases and illnesses. What is needed is a sustainable politics of life that produces surplus health for all rather than excess all-cause mortality for some, often the most vulnerable. Horton's call is one that turns the attention to “the biographies of those who have lived and died with COVID-19”. These biographies matter and are valuable as entry points for producing a critique of the current biomedical and modelling driven COVID-19 response.Doing away with health disparities and social inequality is not just social justice, it is indeed pandemic preparedness at its best. Now is the time to take the SDGs seriously and turn our attention to the broader canvas in which COVID-19 takes place.