With the COVID-19 contagion wreaking havoc on the global economy and on people’s lives and livelihoods, national governments and international agencies are struggling to find ways to provide leadership and responses that offer relief and hope that the world can withstand this crisis and emerge the better from it.
Tetet Lauron interviewed Emilia Reyes, a civil society expert with in-depth knowledge of global sustainable development and gender discussions. Emilia works for Equidad de Género: Ciudadanía, Trabajo y Familia, a feminist Mexican organization. She has been a highly visible figure in many intergovernmental negotiations, including the 2030 Agenda for Sustainable Development Goals, Financing for Development, the UN Commission on the Status of Women, and the UN 2013 Climate Change Conference in Warsaw where she was part of the official Mexican delegation.
How are you coping with the lockdown?
I’ve been under lockdown for five weeks now in Mexico City. I started my quarantine after being in places of risk such as Italy, the United Arab Emirates, New York City, all in line with civil society advocacy for financing for sustainable developmentthe United Nations' urban agenda.
I have an autoimmune condition so it makes it all the more difficult to be in confinement. It is challenging to be an activist and travelling around the world while also being limited [by my condition].
I’m a good introvert, so it hasn’t been that difficult for me to stay at home. I’ve been busy trying to advance the work on the 2030 Agenda for Sustainable Development, climate change, and human rights and gender equality. I’ve been leading on the drafting of a document that lays down the principles for a feminist multilateral global response to COVID-19, which has been very meaningful for me. Also, as co-convener of the Women’s Working Group for FFD, I am jointly planning a series of online seminars on macro-economy and the gendered dimension of this crisis. On a personal level, I’ve been reading poetry and dancing flamenco and contemporary dance every day. I’m trying to keep myself healthy and busy, thinking a lot about what it means to be in a transition and what it means to prepare for a post-crisis world.
How is the pandemic situation in Mexico? Can you describe what this “unorthodox” Mexican response is to this health crisis?
My country is in an interesting place, being neighbours with the United States, which has the highest cases so far of COVID-19 infections and fatalities.
This brings back memories of 2009 when Mexico was the epicentre of another pandemic, the H1N1 or “swine flu” I remember being under lockdown then, and then seeing the reaction by the government that laid out the foundations for the epidemiology strategy currently being followed.
The Mexican government adopted the “Sentinel Surveillance” strategy in tracking the “hot spots” in the territory, and concentrating resources in those locations. Not having enough resources to test everyone, the government is doing randomized testing which is mathematically representative of the population. They are monitoring confirmed and estimated cases in the territory. I have rarely seen other countries measuring estimations rather than just those they can confirm through tests.
Mexico, for about 20 years now, has been implementing the DN-III-E, a response plan that relies on the deployment of its military forces during disasters. For example, during an earthquake or a hurricane, in addition to existing infrastructure, the Mexican government deploys its military forces wherever they are needed to set up on-site hospitals, provide medical supplies, and implement protocols on health, security, food provision, and shelter. This military deployment historically comes with a higher number of unwanted pregnancies, a direct negative effect of the strategy. In this regard, we hope to see measures on emergency response with a gender perspective, including on sexual and reproductive health and rights (SRHR) that feminist organizations have effectively campaigned for. Even though the interruption of pregnancy is legal in most states in Mexico, women are struggling to exercise their rights because of the current context.
One can have a structural reading of when military forces are being sent to a specific location. But with the Sentinel strategy, it is actually easy to detect where the COVID-19 hot spots are, and the army would immediately be able to set up a new hospital on-site in a matter of hours. It is too early to evaluate the effacy of this strategy because Mexico has not reached the peak yet—we are expecting this in May.
The Mexican President is more concerned about his political alliances, but he also trusts the expertise of health sector professionals and scientists who have already faced a previous pandemic. He is promoting cash transfers as a relief measure, which is fine in a time like this, but he is not necessarily thinking of a medium or long-term strategy, which means public policy is not headed towards providing a universal basic income nor progressive tax reforms. The President did ask big companies to pay back corporate taxes amounting to millions of Mexican pesos, mostly needed for the national response. This is why big corporations in Mexico are trying to call out for a riot against the president.
I want to be hopeful about this unique Mexican response because it is rooted in a previous experience. However, in recognizing the existing structural inequalities, no matter what immediate response this government will have, decades of depletion of the health system and of abusing the well-being of most of the population, SARS-CoV-2 will bring a painful episode. It is also scary to see some local right-wing governments in Mexico constantly challenging the measures the President has mandated.
What is your perspective on the recently-promoted narrative that the coronavirus is a kind of “equalizer” since it affects everyone, no matter where they are, no matter what their status in life is?
It does not equalize people in terms of class, skin colour, access to rights—it does the opposite. Any disaster is a window to existing inequalities and it opens the door to greater vulnerabilities. The virus can only impact on the level in which your vulnerabilities allow it. A person who faces multi-layered inequalities will have multi-layered vulnerabilities, preventing the ability to respond to the phenomenon in a resourceful and positive manner. It is all the more important to see this disaster in the light of inequalities, and with a gender perspective.
Worldwide, we are witnessing the pandemic’s differentiated impacts on women and men, due to the gender division of labour. For instance, global statistics show that 60 percent of those who die are men (in Mexico almost 70 percent) precisely because of the gendered configurations in the way men live their lives: they wash their hands less (meaning, their activities are less involved in washing dishes or cleaning the house), and they refuse to wear masks, or they use them improperly. Men are also permitted more freedom of movement within society, and because they are supposed to be the providers, they are in warehouses, they are drivers; and they are less used to taking care of their own health. They will not see a doctor unless someone takes them to the hospital, so they seek medical attention at a later stage in the illness when it is already too late. However, women are facing the hidden figures and unvalued dimensions of life with an extremely negative impact because of the increase in the unpaid domestic and care work they perform, as well as a worrisome rise in violence against women during the pandemic that has been documented by feminist groups. COVID-19 enhances the inequalities and gendered impacts on both women and men, in that we have been living in an unequal and unjust world, and therefore we need differentiated measures.
The lockdown has also been putting pressure on the LGBTI population. Young people are forced to spend more time with families, and with the intimacy generated, many of them have come out of the closet. Some have been expelled from their homes, with an increase in violence and negative repercussions towards them. LGBTI organizations have seen an increase in numbers of people in crisis, as some become isolated in the event of family rejection and find themselves without any support.
More than half of Mexico’s population relies on informal work: regardless of the lockdown, around 60 million people are unable to stop their usual activities. Most of those in the informal sector (the majority of them being women) cannot rely on fixed incomes and access to social services: they are now outside trying to make a living. Despite the strong efforts from health authorities, we will have very harsh figures once we reach the peak.
Mexico also ranks very highly globally in terms of population with morbid obesity and diabetes. We have a population of massive consumers of sugary beverages and processed food. Despite our rich food culture, people got used to unhealthy diets, perhaps also as an outcome of mass media. We foresee young people in need of respirators and ventilators because of these chronic conditions. In Italy, people were saying it’s an illness affecting mostly the older age groups; but in Mexico we expect the age spectrum will be wider.
There are stark differences between the levels of development between urban and rural communities in Mexico. This becomes even more challenging once you add the element of indigenous groups. Mexico has more than a hundred indigenous languages, so providing them with accurate information has been slow. Indigenous peoples have historically been discriminated against, with lower rates of access to education, health, water, and sanitation, and this will all impact the overall figures. Cities are dependent upon the water of rural areas. Even the very basic instruction to wash your hands frequently is accessible only to those regions geographically located with access to running water. As in any developing country, those populations who have been facing structural inequalities will suffer the greatest impact.
Talking about the United Nations 2030 Agenda for Sustainable Development—are the Sustainable Development Goals (SDGs) fit to meet the scale of the COVID-19 challenge?
The SDGs are lacking at the moment because they do not deliver on needed paradigm shifts. They rejected any recognition of the urgent need for redistributive justice. The SDGs do not measure wealth concentration, and we are seeing a corporate capture [of the public response to the virus] on a national, regional, and global level. Hopefully I’m mistaken, because it is a very perverse dynamic. This context would be the moment to make those transformative shifts.
Financial markets still withhold crucial funds as they continue to speculate either on health services, on vaccines, or even on investments in specific sectors such as communications, as opposed to investment in sustainable and fair food systems. We are seeing worse than ‘business as usual’, it has become a bloodhound chase with everybody going after the next big thing they can sink their fangs into.
It’s tortuous to see what is happening on the ground. The International Monetary Fund is supposed to help countries suffering from debt burden, but they are merely suspending debt payments rather than cancelling them: poor countries will still have to pay. Foreign aid actually works in the interests of rich countries and their corporations. All of these things show the multilateral system is unfit for purpose, distracting attention away from the structural responses and just transitions to the equitable world that civil society has been calling for.
What can you say about the UN Secretary General’s appeal to “recover better”?
I think the UN Secretary General (UNSG) has preferred humanitarian responses to sustainable development, leading the UN to a wrong-headed approach. His first decisive and meaningful gesture was his call for an immediate global ceasefire. This is really the type of measure we need to see in the future.
We need a strong UN now more than ever with an articulate response led not only by the World Health Organization (which has been amazing in its leadership and response), because we are seeing multi-layered crises at this moment. It is of course a global health crisis, but the multi-layered effects have expanded to food systems, finance, trade, economic, and political dynamics. We need an International Economic Reconstruction and Systemic Reform Summit in the UN to promote a paradigm shift.
The UNSG just stated in the Forum on Financing for Development that structural issues in the international debt architecture should be addressed as he called for a global stimulus package with fiscal and monetary measures at the core of the response. He stressed debt sustainability as a priority, calling for a mechanism to address sovereign debt restructuring. He did highlight the relevance of women’s contributions (but never mentioned women’s human rights and gender equality, which is definitely limited). At the same time, he emphasized the linkages with the SDGs and the Paris Climate Agreement. We will definitely monitor how these will be translated into real life.
The slow reaction at the multilateral level is extremely worrisome. Not even the usual multilateral spaces like the G20, used to acting under “pragmatic”—and therefore non-inclusive—criteria, are reacting with a firm plan. The European Union dismantled their collective and strategic response by turning to national responses to close borders and restrict movement, limit financial assistance to within those borders, and also limit trade in health and medical provisions. These reactions by rich countries are a powerful indicator of the challenging scenarios for developing countries.
I am extremely concerned about a weak UN, and how we need the strong and meaningful participation of civil society, and hopefully we will find leadership in some governments to promote a solid multilateral system responding to debt cancellation, providing grants instead of loans, a suspension of multilateral trade agreements, stopping intellectual property regimes on health supplies and services, as well as on food systems. Progressive taxation—on wealth concentration and on financial transactions in order to enhance the fiscal base for expenditure—is urgent. We need democratic provisions to be taken against countries which are strengthening their authoritarian basis under the pretext of lockdowns. The international community should not endure abuses of any sort. The immediate ceasefire should be paramount. It is not about ‘rebuilding’. It is about shifting the paradigm to one that truly addresses sustainable development.
What else is on your mind right now?
I am restless about bio-ethical guidelines for triage around the world. These have been devised by philosophers and medical experts; their knowledge is very valuable, but we cannot function under those terms. When we add human rights and an analysis of structural inequalities, the valuation of life and quality of life will achieve a greater weighting with a patient against another under different terms.
To illustrate this point, let’s say there are 2 COVID-19 infections. Patient A is a poor uneducated man in an underpaid job, and with morbid obesity and diabetes. Patient B is a young urban middle-class guy who was infected because he got it at a party. Both are deserving of all the attention needed to ensure their well-being. Patient A is more at risk because of his diabetes, which perhaps resulted from decades of depletion of the health system, of food systems and the impact of marketing, and more. It is outrageous that at this moment in time, all around the world, those who are facing the harshest inequalities are now met at the hospital door with a decision with serious implications over life and death, and they will be at a greater disadvantage.
As experts on inequalities, we need to engage in the conversation in light of structural elements, and not just accept an idealized reasoning on the value of life without bearing in mind the complex intertwining of macro, mezzo, and micro components. I’m not saying the medical staff are being unfair. I am saying there are many layers to unpack before getting to that moment.
Public policy does not operate in a vacuum: it is part of an intertwined chain of other policies. Therefore, the decisions on who gets to live or die should not only be mulled over in an isolated manner, as we are facing many weeks and months of this pandemic. Governments can plan and shift the direction of their programmes and they have a responsibility to do so: this is the right moment to promote progressive fiscal policies to enhance the quality of the health sector. Following this direction also frees the medical staff from the terrible burden of triage decision-making.
On the other hand, I am convinced there is room for differentiated measures to be considered during the emergency stage within the health system. Rather than pitting a patient with a disability against another patient, both deserving of a high standard of health services, a government needs to respond to their own diagnostics: what is the profile of the population hospitalized so far? What is the disaggregation of data in terms of sex, age, disability, chronic conditions, race, geographic status, and others? With those diagnostics, even during disasters— because humanity steps up to respond to disasters—one can plan for differentiated measures to address the specific needs and challenges of specific population groups: those that are more at risk, the most impacted, and those who have suffered the impacts of decades of unfair and unjust economic and political systems. Resources, actions, budgets, and facilities can be aligned to respond better to the emergencies on the ground. Differentiated actions are in the end the premise of triages, but this time, bearing in mind human rights and structural inequalities, governments need to respond better to, and repair, the historical weight of injustices.