Originally published in The Lancet on 1 June 2020

During the COVID-19 pandemic, world leaders should pay more attention to those populations living in the poorest conditions, such as the homeless, those in prisons, poor ethnic & racial minorities, and millions of distressed migrants and refugees in unsanitary camps, settlements, shelters or detention centres. These vulnerable groups are most likely to suffer the consequences of inadequate and inequitable access to testing, treatment and medical care [1]. Socio-economic circumstances determine the distribution of health conditions in populations and the severity of outcomes.

Poverty drives unjust disparities (inequalities, or more accurately, inequities). However, social and health inequalities are not limited to economic hardship – as we are witnessing worldwide during the COVID-19 pandemic -politics plays a key role on who is affected most. The success of our global response to this pandemic will rely on the responses of the weakest health systems. Sadly, health care remains a luxury for many low-income populations.