The Disability Pandemic: What COVID Revealed About Who Gets to Live

The pandemic has been a brutal reminder that disabled people don’t matter. Living through this, as a disabled person with a wonky immune system, has been a reminder that my life doesn’t matter to most.

Where I do matter is in my disability community, the community of people at such risk of this deadly disease who have rallied and worked together to protect ourselves. After two years of lockdowns, fear, forgetting, and being ignored, my nerves are sanded raw. A new variant is announced. Restrictions for me creep back in. I’m left wondering if this is how it will be from now on: no more music, no more crowds, no more indoor anything really, and maybe no more footy. For the rest of my life.

The past two years, and the many before them, showed me that I can build a life in four walls. I can survive terrible things. But isolation is not neutral. It wears you down. And what the disability pandemic has shown is that survival often depends less on government systems and more on each other.

What Is “The Disability Pandemic”?

The disability pandemic refers to the disproportionate risk, neglect, and systemic exclusion experienced by disabled people during COVID-19—especially in access to healthcare, vaccination, social supports, and public policy decisions.

While COVID-19 was a global crisis, its impact was not evenly distributed. In Britain, 60 per cent of those who died from COVID were disabled people. In Australia, that data isn’t properly collected. We aren’t counted.

Instead, we are hidden behind phrases like “underlying health conditions.”

Who is valued?
Whose life is worth saving?
Who gets the ventilator?
Who is triaged out?

These questions were not abstract for disabled people. They were immediate and terrifying.

“You Would Die”: Locking Down Before the World Did

In February 2020, my GP was kind but blunt.

You have to go into lockdown now, she told me. This virus is very serious for you. With all your…and she waved her hands to indicate my entire body. You can’t get this. You would die.

I walked home along Katoomba Street, my stick pressing into the pavement, navigating around people suddenly rendered dangerous. I closed the door to my flat and would not go out again for five months.

A few years earlier, my heart had failed. Doctors stood at the end of my hospital bed and told me I was about to die. It turned out I didn’t want to.

I did everything they told me: restricted fluids, cardiac rehab, and medication. I would place my hand over my heart and whisper to it, willing it to keep beating. Eventually, it did.

During COVID, that same adrenaline-fuelled panic returned. Every surge in cases meant locking down weeks before everyone else. Checking supplies. Preparing to disappear again. This time, I could only control my small part. The rest depended on whether everyone else also didn’t want me to die.

I wasn’t entirely confident.

Living in Two Worlds During COVID

The disability pandemic created a strange split reality.

In one world, things became more accessible than ever. Meetings moved online. Arts events went virtual. I could give evidence to a royal commission without having to navigate inaccessible spaces. For once, everyone was on screen, not just me stuck on someone’s phone in the corner.

In the other world, my supports collapsed. I didn’t see another person for months. Gym and physio disappeared. My arthritis tightened its grip. When I couldn’t get food, I cobbled together strange cupboard meals. When I was lonely, I didn’t say it out loud.

On screen, no one saw my disfigured skin or wonky hands. They didn’t see me limping. In screen-land, I looked like everyone else. That virtual erasure made it harder to explain what was happening behind the camera.

The social model of disability tells us that when environments become accessible, we become less disabled. But during COVID, accessibility sometimes masked a crisis.

Triage Fears and the Shadow of Eugenics

Early reports from overwhelmed health systems overseas raised another fear: rationed care.

Disabled people around the world spoke about being triaged out. Alice Wong imagined a doctor reading her chart and deciding she was a waste of precious resources.

Those fears were not paranoia. They were rooted in history.

Australia has a long record of institutionalizing disabled people. Eugenics found fertile ground here. The Immigration Restriction Act of 1901 excluded people based not only on race, but also on mental and physical health.

Writer Amanda Tink observed that eugenic thinking did not end with World War II; it mutated.

During COVID, people across the political spectrum argued for policies that placed disabled people at higher risk of dying, then shouted at us when we objected.

If disabled people are the ones dying, then the pandemic can feel like it’s happening somewhere else, to someone else.

That is the quiet logic of the disability pandemic.

Government Failure and Community Response

When the pandemic hit, disabled people began making frantic calls:

• I can’t get food.

• My supports have stopped.

• I can’t afford essential medication.

• What are the rules?

• What is Telehealth?

Fifteen to twenty per cent of the population was effectively forgotten.

Advocacy organizations (many run by disabled people) scrambled to respond while facing the same barriers themselves. Governments stonewalled. Complaints were redirected. Concerns were minimized.

The Disability Royal Commission later found that failure to consult disabled people in early pandemic planning led to neglect of our needs during an unprecedented emergency.

The vaccine rollout repeated the pattern. Disabled people were told we were prioritized. In practice, many could not access vaccines. Some group homes were among the last to receive them.

“Everything’s fine,” governments said.

Everything bloody well was not.

Disabled Mutual Aid: Webs of Care That Kept Us Alive

While governments faltered, disabled people organized.

Online groups became information clearinghouses. People translated public health orders. Shared state-by-state updates. Explained income support changes. Crowdfunded emergency funds. The Disability Justice Network of Australia distributed over $40,000 (mostly raised by disabled people for disabled people).

Writer Leah Lakshmi Piepzna-Samarasinha calls these networks “webs of care.” The ways we kept each other alive during COVID, they argue, were nothing short of heroic.

This is what the disability pandemic revealed most clearly: we survive because we build each other’s safety nets.

Not as charity. As solidarity.

First Peoples With Disability and Vaccine Inequity

The failures were even sharper for First Peoples with disabilities.

Damian Griffis, CEO of First Peoples Disability Network, warned that First Nations people with disabilities were at risk of being triaged out or receiving inadequate support. Vaccine access required centre-based appointments, which were not accessible to many.

The fear was justified. The rollout repeatedly failed to reach those most vulnerable.

The disability pandemic intersects with colonial history. Australia’s federation was built on exclusion: white, able, male. That foundation shapes who is visible, who is protected, and who is forgotten.

Freedom for Whom?

I watch people chanting about their freedom and think about what I’ve lost.

Will I ever go to the footy again? I’ve been going to AFL games since I was a kid, sneaking into Princes Park, singing “We are the Navy Blues,” watching my grandmother yell at Hawthorn.

The idea that I might never sit in a crowd again is unbearable.

I have had three vaccine doses. But the people in the ICU, while vaccinated, the ones dying, are people like me. People with “underlying health conditions.”

Friends make complicated plans to see me. Rapid tests. Isolation before visits. Carefully rationed social contact.

Is this how it will be now?

Flavia Dzodan asks what it means to protest public health measures in a country built on occupying space by obliterating others. The question lingers.

Freedom, during the disability pandemic, often meant freedom from considering us.

The Small Things That Are Everything

Leah Lakshmi Piepzna-Samarasinha writes that sometimes we think we must save the world, and anything less is nothing.

But we, in our small crip circles, are the world.

The small, low-key things we do to keep each other alive are nothing. They are everything.

That is the quiet lesson of the disability pandemic.

Disabled people have always built networks of care. We will continue to. These webs will endure beyond COVID, beyond the next crisis, beyond the next wave of forgetting.

We survive because we refuse to let each other disappear.

About the Author
El Gibbs is an award-winning writer and disability advocate. Her work has featured in Growing up Disabled in Australia, Overland, Eureka Street, and Croakey.

Advancing Adult HPV Vaccination: From Evidence to Action

Human papillomavirus (HPV) is one of the most prevalent infections in the world, affecting up to 80% of individuals at some point in their lives. While the immune system clears most infections naturally, persistent high-risk HPV oncogenic genotypes can lead to serious health outcomes, including cervical, anal, vaginal, vulvar, penile, and oropharyngeal cancers. 

Even with highly effective vaccines authorized for adults and available in sufficient supply, vaccination rates among adults remain far too low. Expanding adult HPV vaccination offers a vital opportunity to reduce disease burden, strengthen long-term health outcomes, and accelerate progress toward broader cancer prevention goals.

Why Universal Vaccination Matters for Long-Term Cancer Prevention

Although early HPV prevention initiatives largely prioritized younger age groups, there is now broad recognition that universal HPV vaccination across adulthood is a crucial component of comprehensive disease prevention. Adults continue to face new exposure risks throughout their lives, and vaccination can protect them against HPV types they have not yet encountered. 

Importantly, natural immunity from previous infections does not offer complete protection against other high-risk genotypes, meaning adults with prior HPV exposure still gain meaningful benefit from vaccination. Emerging evidence also highlights positive outcomes when vaccination is delivered before or after cervical conization, reinforcing its value across different stages of adult care.

Barriers Limiting Adult Vaccine Uptake and Why They Must Be Overcome

Although clinical and economic advantages are well-established, adult vaccine uptake remains low due to:

• Lack of awareness and misconceptions about vaccine efficacy
• Limited access and insufficient provider recommendations
• Policy and funding gaps within national immunization programs

Many adults were not vaccinated during adolescence due to eligibility criteria, vaccine availability, or limitations in the healthcare system. Expanding eligibility can close this gap. 

Policymakers are key to establishing sustainable vaccination programs by embedding HPV vaccination for medically or socially vulnerable adults into routine healthcare and ensuring adequate funding and equitable access. Adult programs should not compromise coverage in younger populations. Cultural and linguistic sensitivity must also be part of these strategies to support trust and acceptance.

Accelerating Progress Toward WHO Elimination Goals

WHO has set ambitious goals for cervical cancer elimination, prioritizing adolescent girls as the primary target group, but extending vaccination to boys and adults whenever feasible. National programs should move forward using emerging evidence and practical implementation models. 

Strengthened vaccination systems can help reduce HPV-related cancers, improve health equity, and support progress toward global elimination.

Strengthening Policy and Practice for Adult HPV Vaccination

This call to action emphasizes the value of adult HPV vaccination from public health and economic perspectives. It highlights the global burden of HPV-related diseases and successful policy models from multiple countries. 

Key recommendations include integrating adult vaccination into routine care, expanding national immunization guidelines, strengthening awareness efforts, and adopting universal and inclusive approaches that span ages, genders, and geographies.

Risk Stratification Isn’t Enough, Adults Still Need Protection

Risk-based approaches are limited due to the widespread nature of HPV and varied exposure patterns. Several key considerations support universal adult vaccination:

Adults Remain at Ongoing Risk

Individuals continue to face new exposure risk throughout adulthood.

Men Are Disproportionately Underserved

Without access to established screening programs and often acquiring infections later, adult males represent a highly vulnerable group.

Ending Transmission Requires Addressing the Viral Reservoir

To eliminate HPV-related cancers, transmission must be stopped at its source, requiring immunization of both women and men.

Vaccination Works Even After Exposure

Adults previously exposed to certain HPV types still benefit from protection against other genotypes.

Public Health Outcomes Are Significant

Adult vaccination provides direct protection while reducing transmission and decreasing overall disease burden.

Current Age-Restricted Funding Leaves People Behind

Many national funding systems exclude adults who are still at risk.

Vaccination Must Be Easy to Access

Success depends on convenience, such as pharmacies, workplaces, and community hubs serving as vaccination sites.

A Consensus on Adult Vaccination Is Needed

Clear and unified policy guidance is essential to strengthen recommendations and drive adoption.

Low- and Middle-Income Countries Must Help Shape Global Policy

These regions carry the highest disease burden and must be active contributors to ensure global equity.

Faster Elimination Is Achievable

Countries like Sweden demonstrate that vaccinating adults can accelerate the elimination of HPV-related cancers.

Clear, Inclusive Communication Matters

Language such as “universal vaccination” promotes gender equity and reduces stigma.

A Global Call to Action for Policymakers and Health Leaders

Governments, global health organizations, and national public health associations are urged to expand HPV vaccination programs, particularly for adults and males, mobilize resources, and embed evidence-based strategies into national immunization plans. 

By committing to these priorities today, countries can accelerate cancer prevention and move closer to eliminating HPV-related disease.

Moving Forward Toward Global Health Equity

Expanding HPV vaccination to adults is a critical, evidence-based strategy to reduce HPV-related disease and advance global cancer prevention. Universal adult vaccination delivers individual and population-level benefits, especially in regions with limited access to screening and care. Progress requires collaboration among policymakers and health leaders to address gaps in access, awareness, and coverage. 

Integration into routine healthcare, stigma-free and inclusive communication, and a focus on vulnerable populations, such as individuals living with conditions like HIV, are essential. Taking timely action will drive progress toward eliminating HPV-related cancers and building a more equitable global health future.

Read our original call to action here.

Watch our video on this HPV call to action here.

Leer la llamada en español.

Oral Health Care for the Institutionalized Elderly

Life expectancy has risen significantly across most countries over the past two decades, according to the World Health Organization Global Health Estimates. At the same time, older adults (particularly in countries such as the United States) are far more likely to retain their natural teeth into later life.

While this reflects progress in preventive dentistry, it also introduces new clinical and public health challenges. Without consistent and effective oral hygiene support, poor oral health can intensify systemic conditions and increase health risks, especially among residents of long-term care facilities.

This makes oral health care for the institutionalized elderly a growing global priority.

When Oral Health Declines, Overall Health Follows

For elderly individuals in residential care, oral health is not a cosmetic issue; it is directly connected to chronic disease management and survival outcomes.

Research has linked inadequate oral hygiene with:

• Worsening Type 2 diabetes

• Increased risk and progression of dementia

• Higher incidence of hospital-acquired and aspiration pneumonia

• Greater levels of frailty

Residents in care homes are particularly vulnerable. Many depend on carers for daily hygiene routines, and compromised immune systems amplify the consequences of neglected oral care.

Featured Snippet Summary

Why is oral health care important for institutionalized elderly people?
Poor oral hygiene can worsen diabetes, increase dementia risk, raise the likelihood of pneumonia, and contribute to frailty, particularly among elderly residents who rely on caregivers for daily support.

Recognition at Policy Level: Governments Begin to Respond

Several countries have formally acknowledged the gap in oral health provision within aged care systems.

In England, the National Institute for Health and Care Excellence published guidelines addressing oral health for adults in care homes. This was followed by a review by the Care Quality Commission, which found that many care home owners and staff were unaware of how to ensure that residents’ daily oral hygiene met acceptable standards.

Subsequently, NHS England introduced the Framework for Enhanced Health in Care Homes, followed by a government-issued oral health toolkit for adults in care homes.

In the United States, the comprehensive Smiles for Life curriculum, developed by Smiles for Life, includes a geriatric dentistry module designed to strengthen clinical knowledge.

Earlier pilot initiatives had already demonstrated that structured intervention could improve outcomes. However, scaling those efforts remains an ongoing challenge.

Access Barriers: When Residents Need a Dentist

Daily hygiene is only one component. Access to professional dental services remains a persistent obstacle in many care facilities.

Transport limitations, workforce shortages, and medical complexity often delay in-person dental visits. In response, teledentistry has emerged as a promising solution.

Recent implementations in:

• France

• Japan

• Australia

have demonstrated that remote consultations can support preliminary diagnosis and clinical advice. Digital tools reduce unnecessary transfers while improving timely assessment.

Featured Snippet Summary

How can teledentistry support oral health care for older adults in institutional settings?
Teledentistry enables remote consultation, preliminary diagnosis, and professional advice without requiring residents to travel, improving access and reducing delays in care.

Technology as a Force Multiplier

Emerging technologies are further expanding possibilities.

Research on the evaluation of mobile phone images by off-site dental practitioners has demonstrated effectiveness in screening schoolchildren. Similar approaches can be adapted for aged care settings.

Additionally, real-time artificial intelligence tools, such as Smilio.ai, offer innovative, cost-efficient, and person-centred opportunities to screen for oral diseases in institutional settings.

These tools do not replace clinicians. Instead, they enhance early detection, streamline referrals, and make oral health care for institutionalized older adults more scalable.

Workforce Integration: Training Beyond Dentistry

Sustainable improvement depends on empowering those already providing daily care.

In the United Kingdom, Knowledge Oral Healthcare delivers oral health training to nurses, allied health professionals, and carers in the aged and disability sectors. In Australia, Seniors Dental Care Australia provides similar programs.

A notable systems-level intervention occurred within the U.S. Department of Veterans Affairs, where oral health care was integrated into inpatient services via the nursing workforce. Translating research into clinical practice resulted in measurable improvements in oral hygiene and significant reductions in hospital-acquired pneumonia.

This model demonstrates that embedding oral health responsibilities into existing care frameworks can yield substantial public health gains.

Advocacy and Public Accountability

Policy reform is often accelerated through coordinated advocacy.

In Australia, twelve key stakeholder organizations (including the Public Health Association of Australia and the Australian Dental Association) issued a joint media release on World Oral Health Day, prior to the federal election, calling for stronger aged-care oral health strategies.

The Australian Dental Association’s “Stop the Rot” campaign further highlights the need for systemic reform in aged care.

Media engagement has also played a role. The Australian Health Journal released a World Oral Health Day video advocating for the prioritisation of oral health in aged care and disability services.

The Demographic Reality We Cannot Ignore

As life expectancy increases and more older adults retain their natural dentition, oral health demands will intensify rather than decline.

Improving oral health care for the institutionalized elderly requires coordinated effort from:

• Governments

• Aged care providers

• Dental practitioners

• Nurses and allied health professionals

• Consumer and advocacy organizations

Innovation in teledentistry, mobile imaging, and artificial intelligence offers meaningful opportunities. However, technology alone cannot resolve systemic gaps. Policy alignment, workforce training, and sustained political commitment remain essential.

Closing Perspective

The evidence is clear: oral health is inseparable from general health. For elderly residents in institutional care, neglecting the mouth risks compromising the whole person.

Ensuring high-quality oral health care for the institutionalized elderly is fundamental to maintaining dignity, preventing disease, and achieving equitable health outcomes in ageing societies.

By Kenneth Eaton & Leonie Short

Mental Health a Priority for the Global Healthcare Workforce

The COVID-19 pandemic placed extraordinary pressure on health systems worldwide, and nowhere has this strain been more visible than in the mental health and well-being of healthcare workers. As the world confronts the aftermath of COVID-19 and future public health emergencies, making mental health a priority for healthcare professionals is no longer optional. It is essential for patient safety, workforce sustainability, and health system resilience.

This article provides an evidence-based overview of the mental health challenges faced by healthcare workers during crises, with particular attention to COVID-19. It also outlines practical, organizational, and policy-level actions needed to protect and promote mental well-being in emergencies and in routine care.

A Second Pandemic: Mental Health After COVID-19

While infection rates have declined in many regions, the psychological consequences of the pandemic continue to unfold. Communities worldwide are facing increased trauma, grief, substance use, loneliness, and economic insecurity. Within this broader crisis, healthcare workers are among the most affected groups.

Even before COVID-19, healthcare professionals faced high levels of occupational stress. The pandemic intensified existing vulnerabilities through prolonged workloads, repeated exposure to death and suffering, moral dilemmas, and personal risk of infection. As a result, mental health must be treated as a priority not only during crises but throughout recovery and rebuilding phases.

Stress, Burnout, and Psychological Harm in Healthcare Settings

Healthcare workers are routinely exposed to conditions that elevate psychological risk, including:

• Long working hours and heavy workloads

• Insufficient staffing and limited resources

• Moral conflicts and ethical dilemmas

• Workplace bullying or lack of social support

• Limited control over work environments

These stressors contribute to burnout, anxiety, depression, sleep disorders, and trauma-related symptoms. Burnout, recognized by the WHO as an occupational phenomenon, is characterized by exhaustion, emotional detachment from work, and reduced professional efficacy.

Importantly, burnout not only harms workers. Research consistently links burnout to lower quality of care, increased medical errors, higher absenteeism, staff turnover, and reduced patient satisfaction. Making mental health a priority is therefore directly tied to patient safety and system performance.

Moral Injury and Vicarious Trauma on the Frontlines

Beyond burnout, healthcare workers frequently experience moral injury, a psychological distress resulting from actions (or inaction) that conflict with deeply held moral values. During crises, clinicians may be forced to make life-and-death decisions under resource scarcity, such as rationing ventilators or oxygen.

Moral injury is not itself a mental illness, but it increases vulnerability to depression, PTSD, suicidal ideation, and intentions to leave the profession. Similarly, vicarious traumatization, secondary trauma from empathic engagement with suffering patients, can lead to fatigue, emotional numbness, sleep disturbances, and despair.

Stigma, Silence, and the Risk of Suicide

Despite high levels of distress, many healthcare professionals suffer in silence. Stigma around mental illness, fear of professional consequences, and concerns about licensing or career advancement discourage help-seeking.

Global evidence shows elevated suicide rates among healthcare workers, particularly among women and certain medical specialties. Mental health struggles, burnout, and compassion fatigue are also leading drivers of workforce attrition worldwide. When healthcare workers leave or are lost to suicide, health systems lose irreplaceable skills, experience, and institutional memory.

Mental Health a Priority During Pandemics and Public Health Emergencies

COVID-19 magnified existing risks. Studies across dozens of countries report high prevalence of depression, anxiety, PTSD, sleep disturbances, and emotional exhaustion among healthcare workers during the pandemic. Women, nurses, frontline staff, younger workers, and those in low-resource settings were disproportionately affected.

Similar patterns have been documented during earlier outbreaks, including SARS, MERS, Ebola, and large-scale disasters. The evidence is clear: public health emergencies consistently produce long-lasting psychological harm among healthcare responders, particularly where protections and support systems are weak.

Why Mental Well-Being Is More Than the Absence of Diagnosis

Mental health is not defined solely by diagnosable disorders. Chronic stress, fear of infecting loved ones, overwork, moral conflict, guilt, and exhaustion can severely impair well-being even when diagnostic thresholds are not met.

Large longitudinal studies now underway will provide deeper insights into long-term impacts. However, existing evidence already justifies early intervention, prevention, and sustained support rather than waiting for clinical illness to emerge.

The Role of Self-Care in Sustaining the Workforce

Healthcare professionals are trained to prioritize patients, often at the expense of their own well-being. Yet research consistently shows that self-care is essential for resilience, compassion, and long-term effectiveness.

Effective self-care includes:

• Self-awareness and emotional regulation

• Maintaining sleep, nutrition, and physical activity

• Mindfulness, relaxation, or spiritual practices

• Strong social connections

• Allowing emotional expression rather than suppression

Self-care supports not only individual well-being but also safer, more empathetic, and more sustainable patient care. However, self-care alone is insufficient without organizational and systemic support.

Moving Beyond Symbolic Support to Real Protection

Public displays of gratitude, such as applause or symbolic rewards, offer short-term recognition but do little to address the root causes of distress. Framing healthcare workers as “heroes” may even discourage help-seeking by reinforcing expectations of invulnerability.

What is needed instead are evidence-based prevention and intervention strategies, including:

• Psychological first aid during crises

• Accessible mental health services and self-help programs

• Telemedicine platforms that reduce workload and isolation

• Mindfulness-based stress reduction and resilience training

• Peer support, reflective practice groups, and structured debriefing

Interventions such as WHO’s Self-Help Plus (SH+) demonstrate that scalable, non-diagnostic approaches can significantly reduce psychological distress in high-adversity settings.

Leadership, Culture, and Organizational Responsibility

No mental health strategy will succeed without a supportive workplace culture and leadership. Healthcare leaders must actively reduce stigma, normalize mental health discussions, and foster environments of trust, empathy, and inclusion.

Effective organizational measures include:

• Reasonable limits on shift length and workload

• Mandatory breaks and protected recovery time

• Access to confidential mental health services

• Non-punitive responses to medical errors

• Trauma-informed leadership and supervision

Leadership that acknowledges moral dilemmas and supports ethical reflection plays a critical role in preventing moral injury.

Towards Systemic Change in Healthcare Systems

The pandemic exposed how fragile mental health systems are at precisely the moment they are needed most. Health systems must be redesigned to balance efficiency with humanity, and productivity with sustainability.

Global guidance emphasizes:

• Whole-of-society approaches to mental health

• Investment in long-term mental health infrastructure

• Integration of healthcare workers’ voices through co-production

• Addressing stigma as a systemic issue, not an individual failing

Making mental health a priority requires embedding well-being into policy, financing, workforce planning, and professional standards.

Policy Actions to Make Mental Health a Priority

Evidence supports the following actions:

• Implement long-term, evidence-based mental health programs for healthcare workers

• Ensure adequate staffing levels and fair compensation

• Normalize help-seeking and protect confidentiality

• Actively combat stigma within healthcare institutions

• Involve frontline workers in policy design and decision-making

• Invest in digital and innovative mental health solutions

• Expand research on preparedness and long-term impacts

Conclusion: A Test of Global Commitment

Healthcare workers have carried societies through one of the most disruptive global crises in modern history. Protecting their mental health is not an act of gratitude; it is a responsibility.

Making mental health a priority for healthcare workers strengthens care quality, safeguards patients, and helps health systems withstand future crises. Failure to act carries personal, societal, and economic costs that no system can afford.

End the Genocide of the Yanomami People!

The Genocide of the Yanomami People is unfolding in real time. Indigenous communities in the Yanomami Indigenous Territory (TIY), located on the Brazil–Venezuela border, are facing systemic violence driven by illegal mining, environmental destruction, infectious disease, and the deliberate omission of state protection.

The World Federation of Public Health Associations (WFPHA), the Brazilian Association of Collective Health (Abrasco), and the Brazilian Association of Anthropology (ABA) jointly denounce the Brazilian Federal Government’s inaction and collusion in the escalating crisis affecting the Yanomami and Ye’kwana peoples.

What Is Happening in the Yanomami Indigenous Territory?

More than 20,000 illegal gold miners currently occupy and degrade Yanomami territory. Their presence has led to:

• Destruction of forests, rivers, and food systems

• Mercury contamination of water and bodies

• The collapse of community life and traditional livelihoods

• The spread of malaria, COVID-19, and other infectious diseases

Despite repeated warnings, the federal government failed to prevent mining activities, even during the COVID-19 pandemic, when miners became the primary vectors of disease transmission into isolated communities.

Why This Constitutes the Genocide of the Yanomami People

Genocide is not limited to mass killings. It includes the systematic destruction of the conditions necessary for life.

In the case of the Yanomami people, this destruction is evident through:

• Forced exposure to lethal diseases

• Environmental poisoning via mercury contamination

• Dismantling of primary health care systems

• Failure to remove known aggressors from Indigenous land

These conditions have been created and sustained through intentional state inaction, despite decades of evidence and legal obligations.

A History of Repeated Violence and Preventable Deaths

Infrastructure Projects and Epidemics (1970s)

During the construction of the Perimetral Norte (BR-210) highway, infectious diseases killed 22% to 50% of the Yanomami population in affected villages. These deaths were a direct consequence of imposed “development” without protection.

Gold Mining Invasions (1987–1990)

The invasion of miners triggered malaria epidemics and other diseases, killing at least 15% of the Yanomami population. The crisis was contained only after international pressure compelled the government to remove miners and implement an emergency health plan.

The Return of Illegal Mining and Policy Rollback

After nearly two decades of relative control, the deactivation of Funai Protection Bases and reduced territorial monitoring in the late 2000s enabled mining to surge again.

Yanomami and Ye’kwana organizations, including the Hutukara Yanomami Association and the Wanasseduume Ye’kwana Association, have repeatedly reported invasions, violence, and environmental degradation.

Mercury Contamination and Long-Term Health Damage

A 2014 study in the Paapiú and Waikás regions revealed high mercury exposure, particularly among:

• Children

• Women of reproductive age

At that time, approximately 5,000 miners were present. Today, that number has increased nearly fivefold, dramatically expanding contamination zones and health risks.

COVID-19, Malaria, and the Collapse of Indigenous Health Care

Illegal mining accelerated the spread of COVID-19 in the most environmentally degraded regions, Waikás, Kayanau, and Aracaçá, while malaria cases surged.

Between 2019 and 2021, the dismantling of Indigenous primary health care severely weakened the Yanomami Special Indigenous Health District (DSEI-Y), leaving communities without adequate medical response during overlapping epidemics.

Legal Action and Federal Government Omission

In response to COVID-19’s spread into Indigenous territories, the Articulation of the Indigenous Peoples of Brazil (APIB) filed ADPF No. 709 with the Federal Supreme Court (STF), which condemned the federal government’s omission.

Analyses presented by Abrasco’s Indigenous Health Working Group confirmed a social and health tragedy caused by the state’s failure to prevent and punish illegal mining.

When ordered to report on nutrition, water access, and health services following the deaths of Yanomami children, the Attorney General’s Office issued an evasive response deflecting responsibility away from federal authorities and onto the victims themselves.

Why Immediate Action Is Non-Negotiable

The Genocide of the Yanomami People is not inevitable. It is politically produced.

The primary drivers of this humanitarian catastrophe—illegal miners—remain in place. Without their removal, no health intervention can succeed.

What Must Happen Now

The WFPHA, Abrasco, and ABA call on the global community to support the urgent demands of the Yanomami and Ye’kwana peoples:

Immediate Measures

• Full removal of illegal miners from Yanomami territory

• Protection of land and waterways from further degradation

Structural Response

• Implementation of a comprehensive Emergency Intersectoral Plan for:

  • Health care

  • Territorial control

  • Environmental protection

This plan must include Indigenous organizations, federal, state, and local governments, judicial bodies, and academic institutions.

Ending the Genocide of the Yanomami People Is a Global Responsibility

What is happening in the Yanomami Indigenous Territory is one of the gravest public health and human rights crises in the world today. Silence and delay are forms of complicity.

Protecting Yanomami life means protecting land, health systems, and Indigenous sovereignty—now, not later.

The genocide must end.

Life Course Immunization: Why Lifelong Vaccination is Essential for Public Health

Immunization is a lifelong shield that goes beyond childhood. While pediatric vaccination programs have seen tremendous success, adult and adolescent immunization remains a dangerously overlooked pillar of global health. This critical gap leaves populations vulnerable to preventable diseases, pandemics, and needless suffering at every stage of life.

For decades, vaccination has been rightly celebrated for its role in conquering infectious diseases. A powerful new consensus from the world’s top health organization is expanding its mission: vaccination is a cornerstone of preventing non-communicable diseases (NCDS) like heart attacks, strokes, and diabetic complications.

The urgency to close this gap has never been greater. This paradigm shift is the driving force behind a new global initiative.

The 2024 Geneva Accord: A New Strategy for a New Health Reality

In November 2024, a pivotal meeting in Geneva, convened by the world’s most influential health and community NGOs, aimed to address a silent crisis: the alarming decline in adult vaccination rates and its cascading impact on global health.

The result was a Call to Action: International Health and Community NGOs Advocate for Life-Course Vaccination. This document represents a consensus among organizations representing millions of health professionals and citizens worldwide. It moves the conversation from why life-course immunization is essential to how we must achieve it. Now, with a vital new concept, life-course vaccination is necessary for NCD prevention and healthy aging.

Supported by a Coalition of Global Health Leaders:

This call to action is endorsed by the following organizations, representing millions of doctors, nurses, pharmacists, public health experts, medical students, and aging advocates worldwide:

• Adult Immunization Board

• All.Can

• Cittadinanzattiva-Active Citizenship Network

• Coalition for Life Course Immunisation (CLCI)

• EMR NCD Alliance

• European Academy of Paediatrics (EAP)

• European Interdisciplinary Council on Aging (EICA)

• European Specialist Nurses Organisation

• Federation of European Academies of Medicine (FEAM)

• Global Ageing Network 

• International Council of Nurses (ICN)

• International Federation of Medical Students’ Associations (IFMSA)

• International Federation of Social Workers (IFSW)

• International Federation on Ageing (IFA)

• International Pharmaceutical Federation (FIP)

• International Pharmaceutical Student’s Federation (IPSF) 

• Junior Doctors Network, World Medical Association (JDN, WMA)

• World Association for Infectious Diseases and Immunological Disorders (WAidid)

• World Federation of Public Health Associations (WFPHA)

• World Medical Association (WMA)

• World Obesity Federation

• World Organization of Family Doctors (WONCA)

• World Patients Alliance

The Growing Immunization Gap: How Vaccines Prevent Chronic Disease

The traditional benefits of vaccination, such as preventing outbreaks, reducing healthcare costs, and protecting the vulnerable, remain critically important. Yet, recent data reveal a concerning decline in vaccination rates, posing a threat to global health security.

Reports from the WHO, UNICEF, and other bodies show:

• Adult vaccination rates have stagnated or dropped since the pandemic, particularly among aging and at-risk populations.
• Measles outbreaks are resurging in countries where the disease was previously controlled.
• Low uptake of flu, COVID-19, and RSV vaccines in high-risk groups leads to preventable hospitalizations and deaths, straining healthcare systems.

This evidence underscores the urgent need for the coordinated strategy outlined in the new Call to Action.

What does this mean in practice?

• Influenza & COVID-19 increase heart attacks and strokes: These viral infections cause severe inflammation, which can destabilize arterial plaque, leading to cardiovascular events, risks that vaccinations can reduce.
• RSV & pneumonia can lead to respiratory decline: In older adults or those with COPD, a severe respiratory infection can result in permanent lung damage and a significant decline in functional health.
• HPV & cancer: The human papillomavirus (HPV) is a leading cause of cervical, oropharyngeal, and other cancers. HPV vaccination is, quite literally, a form of cancer prevention.
• Shingles & chronic pain: Reactivation of the varicella-zoster virus, the cause of chickenpox, can lead to debilitating, long-term nerve pain, drastically reducing quality of life.

By preventing the initial infection, vaccines directly prevent the chronic conditions that follow.

The 10-Point Plan: A Roadmap to Integrate Vaccination and NCD Prevention

The coalition’s document provides a clear roadmap. Here are the 10 critical actions it urges advocates and policymakers to implement:

1. Protect Health and Social Care Workers: Ensure they are prioritized to prevent the spread of disease to vulnerable patients.
2. Guarantee Equitable Access: Tailor vaccine access to every stage of life, removing financial and logistical barriers.
3. Mobilize the Health Workforce: Provide tools and resources for vaccine delivery across all care settings.
4. Establish Adult Vaccine Schedules: Develop clear, comprehensive, and equitable vaccination schedules for adults that complement existing pediatric programs.
5. Develop Robust Immunization Registries: Implement interoperable systems to track vaccine uptake in real-time.
6. Integrate Vaccination with NCD Prevention: Recognize the strategic role of vaccination in preventing complications from non-communicable diseases, such as heart disease and diabetes.
7. Expand and Simplify Vaccination Pathways: Make getting vaccinated easier through community-based and mobile clinics.
8. Raise Awareness and Build Confidence: Run public campaigns highlighting the value of vaccination throughout one’s life.
9. Embed Community Engagement: Involve communities in vaccine program design and development to ensure they meet real needs.
10. Leverage the Health Workforce: Empower health professionals, from students to retirees, to be champions for vaccination.

The Tangible Benefits of a Life-Course Immunization Approach

Adopting this framework offers profound advantages that strengthen societies:

• Prevents Deadly Outbreaks: High vaccination coverage across all ages creates a stronger herd immunity, protecting those who can’t be vaccinated.
• Dramatically Reduces Healthcare Costs: Preventing diseases such as shingles, pneumonia, and HPV-related cancers reduces hospitalizations, long-term care needs, and lost productivity.
• Protects Vulnerable Populations: A vaccinated community is a safer environment for older people, newborns, and individuals with weakened immune systems.
• Builds Resilient Health Systems: By preventing illness, health systems are less burdened and better able to handle other crises.
• Promotes Healthy Communities: Lifelong immunization supports well-being at every age and helps entire communities live healthier, more active lives.

From Call to Action to Reality: How We Can All Participate

Implementing this vision requires a commitment from all sectors. The Call to Action provides the blueprint, but we all have a role to play in its implementation.

• Policymakers: Must prioritize funding, establish national adult schedules, and remove regulatory barriers.
• Healthcare Providers: Can integrate vaccine discussions into every routine care visit, for every age group.
• Individuals & Communities: Should stay informed, advocate for access, and get recommended vaccines.
• Organizations: Can sign on to support the call to action and promote their messages internally and externally.

A Healthier Future for All Generations

Life-course immunization is a fundamental right and a shared societal responsibility. We can no longer silo infectious disease and chronic disease efforts. We must unite these two pillars of health.

Life-course immunization is the powerful and practical link that ties it all together. The 2024 Geneva Call to Action provides the definitive framework for achieving this goal. By embracing this strategy, we aren’t just preventing the flu or shingles; we are preventing heart failure, debilitating pain, and cancer. We aim to promote health throughout a person’s lifetime, rather than just treating a specific illness or condition.

By uniting behind this powerful consensus from the world’s leading health authorities, we can build healthier, more equitable, and more resilient communities for generations to come.

If your organization would like to endorse our Call to Action and join us in this effort, please get in touch with us at secretariat@wfpha.org

Click here to read the full, official Call to Action document supported by international NGOs