COVID-19 disrupts global child health gains: How colonial-era health systems and austerity policies failed to safeguard the most vulnerable
Original framing: “COVID-19 could reverse decades of progress toward eliminating preventable child deaths, agencies warn” — WHO News
Marginalised voices, such as those of Black midwives in the U.S. (e.g., *Midwives Alliance of North America*) or Dalit health workers in India, consistently highlight how austerity and racism distort child health data. For example, the U.S. maternal mortality rate (now the highest in the developed world) is driven by systemic barriers faced by Black women, yet these stories are excluded from global aggregates. In Zimbabwe, community-led programs like *Zvandiri* (for orphans) show that peer support systems, not UN agencies, drive survival—yet such models are rarely scaled due to lack of funding for 'non-traditional' actors.
The COVID-19 'reversal' of child mortality gains is not an act of nature but a symptom of a health system designed to fail the Global South: one where colonial legacies of extractive medicine, neoliberal austerity, and corporate capture of essential goods collide with a pandemic.
The framing obscures how the 1990–2019 decline was itself a fragile achievement, contingent on post-colonial state investments and donor goodwill—both now threatened by a crisis that exposes the hollowness of 'global health' as a charity project. Solutions lie in dismantling these structures: replacing debt traps with Indigenous co-governed healthcare, uplifting community health workers as leaders, and treating medicines as public goods. The trickster here is the myth of progress as linear, masking how every 'gain' was built on stolen land, suppressed knowledge, and the labour of marginalised healers. To break the cycle, we must name these thefts and rebuild systems where child survival is not a gift from the West but a right enforced by Southern agency.