Epidemics as Syndemics: Global Inequities, Structural Determinants, and the Urgency of Collective Action in Global Health
1
Institute of Collective Health, Federal University of Bahia, Bahia, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
The contemporary world is shaped by contexts of political instability, economic crises, environmental challenges, recurrent epidemics, and systemic injustices that generate unequal impacts on population health. In this scenario, it becomes necessary to move beyond reductionist biomedical approaches. The concept of syndemics, developed by Merrill Singer and other scholars, provides a central analytical framework for global health by demonstrating that diseases emerge from the synergistic interaction of biological, social, economic, and political factors, thereby amplifying risks, vulnerabilities, and harms.
METHODS:
This is a theoretical-analytical study based on a critical review of the literature in the fields of global health, critical epidemiology, and social sciences in health. Classical and contemporary texts on syndemics, social determinants of health, and global policies for epidemic response were analyzed, with particular emphasis on the COVID-19 pandemic and on contexts marked by profound structural and geopolitical inequalities.
RESULTS:
The analysis demonstrates that epidemics, when understood as syndemics, cannot be interpreted solely as events caused by isolated etiological agents. The COVID-19 pandemic revealed that poverty, income inequality, structural racism, housing precarity, lack of basic sanitation, food insecurity, and unequal access to health systems interacted with the virus, intensifying morbidity and mortality among historically marginalized populations. Furthermore, the globally unequal distribution of vaccines, technologies, and health resources exposed power asymmetries between countries, reinforcing the political dimension of health crises and the persistence of inequities in global health governance.
CONCLUSIONS:
The syndemic approach highlights that addressing epidemics requires collective, intersectoral, and solidaristic action on a global scale. Strategies focused exclusively on biomedical solutions are insufficient in contexts structured by social and economic injustices. Therefore, global health policies must incorporate equity, social justice, and resource redistribution as central principles for preventing future epidemics and reducing contemporary global health inequalities.
The contemporary world is shaped by contexts of political instability, economic crises, environmental challenges, recurrent epidemics, and systemic injustices that generate unequal impacts on population health. In this scenario, it becomes necessary to move beyond reductionist biomedical approaches. The concept of syndemics, developed by Merrill Singer and other scholars, provides a central analytical framework for global health by demonstrating that diseases emerge from the synergistic interaction of biological, social, economic, and political factors, thereby amplifying risks, vulnerabilities, and harms.
METHODS:
This is a theoretical-analytical study based on a critical review of the literature in the fields of global health, critical epidemiology, and social sciences in health. Classical and contemporary texts on syndemics, social determinants of health, and global policies for epidemic response were analyzed, with particular emphasis on the COVID-19 pandemic and on contexts marked by profound structural and geopolitical inequalities.
RESULTS:
The analysis demonstrates that epidemics, when understood as syndemics, cannot be interpreted solely as events caused by isolated etiological agents. The COVID-19 pandemic revealed that poverty, income inequality, structural racism, housing precarity, lack of basic sanitation, food insecurity, and unequal access to health systems interacted with the virus, intensifying morbidity and mortality among historically marginalized populations. Furthermore, the globally unequal distribution of vaccines, technologies, and health resources exposed power asymmetries between countries, reinforcing the political dimension of health crises and the persistence of inequities in global health governance.
CONCLUSIONS:
The syndemic approach highlights that addressing epidemics requires collective, intersectoral, and solidaristic action on a global scale. Strategies focused exclusively on biomedical solutions are insufficient in contexts structured by social and economic injustices. Therefore, global health policies must incorporate equity, social justice, and resource redistribution as central principles for preventing future epidemics and reducing contemporary global health inequalities.
| eISSN: | 2654-1459 |
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