Equity: A Guiding Light

Last summer, when COVID-19 and a series of high-profile cases of violence against Black people became potent indicators of racial injustice, I found myself knee-deep in establishing a coalition of community stakeholders to explore how to best respond to these twin pandemics. As the president and CEO of a key civic and philanthropic entity in the region, the Chicago Community Trust, I saw this moment as a once-in-a-generation opportunity to double down on our commitment to confront the Chicago region’s racial and ethnic wealth gap and ensure that we don’t return to the status quo.

Around this time, I received a call asking me to co-chair a committee for the National Academies of Sciences, Engineering, and Medicine that focused on establishing a framework for an equitable allocation of a COVID-19 vaccine. While I initially hesitated to take on one more major commitment, I quickly realized that I could not say no.

Throughout my career, whether it be in government, philanthropy, or the nonprofit sector, my passion has always been to work towards creating a more just and equitable world. In my lifetime, we have never witnessed a public health crisis that led to as much economic and social disruption, and so highlighted our global inequities. I felt an obligation to play my part in this important effort.

For 10 weeks from July to October, our committee pulled together a consensus study to assist domestic and global policymakers in planning for an equitable allocation of a COVID-19 vaccine, with the understanding that in the beginning demand would exceed supply. We started by developing key foundational principles that helped frame our overarching goals to reduce severe morbidity and mortality as well as the negative societal impact due to the transmission of SARS-CoV-2 (the virus responsible for COVID-19 disease). We established a four-phased allocation framework, placing those who had the highest risk of infection, disease, or negative consequences to society in the first categories and those with lower risk in the later phases.

The final report, released in October, addressed the disproportionate public health and economic impact on communities of color by designating geographic priority to communities high on the CDC’s Social Vulnerability Index, which accounts for a number of factors, including poverty, lack of access to transportation, and crowded housing.

It is important to remember that developing the vaccine is only the first step. People have to be willing to take the vaccine, and it has to be available and accessible, especially for the people at high risk and communities that have been most affected by this pandemic. Although confidence in the vaccine has risen with the recent evidence of successful trials, polls still suggest that only 61% of Americans would definitely or probably take the vaccine. This drops to 42% for African Americans, who’ve been hard-hit by the pandemic but also have reason to distrust medical and public health systems because of the legacy of medical exploitation and bias.

This vaccine effort has the opportunity to demonstrate it is worthy of trust from all people if equity stays at the center. At this moment, there is an awakening to the power of racism, poverty, and bias that is amplifying the health and economic hardship imposed by this pandemic on Black and Latinx communities. We saw our work as one way to address these wrongs. Years from now, when the history books are written about how our generation responded, I am hopeful that the lesson learned from the current crisis on how to improve future responses is that equity must be our guide.  

Helene Gayle, a physician, is the president and CEO of the Chicago Community Trust. She was named one of Forbes’ “100 Most Powerful Women” and Foreign Policy magazine’s “Top 100 Global Thinkers.”