During my fellowship with the Advocacy Project, I’ve been backing up Matthew in Liberia. His recent blog on stigma and Ebola caused me to think about two other killers – Ebola and HIV/AIDS. All of these diseases were very different but had one thing in common. They had different regions of origin, had varying impacts on the immune system, had targeted diverse parts of the demographic, and were treated differently. At first look, these three diseases may look quite different from each other. However, they all caused some form of stigma. In this blog, I will be referring to Matthew’s experiences and blogs in my own analysis in order to better exemplify the importance and implications of stigma. 

First of all, what is stigma? It’s stereotyping a certain group or a person and treating them as social outcasts. Causes of stigma may vary but if we have to identify some, they would be: fear, ignorance, prejudice, political propaganda, racism, and xenophobia. The first and most obvious one is fear. When it comes to disease-related stigma, fear exists above all the other factors as the most obvious reaction from people is being afraid of contracting the disease. This obviously applies across the board to all contagious diseases. With that being said, however, other factors help target certain groups of people which the stigma directly impacts. For HIV, this was gay men; for Ebola, it was the people from Africa, and for COVID-19; we have seen that the Asian community has been a huge target for stigmatization and hate. 

The second most important factor is ignorance and misconception. Usually, when there is a disease that’s spreading at a rapid rate, the most frightening thing about it is its uncertainty. It takes a certain amount of time for the doctors and scientists to come up with a report on the virus or the disease. During that time, conspiracy theories take over the stage. Back in the Middle Ages, they did not understand the science and causes of disease. Even though we are not living in the Middle Ages anymore, we have a new system now that causes ignorance which is the circulation of wrong information through different media outlets. Our Liberia fellow, Matthew has talked about the misinformation campaign during the EVD crisis. The survivors explain that during the spread of the disease, there was a myth that claimed that the crisis was a ploy by the Government to sell human kidneys to some foreigners who were in the country to purchase kidneys for hefty payments. Through the spread of this misinformation, the response against the disease was highly damaged. Stigma caused by misinformation makes it much harder to isolate, understand and deal with the root causes of the problem and use science as our guide.

The next factor is prejudice. With AIDS, it was homosexuality and sex that made people more biased towards the group of people who were being infected. When HIV broke out around 1981 in San Fransisco, people labeled it as “a gay man’s disease.” This label had so many social implications that delayed the founding of the treatment. Because of its main transmission source which is through sex, radical religious groups believed that it was God’s way of punishing gay people or people who are having premarital sex. Of course, in the 1980s gay people were heavily stigmatized, so the disease that was associated with them fed on this bias and fear. 

The most recent factor that we have seen when we are dealing with COVID-19 was political propaganda. When we look at HIV, we have seen a similar political response, where a certain group of people was targeted by the politicians. We also see that the initial response to disease by the politicians highly impacts the perception of people. HIV was not taken seriously by President Reagan and the response was highly delayed causing more deaths and infections. Similarly, during COVID-19, we have witnessed that the politicians around the world did not take the disease seriously at first and the response was delayed. The former U.S. President Donald Trump, not only underestimated the dangers of COVID-19 but also had racist remarks about the origins of the disease by calling it the “Chinese virus” which had a huge impact on the public’s perspective on the disease. 

The final factor which feeds from political propaganda is racism and xenophobia. When politicians openly target a group for a certain problem in society, people seemed to blame that group for all the disasters that the problem has caused. As a result, they also tend to express their hate and dislike towards that group much more bravely. During COVID-19, we have seen that the Asian community has been a huge target for stigmatization and hate because of the aforementioned remarks coming from the president. 

So, what does stigma do other than targeting certain groups of people? The short answer is that the overall result and effect of stigma make the crisis worse. The stigma becomes a barrier to care for patients with HIV, Ebola, and COVID-19, which often lead to some form of disaffection with the infected persons. Patients going untreated because of stigma fuels further transmission. So, the rate of transmission increases leading to a higher number of cases. Stigma also leads to discrimination after the disease has been treated as well. For example, patients who have recovered from Ebola faced discrimination, primarily due to fear, ignorance. According to Matthew’s first blog, he is talking about a risk officer at the local bank who has lost his job because he contracted Ebola and was denied access to the bank even after he recovered. 

Many questions arise from this discussion: Are we going to see prejudice against the survivors of COVID-19? If yes, how will that look like? Are we going to see prejudice against anti-vaxxers and how are we going to make sure that everyone gets vaccinated? Would stigmatizing anti-vaxxers work or would that make this problem even more dangerous? The answers to these questions are going to be integral as we enter a post-pandemic world. From the looks of it, we are about to see a huge backlash against unvaccinated people as the countries in Europe are thinking about limiting unvaccinated people’s access to public transportation, public spaces, and malls. However, this can cause unvaccinated people to have more radicalized opinions and completely deter them from getting the vaccine. It’s also important to remember that some people around the world, especially in the Global South and developing countries, are still struggling to get the vaccine. This means that stigma might develop against people from less fortunate backgrounds and places with none to limited resources causing once again for minorities and marginalized communities to take the biggest hit.