Governments in industrialised countries must not ignore the plight of poorer nations facing the coronavirus pandemic, or the disease will not be brought under control.
African nations report growing numbers of cases, and more and more infections are being detected in countries with endemic poverty in Asia as testing picks. There are growing fears that developing countries could soon see major outbreaks they will not be able to cope with.
A potential paralysis of already vulnerable healthcare systems would not only have a drastic impact on public health, but could also push people further into poverty and deprivation. If developed countries in Europe and North America bring COVID-19 under control, there is a threat that the disease would rage on in developing countries, with the danger that it could spread back into places like North America and Europe.
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Rich states must keep a focus on helping other countries with weak healthcare systems, despite the fact they are fighting their own battle with the disease.
“High income countries are completely consumed with what is happening in their own states, but it would be good if they could give at least some focus to poorer countries,” Amanda Glassman of the Washington-based Global Centre for Development think-tank. “If things are not brought under control in less developed countries, it could come back to hurt developed countries later on.”
But while there have been far fewer registered cases of the disease in Africa, Asia and South America, many health experts believe that those numbers could very quickly rise dramatically. Some countries also face extra burdens of other endemic diseases, recent natural disasters or coping with large-scale refugee influxes.
“Sub-Saharan Africa is already struggling with the Ebola virus and the locust invasion and associated famines. It now faces a third war against the coronavirus. In many countries, resources are stretched thin,” said Dan Steinbock of the Difference Group advisory organisation.
South Africa has the world’s worst HIV/AIDS epidemic and it is not known how a major coronavirus outbreak may affect treatment for those with HIV/AIDS or outcomes if they are infected with COVID-19. In Latin America, where more than two thirds of people live in extreme poverty, doctors have already warned of the strain widespread coronavirus infections could put on hospitals and health workers.
Any major COVID-19 outbreak could affect incidence, and treatment of other diseases in some African states, says Ambrose Talisuna at the WHO Regional Office for Africa. “We saw this with Ebola outbreaks in some African countries. There was a diversion of resources to the disease and the healthcare system couldn’t deal with the shock of the outbreak. People died of malaria, people couldn’t get treatment for tuberculosis.”
There would also be serious economic problems. Not only would massive financial resources have to go into healthcare rapidly, but measures implemented to contain the virus’s spread, such as travel restrictions, business closures, quarantines, would very soon affect people’s incomes.
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One potential advantage some less developed countries may have in dealing with an initial outbreak is their experience with other deadly infectious diseases. In the Democratic Republic of Congo, a devastating Ebola outbreak has just been brought under control. Tests for COVID-19 could simply be added to existing Ebola screening on entry into the country.
Some of the poorest in the world in Asia, Latin America and Africa, have begun introducing strict measures to try and halt the spread of the disease. These have included closing borders and lockdowns. While WHO has supported the use of such measures, they have been shown to have had an enormous economic toll with sectors such as travel, transportation, tourism and retail, among others, all seriously affected.
“The draconian measures that China opted for have been very costly. But all alternatives would have been much worse. The Chinese leadership had to choose between extensive economic damage in one to two quarters with probable virus containment, or far greater economic devastation coupled with drastic increases in cases and deaths,” explained Steinbock.
But the costs cannot, and should not, be borne by developing nations alone, development experts say. While local governments can help businesses and individuals with measures such as tax relief, providing financial support through loans, and exemptions from health and social security payments, other countries have a role to play.
This month the World Bank made $12 billion available in immediate support to help countries coping with the health and economic impacts of the global outbreak. The International Monetary Fund has said $10 billion could be mobilised in loans to low-income countries tackling the virus. On March 13 WHO and its partners launched the COVID-19 Solidarity Response Fund which aims to raise funds from private and corporate individuals to contribute to global response efforts. Meanwhile, the Global Fund for HIV, TB and malaria is to allow some funds to be used for the virus response while the United Nations’ Central Emergency Response Fund global emergency response fund has made $15 million available.
Over a month ago, WHO chief Tedros Adhanom Ghebreyesus launched a $675 million preparedness plan hoping to contain the crisis and pave the way to deter future crises. But that is less than 1% of the US 2020 military budget. In late February, the European Commission earmarked $124 million for the WHO response plan, but others have not proved as generous.
Added Steinbock: “No matter how it is funded, experts agree that developing countries must be given whatever help is needed to contain the disease. If cases escape detection in poor countries, then it is more likely than not that weak healthcare systems, coupled with endemic poverty and social instability could result in a secondary epidemic with potential global impact.”