Why Could the New Coronavirus be Deadlier for Low-Income Countries?

The risk is that the efforts undertaken by Europe, USA and other developed nations will be limited to themselves. It would be foolish to face a pandemic without looking beyond political borders

While the coronavirus crisis is sucking the attention and resources of rich nations with the force of a black hole, the other half of the planet observes with ill-concealed worry what is about to hit them. For regions like Sub-Saharan Africa, COVID-19 can be a perfect storm for the sanitary system and, above all, an economic catastrophe for those without a safety net. The international community should definitely bear this in mind when defining its response, because, in this matter, we swim or we drown together.

From the epidemiological point of view, there are as many uncertainties as certainties. This week, Egypt declared the first death by coronavirus on the continent – a German citizen – and the epidemic has not yet reached the pace it has reached on the other side of the Mediterranean. The average age of the population and the response of the virus to warmer climates could favour regions like Africa, Central America and Southern Asia.

The real vulnerability of the poorest countries is the fragility of their health systems and of certain groups of patients.

But, as this BBC report clearly explains, the real vulnerability of the poorest countries is the fragility of their health systems and of certain groups of patients. Whole countries have been devastated by infectious diseases that are more devastating but less widespread, like for example the Ebola outbreak in 2014-2016. It is true that the lethality of this epidemic is much lower, and this could define the response. In a country like Mozambique, where almost 80,000 children die every year before reaching their fifth birthday, it would be understandable that the coronavirus will not be among the public health priorities. Specially because these ciphers could plummet by tackling form of child pneumonia that are completely preventable and treatable today, as numerous experts underlined recently. But COVID-19 is particularly deadly in immunosuppressed patients (remember: almost 24 million people infected with HIV live in Africa), spreads like wildfire in crowded cities and can collapse health systems that are busy dealing with the rest of priorities.

The economic consequences of the crisis cast even less doubts: regions that were already in trouble will be hit the hardest. This week, the UNCTAD published a first estimate of the global cost of the epidemic: around one trillion USD in 2020 and an undetermined amount for the following years. The large emerging economies will see a slowing down of growth and demand (you can read a detailed explanation on the short and long-term consequences in this article by the Centre for Global Development). But it is the poorest, raw material-exporting countries that that will be hit the hardest. These countries managed to stay afloat the Great Recession with dignity thanks to the boost of the Chinese economy. This time they will not be so lucky and will be left with a debt crisis that currently doubles (191%) the total GDP of the developing world. At least one fifth of the 117 developing countries have the combined vulnerability of a high debt and a strong dependency on Chinese commerce (who, on top, is one of the main creditors).

In a country like Mozambique, where almost 80,000 children die every year before reaching their fifth birthday, it would be understandable that the coronavirus will not be among the public health priorities.

UNCTAD makes it clear that the intensity, duration and reach of this economic crash will depend on several variables: the spread of the epidemic, the early development of a vaccine, and, most important of all, the response of the governments. For the poorer counries, that lack any kind of fiscal space, the risk is that all the efforts undertaken by Europe, US and other developed regions will be limited to themselves. This would be not only unfair, but foolish. The World Bank has announced a first package of 12,000 million USD to respond to the epidemic, of which 6,000 will be channelled in priority to the poorest countries and to the strengthening of health systems. According to the data collected and updated by the Kaiser Family Foundation, the second donor after the World Bank is the USA, with 1,300 million USD. The European Commission, alas, is in third place with 140,000 USD, which is basically what the citizens in Madrid have spent in toilet paper stocks. Hopefully, the commotion of these weeks will make way to common sense and international solidarity.

We must not forget a fundamental lesson of this crisis: the underlying nature of an infectious pandemic is that it cannot be fought based on our arbitrary political frontiers. Over the last decade we have seen through the rear-view mirror epidemics such as Zika, Ebola, or Chikungunya, with dire consequences for the affected countries (all of them poor). COVID-19 is the first global health crisis with an epicentre in Europe. What is valid for us and our interests must be also valid for others.