International strategy required to defeat COVID-19

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The world is confronted with a health and economic crisis that is enormous in size and scope, and one that will inevitably impose its heaviest tolls on the most vulnerable. A health emergency on a dramatic scale has triggered an economic and financial crisis, and the globalised nature of the world in which we live and the structural disparities within it will unfortunately ensure that it is the world’s poorest who will suffer most.

The COVID-19 pandemic will expose afresh the depth of the inequalities within and between countries. In the midst of all that we are going through here in Ireland, it can be easy to forget that there are many people who are in a far worse situation. But we must also consider the implications for the countries of the Global South. While developing countries are currently scaling up their infrastructure as well as they can to deal with the coronavirus, many have already been heavily impacted by the collapse in the price of several commodities and a slowing or breaking of global supply chains. This will get worse before it gets better.

The United Nations has launched a Global Humanitarian Response Plan worth $2 billion, but many multiples of this will be needed.

Of Irish Aid’s nine key partner countries, eight (Ethiopia, Lesotho, Malawi, Mozambique, Sierra Leone, Tanzania, Uganda, and Zambia) are in Sub-Saharan Africa, where conditions are such that the effects of COVID-19 will be far worse than in Europe and the rest of the developed world.

Some points worth remembering

• 400 million people in Africa live on less than the equivalent of $1.90 a day, the international poverty line as set by the World Bank.
• Around one in five Africans live in crowded slums, making a contagious virus (especially a silent spreader like COVID-19) especially dangerous. Self-isolation and social distancing are not practical or possible in shanty towns and overcrowded slums, many of which have no running water to allow proper hand-washing.
• Most Africans cannot ‘work from home’ the way many in more developed countries can. For example, 60 per cent of Ugandan workers are either self-employed or work in a family business: if they do not work, they do not eat. Lockdowns of the kind seen in the rest of the world will increase poverty and hunger.
• African countries do not have the well-developed and well-funded welfare states of Europe and North America. In response to the coronavirus, several dozen countries around the world have introduced, adapted or expanded social-protection schemes. In sub-Saharan Africa, only South Africa and Kenya have done so to any significant degree. This is largely because African countries do not have enough money to do any more than they are already doing.
• Healthcare systems on the continent are already under strain. Sub-Saharan Africa has about one doctor for every 5,000 citizens, compared with one per 300 in Europe. The average European hospital has more intensive-care beds than many African countries. Mozambique has one ventilator for every million people. 
• Underlying health is another cause for fear. More than 25 million Africans are infected with HIV. In Lesotho, almost a quarter of the population is infected. Medical workers and scientists do not yet know if they are at greater risk from COVID-19.
• There is a clear overlap between vulnerable public health care systems and government debt in developing countries. Rising debt levels limit the capacity of many countries to provide services. This is key to understanding the vulnerabilities of countries in the Global South to the COVID-19 pandemic.

There are some reasons to be optimistic

• In some countries such as Malawi, where most people subsist by growing their own food, the economic impact of the pandemic may be relatively small. Most farmers can continue to plough, sow and harvest without social distancing. But in many other countries, the restrictions on economic activity will have catastrophic effects.
• Poor countries tend to be younger, and COVID-19 is most dangerous to the elderly. It is estimated that less than 4 per cent of Africans are aged over 65 and less than 1 per cent over 80. In Europe those rates are five times higher. The median age in Africa is 19 and a half years.
• Many of the African countries that dealt with Ebola and other outbreaks have experience in contact-tracing and public health campaigns reminding their population of the importance of things like handwashing.

But in general, as bad as this pandemic has been and will continue to be for the developed world, it will likely be far worse for the Global South. This is why Ireland and other rich countries must act accordingly.

Ireland’s and Overseas Aid

Budget 2020 allocated €837m to Ireland’s Official Development Assistance (ODA) programme. This was an increase of approximately €20m on the amount pledged in Budget 2019.

Prior to the Budget, Social Justice Ireland urged Government to make a commitment to increase the aid budget over the six years to 2025 in order to reach 0.70 per cent of GNI*. (As part of a United Nations agreement, developed countries like Ireland have pledged to donate 0.7 per cent of their national income as ODA each year). We estimated at the time that the increase in ODA in Budget 2020 would bring the total ODA allocation to 0.41 per cent of projected GNI* in 2020, though it would be difficult to make a realistic projection of national income for 2020 now.

This money is needed now more than ever before. The 2008 financial crisis led to decreased ODA from Ireland (and indeed many other countries). But some countries, including France and Germany, increased their levels. Budgets are about choices and priorities. Now is not the time to reduce aid to the most vulnerable. The global economic downturn will be exacerbated in the developing world by movements within financial markets. Foreign investors are pulling tens of billions of dollars (it may soon be hundreds of billions) from what are termed ‘emerging markets’ since the start of the crisis, in what the Institute of International Finance has described as the largest capital outflow ever recorded. Governments in richer countries, including the European Union, can borrow cheaply (in some cases practically for free) to scale up health and welfare provisions, and provide economic stimulus. However, poorer countries usually see their borrowing costs escalate during economic crises.

What else is required

Simply maintaining ODA will not be enough. Better off countries must take action to provide developing nations with the resources and opportunity to act. According to Oxfam It would cost approximately $159 billion to double the public health spending of all of world’s 85 poorest countries, where 3.7 billion people live. This is less than 8 per cent of the latest U.S. fiscal stimulus alone.

Rich countries could agree to an immediate moratorium on debt interest payments for poor countries. This has already been called for by the World Bank and the IMF. In Africa, this could free up an estimated $44 billion in 2020 alone to help finance the response to the pandemic. Others have suggested that Africa needs an immediate emergency economic stimulus of around US$100 billion. As such, the waiver of all interest payments, and the possible extension of the waiver to the medium term, would provide immediate fiscal space to Governments. As UN Secretary General António Guterres has said, “we are in an unprecedented situation and the normal rules no longer apply".

It is in our own interest to help

It is understandable that national leaders are focused on tackling this crisis in their own backyards, but countries must find the space for supporting other nations too if humanity is to defeat this disease. It is therefore incumbent on rich countries to help poorer countries. This must take place at a supranational level as well, but individual donor countries, including Ireland, must be ready to play their part in a spirit of solidarity and generosity. It is in rich countries’ interests to think and act globally as well as locally:

• It takes a co-ordinated global effort to tackle, roll back, and eradicate a global pandemic.
• If the developing world is left to fight COVID-19 alone and fails (as it almost inevitably would), the virus would soon spread back to the developed world, even if it has been eradicated there.
• Countries remember those who help them. It is not just in Italy that China and Cuba are currently winning friends and influence with high-profile deliveries of medical equipment and the deployment of doctors.

The scope and gravity of the situation therefore requires an ambitious multi-lateral response under the coordination of the United Nations and other international bodies. It will involve significant health and economic aid, cheap credit, expertise and manpower.

Ireland is regularly commended by the OECD Development Assistance Committee Peer Review for the effectiveness of our aid programme. We can be justifiably proud of our record of providing high quality, untied, grant-based aid. These qualities are required now more than ever. At uncertain economic times, it is important that policymakers remember to protect the vulnerable. ODA plays a major role in such an approach. Social Justice Ireland have previously argued that this is particularly so given that the recipients of Irish ODA tend to live in some of the countries who experience the worst effects of climate change—an area is which Ireland is a prime offender. Humanitarian needs that are the result of climate change will only get worse during this crisis. That is particularly so for refugees. Funding, therefore, cannot be diverted from existing humanitarian needs for the purpose of dealing with the current pandemic. New funding must be found.

In addition, a coordinated effort of the kind necessary could put the international community back on track to realize the aspirations of the 2030 Agenda for Sustainable Development.