COVID-19: Immunising one country and leaving the rest to their fate not enough to protect citizens

Image: Getty, DKosig
Image: Getty, DKosig

The Group of 20, chaired by Saudi Arabia, must consider the specific plight of the poorest countries during global pandemics

With the number of Covid-19 cases moving steadily towards the 230,000 mark across the world (with about 86,000 recoveries) and the number of fatalities already more than 9,000, most countries are taking extreme national measures to contain the outbreak.

These measures have precipitated the bloodbath the markets have experienced in recent weeks as many thought that the steps taken by national governments were woefully insufficient. The growing impact on people’s livelihoods from quarantines, social-distancing and travel bans illustrates something we have known for a long time — that securing global health is the quintessential global public good.

Most of the responses remain reminiscent of medieval towns pulling up the drawbridge. These are necessary to contain the virus, but not enough. Reports of attempts by the US to lure a German firm working on the vaccine to the US, if true, are part of a narrow-minded understanding of global pandemics — one that imagines that immunising one country and leaving the rest to their fate is sufficient to protect one’s citizens.

Instead, focusing on reducing the global spread would actually save more lives overall, especially as a global pandemic needs no visa and knows no border. That is why fighting a pandemic jointly is a global public good.

This Covid-19 black swan requires global co-operation and co-ordination. We have seen some moves by the EU in the past few days towards a regional response, while the Group of 7 (G7) countries has announced that it will do “whatever is necessary” to stabilise the global economy and to co-ordinate their recovery plans.

Yet 12 years ago, the onset of the global financial crisis pressed home that the G8, as it was then, was not enough. It resulted in the Group of 20 (G20) finance ministers being elevated to summit level, galvanising urgent action that helped to ameliorate what would have been a deeper global economic crisis. The world needs a similar initiative now.

Saudi Arabia, the current chair of the G20, should convene a virtual meeting of all G20 leaders, and include the World Health Organisation (WHO) to co-ordinate responses to fight the virus. This would entail keeping channels of communication open among world leaders on actions they are taking so as to build trust among citizens in their governments’ and international agencies’ responses; to adopt common fiscal and monetary approaches to deal with the economic fallout, while mobilising the private sector for the global good; and, finally, to facilitate and expedite scientific co-operation on vaccine development.

The world needs a long-term response, so the Saudi presidency should also work closely with the next two G20 presidencies, Italy (2021) and India (2022). This would allow for significant continuity in the actions taken by the G20 as a collective, as the pandemic could last between 12 and 18 months before a vaccine is rolled out globally. Certainly, the socioeconomic and fiscal effects will be felt for some time after that, even if the pandemic were to be flattened sooner.

Poor countries

Critically, the G20 must also consider the specific plight of the poorest countries during this global pandemic, in line with its recognition in 2010 of the necessity to narrow the development gap between richer and poorer countries and how their policy decisions affect low-income countries.

To tackle longer-term global health inequality, it is essential for the G20 to spearhead the establishment of a global medical stockpiles reserve that will mitigate the challenges the world is now facing with just-in-time health supply chains. This pandemic will have significant long-term consequences for the development prospects and coping ability of less developed nations, and, relatedly, for their achievement of the UN sustainable development goals (SDGs).

Building up an effective and integrated global health system is a much bigger challenge, but this pandemic should highlight the world’s interconnectedness and that the weak links in the provision of global public good put the whole system at risk.

Although cases of Covid-19 in Africa are only in the hundreds  so far, it is the most vulnerable continent in terms of its public health systems. It is also home to the world’s most fragile and conflict-affected countries. Thirty countries have reported cases to date, with Egypt at nearly 200 and countries such as Namibia, Nigeria and Kenya with two or three, but the situation is changing daily.

Isolation and quarantines in countries that have a limited social safety net and weak public health systems will cause great suffering to the poor and overwhelm health infrastructures.

The 2019 report of the Global Preparedness Monitoring Board found that global preparedness for the outbreak of infectious diseases has strengthened since the outbreak of Ebola in West Africa in 2014/2015, but that there is still insufficient investment to balance country preparedness and response activities with global readiness to act in the event of country capacity being exceeded.

Last year, the Okayama Declaration of G20 health ministers reaffirmed that strong health systems and compliance with the WHO international health regulations are essential for global health preparedness. The regulations were substantially strengthened after the 2003 SARS outbreak. Yet no government has fully funded or implemented them.

The WHO contingency fund for emergencies, intended to enable the WHO to provide quick responses to outbreaks, lacks sustainable financing. In the case of Covid-19, it had disbursed about $9.5m by mid-February — while the World Bank’s pandemic emergency financing facility, a pandemic bond and derivative fund aimed at helping the poorest countries, have yet to be triggered, but would amount to about $450m.

The big question is whether this would be sufficient to assist those least able to cope.

SA is a member of the G20 and also currently chairs the AU. It is urgent that it works with African leaders and bodies to establish and co-ordinate the continent’s most urgent medical and emergency needs.

Key equipment, testing kits, financing support, medical response teams and medicines are essential, but the gathering and communication of accurate information to ensure effective co-ordination of African input to the G20, the WHO and World Bank are equally pressing.