The COVID-19 pandemic is unlike any the world has seen before and presents unprecedented challenges. The World Health Organisation (WHO) has recommended physical distancing measures as a way of curbing the spread of the infectious disease but the world is realising that not all countries have the resources to adequately meet this requirement.
Simply put, battling the novel coronavirus cannot be done effectively without lots of money- not only to expand and improve health infrastructure but to keep the economy afloat and encourage people to comply with physical distancing rules as best as possible. Developing countries, many of which depend heavily on foreign aid, however, do not have the resources.
About six weeks after Nigeria confirmed its index COVID-19 case, the government announced that it was planning to borrow 6.9 billion dollars (N2.7 trillion) from various international lenders to meet emergency needs. It has also requested to raise 2.2 billion dollars (N850 billion) from the domestic market for the same purpose.
Nigeria is not the only country that desperately needs financial assistance. The International Monetary Fund (IMF) announced in April that it would be giving a loan of 11 billion dollars to 32 countries in Sub-Saharan Africa which had requested for help to fight the pandemic.
Huge as it is, the boost from the IMF is still small compared to what the countries truly need to thrive during the health crisis.
An estimate by the international organisation is that African countries need 114 billion dollars to fight COVID-19 – amount that equals the Gross Domestic Product (GDP) of at least 25 countries on the continent, including Burkina Faso, Rwanda and Sierra Leone.
In earlier weeks, a good number of countries enforced lockdown protocols, especially in the hotbeds of COVID-19 infection, taking after places like China, Italy and the United States.
Although the peak period in the spread of the virus has not been reached yet, according to health experts, many countries recently started to relax restrictions on movements due to unbearable impacts on the economy.
Towards the end of April, Ghana lifted a three-week lockdown in two key regions after finding that it “occasioned a number of severe difficulties for all of us across the country, especially for the poor and vulnerable”.
Also citing the loss of livelihoods and adverse effects on businesses, Nigeria’s government said the country could not afford a sustained lockdown and started relaxing restrictions on movement from Monday, May 4.
Similar trends can be seen in Botswana, South Africa, Rwanda, Zimbabwe, among other countries. Outside Africa, countries such as Brazil, Mexico, India, and Indonesia are taking similar steps. The question is: are we heading for disaster?
Dr Michael Ryan, Executive Director of WHO’s Health Emergencies Programme, said different measures could be taken in dealing with the virus.
These include public health measures where the focus is on identifying confirmed cases and their contacts and separating them from the rest of the population, he explained.
Ryan said if the spread of the disease reached the level of community transmission and it was no longer practicable to only isolate suspected cases, “then you move to separating everybody from everybody else.
“You create physical distance between everybody because you don’t know exactly who might have the virus.”
He added: “If we look at that situation that’s very difficult to manage because that’s costly in social terms, that’s costly in economic terms and ideally our approach to this should be to really focus on containment measures, case finding, isolation, quarantine of contacts and in that situation the social distancing or the physical distancing measures or the movement restriction mechanisms may not have to be as extreme.
“If you think about Singapore in its fight against COVID-19, it never closed its schools, it didn’t shut down its public health system, it didn’t do lockdown but it was absolutely committed to the concept of case investigation, cluster investigation, case isolation, quarantine of contacts and it really, really, really stuck to that task.”
In other words, unless there are no clear sources of infection in a community that can be separated from everyone else, movements do not have to be strictly restricted as long as other steps are taken such as contact tracing and aggressive testing, he said.
The United Nations Children’s Fund (UNICEF) has likewise discouraged the enforcement of blanket lockdowns in developing countries because of how they worsen access to healthcare when it comes to other ailments.
“Indiscriminate lockdown measures do not have an optimal effect on the virus,” said Dr Stefan Peterson, UNICEF’s Chief of Health, during an interview.
“If you’re asking families to stay at home in one room in a slum without food or water, that won’t limit virus transmission. I’m concerned that lockdown measures have been copied between countries for lack of knowing what to do, rarely with any contextualisation for the local situation,” Peterson said.
He recommended that restrictions should only be limited to places identified as hotspots of the spread of the virus.
Moreover, it has been found that even during the strict lockdown period, many people, especially in the suburbs, still went outdoors and interacted as though it was business as usual. Such conducts have sabotaged the plans of the government in other countries.
Peru, for example, was one of the first Latin American countries to impose a stringent lockdown but it is still one of the worst hit places in the region and the number of new cases recorded daily keep rising.
Elmer Huerta, a Peruvian doctor, explained that “the problem was people’s behaviour.”
“The fact that on the eighth week of confinement you have thousands of people who are positive means that those people got the virus while the country was in lockdown – which means they did not respect the law,” he said.
Julian Jamison, a professor of economics at the University of Exeter, agrees with UNICEF about the need for more “nuanced strategies” in addressing the pandemic in various places.
“Someone surviving on three dollars or less per day with no savings or social safety net — a description that applies to about a quarter of the world’s population, or two billion people — faces radically different priorities and trade-offs than their American or European counterparts,” he noted.
He advised that developing countries should place more emphasis on low-hanging fruits such as personal hygiene, avoiding physical greetings, wearing homemade masks, hand washing and taking precautions while coughing or sneezing.
“Other smart responses include temporarily banning large indoor gatherings such as religious services, and closing clubs and bars,” the professor added.