Grim outlook for world’s poorest amid virus threat
After ravaging the Western world, notably Europe, where it continues to exact a heavy toll, the coronavirus disease (COVID-19) has arrived in the developing world. Over the last few weeks, there have been numerous cases reported in a whole host of nations, including Sudan, Egypt and Rwanda in Africa, as well as a much larger number of incidents in South Asian nations, notably India and Pakistan.
The spread of COVID-19 to the developing world is not a surprise and was indeed just a matter of time. But several experts have warned that the number of deaths caused by coronavirus in Italy, Spain or China will fade in comparison to the number of victims it could claim in the developing world, where most countries lack the defensive mechanisms needed to prevent the virus from spreading.
First is social distancing, which is meant to be one of the most effective ways to keep an epidemic in check. This is physically impossible in many developing countries, notably on the metros and in large urban centers, where tens of millions of people live cheek by jowl in slums. Take Mumbai’s Dharavi, one of the world’s largest slums. Spread over just 2 square kilometers, it is home to more than 700,000 people, with a population density of about 300,000 per square kilometer, meaning social distancing is impossible. The situation is very similar, if not worse, in other slum clusters around the world, from Dhaka and Lagos to Sao Paulo and Manila.
Another basic preventive measure is regular handwashing, as well as using sanitizers to prevent infection. However, these basic facilities are a rarity in most homes in the developing world. According to a 2017 report by the World Health Organization, nearly 3 billion people, or more than 45 percent of the world’s population, lack basic handwashing facilities. Water scarcity is already a huge challenge in large parts of South Asia and Africa.
The other major problem with the spread of the coronavirus is, of course, the extremely poor health care infrastructure across the entire developing world. Well-equipped hospitals, even where present, are beyond the reach of even the middle classes, let alone the masses. Most public hospitals are in decrepit condition, lack basic facilities and medicines, and are severely understaffed, in addition to there not being enough to cater for the entire population. According to the World Bank, Bangladesh has just 0.8 hospital beds for every 1,000 inhabitants, while Chad has 0.4. In sharp contrast, France has 6.2 beds per 1,000 people and Japan 13.4.
An epidemic of COVID-19 in certain countries would not only wreak havoc on the health care sector, but also cause tens of thousands of deaths. A predictive model carried out by the Indian Council of Medical Research showed that, in the worst-case scenario, the virus could infect nearly 30 million people in India, with more than 10 million infections in New Delhi alone, 4 million in Mumbai and 500,000 in several other cities. The virus could kill well over 30,000, even though it would peak in barely 50 days.
In the more optimistic scenario, a flatter curve with a peak in 200 days would infect about 1.5 million people in Delhi and about 500,000 each in Mumbai and half a dozen other Indian cities. In both scenarios, the poor would be the most impacted. Even a large developing country like India is vastly underprepared for such a crisis. The country is already facing shortages of face masks, hand sanitizer, ventilators, protective gear for medical personnel and, of course, hospital beds and skilled manpower.
Well-equipped hospitals, even where present, are beyond the reach of even the middle classes, let alone the masses.
For the poor, the threat is twofold. Not only are they at risk of infection, but an equally bigger threat comes from hunger. With 1.3 billion people in complete lockdown for at least three weeks and a public distribution system not worth speaking of, India’s extreme poor — numbering close to 300 million — face the threat of starvation, which is a near certainty for many, as they have no savings and only earn when they work.
The situation is grim and, if a vaccine or treatment is not made available to the developing world, we could see a repeat of the Spanish flu outbreak of the early 20th century, which claimed nearly 19 million lives in India — almost 6 percent of the population. Then, as now, the outbreak was made worse by poor health care, malnourishment, and crowded cities. The story will be even bleaker in some other developing nations, such as Zimbabwe, which has just announced a 21-day lockdown, putting the country’s poor, already on the verge of starvation, at huge risk.
- Ranvir Nayar is the editor of Media India Group, a global platform based in Europe and India that encompasses publishing, communication and consultation services.