The greatest coronavirus challenge is yet to come — and it will affect us all

When Covid-19 hits the developing world properly, global instability will follow

A mother and baby take precautions against coronavirus in Uganda, which saw its first confirmed case over the weekend (AFP via Getty Images)

Covid-19 is the largest public health crisis in a gene ratio — we know this. But it is also the largest security issue since the Second World War and potentially a humanitarian crisis that has no parallel.

The UN is preparing for the aftermath of this pandemic and our global resources are severely lacking. Understandably, the economic impact of Covid-19 will be immense. As the funding formula of the UN is based on a percentage of each country’s GDP, the ensuing impending global recession will have a direct budgetary impact on our organization. But this is something to worry about when it happens.

New York has declared a state of emergency, there is a lack of respirators, and a hospital ship from the US Navy will be sailing to the state, not to assist with Covid-19, but to ensure those with secondary conditions can still be treated. The fact that the US has had to call on the military so soon reinforces the fragile nature of the US’s healthcare system. But they are not alone in doing so: Italy now has its army patrolling famous landmarks and UK reservists are on standby.

Developing countries do not have the same capacity to respond and are already feeling the strain.

The regime of Iran has felt the full brunt of Covid-19. First Vice-President Eshaq Jahangiri recently tested positive, joining several other ministers in the Iranian cabinet who have the virus. Releasing over 85,000 prisoners was a commendable (and rare) show of humanitarian compassion by the regime, but it has also shown how underprepared they were to tackle a crisis. Meanwhile, President Hassan Rouhani has started blaming “counter-revolutionaries” for the hit Iran’s economy has taken. This shift in language signals a shared common fear within authoritative regimes: Maintaining their position is paramount, and that creates a need for someone else to blame. The Covid-19 situation has the potential to stress this in the extreme and defray further the strained ties that keep revolution down.

China’s response is key to this. Understandably, they were very quick to lock everything down. Li Wenliang, the doctor who blew the whistle and subsequently tragically died, went from ophthalmologist, whistleblower, reprimanded pariah, and exonerated hero in a matter of weeks. From a public health standpoint, China’s decision to close cities made sense. Their confused response to Li Wenliang, however, risked fatally damaging trust in the government when it was needed most. Hopefully they have learnt some lessons for the future.

But the greatest challenge with Covid-19 is yet to hit. South America and Africa have some of the largest informal developments and slums in the world. So far, countries in these regions have not been affected on the same scale as Europe, North America and Asia. However, Covid-19 is clearly in these countries too. Uganda saw its first confirmed case over the weekend; Zimbabwe, Nigeria and Gambia have all already confirmed coronavirus-related deaths, and South Africa's are at over 400.

These countries do not have the same capacity to respond. There are no hospital ships that will come. Those who would traditionally support peacekeeping operations and humanitarian assistance will turn to focus on their own internal issues. There are not enough respirators for developed countries, and the situation in a developing one is far worse. For example, in Kiberia, one of the largest slums in Africa, there are upwards of 200,000 people, most of whom live in one or two-room apartments. Many live with HIV or Aids; conditions such as TB, cholera and typhoid are still circulating in their communities. How will these families self-isolate, how will they support themselves and how will their governments respond? From past crises of a lesser magnitude, we know these countries cannot adequately respond. Now a real test is coming.

The issue is not so much coronavirus itself. It's the secondary illnesses — and the secondary social issues mass infection will bring.

Collectively, we must not turn inwards. Countries that have needed our help most previously need it more than ever now. The mortality rate of Covid-19 among people with pre-existing conditions is much higher than in those without. African and Latin American countries have populations at the highest potential risk point — and they also have the least capacity to respond.

It is not a case of “if”, but “when”. While the UN is mobilising to support peacekeeping missions, it will not be enough; what is coming for these developing countries is far worse than what we’ve seen in Italy or Iran. This is something that we should collectively consider, and if we can donate to UNICEF, Oxfam and other charities and NGOs operating in the developing world, then we should now. Yes, charity begins at home. However, for those living in countries where this is yet to strike, the instability that it could bring could present itself on our doorsteps through further waves of refugees or potentially something even worse.

Emin Pasha is the pseudonym of a United Nations diplomat based in New York