More than half a dozen experts and humanitarian aid officials, some of whom have served in the United States government, have expressed concern that the virus that has already caused over 268,000 victims could have devastating chain effects on the most broad global health and safety.
These experts worry about repercussions against diseases such as tuberculosis and measles and warn of the potential for widespread famine, as humanitarian organizations try to balance their response to the outbreak with their efforts to combat the ongoing challenges.
“If you don’t take Covid-19 but die of malaria, obviously you’re not better. All that work can’t stop just because the focus has shifted elsewhere, it has to continue,” said Bill O’Keefe, executive vice president for Mission, Mobilization and Advocacy at Catholic Relief Services.
The battle will take place on many fronts and will require an answer on all, said Gayle Smith, President and CEO of ONE Campaign, a defense group that fights extreme poverty and preventable diseases.
“The sharp end to this crisis is the pandemic, but the chain effects on wider public health, food security, local economies, macroeconomics are such that we need to have a multifaceted response,” said Smith. “Otherwise, fix something here and then catch your breath and look further and you have another crisis in your hands on the other side.”
O’Keefe said his organization was “really ridiculously busy” and was able to adapt the work as the distribution of the malaria bed network for the pandemic. However, others who spoke to CNN said there was already evidence that health treatments are being affected by closures, blockages, disruptions in the supply chain and even fear of going to medical facilities.
In India, health professionals have seen an almost 80% drop in daily notifications about tuberculosis and “it’s not because it’s not spreading, it’s because we don’t know why people won’t, they’re not using services”, said Amanda Glassman, executive vice president and senior colleague at the Center for Global Development, which works to reduce poverty in developing countries.
Smith said that “anecdotal evidence” of clinic closings is already emerging, leaving people unable to access services.
“Some of the field activities carried out due to blockages in various places have been stopped,” he said.
Glassman told CNN that “we have to find a way to continue supporting other truly essential health services or we will be stuck in a worse health situation than we started with.”
Experts warn that interruptions in immunization campaigns could have devastating consequences. Smith, a former administrator of the United States Agency for International Development (USAID), noted that measles and malaria resurgences occurred during the Ebola outbreak.
“Our community is concerned about the impacts in countries that are fighting measles, cholera, polio, such outbreaks while at the same time facing the spread of Covid-19,” said Noam Unger, vice president of development, patronage and learning policy at InterAction, an alliance of NGOs and international partners.
In late March, the World Health Organization recommended that governments “temporarily pause preventive immunization campaigns where there is no active outbreak of a vaccine-preventable disease.”
The United Nations Children’s Fund (UNICEF) said that vaccine shipments have dropped from 70% to 80% since late March due to logistical constraints linked to the pandemic.
UNICEF spokeswoman Marixie Mercado said that dozens of countries are at risk of running out of supplies, including at least five countries that experienced measles outbreaks in 2019.
“Interruptions in routine immunization campaigns, particularly in countries with weak health systems, could lead to disastrous epidemics in 2020 and beyond,” he said.
The Measles and Rubella Initiative – which includes the American Red Cross, the US Centers for Disease Control and Prevention, WHO, the United Nations Foundation and UNICEF – estimates that 117 million children are at risk of losing the measles vaccine due to the pandemic.
Strike with ‘greater ferocity’
Many developing countries are already at a disadvantage when it comes to fighting coronavirus, experts told CNN, and the secondary consequences of the epidemic – such as supply chain disruptions and staff shortages – could be devastating.
“Globally, 42% of healthcare facilities do not have hand hygiene at the point of care. Only 55% of healthcare facilities even have access to basic water services,” said Interger’s Unger.
Steve Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies, noted that low-income countries already show a “lack of preparedness across the board in terms of protective equipment for suppliers, in terms of test kits, vials, in terms of systems capable of screening and tracing contacts, supplying oxygen to structures “.
And the global economic slowdown will hit these trade-dependent countries with “greater ferocity,” he said, likely leaving them even less able to get the supplies they need to protect their health workers.
Morrison said that those who study global health also care about funding cuts for other diseases and health problems.
“There is concern that funding will fall due to Covid’s colossal cost. There will be stress on donors,” he told CNN.
The State Department spokesman told CNN that “within the current funding levels, USAID is adjusting its Global Health activities to support Covid’s response, given the (new) operating environment”, but did not provide further details on the adjustments.
O’Keefe said that being prepared for the risk of insecurity, damage to livelihoods and threats to health in the rest of the world will mean “in part, providing adequate funding in a flexible way”.
Smith from ONE Campaign said that resources for Covid should not drain more funding. “Absolutely our hope is that the resources for Covid are additional. … We have to fight this pandemic, but if, while we are fighting this pandemic, we see the erosion of public health or other development gains, then we are finally making a step back. “
Lawyers hope Congress will include at least $ 12 billion in international assistance in the next additional package.
Nancy Lindborg, president and CEO of the United States Institute for Peace, noted that the amount is “a small fraction” compared to the trillions spent or allocated to fight the pandemic “, but a very useful fraction to safeguard a safer future and healthier for the world, but also for the United States. “
‘Big, big, big, big, big, big worry’
Another “big, big, big, big, big, big concern,” O’Keefe said, are fears of widespread global food insecurity.
Lindborg said she was particularly concerned about the Horn of Africa, where countries are also facing drought and locust swarms.
“It is quite possible that large areas of that region will face the famine. And after working through the 2011 famine, I hope that a large-scale famine will never happen again,” said Lindborg, a former senior USAID official, . “I mean, those famines are a terrible additional loss of life. So you have the possibility of death on a large scale, both from illness and from hunger.”
He also expressed concern about “conflict-affected places like Yemen, Syria, the Sahel, where you have drought, along with growing violent extremism.”
“What Covid does is just to point out all those places that were already stressed out enough, that needed a lot of help already … and then the pressure increases,” Lindborg said.
Despite the big challenges, ONE Campaign’s Smith said, “there are some excellent signs that there are ongoing efforts to protect the gains that have been made in recent years.”
He stressed the efforts of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which “is actually about walking and chewing gum at the same time, continuing their work on HIV AIDS and malaria, but they also set up the facility and put their resources into the fight against Covid at the same time. “
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