COVID-19 A Global Perspective

The Gates Foundation gives us a perspective on the COVID-19 pandemic.  This is in both human terms, country terms, worldwide terms and economic terms. 

COVID-19 has killed more than 850,000 people.  It has plunged the world into a recession that is likely to get worse.  Many countries are bracing for another surge in cases. 

In previous reports from the Gates Foundation, there has been celebration of the historic progress in fighting poverty and disease. 

Unfortunately, this progress has now stopped and in the following report, they track 18 indicators included in the United Nations Sustainable Development Goals, SDGs. 

In recent years, the world had improved on every single one. 

Unfortunately, this year on the vast majority, the world has regressed. 

The Gates Foundation assesses the damage that the pandemic has done and is still doing to health to economies and to virtually everything else. 

They argue for a collaborative response. 

They do not believe that there is such a thing as a national solution to a global crisis.  They suggest that all countries must work together to end the pandemic and begin rebuilding economies. 

They argue that the world has been set back about 25 years in the last 25 weeks.

They found that governments moved resources to try and manage the pandemic and people stopped seeking healthcare to avoid being infected.  They found that vaccine coverage in 2020 dropped to levels last seen in the 1990s. 

At the same time, as the catastrophe caused governments to implement necessary policies to slow the spread of the virus and people changed their behaviour to limit exposure, global supply chains started to shut down and this contributed to an economic catastrophe.  Schools closed and hundreds of millions of students are still trying to learn on their own at home. 

Interestingly, data from the Ebola epidemic in West Africa suggests that when schools reopen, girls are less likely to return, thereby closing off opportunities for themselves and for their future children.  According to the US Census Bureau, 23% of white Americans said they were not confident that they could make rent in August. 

This is clearly a frightening enough statistic but among black and Latin Americans the number was double, 46% did not think that they could pay for the roof over their head. 

The Economic Catastrophe 

The widest ranging catastrophe, the one that has spread to every country regardless of the spread of the disease is economic.  The International Monetary Fund, the IMF has projected that even with the US $18 trillion that has already been spent to stimulate economies around the world, the global economy will lose $12 trillion or more by the end of 2021.  This will be the worst recession since the end of World War II, when war production stopped in an instance.  At that time, 3% of the world’s per war population was dead, an entire continent and parts of another were destroyed. 

In those same terms, the COVID-19 financial loss is twice as great as the recession of 2008.  This compares with the last recession as bad as this which was in 1870, two lifetimes ago. 

Among the G20 countries, stimulus funding averaged about 22% of GDP.  Among Sub Saharan African countries, the average was just 3% and of course, their GDPs are much less. 

With these constraints, many low and middle income countries have been innovative to meet the challenges they face. 

Vietnam’s contact tracing system is a global model. – with a population of more than 100 million the country has just seen 1044 confirmed cases and 34 deaths from COVID. 

Ghana started pooling tests instead of testing people individually to conserve scarce resources while still tracking the spread of the disease. 

Nigeria created the coalition against COVID and have raised $18 million so far to bolster the government’s response.  Many partners launched the African medical supplies platform to ensure that countries on the continent had access to affordable, high quality, lifesaving equipment and supplies.  Digital cash transfers were initiated in many developing countries and this led to a transfer of cash to 200 million women almost immediately once the crisis hit in India, thus reducing COVID-19’s impact on hunger and poverty, but also advancing India’s long term goal of empowering women by including them in the economy. 

In spite of all these measures, it is estimated that extreme poverty has gone up by 7% in just a few months because of COVID-19. 

In Africa, the earnings of informal workers declined more than 80% in the first month of the pandemic.  These newly impoverished people were more likely to be women than men.  The Gates report continues to expand that every person on the planet shares this crisis and as such solutions should also be shared.  They argue that we cannot keep ourselves safe from Coronavirus by ourselves.  We have to rely on one another – to keep distance, wash our hands, and wear a mask. 

However, no matter how good any individual country is at testing and contact tracing and quarantining, a person who has no idea that they are contagious can still get on an airplane and be in another place in several hours.  The Gates Foundation continues to expand that in this century of sophisticated interconnections, no country’s economy can be fully healthy if the global economy is sick. 

The Gates Foundation suggest that to get this pandemic under control and to end it, the world needs to collaborate on three tasks as quickly as possible: 

  1. Develop diagnostics and treatments to manage the pandemic in the short term and vaccines to end it in the medium term. 
  2. Manufacture as many tests and doses as we can as fast as we can. 
  3. Deliver these tools equitably to those who need them most, no matter where they live or how much money they have. 

They reflect that the key to developing new vaccines, especially in the early stages, is to pursue as many candidates as possible.  Some countries have started making deals with pharmaceutical companies to reserve doses of a given vaccine candidate in the event that it eventually succeeds.  This is not a bad thing – Governments have a responsibility to protect the health of their people, and these investments by them help jumpstart important research and development and pay for new manufacturing facilities and bring the world closer to delivering a vaccine. 

However, this steady trickle of headlines about promising early stage clinical trials results obscures the fact that research and development is inherently very high risk: The probability of success is 7% in early stages and 17% once candidates move on to human testing.  Governments are essentially placing long shot bets on the vaccine candidates they hope will win, but most in fact will lose.  One way to minimise this risk is for companies to invest jointly in a large portfolio of candidates. 

The next big issue is manufacturing.  Once a vaccine or vaccines are found that work, we will need to manufacture billions of doses as quickly as possible.  At present, there is nowhere near enough manufacturing capacity to do this and no individual country has the incentive to scale up on its own.  Yet, every dose of a vaccine the world fails to manufacture means a longer pandemic, more deaths and a longer global recession. 

Countries which have invested and betted on vaccines to protect their own people will in fact extend the life of the pandemic everywhere else.  They will also be contributing to a much larger death toll.  According to modeling from North Eastern University, if rich countries buy up the first 2 billion doses of vaccine instead of making sure they are distributed in proportion to the global population, then almost twice as many people could die from COVID-19. 

The Foundation argues it is not yet clear precisely how the world will organise a collaborative response.  They also argue that organisations promoting collaboration will cost a lot of money, but not as much compared to the cost of the festering pandemic.  They say that every single month the global economy loses $500 billion and a collaborative approach would shave many months off the world’s timeline. 

This is a sombering prospect and here at The London General Practice, we are passionate that there should be a global response to this dreadful pandemic and all countries of all means and political persuasions should come together to ward off, fight off and destroy this disease.

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