Coronavirus in developing countries: Mapping national policy responses

Philip Brien

Some predicted that the coronavirus pandemic had the potential to be a health catastrophe for developing countries. There were concerns that it would result in millions of deaths.

But the developing world is not a monolith. And the emerging picture is more complex and nuanced.

This Insight maps the main trends in policy to date among developing countries. It highlights some of the ongoing debates in these countries about the pandemic.

The publication of this Insight launches the Library’s new Coronavirus: International dimensions webpage.

Developing countries here means low-income and lower middle-income countries as classified by the World Bank.

This is a fast-moving issue and should be read as correct at the date of publication (29.06.20).

A mixed picture

Some developing countries have been described as “success stories”. As the chart below shows, death rates have so far been lower than some feared. But the rate of infection is now rising fast in some developing countries.

A chart to show deaths for Covid-19 by country income category — Image description

Some observers have detected a worrying trend in several developing countries – that the coronavirus might facilitate a drift towards heightened political authoritarianism.

Lockdown impacts

Many developing countries moved rapidly towards lockdowns between mid-March and early-April. In most instances, this was a pre-emptive measure. Recorded cases of the virus were low. But the economic impact was swift. Millions of jobs and livelihoods evaporated.

Within a matter of weeks some were arguing that the consequences of lockdowns were potentially worse than the virus itself. Governments sought to cushion the economic impact on poor people. They implemented welfare programmes, waivers on taxes and fees, etc along with food aid and cash transfers. But these measures were never going to match the scale of the challenge.

Blanket lockdowns criticised

Critics of blanket lockdowns were concerned about their impact on other health priorities. There are particular concerns about the impact of lockdown strategies on vaccination campaigns. In April, about 40 million children reportedly missed their polio vaccination in Pakistan.

Physical distancing is often difficult in crowded urban environments.

Although reliable statistics are in short supply, these factors and others have triggered worries about high levels of “ex c ess deaths” in developing countries.

Easing the lockdowns

By May, many developing countries were beginning to relax lockdown measures. A few countries, like Tanzania and Haiti, had not gone far down the route of lockdown in the first place.

But the World Health Organisation (WHO) warned that relaxation could prove premature. The absence of effective testing and contact tracing regimes increases these concerns.

“Smart lockdowns”

There has been growing talk of “localised” or “smart lockdowns.” The virus tends to spread unevenly across countries. It might be possible to lockdown only the affected areas. Pakistan is amongst those countries currently trying this approach.

In India, the world’s second most populous nation, relaxation of the national lockdown has advanced. This is despite a rapidly rising number of infections and deaths. In mid-June there were warnings of a 20-fold increase in new infections in New Delhi, the capital. Lockdown had to be re-imposed in the city of Chennai. There are fears the virus may gain hold in some rural areas of India.

Some developing countries have been innovative in their pandemic response. For example, Rwanda has been using drones and robots as part of its response and has scaled up its testing impressively. Senegal is currently trialling its own $1 testing kits.

“Social mobilisation”

Some of the better-performing developing countries have employed a strategy of “social mobilisation.” This requires active citizen participation in health measures. It has performed an important role in past anti-pandemic strategies, including the 2014 Ebola outbreak in West Africa.

The quality of health systems varies greatly in developing countries. Social mobilisation can partly compensate for weak systems. But there are also examples of effective community-based public health services.

In K e rala, India, social mobilisation was a big part of the response. It enabled an effective curfew, contact tracing, and a quarantine system to combat coronavirus.

Coronavirus intersecting with other crises

At the other end of the spectrum are developing countries wracked by conflict and humanitarian crisis.

For example, in Yemen anti-virus initiatives rely almost entirely on international donors and local civil society actors. In Afghanistan health workers are still being deliberately targeted for attack by armed parties.

There is also worry about coronavirus taking hold in large refugee camps across the developing world.

Some regional bodies have played a positive role in promoting and coordinating anti-pandemic efforts. The African Union’s public health body, the Africa Centres for Disease Control and Prevention, has been praised. It is managing a new Africa Medical Supplies Platform, through which African countries can purchase testing kits, protective equipment and future vaccines affordably.

Human rights concerns

The leaders of several developing countries have been accused of using the current state of emergency as a pretext for limiting freedoms. The UN has expressed concern that lockdowns have sometimes been policed excessively violently.

In Zimbabwe, the political opposition claims that the authorities have increased arrests and harassment of its supporters.

In India, the authorities have been accused of doing nothing to combat hate speech towards the Muslim minority amidst claims that coronavirus is a “Muslim virus”.

Tanzania, which critics cite as an example of official denialism about coronavirus, ceased to publish daily data on the number of confirmed cases at the end of April, depriving its citizens of vital information about the course of the epidemic.

One size does not fit all

“One size fits all” lockdowns have attracted a lot of criticism. Many developing countries have a much larger proportion of young people in their populations. For example, in sub-Saharan Africa 3% of the population is 65 years or older, with 43% under 15 years old.

Young people often experience mild or sometimes no symptoms of coronavirus. Locking down an entire population where a significant proportion are unaffected might be disproportionate.

Others have speculated that the virus may simply be less dangerous in warmer climates.

Ongoing debates

There has been comparatively little debate in developing countries about whether “democracies do better” in tackling coronavirus. But there has been plenty of discussion about the importance of treating people as “citizens” rather than as passive subjects.

Many have argued that the coronavirus has “blown away the myth” that developed countries are more competent in tackling disease outbreaks than developing countries.

Perspectives on China’s support to developing countries have been varied. Some warmly welcome its offers of assistance, but others are more cautious.