A Pledge for Africa
In 34 of Sub-Saharan Africa’s 45 countries, annual per capita health spending is below $200, and measures like lockdowns, stay-at-home orders, and even frequent handwashing to combat COVID-19 are nearly impossible to implement. This simple fact underscores the urgent need for the Global Health Pledging Conference on May 4.
ADDIS ABABA – The world will not be free of the COVID-19 pandemic until all countries are free of the coronavirus that causes it. This simple fact underscores the urgent need for the Global Health Pledging Conference to be held on May 4. Only by acting now to support developing countries’ ability to combat the disease can the world avoid a second wave of the virus this autumn.
African Union leaders welcome the offers that are now coming in of test kits, ventilators, and personal protective equipment (PPE) from the developed world. But if we are to turn the tide against COVID-19, the world’s richest countries must hear and respond to the developing world’s pleas for a comprehensive strategy to overcome the dual public-health and economic crisis we face.
Up to now, there has been a huge disconnect between the rhetoric of rich-country leaders – that this is an existential, once-in-a-century global crisis – and the support for the world’s poor and developing countries than they seem willing to contemplate. Indeed, until last week, African countries were spending more on debt payments than on health care.
In 34 of Sub-Saharan Africa’s 45 countries, annual per capita health spending is below $200 – and barely reaches $50 in many of these countries. Such low levels of spending make it impossible to fund acute-care hospital beds, ventilators, and the drugs needed to confront diseases like COVID-19. Paying for doctors, nurses, X-ray technicians, and other health professionals, together with their equipment, can seem almost like a luxury.
Worse yet, many of the measures available to richer economies as they work to mitigate the disease – lockdowns, stay-at-home orders, and even frequent handwashing – cannot easily be implemented in much of the developing world. In often-overcrowded cities, social distancing is all but impossible, and there are not enough resources to provide adequate sanitation and, in many cases, the running water that people need.
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So, what must be done? For starters, Africa’s governments need an immediate flow of funds to enable investment in health care and social safety nets. Here, the most effective starting point is debt relief. So far, relief from bilateral debt is available for the 173 members of the International Development Association (the World Bank’s concessional lending arm for the poorest developing countries) only until December. To meet our immediate needs and to plan ahead, we need an agreement for debt relief not just for this year but for next year as well.
Beyond debt relief, the grant and lending ceilings of the International Monetary Fund, the World Bank, and other multilateral development banks will need to be raised substantially. And an issuance of international money – the IMF’s Special Drawing Rights – to raise $1.5 trillion must take place soon.
We in Africa are asking for this support not only for ourselves, though our needs in this crisis are perhaps greater than they have ever been. We in Africa seek the help of the developed countries (including China) so that we can do our best to protect the entire world from a return of this scourge.
But time is short. Africa may be among the last places on Earth to be struck by COVID-19, but the disease remains as potent and deadly as ever. If we are to eliminate the threat, every country needs to do what it can to accelerate the search for a vaccine and ensure that it is available everywhere.
To that end, the Coalition for Epidemic Preparedness Innovations needs sufficient funding – $3 billion immediately, with more in 2021 and beyond – not only to develop and produce a vaccine for those who can afford it, but also to be in a position to distribute it equitably around the world. And Gavi, the Vaccine Alliance needs the funds to ensure that this happens.
Likewise, a coordinated global effort could greatly accelerate production of the PPE, testing kits, and ventilators that are needed in every country and on every continent, and ensure that these life-and-death supplies are fairly distributed, not hoarded by the rich and few. Countries that have few coronavirus cases and are beyond the pandemic’s peak should be willing to help poorer countries by sending lifesaving equipment to them. And, looking ahead, we should be building up stocks of these supplies for emergencies, so that we can help each other the next time we need help the most.
All of these issues are on the agenda for the Global Health Pledging event on May 4. We ask all countries in a position to do so to participate, to listen and advise, and, most important, to give.