Digest 1 - Six themes about the array of COVID-19 country experiences
COVID-19: Highlighting six themes among the current array of experiences and ideas being shared globally – Digest 1
- Other countries’ COVID-19 experiences
Beyond the nature of the specific responses, these point to how the broader political-economy of the country/state (in Kerala’s case) influences responses - and
- either how the Covid19 response is enabled by past investment in (public) health systems and wider socio-economic investments, or
- how the response is undermined by current political crises and failings, and neglect of health and wider socio-economic investments.
For example, consider:
- Cuba’s experience of responding at home - and supporting other countries
- Vietnam’s experience, which is identified as a strong response
(there’s another good piece on Vietnam in the Financial Times, but it is paywalled)
- Kerala, India’s experience, also identified as a strong response
- South Korean experience
As compared to:
- Wider Indian experience - and there are a growing number of pieces critical of the national-level Indian response
- Bolivian experience
- Tanzanian experience
- Considering previous experiences
The past experience of SARS, MERs are being seen as important in e.g. South Korean responses (see above piece), but the piece below presents a political analysis of the 2008 cholera epidemic in Zimbabwe, revealing how wider political and economic factors exacerbated the epidemic - creating a crisis of political trust.
- From cholera to corona: The politics of plague in Africa
Simukai Chigudu concludes:
The present moment calls for social solidarity, political leadership, and community mobilization. And yet, for the reasons I’ve laid out in this essay, this seems a tall order. Nevertheless, I will continue to hope that the unsung heroes of Zimbabwe’s cholera outbreak—doctors and healthcare practitioners, bureaucrats and aid workers, churches and volunteer groups – will once again rise to the occasion. But this will never be enough. Epidemics are tests of social and political systems. Cholera exposed the myriad weaknesses of Zimbabwe’s politics in 2008. Will the coronavirus do the same 12 years later?
- Experience at the South African frontlines of response
These pieces clearly demonstrate the multiple everyday challenges that must be navigated in implementing COVID responses:
Consider, for example:
- CHW experiences:
- the experience of frontline police:
- The particular challenges of implementing responses in informal settlements in the ‘global south’
Concluding that it is important to:
- Monitor conditions in informal and formal neighbourhoods
- Identify high-risk locations and help those individuals who are not well to isolate.
- Identify high-risk occupations and begin to roll out health programmes.
- Establish effective partnerships between key stakeholders including organised citizens, national and international government agencies,
- Establish reliable sources of information so that people can act effectively to reduce risk and protect lives.
- Work together – organised communities, local government and health ministries have to work with one another to identify and test solutions to this crisis.
- Capacitate networks of community leaders (working both in neighbourhoods and specific sectors) to share information that they collect upwards to the responsible agencies and share key health messages downwards.
- Emerging lessons for health systems
- Five key lessons:
1/Government leadership; 2/An appropriate mix of hospitals, PHC and public health; 3/Supporting people to manage their own health; 4/Working with all parts of the health service to meet national goals (public and private); 5/The potential contributions of new treatments, vaccines, tests and technology
- Specific ideas about how to budget for the Covid-19 response:
- Recognizing the importance of strong public health systems:
- Reflections on the ‘crisis of capitalism’ being revealed by Covid
- At global level
Concluding that the measures that can mitigate the way the virus spreads include:
- Greater regulation of markets locally and internationally, to address hotspots such as live animal markets.
- More biosecurity measures to control regional, national and international trade, including better tracking of international traders and business travellers.
- Fiscal measures to encourage localisation of production and consumption, rather than globalisation.
- Mass testing and contact tracing if an outbreak of a virus occurs in a jurisdiction.
- Funding of health services so they are run not as just-in-time enterprises with limited excess capacity, but with flexibility to absorb crises such as an epi/pandemic.
- Establishing resilient support networks for old/vulnerable people if severe social distancing is required in future.
- And in South Africa:
- again, emphasising that ‘Public health is a common good’.