Beyond the need for medical gear and proper public handwashing stations to adequately curb the transmission of Covid-19, institutional shortcomings in low- and middle-income countries (LMICs) present distinct challenges for effective public health measures. From crowded living spaces in slums and informal markets to the vulnerable livelihoods of refugee and migrant populations alongside women and children, LMICs are most fragile to this crisis.
Urban slums and rural areas
People living in overcrowded situations with little access to water and sanitation are at the greatest risk of exposure. The one-eighth of the world’s population who live in urban slums cannot properly practice physical distancing or regular hand washing. Often without hospitals or ambulances and no or few police to enforce measures (a source of conflict in itself), conditions for effective policy implementation are dire. In Rio de Janeiro, in response to the government’s downplaying of this crisis, local criminal groups have declared a pandemic-related curfew. Yet outsourcing enforcement to criminal groups is a precarious move as groups may use the opportunity to undermine civil society.
Persuading slum-dwellers to stay in one-room shacks with many relatives will be tougher than getting people in New York or London to stay on the sofa watching Netflix. Addis Ababa for The Economist
In rural isolated environments, where the largest concentration of the poorest and most food-insecure people live, smallholder farming families are particularly vulnerable. Distanced from equipped health facilities and other public services, rural residents also hold fewer savings and assets and interact with more risk per their partial engagement in food markets and participation in subsistence-based agriculture. In Malawi, the announcement of a national lockdown was met with protest that called on the government to expand support measures, like strengthening the resilience of farmers with more climate-resilient and nutritionally enriched crops. Yet high transaction costs in rural areas make it difficult to access banks and withdraw welfare funds.
Unemployment, poverty, and informal markets
Global unemployment is estimated to increase between 5.3 million and 24.7 million as a result of Covid-19. The significant loss in employment indicates losses in income across countries. Extreme and moderate working poverty (less than 3.20 USD per day, purchasing power parity) is also estimated to increase anywhere from 1.2 to 5.0 million in low-income countries, 3.7 to 14.8 million in lower middle-income countries, and 3.6 to 14.5 million in upper middle-income countries. Increases in unemployment and poverty have devastated unprotected workers (self-employed, casual, and gig workers). Street vendors, whose demand is derived from bustling schools and offices, now find themselves without customers, a similar experience to others in the informal economy.
With 93 percent of informal labor occurring in emerging and developing countries, the economic implications of this crisis present many difficulties in the employment and unemployment of this sector. In Kenya, where 83.6 percent of the labor force works informally and has access to few protection schemes like unemployment benefits, safety regulations, or social security, the cost of full compliance with public health measures and staying home is significant. The cash-based transactions and close person-to-person contact involved in most informal economy models augment people’s risk of contraction.
For government officials, the trade-off between flattening the curve and protecting the economy is complicated. Nonetheless, Amr Adly, an assistant professor at the American University in Cairo, is hopeful that the scale of this crisis could encourage a change in structure toward more formalization of work rather than the formalization of firms and their assets, which has been the traditional aim of governments and international organizations.
Gender disparities and domestic violence
Covid-19 has also exposed and exacerbated some of the struggles that social minorities face in society, particularly for women. In Latin America and the Caribbean, where despite sustained improvement trends, gender violence and discrimination remains blatant, this crisis has affirmed disparities. Noticeably, conditions of social isolation weaken support networks and give domestic abusers the opportunity to control their victims far from family, friends, and employment. Since the beginning of national lockdown, emergency calls for domestic violence have increased by 25 percent in Argentina, 60 percent in Mexico, and 79 percent in Colombia.
In addition to the increase in reported incidents, gendered isolation orders, where residents are assigned times to leave their homes based on gender, have highlighted differences in home production responsibilities. Across Latin America, greater rates of female labor participation in recent years do not imply a change in the distribution of household chores. In Peru, this was evident when “pico y género” caused overcrowding in supermarkets and pharmacies during women’s assigned days and was retracted eight days later. In Colombia, Bogota continues to enforce this measure.
Gender disparities also extend to the paid labor market. In Bangladesh, one million garment workers, who are disproportionately women, compromise 7 percent of the country’s labor force, and are mostly informally employed, lost their jobs due to the halting of production flows during the global lockdown. While hundreds of garment factories have reopened this week, unemployment may continue as owners may be uncertain of the demand for clothing in the Global North with people having less disposable income.
Refugees and moving populations
The majority of the world’s 25.9 million refugees and 41.3 million internally displaced persons are in LMICs. Similarly to urban slums, refugees and migrants living in camps cannot practice physical distancing and often also lack the proper access to water and sanitation. Prohibition of social gatherings has also affected migrant support services like the closure of the Colombian border’s migrant kitchen that serves an average of 8,000 meals every day and provides basic medical services and bathrooms. With experts warning that refugees and migrants could be the last in line to receive protective equipment and resources for testing, the temporary suspension of resettlement flights has also placed a strain on LMICs’ limited welfare resources. These travel measures extend to the suspension of labor migration. Under national lockdowns, migrant laborers without work are stranded in unaffordable urban hotspots and without transportation home. In India, many have begun to walk hundreds of kilometers to their villages.
The circumstances of development that are unique to low- and middle-income countries in the Global South requires a Covid-19 playbook different from the one currently employed by LMICs. Achim Steiner from the United Nations Development Program (UNDP) and Angel Gurría from the Organisation for Economic Cooperation and Development (OECD) have urged governments and businesses to boost foreign aid spending; direct scarce medical supplies to communities where they will have the most impact; maintain borders open to goods and services; slash transfer fees for funds sent by migrant workers and family members abroad; address rising debt. Addressing the fundamental weaknesses of LMICs in the context of the UN’s Sustainable Development Goals (SDGs) is thus necessary to minimize and mitigate the aftershocks of Covid-19.