Wednesday 22 April 2020

C-19 Sensemaking

A global pandemic needs a global response

But there has been a sorry absence of international political leadership. The UK, with its tremendous network of humanitarian NGOs, can fill the void

By Ruth Davidson and James Cowan

Earlier this month, Libya recorded its first death from coronavirus. At time of writing, there are 51 confirmed cases in the country, although there will eventually be even more. It promises a disaster. Countries like Britain have been brought to a halt by the disease, and we have a strong health service and a united society. Libya has neither of those things.

After nine years of conflict, Libya’s few functioning hospitals are full of the war-wounded. Two medical facilities that had recently been assigned for Covid-19 patients came under auxiliary shelling and had to be evacuated due to damage. Much of its population struggles simply to exist – few have access to water and electricity. The price of a kilogram of tomatoes went by up 800 per cent in one city two weeks ago and, with no air freight, imported food and vital aid supplies are running scarce. The role of international aid will be vital.

In fact, while global supply chains are shutting down, no-one talks much about the global aid supply chain. Last week, the World Food Programme announced that it is halving its aid to certain parts of Yemen, another country in the midst of a humanitarian crisis. Apparently, this was due to a “critical funding shortage” – people have been holding back from giving to the country, from understandable fears that their donations would be caught up in the civil war between the Saudi-backed government and the Iran-backed Houthi rebels.

World Food Programme employees wear protective masks while distributing aid in Yemen

And now coronavirus. Or, as the UN has put it, “a war on two fronts”. Libya and Yemen join a growing list of countries that face this disease with precious little infrastructure to manage a lockdown, let alone to coordinate a major healthcare response. In Somalia and Somaliland, it isn’t the case that there aren’t enough ventilators. There aren’t any, full stop.

This list of countries is not something that British officials should just look at once and forget. It ought to worry us deeply, in part because of what it means for us. As scientists scramble to find an effective vaccine, test it and get it into mass production, we need to use this time to work out its delivery. All the pain and cost of lockdown and furlough on these shores counts for little if secondary and tertiary waves engulf us in future because Covid-19 wasn’t addressed everywhere. That’s the thing with global pandemics. Their eradication depends on us all.

It’s an economic problem as well as a healthcare one. It is absolutely right that the home front – isolating the vulnerable, equipping medics and carers, flattening the curve – is the immediate priority for Boris Johnson and his government. But rebooting the economy after the current, terrible peak means restarting the international movement of goods and people. This is necessary, but it also carries inherent risk. Covid-19 needs no passport, visa or customs papers to cross international borders.

The effects of a rocket attack on a hospital in Tripoli, Libya

Yet countries such as Yemen, Libya and Somaliland represent a distinct challenge to this effort. Not just because of how bad the coronavirus could get there, but also because of the difficulty of delivering an operational vaccine programme on the ground. How and where do you even start?

We do know what it takes to overcome such difficulties. The Ebola crisis showed us that epidemics and pandemics can and are defeated – but it takes huge international effort to do so. Just ask the UK’s chief medical officer, Professor Chris Whitty, who spearheaded the UK’s fight against Ebola as chief scientific adviser to the Department for International Development during the outbreak.

Stopping the spread of Ebola – and a second wave, which flared up several years after the first – took an extensive vaccine programme plus monitoring, tracing and real-time data analysis. It also meant going to areas blighted by military tension, huge poverty and little or no infrastructure.

Now, as the number of confirmed cases of Covid-19 reaches 2.5 million – and we know the true number is many multiples of that – the case for another global fight against disease is unambiguous. The moral, economic and health imperatives are overwhelming, and yet the action taken so far is not. In fact, there is a gaping hole in international political leadership.

Earlier this month, for example, we saw the head of the European Research Council resign, frustrated that his proposals for a more agile Covid-19 response were rejected. Last week, President Trump suspended US funding to the World Health Organisation, the global body coordinating the healthcare response.

It could and should be so different. The G20’s vision for leadership is the right one – a global response to an interconnected global crisis – yet their commitment to “do what it takes” needs to be turned into action. Of course, that requires funding for aid appeals and vaccine research. It also means supporting the WHO to be as effective as possible.

Medical personnel check people's temperatures at a displacement camp in Yemen

But, most of all, it needs a coalition of the willing to act now while looking to the future. This needs to include the G20, but it can’t stop there. Only by including countries in need of technical and financial assistance will we have a chance of leveraging global expertise to combat Covid-19 everywhere, and thereby limit the devastating effects of the virus.

That requires leadership, and the UK should step up to fill the void that individual states’ nationalistic responses have left. Our government is beginning to make the right noises, with the foreign secretary, Dominic Raab, committing Britain to taking a leading role in the global Covid-19 response. Anne-Marie Trevelyan, secretary of state for international development, has followed by pledging an additional £200 million of the UK’s aid budget. But bold words and funding announcements do not, by themselves, add up to the operational leadership that will be required.

The UK is a global centre of excellence in humanitarian response. It is home to some of the top policy institutions and many of the leading international NGOs specialising in humanitarian action (such as the HALO Trust; see box-out below). Organisations with boots on the ground in some of the toughest places on earth. Teams that are already trusted in communities where trust is in vanishingly short supply.

A group of volunteers distribute cleaning supplies to refugees in Mogadishu, Somalia

Their work already shows Global Britain at its best. And, empowered to use their skills, knowledge, experience and supply chains, these NGOs can deliver for the whole world. Private donors are already recognising this fact. One anonymous donor is funding clearance of landmines by the HALO Trust in two countries – he is now pivoting his money to support the Covid-19 response as well.

But the UK government needs to move fast, too, and empower NGOs with on the ground experience to deliver – even if healthcare is not their day job. These organisations may well already have a standing staff capacity, extensive logistical infrastructure and large vehicle fleets, including medical vehicles. The UK and other international donors should harness this type of existing capacity, and back it up with flexible funding.

Libya’s first 51 cases will not be their last. The nature of pandemics means their problem is very much our own. The UK should not wait for other countries to join the global fight against the coronavirus – it should lead.

Ruth Davidson is a member of the Scottish Parliament, and served as leader of the Scottish Conservative Party from 2011 to 2019. James Cowan CBE is a former British Army officer and now CEO of the HALO Trust.

Both Ruth and James will be joining a Tortoise ThinkIn on Thursday 23 April. You can book tickets here.

The HALO Trust

With over 8,500 staff in 26 countries, the HALO Trust is just one of the organisations committed to turning the tide against this pandemic. More used to digging mines and unexploded ordnance out of the ground, it stands ready to address this new emergency. As well as fleets of ambulances and Land Rovers, and some of the best (indeed, in some countries, the only) mapping of remote settlements, they also have highly skilled, highly trained local men and women who are trusted by the communities they serve and used to operating according rigorous safety protocols. Many of the countries where it works, such as Syria and Libya, are still in conflict. Others, like Afghanistan, remain dangerous and, in large parts, lawless territory.

Some of the places where HALO operates aren’t even recognised as legitimate states at all. By pivoting its teams, vehicle fleets and huge logistical and survey expertise, HALO can deliver medical and sanitation supplies to places where Covid-19 will continue to transmit and spread; either because they do not appear on any maps, or because no other organisation has the consent of local forces to access them. Crucially, it can also work with local communities to increase awareness about the importance of vaccination and sanitation, engendering crucial buy-in to the global programme.

Photographs Getty Images


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