Current media attention on the unfolding COVID-19 crisis is largely focussed on impacted countries in the global North – Italy, Spain, the United Kingdom and the United States. These countries (along with China) lead the league table of infections and death. Graphic media coverage of overwhelmed health systems, mass graves, and deserted city streets concentrate our attention on what is happening in these resource wealthy countries.
Yet, the greatest impact of COVID-19 in terms deaths and infections will occur in the Global South. Reported infections and deaths currently remain low due to the late introduction of COVID-19 to many countries across Asia, Africa and Latin America, low rates of testing, and delays in reporting. Current reported low infection rates should not though be cause for optimism or apathy.
COVID-19 will devastate resource-poor countries characterised by limited health infrastructure, densely populated urban centres, poor underlying health rates, inability to access health care, and a lack of economic resources to survive sharp and deep economic contraction. It is highly probable that however shocking the scenes of the sick and dying have been in countries such as Italy and the United States, this will pale into insignificance to what will be experienced across the Global South.
COVID-19 will not just be a health pandemic and associated economic downturn – it will be a humanitarian emergency for hundreds of millions of already poor and vulnerable people.
The international community responds quickly and generously to humanitarian events. Every year, the international humanitarian sector responds to over 400 natural and human induced disasters that kill 100,000 and affected 120 million more. Tens of billions of dollars are raised and expended in response to these emergencies.
The humanitarian sector has evolved and grown over the last 150 years since Henry Dunant bore witness to the horror and immunity of the Battle of Solferino in 1859. Dunant’s response led in time to the establishment of the International Federation of the Red Cross (Crescent) movement and four principles of humanitarian action: humanity, independence, neutrality and impartiality.
These humanitarian principles have shaped how the international community has designed and delivered humanitarian responses globally. The historical value of these humanitarian principles cannot be overstated. However, their contemporary value and whether they remain fit for purpose must now be questioned.
The consequences of COVID-19 across the Global South will be at a level not previously seen (but will be analogous to the 2004 Indian Ocean Tsunami – though on an even greater scale). It is probable that the number of people affected directly and indirectly will overwhelm both local capacity but also the international resources that will be made available, already constrained due to domestic expenditure addressing COVID-19.
In an environment of enormous need and limited resources to respond, humanitarian actors will be faced with decision-making of immense consequences. The existing humanitarian principles are not sufficient to provide the guidance and structure by which these decisions will be made.
With hospitals unable to admit patients, a lack of health equipment to treat patients, and insufficient testing to support diagnosis within contracting economies, all decisions will have consequences that by necessity fail to protect life, reinforce existing inequities, preference certain communities or groups over others and require political considerations be accounted for.
The humanitarian principles that have directed the international community’s response to disasters for 150 years are ill-equipped to guide the response to COVID-19.
Alternative principles are required. More appropriate principles could be: equity, solidarity, compassion and diversity.
- Equity recognises that not all are equally affected by COVID-19 and responses must purposely seek to avoid deepening existing inequities.
- Solidarity conveys the collective obligation we have to address the needs of others. It brings those that are affected closer to those that are responding by removing the false premise of impartiality from our actions. Solidarity strengthens our resolve to assist.
- Compassion connects one human to another at a very personal level. In an increasingly strained environments where COVID-19 affects all countries, compassion will be a foil against disinterest, lethargy or fatigue.
- Diversity forces those acting to appreciate the differences that exist within society and to properly account for them.
The humanitarian response to COVID-19 can be different if guided by alternative principles.
These four alternative principles may not be perfect, but hopefully they can open the much-needed conversation within the humanitarian sector as to what guiding principles are needed within the system. This debate is already overdue because of the changing nature of humanitarian events including climate change, mass movements of people and prolonged periods of conflict.
COVID-19 demands this debate now take place – it is urgent. The original principles are no longer fit for purpose as will be sadly be demonstrated as the impact of the pandemic unfolds across the Global South, leaving misery in its wake.