Are we doing as well as other nations when it comes to responding to the coronavirus? As Bangladesh enters a crucial time in its fight against Covid-19, it’s key to look at where we position ourselves in the global pandemic response, and how both global health policies and politics are going to affect our response. Abdullah All Shakil specially for the Dhaka Tribune.
Bangladesh is already bearing financial and humanitarian costs and is expected to bear a significant health cost, according to the World Health Organization (WHO). So there needs to be a harsher spotlight on funding the public health response, and the need for international medical assistance to the overburdened and underdeveloped health systems.
Global health in the time of Covid-19
In a disease outbreak, every second counts and a timely political response is critical. In the inaugural Global Health Security (GHS) Index published weeks before the Covid-19 outbreak, the US and UK topped the 195-country chart. Yet they were among the hardest hit by Covid-19.
Health care facilities are on the brink of collapse, healthcare providers are overwhelmed by the number of patients, and wartime effort has been evoked to produce ventilators.
A key reason behind this failure is that political leaders either denied or undermined the threat of the epidemic to protect the economy. Such denial campaigns paved a golden opportunity for the Covid-19 pathogen to spread widely and to take more than 200,000 lives so far.
In contrast, countries such as Taiwan and South Korea with universal health coverage had the political will and the health systems to combat Covid-19 effectively.
Looking at the response time and spread of Covid-19 in countries, it appears that political will and foresight, public communication, and overall coordination played the most crucial role.
While most of the donor countries are busy in managing the epidemic in their own country, the global health financing and humanitarian assistance have suddenly dried up. This development has an immediate and potentially long-term impact on the Covid-19 response in Bangladesh.
It’s a crisis-driven primarily by a void in global leadership. US President Donald Trump accused the WHO of being biased towards China and cut funding of this multilateral global health institution.
WHO heavily relies on the member states for its $4.4 billion annual budget, and the loss of funding will have an adverse impact on the Covid-19 response in the LDCs. Since the 2014 Ebola outbreak, WHO has been criticized for its slow response and weak leadership.
Many EU countries have been rattled by the pandemic and are looking for regional support. The possibility of having an international support package from the EU is grim.
In this crisis, we are seeing China coming as the new global health donor country, airlifting aid packages. It might not be early to say that China is filling a void, which has been left by the Trump administration.
Response in Bangladesh and the limitations
As the world struggles to deal with Covid-19, Bangladesh has arguably entered into the fourth step of the epidemic: There remains a significant chance of wide-scale community transmission.
To place Bangladesh in the international context, according to the GHS index, Bangladesh scored 27.3 points and received zero points in biosafety, biosecurity, and the use of research in the culture of responsible science.
While the primary health care services helped to achieve notable success, secondary health care in Bangladesh remains underfunded and poorly managed. Despite being the fastest-growing economy in the region, Bangladesh invests lower than the regional average in health care.
Lack of coordination and mismanagement will be bigger challenges in responding to Covid-19. The government took a timely decision by announcing the general holiday and enforcing social distancing. The initial limitations of testing facilities and medical supplies are gradually being managed.
Yet implementing the lockdown has been haphazard — Bangladesh isn’t alone there — allowing the pathogen plenty of opportunity to thrive. The most obvious example was to allow millions to leave Dhaka and then allowing many of the garment workers to return.
The government urgently needs to boost the morale of health care professionals. They need to improve their communication but also to back it up with a boost to medical equipment — the absence of protective equipment (PPE) prevented many health workers from treating patients.
Given the health system’s existing vulnerabilities, Dhaka’s political choices become vital to success. The government needs to mobilize and incorporate public, private, and NGO-run healthcare facilities in response to Covid-19.
Public health communication needs to scale up and grassroots health workers and community leaders need to be a part of the national response. Misinformation needs to be eliminated to help contain the virus, both medically and socially.
With 90% of people in Bangladesh engaged in informal sectors, public health intervention might not be effective without a comprehensive social safety net to support the daily wage earners. Multi-sectoral engagement can improve the management and outcomes of the support system.
While we’re distracted by Covid-19, regular public health programs also need to continue. Gavi, The Vaccine Alliance, estimated 13.5 million people are going to miss out on vaccination globally due to postponement and interruptions in routine vaccinations.
The dengue season is about to approach, and the fear of last year’s outbreak returning is there. Thus, along with our effort to control Covid-19, our planned regular health services should continue, even if we need to compromise with the schedule.
Frontline health care providers, law enforcement personnel, and city corporation service providers need to be protected. If these service providers contract infection, that might add extra burden to the overall system.
There is also no alternative to international assistance. The government has already asked for international assistance from China, and these sources need to be diversified.
But as global leaders become more insular and initial spike in emergency response slows, countries like Bangladesh have to stand on their own feet.
Also, world leaders need to extend support for the most vulnerable countries to go back to the “normal.” Otherwise, the Covid-19 pandemic may continue for an extended period and cause irreversible damage.
Abdullah All Shakil is a Consultant, Vaccine Alliance for Production and Immunization, Islamic Development Bank.