Not a First-World Problem: COVID-19 in the Global South

While recent epidemics hit almost only developing countries, the COVID-19 pandemic is hitting both the global south and the global north. Although this might create an illusion that the pandemic is an equalizer, impacts are unevenly distributed across and within countries.

Rodrigo Fracalossi de Moraes
April 24, 2020

For most people in the global north (as well as affluent people in the global south) impacts can be hard, but they pale in comparison to the potential catastrophe that may afflict the poor in developing countries. In the global north, with the exception of marginalized groups, of those at higher risk of severe illness from COVID-19 and of frontline workers, sacrifices necessary to contain the pandemic and deal with its consequences are relatively mild. Access to essential and intensive care is higher in the global north; access to preventive items is widespread, including handwashing facilities, soap and hand sanitizers; consumption of essential goods and services (such as food and electricity) is unlikely to decrease substantially; and greater fiscal capacity allows governments to make up for income losses, to stimulate the economy and to borrow at lower rates. In addition, self-isolating at home is not as stressful due to the amount of space at home, as well as more resources that allow people to have fun or partake in relaxing activities. Education is not severely disrupted, since children have more educational resources at home and schools often maintain distance learning. Institutions in the global north are generally stronger, serving as a check against the influence of pandemic-negationists. 

If the pandemic spreads in developing countries as it did in Europe and North America, the situation of poor people will deteriorate fast. According to the WHO, 50% of the world population lack access even to essential healthcare, let alone to intensive care, implying a much higher chance of death for those with higher risk of severe illness from COVID-19.

Lockdowns may be the best short-term solution for containing the pandemic, but they might imply unbearable sacrifices unless accompanied by compensations. Low-income people usually live hand-to-mouth, making them extremely vulnerable to income fluctuations. This is especially problematic for those with informal jobs, who do not have right to sick pay or most other social safety services. According to the ILO, 60% of workers in the world (around 2 billion people) work in the informal economy. A key factor here is education: 94% of workers with no education are in the informal economy, compared to 52% for those with secondary education.

In Brazil, for example, around 40% of workers have informal jobs, many of whom saw their income drop to zero overnight. In a survey conducted in 226 favelas in Brazil a few days after social distancing measures were introduced, around 70% of people reported a decrease of income, 72% said they did not have savings, and 86% reported they would have to sacrifice food consumption. Even worse impacts are likely to occur in India, where levels of income are lower and 78% of workers (excluding agriculture) are in the informal economy. Similar consequences should also be expected in Pakistan, where 70% of workers have informal jobs (also excluding agriculture). Due to the social distancing measures, these workers’ options are either to try and find work, which implies a risk of getting infected, or to stay at home and risk having no income.

In addition, the experience of a quarantine is completely different for the poor in the global south than it is for populations in the global north due to crowded housing, fewer options for indoor activities, and the difficulty of getting physical exercise. For the poor, both money and space are scarcer, making the quarantine probably unbearable for long periods. Tips circulating in Europe and North America about how to entertain children or to continue their education while at home, for example, are not as easily transferrable to poorer communities in the global south.

All of this is made worse by the spread of rumors and disinformation. To a large extent, these are produced or spread by populist and religious leaders who negate the pandemic’s seriousness, or simply refuse to cooperate. While this is also observed in the global north, state and civil society institutions are weaker and reliable information is scarcer in developing countries, making people more susceptible to the influence of disinformation. In Pakistan and Brazil, for example, a few religious leaders refused to close mosques or churches, arguing that the pandemic was no reason to skip Friday prayers and that people should keep going to church. Even if these sites were eventually closed due to social pressure or judicial decisions, a few religious and political leaders continue to spread disinformation, arguing for example that the WHO is part of a Zionist conspiracy or that the entire pandemic is a media trick.  

A lack of compensation for steep losses of income, combined with quarantine in crowded housing, disinformation about the pandemic, and distrust of science create a fertile terrain for social chaos. All of this creates incentives for people to violate rules of social distancing, increasing their likelihood of infection and infecting others along the way.

Top-down social distancing measures may be necessary, but authorities should be sensitive to the needs of the poor as well. Otherwise, they could face something similar to what happened in Rio de Janeiro in 1904 during the Vaccine Revolt, when people rebelled against mandatory vaccination, against a backdrop of increasing inequality and gentrification.

This is not to say that the pandemic does not bring suffering for everybody. However, it is to say that the distribution of suffering is unequal, with a far greater impact on the poor in developing countries. As the pandemic spreads through the global south, disruption and suffering are likely to reach levels that have not been seen so far.

Cooperation from countries that have accumulated experience in coping with the pandemic will come to be a vital source of help. This will help reduce suffering throughout the pandemic, as well as the likelihood of the virus spreading once more to previously affected areas. Governments and international organizations should also begin preparing for a post-pandemic world. As fiscal capacity is weaker and costs of credit greater in the global south, bilateral or multilateral help will be essential for these economies to recover from what is expected to be the worst recession in living memory.

Rodrigo Fracalossi de Moraes is a researcher at the Institute for Applied Economic Research (Ipea), a think-tank in Rio de Janeiro. He has a DPhil in International Relations from the University of Oxford and has previously taught at the University of Oxford’s Diplomatic Studies Programme.