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COVID-19 as a governance challenge

UN Development Programme
Mar 19 · 3 min read
In rural areas, health capacity may be far lower than in urban areas. It is critical that we ensure that all countries receive the support they need to care for their entire population — leaving no one behind. Photo: UNDP Guatemala

On March 11, 2020 the World Health Organization declared COVID-19 a global pandemic. While the disease was slow to spread to Latin America and the Caribbean countries at first, since the end of February the number of confirmed cases has been climbing rapidly. It is important that countries take swift action to prevent the spread of the disease and to protect their populations. As Vernon Lee, the director of the communicable diseases division at Singapore’s Ministry of Health has said, we need “to stay one or two steps ahead of the virus. If you chase the virus, you will always be behind the curve.”

Critical in responding to this disease is the need to “flatten the curve”. This means protective measures to slow down the spread of the disease so that the number of cases does not overwhelm health care systems. This #GraphForThought takes a look at the COVID-19 in the region and assesses countries’ capacity to respond. Latin America and Caribbean countries are shown in green and benchmark countries — China, Italy, Spain, and the USA — are shown in grey. The graph uses the number of hospital beds per 10,000 people as a proxy for capacity in the health sector — as severe cases of COVID-19 require hospitalization. This is represented on the graph by the dot. The total number of confirmed COVID-19 cases in the country per 10,000 people is shown by the bar. Each bar is labeled with the total number of cases, not normalized. It is important to note, however, that the cases shown here are only those that have been confirmed by testing — and countries with higher capacity are likely those that are testing more. We have no data on the number of undetected cases — and importantly, we can only respond to the cases we know. Indeed, the World Health Organization is urging countries to “test, test, test.”

The graph shows us that that while some countries in the region have relatively high capacity, others may struggle greatly to meet a surge in demand. We see that countries such as Barbados, Cuba, and Argentina have a high capacity to respond. On the other hand, Honduras, Haiti, and Guatemala have a far lower capacity. If countries such as Italy, with a well-developed healthcare system was overwhelmed by COVID-19, these lower capacity countries may face an even more difficult situation if prevention is not taken seriously. It is also important to note that these numbers show national level averages for health capacity — greatly obscuring inequalities within countries. For example, in rural areas, health capacity may be far lower than in urban areas. It is critical that we ensure that all countries receive the support they need to care for their entire population — leaving no one behind.

It is important to remember that diseases do in fact discriminate — and the most vulnerable among us may be the most at risk. It is not only age that makes people more vulnerable, but also one’s socioeconomic situation. Not only are those in lower socioeconomic rungs more likely to have a chronic health condition, they may be less likely to have good healthcare and also less likely to be employed in a job that allows them to work remotely or take paid time off. They are also the least likely to be able to weather a sudden loss of income. This creates a self-reinforcing cycle between coronavirus and inequality.

We must ensure that our social safety nets are strong and reaching those who need them the most right now. We must support our partner countries in building resilience at this challenging moment.

By: Luis Felipe López Calva, UN Assistant Secretary-General and UNDP Regional Director for Latin America and the Caribbean

UN Development Programme

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