Grappling with a crisis like no other: the fragility of Arab countries in the face of COVID-19
By Adel Abdellatif and Ellen Hsu
In his 2014 book “The Butterfly Defect”, Oxford Martin School Professor Ian Goldin warned against the increase in systemic risks as a result of globalization. He borrowed the widely used term “butterfly effect” from chaos theory, replacing ‘effect’ by ‘defect’ to highlight the risks associated with a highly connected and integrated world. In a dedicated chapter on the systemic risk of pandemics, he foreshadowed the crisis we are witnessing today by pointing to the following factors as evidence of how a pandemic can have “profound and potentially catastrophic systemic consequences”:
1. The risk of connectivity, due to the density and intensity of connections between humans, and also between humans and animals;
2. The risk of concentration, as more and more people live in megacities and inequality within cities excludes parts of the population from basic services such as sanitation, clean water and medical care;
3. The risk of “social” contagion, given the almost instantaneous spread of information and rumors in the age of Internet and social media.
A systemic crisis
As the first systemic crisis of the 21st century, the financial crisis of 2008 shed important light on the fragility of an interconnected world, yet despite the global nature of the outfall, many Arab countries were shielded from its worse consequences by virtue of their relative isolation from the global financial system. The COVID-19 pandemic is another story. With close to 700,000 number of cases and more than 30,000 number of deaths in 202 countries worldwide, as of March 30, it has officially spread to nearly every country in the Arab region.
However it is important to keep in mind that official numbers do not provide an accurate picture of the situation, since they only account for a fraction of the actual number of infected people; moreover, new figures arrive every day. Countries that are reporting no or few cases — like Libya, Syria, Yemen, Sudan, Somalia, Djibouti, at time of writing — lack the testing capacity to identify cases. We must act regardless.
Beyond its health impact, this pandemic is hitting on all aspects of society and indeed, its uniqueness lies in the fact that we are dealing with a global multidimensional crisis for the first time. In a 2006 Ted Talk, epidemiologist Larry Brilliant shared his colleagues’ predictions of a potential pandemic: 1 billion people would get sick, as many as 165 million people would die, there would be a global recession and depression with a cost to the global economy of USD $1 to $3 trillion. Remarkably, early estimates of the impact of the current pandemic are consistent with these projections. An UNCTAD report released on 9 March identifies the possibility of a $2 trillion fallout. And according to early estimates from ESCWA, the Arab region is set to lose at least $42 billion in GDP and at least 1.7 million jobs in 2020. A prolonged global economic slowdown will adversely impact progress towards achieving the Sustainable Development Goals (SDGs), and this pandemic threatens to disrupt sustainable development efforts in all sectors. Measures like school closures, though a necessary component of the response, are upending every aspect of social and economic life, in ways which ensure vast challenges for development progress.
Crisis upon a crisis — COVID-19 and fragility
In a region already affected by many protracted and violent conflicts as well as significant displaced, refugee, and migrant populations, a pandemic of this scale will deepen pre-existing fragilities in already-vulnerable countries and introduce fragility in middle- and high-income ones. Countries’ level of preparedness, institutional capacities as well as the effectiveness of their preparation and response will largely determine how they will emerge from this crisis. According to the Global Health Security Index, an assessment of global health security capabilities in 195 countries, the Arab region stands at an average ranking of 122 out of 195 (37th percentile).
When it comes to physician density, the regional mean was 11 per 10,000 people in 2015, versus 15 globally, driven by the fact that the most populous countries in the region have the lowest tally of physicians-per-capita.
Despite a stronger health system, Gulf countries are not necessarily better positioned to weather this crisis, due to close inter-linkages with the international financial, goods and labor markets and heavy reliance on oil revenue, which has been dwindling amid a drop in demand. Gulf countries also host 23 million labor migrants who live and work in precarious conditions, making them particularly vulnerable to the spread of COVID-19. As their ability to send remittances back to their countries of origin is hampered, ripple effects are likely to be felt throughout the region; Egypt, Jordan, Lebanon, State of Palestine and Yemen are among of the largest recipients of remittances from the Gulf.
In middle-income countries, despite the presence of a central authority, institutional gaps and weak governance may hinder the implementation of swift, coordinated and strong measures, exposing citizens to further shocks. The Arab Barometer has shown year-after-year that low trust in governments besets the region. Meanwhile, lack of reliable data makes it harder to respond to the crisis, starting with the challenge of transparent communication to the public. According to the Open Data Inventory, which assesses the coverage and openness of official statistics provided by National Statistics Offices, data on health facilities is poorly covered in low-income Arab countries such as Mauritania and Djibouti but also in high and middle-income countries like Lebanon, Libya and the United Arab Emirates (UAE).
Finally, debt vulnerabilities present an additional challenge; with levels of debt over 90% of GDP, the governments of Sudan, Lebanon and Jordan have little fiscal space to put in place the kind of policies advocated by the IMF, such as fiscal stimulus, interest rate cuts or stabilizing the banking system. By contrast, Gulf countries have already announced sizable stimulus packages, including $13.3 billion in Saudi Arabia, $23 billion in Qatar, $11.4 billion in Bahrain and $27 billion in the UAE.
But the situation in fragile countries where violence is raging remains the most worrying. On March 23, the Secretary-General of the United Nations called for a global ceasefire in the face of COVID-19. Countries like Syria have seen years of protracted conflict destroy infrastructure and decimate their health systems: in 2018 alone, there were 308 attacks on health care reported in the State of Palestine, the highest number globally; 257 in Syria; 53 in Yemen and 47 in Libya. Although some of these countries are less connected to global traffic, which might insulate them temporarily to the spread of the virus, once community transmission becomes a reality, they will neither have the tools nor the capacity to prevent and respond effectively. In Libya and Yemen, where competing parties are controlling different swathes of the territory, any prospect of cohesive and prompt action is slim. The pandemic also puts food security and the provision of food assistance at risk, especially for those who are dependent on humanitarian aid. In the Arab region, that includes 20 million food-insecure Yemenis, 6.5 million Syrians, 1.6 million Somalis and 5.8 million Sudanese, as of September 2019. Times of crisis inevitably affect the most vulnerable dis-proportionally — migrant workers, rural and slum dwellers, women, unemployed people, refugees living in camps. As a renewed humanitarian crisis is looming, we must endeavor to minimize the impact on the world’s most vulnerable populations.
A society-wide response
The COVID-19 pandemic has highlighted the importance of having an effective government that is able to mobilize quickly the entirety of its institutions and adopt a whole-of-society approach, by engaging actors such as the private sector, the media and civil society organizations. Religious leaders in particular, hold significant moral authority in many Arab countries and leveraging their position can prove vital to community engagement at the local level. Social media platforms are another key channel through which governments can raise awareness and reach citizens directly. More broadly speaking, the role of digital technologies in navigating such a crisis is emerging strongly as learning, government services, and businesses are all moving online. Adopting forecasting and early warning tools can also allow countries to better prevent and prepare for future epidemics, which are expected to occur more frequently. With close to 50% of its population still not using the Internet, there is an imperative to accelerate digitalization efforts in the Arab region.
There are still many unknowns in this unfolding tragedy but what is certain is that this unique crisis will require new thinking, as well as collective action and solidarity from governments, citizens and international organizations. By supporting countries during all three stages of the pandemic — preparing, responding and recovering, UNDP is committed to help them mitigate the immediate short-term consequences of COVID-19 while building resilience to face future crises.
Adel Abdellatif is Deputy Director, a.i. and Senior Strategic Advisor at the UNDP Regional Bureau for Arab States. Ellen Hsu is a Researcher, at the same Bureau.