This post is the first in a series exploring issues around how data can be leveraged to improve coronavirus response, mitigate large outbreaks, understand public perception of COVID-19, measure misinformation spread through social media, and examine the economic impact of COVID-19 and self-isolation in the Global South. This current piece will focus on healthcare, with subsequent posts discussing privacy & security, government, and social media.
Early on, COVID-19 drastically affected countries like China, Italy, Spain, and the United States, but it has now rapidly spread to the Global South. While many countries in this region were last to be affected, their more vulnerable healthcare systems — coupled with larger population sizes and more dense cities — could lead to a more severe impact. Countries like Brazil, India, Mexico, Nigeria, and Peru are experiencing large upticks in daily cases and many are not expected to flatten their curve until the end of July, if not later.
Over the past few months, members of the MD4SG Working Group on Development have held numerous meetings discussing ways in which we can leverage our skills and knowledge to address COVID-19 related issues in the Global South. Many of the working group members have connections to and interests in the African continent especially, with group members coming from countries such as Burundi, Ethiopia, Nigeria, and Uganda and actively pursuing research topics within the continent.
There was strong consensus within the group that Western measures such as social distancing or quarantining may not translate well to our context based on the distinct societal and economic makeup of the 54 nations in Africa. Other issues such as the spread of misinformation and the design of effective testing strategies in extremely resource-constrained settings present major issues.
Based on discussions within our group, we highlight some of the issues particular to the Global South and suggest some avenues for research and collaboration. The topics are broken down into four main categories and we will focus on the first in this piece:
- Healthcare
- Privacy & Security
- Social media
- Government
Healthcare
With the pandemic overwhelming healthcare systems in countries such as the United States and Italy, the state of healthcare infrastructure within countries in the Global South makes these regions particularly vulnerable. Many countries are undergoing concurrent healthcare outbreaks such as Lassa fever in Nigeria and agricultural infestations like the locust swarms in East Africa, making the current COVID-19 crisis even more threatening in the Global South.
As seen in prior outbreaks, such as the Ebola pandemic in 2013, the coronavirus pandemic has the potential to (and for many populations already has) led to an increase of deaths from diseases such as malaria, Lassa fever, and yellow fever. The Bill and Melinda Gates Foundation is now focusing solely on the COVID-19 pandemic and has acknowledged that other public health work the Foundation does may suffer. With this shift away from the Foundation’s previous focus on HIV, malaria, and polio, the current pandemic will delay the progress already made in curtailing and eradicating these diseases.
Worries about the potential impact of the pandemic have been particularly acute in the Indian subcontinent. As is the case with many nations in the Global South, India’s medical infrastructure is thinly spread across the population. With major cities like Mumbai having a population density of over 30,000 people per square kilometer, the potential for quickly overwhelming medical institutions is frightening. Many essential aspects of public health, such as access to basic handwashing facilities, are severely lacking in India, with 60% of the Indian population lacking access to such infrastructure.
Despite these limitations, a number of countries in the Global South are experienced in handling pandemics. This has informed decision-making and improved their preparedness. During the Ebola crisis, for instance, Sierra Leone successfully implemented a 72 hour lockdown, which led to further quarantine restrictions, and an eventual eradication of the Ebola virus. During this current outbreak, Sierra Leone has taken their experience with lockdowns to enact similar policies. Sierra Leone’s stockpile of PPE left over from the Ebola outbreak has kept the number of cases low. These sustained efforts in Sierra Leone could serve as a model for the rest of the Global South and prove effective in slowing the transmission of coronavirus.
Other countries, like Ethiopia, have been vigilant in providing data about the outbreak, and introducing measures to ease transmission such as improving internet access to allow workers to work from home. Countries like Rwanda and Ghana have provided relief to vulnerable households through the delivery of food items, and provision of essential services such as water and electricity for free.
In our working group, members have discussed various strategies for mitigation and prevention of COVID-19 in low-resource settings. One example is using group testing strategies to combat current shortages. An example is an article published by Jakob Jonnerby, Edwin Lock, and Francisco Marmolejo at the University of Oxford. This work was recently highlighted by the Stockholm School of Economics and presented at the Data Science for Africa (DSA) COVID-19 Response Webinar.
We believe that documenting innovative solutions, technologies, and approaches that were particularly relevant and successful in the Global South in response to this pandemic can be helpful when designing approaches for future ones.
A major issue is that data collection capabilities and efforts within the Global South have not been structured to take advantage of current analysis methods. Challenges such as infrequent data collection, lack of telecommunications infrastructure, and the cost of data processing inhibit access to high-quality data that could inform government policies and provide insight on development targets. Members within our working group are particularly interested in curating datasets on medical equipment procurement and distribution to help improve the coordination and allocation of scarce medical resources during public health crises.
Beyond combating the spread of the disease, social, economic, and cultural practices are also changing drastically. From changes in religious practices to marketplace habits or e-commerce delivery trends, examining what barriers may exist in the adoption of social distancing or other policies can help inform the design of culturally-appropriate health policies. Not only is data collection and curation important, but it can help inform and re-shape policies, slowing the spread of infection, protecting livelihoods, and supporting the recovery of economies.
Conclusion
There are many opportunities for further investigation that are currently undertaken by the working group. Working group members have had meetings with UNICEF officials in Paraguay, ministers in Mexico and India, and initiatives building contact tracing apps in Ethiopia. The group will continue to tackle issues around contact tracing, data curation, and understanding socioeconomic and cultural practices in partnership with domain experts based in Ethiopia, India, Mexico, and Nigeria. The working group organizers welcome suggestions and collaborations.
Written by Chinasa Okolo with contributions from the MD4SG Development Working Group. This is the first in a series of posts on COVID-19 response in the Global South. The post summarizes ongoing conversation within the MD4SG Development Working Group. If you would like to join this conversation we are excited to have you! Please feel free to reach out to us at wg@md4sg.com.
