Making the Case for LMIC’s to be Partners in the Global Solution for COVID-19

The growing success of containing the spread of COVID-19 presents yet another challenge: How to end lockdowns without causing a second wave? There is no modern comparison of the countrywide shutdowns on economic activity. Ending any countrywide lockdown needs unparalleled capabilities in testing, tracing, and most importantly— a vaccine needs to be developed.

Decisions to impose or remove restrictions could be extremely challenging politically. Governments must find an appropriate balance between a prolonged lockdown that damages the economy and reopening too soon, risking public health and potentially triggering a second wave. The decrease in new cases and relatively low hospitalization and death rates should guide these important decisions.

The world is currently focused on the development of a vaccine for COVID-19. There are at least 254 treatments and 95 vaccine candidates being explored.

The first nation to develop a vaccine for COVID-19 would have an economic advantage over others as well as a tremendous public-health achievement. China is making rapid progress, with three vaccines entering the advanced development stage. The U.S. is entering the race with five or six companies which operate primarily in the U.S. The Europeans are also making great progress and a laboratory at Oxford University projects that the first few million doses of the vaccine could be available by September. However, the challenge for the three competing powers (the U.S., China, and the UK) is making enough vaccines for their population and for other nations who lack the resources to develop their own.

Poorer countries in Africa, Latin America, and Asia would be served last if market power determines access to a vaccine. Thus, it’s important for Low and Middle-income countries (LMIC) to take steps to prepare to manufacture the vaccine on a local and/or regional scale. More than one manufacturer would be needed in any case to maximize production. The most prepared country among the LMIC could inoculate its own population quickly and perhaps share the product with other countries, particularly those in most need.

Generally, LMIC are ill-prepared to counteract a public health crisis. LMIC are dependent on partnerships for short-circuiting transmission, securing vaccines, and preventing future outbreaks. Over the last several years, the World Bank Group has been the leading international financier for health emergency preparedness to assist LICs and LMICs. However, new catalytic financial mechanisms are needed to respond to the severity of the coronavirus outbreak.

Low and Middle-income countries (LMIC) should focus on providing testing primarily to key public hospitals where patients are likely to show up and to public health laboratories throughout their respective countries. In parallel, LMICs should conduct random population testing to determine the virus’ prevalence across regions and provinces. Restarting social and economic activity on the basis of transmission risk while continuing strict isolation for vulnerable populations such as the elderly or patients with cancer may be the right strategy for low-income countries (LIC) that are unable to rapidly build up health care and testing capacity. Most importantly, these governments need to strategize lifting the lockdowns in a way that allows for adjustments as conditions change.

Usually, the Emergency Reserve Fund for Contagious Infectious Diseases at the U.S. Agency for International Development (USAID) collaborates with the World Health Organization (WHO) under the Strategic Preparedness and Response Plan (SPRP). However, President Trump’s unilateral decision to cut financial assistance to the WHO, severely hinders international efforts to address the impact of the virus in LMICs.

Given what’s at stake, on May 4th, a high-level meeting between European leaders and the Bill and Melinda Gates Foundation occurred to discuss raising €8 billion to establish a global vaccine distribution agency within the World Health Organization (WHO). LMICs are expected to benefit greatly from this multilateral initiative. Recently, Bill Gates said that his foundation would fund the production and research of the seven most promising candidates for the vaccine.

The COVID-19 crisis will have a major and long-lasting impact on LMICs and the developed world. Assisting LMICs would improve their abilities to respond to future health crises. By contrast, disregarding the needs of LMICs could lead to geopolitical consequences, economic recessions, surging unemployment, financial hardships, political instability, the rise of radicalization, and a surge in migrants. These interconnected issues between the developed and developing world all the more underscore the need for an interconnected solution between both worlds.