The COVID-19 pandemic first hit China, then spread throughout Europe and the United States. As a result, initial reporting on the disease focused on the lockdown in the Chinese city of Wuhan, where the virus is believed to have originated, and on the rising infection rates in early hotspots like Italy, Spain, and the U.S. Since then, Western media attention has remained largely fixed on the Global North, even though the pandemic has become a truly global phenomenon. Some of this is explained by the fact that the U.S. continues to lead the world in coronavirus cases and deaths, while other developed countries have managed to get the virus under control. Still, this often-myopic focus persists in spite of the virus’s spread across the Global South. Many of these countries face unique virus-related challenges that are distinct from those with which the Global North contends.

Here, I highlight some of the challenges that nations in the Global South are confronting as they battle the virus. This is not meant to be a comprehensive list, rather, they are anecdotal examples intended to serve as reminders that, while the novel coronavirus itself is indiscriminate in terms of who it affects and how it affects them, the ongoing pandemic is far from a global equalizer. Indeed, in many ways, the COVID-19 pandemic serves to underscore the deadliness of the radical inequality of wealth, resources, and power between the Global North and Global South.

Density, Overcrowding, and the Impossibility of Social Distancing

The density and physical layouts of many cities in the Global South render social distancing – a key public health step recommended by the World Health Organization (WHO) – extremely difficult, if not functionally impossible, in certain instances. Many cities are densely populated and have narrow sidewalks, overcrowded public transportation, and often people are occupying small living quarters. Moreover, the people in these cities, especially those who live in the most cramped living conditions, overwhelmingly cannot afford to be unemployed or otherwise not to engage in social life outside of the home. For example, in Nairobi, Kenya, only a small, highly privileged subset of residents have the ability to even come close to practicing the kind of social distancing recommended by the WHO, as public transportation, which is the main way to arrive to and from work for many Nairobi residents, is heavily crowded.

Social distancing is also a major challenge wherever you find large populations of displaced persons. Many nations in the Global South contain large populations of internally displaced persons. For example, according to a report by the African Center for Strategic Studies, across the African continent, 25 million people were displaced (as refugees, internally displaced persons (IDPs), or asylum seekers) in 2018. Nearly 17 million of these people were IDP, meaning they remain within the borders of their home countries. These populations lack stable, independent housing, and are often forced to live in cramped camps, where social distancing is functionally impossible.

Thus, the ongoing pandemic has created new risks for these already vulnerable populations and has exacerbated the factors that pushed people from their homes in the first place. These factors remain diverse, but often involve some mix of violence, political conflict, social strife, and competition for resources, sometimes spurred on by the effects of climate change or other changes in the natural environment.

In Nigeria, for example, population displacement has largely been triggered by the conflict with the Islamic militant group Boko Haram, and by competition between pastoralists and farmers. This displacement is further spurred on by recent natural disasters, especially seasonal flooding, which is caused by rapid urbanization, poor urban planning, and increasing rainfall levels attributed to climate change. These seasonal floods have caused the displacement of thousands of additional people in recent years. One result has been the establishment of large, longstanding IDP camps. For example, the Gubio displaced person camp in northeast Nigeria – just one of many camps for displaced people in the state of Borno – currently houses approximately 38,000 people. The camp is overcrowded, and people pack tightly together in order to escape the hot sun. These conditions make following social distancing recommendations extremely hard, as the International Committee of the Red Cross reports.

Another WHO recommendation aimed at slowing the spread of the virus has been the practice of self-quarantine by individuals who have tested positive for the coronavirus (or exhibit symptoms associated with the virus). However, in many countries in the Global South, most of the population shares bathrooms, living spaces, and bedrooms with their family, as well as people outside of their immediate family, rendering self-quarantining a difficult, if not functionally impossible, practice. This is especially true in places where bathrooms are communally shared. This problem will persist unless governments are able to set up separate quarters for people to temporarily stay until it is safe for them to return home, similarly to what China did in Wuhan.

For example, in Brazil’s Favela de Rocinha, Rio de Janeiro’s biggest slum, about 250,000 people live in cramped conditions. Living quarters are overcrowded, as residents typically share their homes with other families, and suffer from a lack of basic sanitation. Most homes do not have running water, rendering basic hygiene – such as regular handwashing with soap and clean water – far more difficult. If a person living in one of Brazil’s many favelas tests positive for the virus or exhibits symptoms associated with it, there is likely to be no space for them to isolate. Given that Brazil has become a world leader in coronavirus infections and associated COVID-19 deaths, the potential for even more death remains perilously high.

Yemen is also suffering from uncontrolled spread of the virus and the fatality rate in the country is extremely alarming, as it is five times higher than the global average. Before the coronavirus even hit, the United Nations declared Yemen’s situation as the most acute crisis in the world in February. The U.N. estimates that 24 million people, about 80 percent of Yemen’s population, are in need of humanitarian assistance and protection. Since the conflict between government forces, backed by a Saudi-led coalition, and Houthi rebels has caused millions to be without clean water or sanitation, preventing the spread of the pandemic is extremely difficult. The conflict has also taking a toll on the country’s already weak healthcare system, which now lacks the capacity to deal with the coronavirus. Additionally, medical and humanitarian supplies are difficult to provide as the Saudi-led coalition blockades supplies from reaching Houthi territories, and since rebel groups prevent the distribution of aid as well. The coronavirus pandemic threatens the groups who were already so vulnerable in Yemen, such as IDPs and refugees, and it has made them even more vulnerable.

Infrastructures and Indigenous People

Overcrowding and a lack of public health infrastructure in cities in the Global South is a major problem, but this does not mean that populations living in rural or remote locations are not also at a heightened risk of contracting coronavirus. Brazil’s Amazon region contains a large and diverse population of indigenous communities. To reach certain indigenous communities in Brazil it may take days of travel, using transportation methods that may seem unconventional to many in the Global North. These remote communities not only lack basic sanitation and health facilities, but are chronically understaffed with trained medical personnel and suffer from insufficient health care equipment. Many of these rural communities have no hospitals, let alone intensive care units (ICUs). ICU beds – critical to the survival of those who contract a serious case of coronavirus – are often many miles away from the populations that need them. Ten percent of Brazil’s Amazonian villages are between 434 miles to 670 miles from a facility with an ICU. The situation is similar in South Sudan, where more than 1.6 million people are already displaced and it can take hours or even days to reach healthcare facilities.

In April, the African Commission on Human and Peoples’ Rights issued a statement expressing concern regarding the growing number of coronavirus infections in African countries. The Commission expressed its concern regarding

the precarious conditions in which the majority of indigenous populations, especially indigenous women, live, including extreme poverty, lack of clean drinking water, lack of decent housing and toilets, posing a real hygiene and health problem and thus constituting a real risk for the spread of COVID-19.

These same populations also generally suffer from a lack of resources and tend to be located far away from health centers. Finally, proposed health regulations often do not take into consideration the indigenous way of life and as such, may be ignored or rejected.

The Commission also noted that some of the measures taken by African States to curb the spread of the coronavirus, including the closure of markets and restrictions on mobility, may compound the risks to indigenous populations, by “curtal[ing] their livelihoods” and “hamper[ing] their pastoral activities.”

Socio-Economic Conditions

Along with its direct health effects, COVID-19 has also indirectly imperiled the lives of vulnerable populations due to the economic fallout left in its wake. The pandemic has caused a steady stream of negative economic repercussions across the globe (see here, here, and here). However, for many people living in the Global South, particularly those without savings or working in the informal economy, this fallout may be life-threatening.

When the pandemic hit Kenya, for example, as Maureen Were explains in her note for United Nations University, the government initiated a set of policies amounting to a near total lockdown. This lockdown quickly devastated the Kenyan economy. In March, the Central Bank of Kenya lowered its 2020 growth forecast by nearly 50 percent (from 6.2 percent to 3.4 percent), only a month after the first positive coronavirus test in the country.

In Kenya, many working sectors were hit hard by the pandemic, especially the aviation, hospitality, tourism, and agricultural sectors. The closure of borders has also affected trade, including disruptions to the steady supply of essential foodstuffs from Uganda and Tanzania. Furthermore, the pandemic further damaged the agricultural sector in the country, which was already suffering one of East Africa’s worst locust swarms in decades. The combined effects of the pandemic and locust blight has raised concerns of potential shortages of key foods, including maize, a primary staple of the Kenyan diet.

The pandemic also influenced Kenya’s informal sector workers, casual employees, and daily-wage earners in the formal sector. Were explains that “the majority of working Kenyans are employed in the informal sector, which is likely to be most affected.” This is because these workers are often self-employed and poor, whos’ livelihood and financial survivor is based upon the informal business activity which was affected by the pandemic.

The pandemic has also stifled international trade. For example, trade between African nations and China has dropped significantly. This is especially alarming since China is Africa’s largest trading partner, and also the continent’s largest bilateral creditor.

The situation in India is similar in some respects to the one in Kenya. As the coronavirus spread, India quickly entered into a countrywide lockdown. As a result, explains Kunal Sen, millions of migrant workers within India attempted to flee from cities where they worked to their rural homes. The lockdown for these workers – most of whom survive on daily wages and work predominantly in India’s informal sector – means that they have no means of livelihood and may need to survive without an income for a sustained period, despite typically having little or no savings. To assist these workers, as well as those in other sectors in India, Prime Minister Narendra Modi announced an economic rescue package of more than $260 billion. In addition, Sen speculates that the measures taken by the Indian government to stop the spread of the pandemic may cause a decrease in the national GDP.

In Argentina, the pandemic could not have come at a worse time. The Argentinian economy was already in a fragile situation, following a two-year recession, with inflation rates of over 50 percent, and 35.5 percent of the population living in poverty according to a May 2020 U.N. Development Program report. The World Bank’s June 2020 Global Economic Prospects report predicts a contraction of 7.3 percent in Argentina’s GDP this year, attributable primarily to the strict measures Argentina is taking to fight the COVID-19 pandemic, lower demands for the country’s exports, and the overall uncertainty regarding its debt negotiations.

The socio-economic fallout of the pandemic is also being acutely felt in Afghanistan. There are an estimated 14 million people in Afghanistan who are in humanitarian need, according to an analysis by REACH, a humanitarian monitoring and data organization. However, due to the measures taken by the government to curb the spread of the coronavirus, Afghans are also now suffering from a new economic crisis, REACH reports. In Afghanistan the pandemic has caused prices of key products to rise sharply, putting the country’s already vulnerable population at greater risk. Indeed, some Afghans are already struggling to afford core life-sustaining products – including food – as prices continue to go up.

Without international support, it will be difficult for countries in the Global South to come out of this crisis. As countries work in collaboration to find a vaccine and secure their economies, the world also needs to pay attention to the unique difficulties being faced in the Global South and to try and find comprehensive solutions.

Image: Coronavirus with world map (Photo by Peter Zelei/Getty Images)