How COVID-19 impacts global poverty, world hunger, and humanitarian issues in developing countries

All for one and one for all, united we stand divided we fall.

– Alexandre Dumas, The Three Musketeers (1844)

At times of a global crisis such as the COVID-19 pandemic, nations often look inwards in neglect of those who are the most vulnerable. The goal of this article is not to criticize the effectiveness of local, national, or global pandemic response, but rather to bring awareness of urgent global issues of the developing world and beyond. This article highlights the impact of COVID-19 on (1) global poverty and world hunger and (2) health and disease beyond COVID-19.

gray concrete pathway between buildings

Global Poverty & World Hunger: Turning a Blind Eye, Again

At the same time while dealing with a COVID-19 pandemic, we are also on the brink of a hunger pandemic.
– David Beasley, Executive Director for the UN World Food Programme

Figure 1. The forecasted impact of COVID-19 on global poverty. Figures adapted from World Bank estimates (Mahler et al., 2020). Predicted number of people in extreme poverty with and without COVID-19 (top), distribution of additional people pushed into extreme poverty across global regions (bottom).

In response to COVID-19, many countries have issued lockdown protocols and quarantine measures that have devastated global economies. The International Labour Organization (ILO) predicted that 14% of working hours have been affected in the second quarter of 2020, equivalent to 400 million fulltime workers. The global response to COVID-19 has affected billions around the world, yet those in developing countries, particularly migrant workers, are disproportionately affected. In 2017, ILO reported 164 million migrant workers worldwide, of whom 100 million work in India. These workers often live in dire conditions, have restricted access to healthcare, and lack legal and social protections. These populations are extremely vulnerable during the pandemic lockdown, highlighted in recent reports of hundreds of India’s migrant workers dying from starvation, suicide, police brutality, exhaustion, and road accidents while trekking hundreds of kilometers to return home.

ILO also reports that due to the impact of lockdowns to the service industry, women workers worldwide were disproportionately affected, threatening to undo decades of progress against gender inequalities within the workforce. Survey by ILO indicated that the decrease in employment in April 2020 compared to April 2019 across 6 reported countries was 17.1% more in women compared to men. This is partially due to a higher percentage of employed women (40%) working in hard-hit industries compared to men (36.6%) worldwide. Furthermore, disruptions in childcare services and shutdowns of schools increase amount of time women dedicate to unpaid childcare compared to men, taking away time devoted to jobs. During these trying times, nations must remember that human rights to health, social security, and life also extend to marginalized communities.

Despite an incredible achievement in reducing global poverty from 36% to 8% between 1990 and 2018, the World Bank estimates that 71-100 million additional people will be pushed into extreme poverty (defined as having an income of <$1.90 USD per day) in 2020. Furthermore, the disruption of food supply chains, trade barriers, and loss of income will result in 265 million people suffering from acute hunger in 2020, as estimated by World Food Programme (WFP). Malnutrition, starvation, and scarce access to clean water will increase mortality and risk of infectious diseases.

Health Beyond COVID-19: The Fight Against Many Battles

“The right to health means that no one disease should be fought at the expense of the other”.
– Winnie Byanyima, the executive director of UNAIDS (2020)

The easiest way for a frozen lake to break is to drive a hammer at its weakest point. In low- and middle-income countries, fragile health infrastructures were already overwhelmed by infectious disease outbreaks, such as the HIV/AIDS, malaria, cholera, and measles epidemics. Despite numerous global health humanitarian efforts in recent decades, COVID-19 and the pandemic response puts a hammer and nail into the healing fractures of the world. Lockdown of borders, disruptions to global pharmaceutical and medical supply chains (including vaccines), and reassignment of healthcare professionals to the COVID-19 response have led to severe disruptions in global health campaigns.

MALARIA: It is estimated that disruptions to insecticide-treated net campaigns and anti-malarial drug distribution could result in doubling of annual deaths to 769,000.
HIV/AIDS: A 6-month disruption on antiretroviral therapy could lead to additional 500,000 AIDS-related deaths in
sub-Saharan Africa.
VACCINE PREVENTABLE DISEASES: WHO, UNICEF and GAVI predicted that COVID-19 related disruptions in vaccination campaigns will put 80 million children of vaccine-preventable fatalities from diseases such as measles, tuberculosis, yellow fever and cholera.

As medical supplies and healthcare professionals get reassigned to the COVID-19 response, people with health problems unrelated to the pandemic find it harder to access regular essential health services. The WHO reported that of the 155 countries surveyed, 94% had partial or full reassignment of health staff to support COVID-19, 50% reported postponing public health screening programs (e.g. of breast and cervical cancers), and 20% reported shortages of medical supplies. Noncommunicable diseases (NCDs), such as cancer, diabetes and cardiovascular disease, kill 41 million people each year. Cancellations on medical appointments will have long-term impact in the early detection and treatment of these chronic diseases. Finally, indirect effects of COVID-19 (e.g. loss of jobs, death of family members, adjusting to new social norms) are likely to exacerbate the often-neglected issues of mental health. Whether it is vaccine-preventable diseases, NCDs or mental health illnesses, we must not let the response to one outbreak risk the emergence of another.

orange umbrella on sidewalk during daytime

Systemic issues of inequitable healthcare are also becoming increasingly apparent as COVID-19 rages on. Even before COVID-19, the WHO predicted that 5 billion people will not have access to healthcare by 2030. In Africa, there is a shortage of medical professionals, with 1:3,324 doctors per population compared to 1:293 in Europe. These numbers will most likely be exacerbated by the long-term economic and social impact of COVID-19. Even in rich countries, COVID-19 is disproportionately affecting vulnerable and marginalized populations, re-exposing the deep-rooted health and social inequities within, for example, the United States of America. On April 6, Louisiana reported that African Americans accounted for 70% of COVID-19 deaths despite making up only 33% of the population. These examples demonstrate the urgency in tackling healthcare inequalities around the world.

Figure 2: Causes of death worldwide in comparison to COVID-19. Number of annual deaths by causes including vaccine-preventable communicable diseases (purple), and causes associated with poverty, acute hunger, and lack of sanitary environments (blue) compared to deaths from COVID-19 thus far. Death estimates from WHO or other academic literature.

Conclusion Statement

Although these issues of poverty, hunger, and global health in developing
countries may seem distant, we must not mistake this for irrelevance. As our nations turn inwards by closing borders physically and otherwise, it is not of good conscience to neglect foreign aid for the most vulnerable in developing countries. The increase in global poverty will negatively impact economies of the rich and letting infectious diseases (COVID-19 included) spread amongst our neighbouring countries will most definitely circle back on us. What better time than now as we are amidst a global crisis to show the world that solidarity, cooperation and humanitarianism can triumph over nationalism, silence and protectionism? What better time than now to tackle issues of institutional inequities of healthcare and social security within our own country? Perhaps the best tool against a global pandemic is humanitarian in nature.

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Douglas Chung

Douglas is currently a PhD candidate under the supervision of Dr. Pamela Ohashi at Princess Margaret Cancer Center. He is currently interested in understanding novel mechanisms of immune suppression within the tumour microenvironment. Beyond research he is actively involved in science outreach such as Let's Talk Cancer and Science Rendezvous. Through these initiatives he hopes to inspire next generation of young scientists.
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