COVID-19, corruption and Zim health sector crisis

Source: COVID-19, corruption and Zim health sector crisis | Newsday (News)

CORRUPTION is one of the factors stifling development in Africa. However, COVID-19 exposes the extent to which corruption has contributed to the destruction of State institutions’ capacity as the public health system, which the poor depend on, struggle to deal with the viral infections to save lives. The Zimbabwean healthcare crisis, and the country’s poor response to the pandemic better illustrate the situation of many African countries.

The COVID-19 pandemic is affecting everyone’s life, with the poor the most affected. Countries are battling to contain the rates of infection and loss of life. Most are on lockdown to restrict people’s movements and minimise infections. While the rich and the poor are both affected by the virus and lockdown measures, it is the latter who suffer most.

In Africa the poor depend on the incapacitated public health systems while the rich can use their wealth to access quality private healthcare, including abroad. Secondly, the poor are the most economically affected as most depend on income generated in the informal sector which has been seriously affected by the lockdown measures. Against this backdrop, some countries (such as South Africa) adjusted their measures to allow segments of informal sector traders to operate during the lockdown. However, the country-specific adjustments do little to support most of the poor.

The COVID-19 outbreak

Ever since its outbreak in the Chinese city of Wuhan at the end of 2019, there are currently over 200 000 deaths from slightly over three million confirmed cases globally (end of April 2020) according to the Johns Hopkins University. The global epicentre of the viral infections has shifted from China to Europe, and then to the US. The US is now the leading country in terms of confirmed cases (over 900 000) and deaths (over 50 000).

In Africa there are currently more than 30 000 confirmed cases, with South Africa leading with more than 4 500. Although many African countries have few confirmed cases, there is fear that as many people get infected the public health sectors will not cope, leading to many deaths and economic disruptions that affect millions of the continent’s poor.

Some governments, especially in the global north, have released multi-billion-dollar stimulus packages to support their hard-hit economies and boost the capacity of their health sectors to fight the pandemic and save lives. Many poor African countries do not have resources to fight COVID-19. Their health sectors are under-resourced and mismanaged. The countries also lack resources to stimulate their economies, most of which will need “intensive care” to resuscitate after the pandemic. They also do not have resources to introduce programmes to support the poor economically during the lockdowns.

If gold rusts, what then will iron do?

The global impact of COVID-19 is tremendous. It has ravaged economies, with the livelihoods of millions affected. In the US, over 26 million people filed for unemployment benefits. Millions have lost their jobs or means of income across the globe as people were forced to remain at home as part of social distancing measures.

While rich nations can put together programmes to support their poor during the crisis, many African governments do not have reserves to do the same for the poor whose precarious livelihoods have been affected by lockdown measures.

Millions of Africans who make a living in the informal sector have lost their sources of income due to the lockdowns. Many households will suffer from hunger and malnutrition the more they stay at home.

The pandemic has exposed the structural inequalities in many African countries. The lockdown measures favour the middle class and the rich who can continue to have income while working from home or can use their savings to buy necessities during the lockdown period.

Most of the poor who are confined in their homes, with security forces lurking in their streets to enforce compliance, have become more vulnerable. They do not have savings or adequate supplies of food to sustain them in times like these.

This also exposes the limits of the “settler models” in southern Africa which left many black Africans landless and dependent on wage employment. With the capitalist sector unable to absorb all the labour, many Africans make a living in the precarious informal sector. The combination of the effects of COVID-19 on the informal sector, and the inability to produce food for household consumption and sale has left many households vulnerable to food insecurity and poverty.

In the global north, COVID-19 has overwhelmed the healthcare systems, triggered shortages of critical medical supplies, personal protective equipment and many deaths. Some governments announced more stimulus packages to fight the virus and boost their economies.

In Europe, several governments injected hundreds of billions of Euros while the US government approved a stimulus package amounting to over US$2 trillion. These countries draw from their reserves to respond to the challenges presented by the pandemic. Despite this, their health systems are not coping with the rate of infections with many people dying. If gold (rich nations) rusts, what then will iron (poor Africa) do?

Confirmed cases are slowly rising in Africa. However, there is concern that if many people get infected, the pandemic can inflict more damage (in terms of deaths and economic recession) at a scale greater than what we have seen in the global north. Many poor people live in crowded spaces (a legacy of colonialism and economic inequality) where social distancing is difficult to enforce. Because of poverty and poor health, many of the poor have underlying medical conditions making them vulnerable to COVID-19.

Early data from the US shows that the coronavirus is disproportionately killing African-Americans with poverty and prior medical conditions part of contributing factors. In Chicago, Illinois, seven in 10 patients who died from coronavirus were African-Americans although they are 30% of the city’s population. In Louisiana they constituted 70% of the deaths despite accounting for 32% of the population.

The BBC has also reported that emerging evidence in the UK suggests that “more than a third of patients who are critically ill in hospital with the virus” are ethnic minorities (black, Asian etc). This evidence warns of the disastrous impact COVID-19 can have on Africa if the virus infections spike.

The public health systems, which the poor rely on, do not have the required capacity to deal with the pandemic and save lives. Most countries simply do not have the required facilities and equipment to test and treat the infected, including personal protective equipment for health workers. This means that when the poor go to hospitals after contracting the virus, they will not get adequate treatment to save their lives. Some among the middle class and the rich can use their medical cover and savings to access private healthcare. Nonetheless, in many countries even the private healthcare is ill-prepared to deal with an outbreak of coronavirus. With many countries under lockdown, even the rich (including the corrupt) cannot use their wealth to access quality care abroad as they normally do.
Zimbabwe’s response to coronavirus

An analysis of the coronavirus updates by the Zimbabwean Health and Child Care ministry confirm my argument in this article.

 Clemence Rusenga is a post-doctoral research fellow with the NRF Chair in Land Reform and Democracy in South Africa at the Centre for African Studies, University of Cape Town. He writes in his personal capacity.

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