Travel restrictions hamper COVID-19 response

The COVID-19 pandemic has sparked an unprecedented shutdown of borders and airlines, with 90% of commercial passenger flights grounded, all of which is severely restricting the movement of essential medical personnel and supplies that are vital to save lives.

At least 90% of the world’s population, or 7·1 billion people, live in countries with restrictions on people arriving from other countries who are neither citizens nor residents, according to a Pew Research Center analysis.

The World Health Organization (WHO) gives the example of Africa where the delivery of equipment and personnel is vital for the COVID-19 response. “There are 47 countries not allowing any airlines to land and we need to support them with equipment, especially as we cannot send any experts to give technical support, for example, with contact tracing or analysis”, Michel Yao, head of WHO’s emergency operations in Africa, told The Lancet. “There is a big shortage of ventilators and also intensive care unit capacity. There are only about 3000 doctors who have intensive care unit expertise in all of Africa.”

“What people don’t realize is that passenger planes also carry a large bulk of the world’s cargo, and [so the major reduction in regular commercial flights] poses a huge problem for us”, Amer Daoudi, head of logistics for World Food Programme (WFP), told The Lancet. As a result of the restrictions, the WFP has an ambitious network of air bridges that will act like a humanitarian airline for fighting COVID-19 around the world, with WHO as the lead partner for sourcing medical supplies and personnel.

“WFP is committed to getting vital medical supplies to front lines and shielding medical workers as they save lives”, said David Beasley, WFP’s executive director. “Our air bridges need to be fully funded to do this and we stand ready to transport frontline health and humanitarian workers as well as medical cargo.”

Médecins Sans Frontières (MSF) received exemption from the EU’s ban on exports of personal protective equipment (PPE), said Brice de le Vingne, head of MSF’s COVID-19 task force. MSF needs PPE for its own personnel who work around the world as well as for training on infection prevention and control measures it provides, for example, in Iraq.

Issues of deployment and repatriation of experts have also hit the Pan American Health Organization (PAHO), the WHO regional office for the Americas. “A recent example of this occurred when we deployed an expert to Guayaquil [Ecuador], which we were only able to do by hiring a charter flight from Colombia”, Jarbas Barbosa, assistant director of PAHO, told The Lancet. Restrictions on commercial flights had also caused widespread disruption to deliveries of medical supplies, he said. “Shipments, including PPE, lab supplies, etc, have to wait for space on cargo planes and as demand for these planes increases, there have been challenges.”

[The Lancet]

China steps up to the plate with $2B in funding

China will provide 2 billion U.S. dollars over two years to help with COVID-19 response and with economic and social development in affected countries, especially developing countries.

So announced  Chinese President Xi Jinping via video link on Monday at the opening of the 73rd session of the World Health Assembly.

Xi added that when a vaccine for the disease is available, it “will be made a global public good.” A number of Chinese companies are at the forefront of development and testing for a Covid-19 vaccine.

Xi also emphasized how China would work in particular to support Africa in virus prevention and control efforts.

Major implications for the world’s most vulnerable if America cuts funding to WHO

The head of emergencies at the World Health Organization, Michael Ryan, warned Wednesday that any end to sizable U.S. funding for the U.N. health agency will have a “major implication for delivering essential health services to the most vulnerable people in the world.”

“Replacing those lifesaving funds for front-line health services to some of the most difficult places in the world: we’ll obviously have to work with other partners to ensure that those funds can still flow,” Ryan said. “We trust that other donors will, if necessary, step in to fill that gap.”

WHO Director-General Tedros Adhanom Ghebreyesus said: “We have of course received the letter [from President Donald Trump] and we are looking into it.”

Trump has criticized the WHO for its early response to the outbreak and what he considers its excessive praise of China, where the outbreak began, at a time when his administration’s response in the U.S. has come under scrutiny.

Trump has already ordered a pause in U.S. funding, which totaled nearly $900 million to the WHO’s budget for 2018-19, according to information on the agency’s website. That represented one-fifth of its total $4.4 billion budget for those years.

[AP]

On President Trump’s letter to the World Health Organization

NPR spoke to global health experts in the U.S., Canada and Switzerland regarding some of the assertions in President Trump’s letter to the WHO:

An excerpt from Trump’s letter reads: “The International Health Regulations require countries to report the risk of a health emergency within 24 hours. But China did not inform the World Health Organization of Wuhan’s several cases of pneumonia, of unknown origin, until December 31, 2019, even though it likely had knowledge of these cases days or weeks earlier. Even now, China continues to … refusing to share accurate and timely data, viral samples and isolates, and by withholding vital information about the virus and its origins.“

Lawrence Gostin, a global health professor at Georgetown University Law Center, agrees China was not transparent early on in the outbreak. “China was anywhere from two to even up to six weeks’ late in reporting to the World Health Organization,” noting there’s evidence that Chinese health authorities knew the coronavirus was circulating in December.

Second, while China quickly shared the genome sequence for the coronavirus, “it has not been as forthcoming with sharing biological samples which are needed for epidemiology and also for vaccines and treatments,” Gostin adds.

But Gostin said blaming the WHO for China’s reporting delays and sample hoarding is misdirected. Of these charges by Trump, he said: “They’re valid critiques of China but not the World Health Organization.”

Trump’s letter also states: “The World Health Organization consistently ignored credible reports of the virus spreading in Wuhan in early December 2019 or even earlier, including reports from the Lancet medical journal. The World Health Organization failed to independently investigate credible reports that conflicted directly with the Chinese government’s official accounts, even those that came from sources within Wuhan itself.“

The Lancet, a respected medical journal, said of this statement: “This statement is factually incorrect.” The journal said it published its first papers on the novel coronavirus on Jan. 24. In two papers published that day, researchers from China and Hong Kong described the first 41 patients in Wuhan and provided scientific evidence for human-to-human transmission.

On Jan. 24, Trump tweeted: “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”

Yet in his letter to the WHO dated May 18, Trump writes: “The only way forward for the World Health Organization is if it can actually demonstrate independence from China. My Administration has already started discussions with you on how to reform the organization. But action is needed quickly.“

This demand comes with no specifics, global health observers said. “What exactly does the Trump administration want WHO to do?” asks Kelley Lee, a global health professor at Simon Fraser University. It’s not clear what “action” the U.S. is asking for, or how WHO could demonstrate “independence from China,” because no solutions are outlined in the letter.

“For the United States to blame the World Health Organization for its own months and months and months of inaction seems factually untrue and designed to divide the world at a moment when global solidarity is needed most,” said Benjamin Mason Meier, associate professor of global health policy at the University of North Carolina at Chapel Hill. “It undercuts the World Health Organization‘s efforts to provide a collective response to this common threat [of the COVID-19 pandemic].”

[Read full NPR article]

Lancet urges “replace Trump and bolster the CDC”

Americans should oust President Trump from the White House and elect a leader who will support – rather than undermine – public health experts who are battling the COVID-19 pandemic, British medical journal The Lancet says in a newly published editorial.

The unsigned editorial sharply criticizes the Trump administration, saying it has marginalized the Centers for Disease Control and Prevention to a degree that is dangerous for both the U.S. and the world. “Americans must put a president in the White House come January, 2021, who will understand that public health should not be guided by partisan politics,” the medical journal says.

“The Administration is obsessed with magic bullets — vaccines, new medicines, or a hope that the virus will simply disappear,” the journal states. “But only a steadfast reliance on basic public health principles, like test, trace, and isolate, will see the emergency brought to an end, and this requires an effective national public health agency.”

Seeking to lay a pile of critical failings at Trump’s feet, the editorial says a federal agency that was once “the gold standard for global disease detection and control” has devolved into an “ineffective and nominal adviser” on the U.S. response to a disease that poses a public health threat of historic proportions.

The Trump administration has “chipped away at the CDC’s capacity to combat infectious diseases” in a number of ways, The Lancet says, citing the reduction of CDC staff in China and the withdrawal of the last American CDC expert from the Chinese CDC campus last July – moves that left an “intelligence vacuum” when the novel coronavirus was detected in Hubei province in late 2019.

The Lancet is a weekly journal that has become one of the world’s leading medical periodicals since its founding in 1823.

[NPR]

Angelina Jolie Mother’s Day Tribute to refugee moms

On Mother’s Day 2020, Angelina Jolie recognized women with children who are refugees, acknowledging their marked strength and sacrifices.

Her essay, published by the New York Times on Saturday, spoke to the challenges faced by refugee mothers caring for families without economic resources or physical security.

“This Mother’s Day, I think of refugee mothers I have met, living in poverty and displacement,” wrote the actor, filmmaker and activist, who became a Special Envoy to the United Nations’ Refugee Agency (UNHCR) in 2012. “Every one began her journey of motherhood with a promise to do all she could to protect her child. To lay down her life if necessary. And if she is defeated and silenced, few things are more tragic.”

Continuing, Jolie shared lessons she has learned about motherhood from interactions with women living as refugees. “I’ve come to believe that a mother is the strongest person on earth,” she said, referencing the elevated incidence of gender-based violence against women in areas of conflict. As human rights organizations like UNHCR have noted, many women refugees have experienced abuse, with some seeking asylum specifically to escape it. According to a report from the Migration Policy Institute, it is not uncommon for women and girls pursuing refugee status to encounter continued threats to their physical safety along the way.

Jolie paid reverence to women refugees and others who have survived gender-based violence, calling particular attention to the prioritization of their children’s safety. “Women who are abused aren’t ‘weak women,’ they are often mothers. They are often trying to manage danger with no way out. They will stand between their child and harm. They will face isolation and criticism.

“But their only thought will be: ‘Hurt me, not my child. Insult and ignore me, not my child. Take away my food, but not my child’s,'” she wrote, adding, “to the mothers everywhere who feel helpless — yet who still give every last bit of energy, every last bite of food and the only blanket to their children — I honor you.”

[Newsweek]

Allies despair as Trump abandons America’s leadership role at a time of global crisis

The United States has scaled back its role on the world stage, taken actions that are undermining efforts to battle the coronavirus pandemic and left the international community without a traditional global leader, according to experts, diplomats and analysts.

The US — usually at the head of the table helping to coordinate in global crises — has declined to take a seat at virtual international meetings convened by the World Health Organization and the European Union to coordinate work on potentially lifesaving vaccines. Former world leaders warn that the Trump administration risks alienating allies by politicizing the deadly pandemic with its push to punish China and have other nations choose sides.

The administration’s decision to halt funding for the WHO, the world body best positioned to coordinate the global response to the raging pandemic, has appalled global health officials. Then on Friday, the US blocked a vote on a UN Security Council resolution that called for a global ceasefire aimed at collectively assisting a planet devastated by the outbreak. The US has similarly blocked expressions of global unity at G7 and G20 meetings due to anger about China and the WHO.

And where US presidents have in the past offered a steadying voice, observers from the Asia Pacific to Europe expressed incredulity, amusement and sadness at President Donald Trump’s briefings on the virus, saying they are deeply damaging to the US image abroad.

At a time when nearly 4 million people worldwide have been infected with the virus, diplomats say many countries are yearning for the firm US leadership they’ve seen at historic moments and in prior epidemics, citing President Barack Obama’s response to Ebola and President George W. Bush’s work on HIV/AIDS.

Thomas Gomart, director of the Paris-based French Institute of International Relations, said that Europe was watching Trump’s response to the pandemic in amazement, calling his behavior “stranger than fiction.” “He provides for us a very mixed balance of amusement and a sadness, which is just not what is expected from a US president.”

[CNN]

Coronavirus traps migrants in mid-route limbo

Thousands of desperate migrants are trapped in limbo and even at risk of death without food, water or shelter in scorching deserts and at sea, as governments close off borders and ports amid the coronavirus pandemic.

Migrants have been dropped by the truckload in the Sahara Desert or bused to Mexico’s desolate border with Guatemala and beyond.

They are drifting in the Mediterranean Sea after European and Libyan authorities declared their ports unsafe.

And about 100 Rohingya refugees from Myanmar are believed to have died in the Bay of Bengal, as country after country pushes them back out to sea.

[AP]

WHO’s members owe it more than $470 million

Two countries account for over half the unpaid membership dues at the World Health Organization: As of 31 March, the United States owed $196 million, while China’s outstanding bill stood at $57 million. 

They’re not alone: 151 members collectively owed $473 million in unpaid dues – about 20 percent of the WHO’s annual budget – and a quarter of it was more than a year late.

But the size of the US and Chinese debts highlight the WHO’s reliance on its largest members.

The WHO’s coffers are nevertheless filling up with extra funding for COVID-19 – it is set to comfortably meet a funding target of $450 million in additional earmarked funds – the pandemic, criticism from the White House, and geo-strategic rivalries have all generated fresh interest in the financing of the global health body. 

The WHO relies on two types of funding: about 20 percent comes from membership dues or “assessed contributions” from its member countries. The rest comes as voluntary payments from member countries, foundations, and the private sector. (Assessed funding has the advantage, for the WHO’s management, of not being tied to specific projects, unlike funds for polio vaccination, Ebola control, or COVID-19.)

The United States is the largest contributor to the WHO’s core budget ($115 million a year). But it pays much more – an average of $450 million per year, according to a WHO fact sheet – as the largest voluntary contributor as well. Prior to suspending its funding for the WHO in reaction to what it alleges as weaknesses in the UN agency’s COVID-19 response, … the United States had paid $316 million in voluntary funding in 2020 before the freeze.

Countries that don’t pay eventually lose the right to vote in the WHO’s assembly. In 2019, Central African Republic, Comoros, Guinea-Bissau, South Sudan, The Gambia, Ukraine, and Venezuela were all barred from voting. A state can get back its voting privileges by agreeing to a gradual repayment plan, one example being Somalia whose annual fee is set at the minimum rate: $4,790.

The United States owes 1.7 times its annual obligatory contributions, not enough to pose a risk to its voting rights in 2020.

[The New Humanitarian]

Coronavirus could kill more than 3 million people in vulnerable and poor countries

The International Rescue Committee, a humanitarian non-governmental organization, said Tuesday in a new report:

• The coronavirus could infect up to one billion people and kill 3.2 million people in 34 “crisis-affected countries” as the pandemic exacerbates humanitarian crises.
• “These numbers should serve as a wake-up call: the full, devastating and disproportionate weight of this pandemic has yet to be felt in the world’s most fragile and war-torn countries,” CEO David Miliband said.
• The IRC warned that some of the countries included, such as Bangladesh, host the largest and most densely populated refugee camps in the world, where the virus could spread even more rapidly. 

“While COVID-19 is a novel virus and much is still unknown, it is clear that its impact in these settings will be different than in the wealthier countries first hit by the pandemic,” the report says.

[Read full CNBC article]