In only half a year, the coronavirus pandemic has wiped out decades of global development in everything from health to the economy.
Progress has not only stopped, but has regressed in areas like getting people out of poverty and improving conditions for women and children around the world, the Bill and Melinda Gates Foundation finds in its 2020 Goalkeepers report published Monday.
Vaccination coverage, seen as a good indicator for how health systems are functioning, is dropping to levels last seen in the 1990s, it says.
“In other words, we’ve been set back about 25 years in about 25 weeks,” the report says. “What the world does in the next months matters a great deal."
Global action to stop the pandemic would prevent illness and deaths caused by Covid-19, but there's more at stake: The crisis sets back strides made in global poverty, HIV transmission, malnutrition, gender equality, education and many more areas. Even if the world manages to get the coronavirus under control soon, it could take years to claw back lost progress.
“We’re at the real cusp moment at how you can tackle this and how long-term the effects are,” Mark Suzman, the CEO of the Gates Foundation, told POLITICO.
If the world can get a coronavirus vaccine successfully distributed in the next 18 months or so, things may return to the way they were before the pandemic in one or two years, he said. But in some developing countries, reversing the economic downturn may take longer because they don’t have the ability to invest as much money in their economies as rich countries, Suzman said.
Every year it was released since 2017, the Goalkeepers report celebrated progress in fighting poverty and disease in the developing world, Suzman said.
But this year it's striving to show just how bad things are.
After 20 years of continuous progress, almost 37 million people have this year become extremely poor, living on less than $1.90 a day, according to the report. "'Falling below the poverty line' is a euphemism, though; what it means is having to scratch and claw every single moment just to keep your family alive,” it says.
These newly impoverished people are likely to be more women who work mostly in informal jobs in low- and middle-income countries.
And the coronavirus's bad news for women doesn’t stop there.
“Indirectly, COVID will cause more women than men to suffer and die, in large part because the pandemic has disrupted health care before, during, and immediately after childbirth,” the report says. Newborns are at risk too, as more infants are likely to die when health systems falter — as is happening now around the world.
Children are also at risk of contracting life-threatening diseases such as diphtheria, tetanus and pertussis since, for the first time in almost 30 years, the first four months of 2020 showed a substantial drop in the number of those completing the three doses of the DTP vaccine, according to the World Health Organization and UNICEF.
And outbreaks harm not only children’s health, but also their education.
“Data from the Ebola epidemic in West Africa suggests that, when schools open again, girls are less likely to return, thereby closing off opportunities for themselves and for their future children,” the Goalkeepers report says.
The early signs of that are present in Malawi, for example.
Teenage girls living with HIV who have been stuck at home as schools were closed because of the pandemic are getting pregnant, Grace Ngulube, a 25-year old HIV activist based in Blantyre, Malawi's second largest city, told POLITICO. As schools reopen, they will be busy taking care of their babies at home, she said.
Ngulube, who works with the country’s association for young people living with HIV and who was born with the disease, said some are afraid to go to youth clinics to get treatments and mental health support like they would have before the pandemic. Those who can make it need to wear a face mask, and that can be an expensive item to procure for some young people who have lost their jobs, she said.
“A lot of young people are really struggling, and some of them, they have contracted themselves into prostitution or maybe transactional sex,” she said. That could lead to new HIV infections.
In 2018, almost 1 in 10 people between 15 and 49 years old lived with HIV in the country, according to UNAIDS. Overall, 1 million out of the 18 million people in Malawi had HIV in 2018.
Recent modeling studies show that deaths from HIV, tuberculosis and malaria could as much as double in the next year as a result of the pandemic, wiping out decades of progress, the Global Fund to Fight AIDS, Tuberculosis and Malaria said in a report on Monday. There could be a half-million more AIDS deaths globally compared to 2018, setting the world close to 2008 levels, it said.
To try to avoid that, HIV Alliance India called citizens who had returned home as the country locked down to tell them which were the closest facilities providing antiretroviral treatment, Rosenara Huidrom from the Alliance told POLITICO. Field workers provided treatment to those who were too scared of getting infected with coronavirus to go out for it, she said. India has the third-highest number of people with HIV and the second-highest number of coronavirus cases.
Richer countries need to work with middle- and low-income countries to figure out how to help, the United States' top infections disease expert Anthony Fauci said during a virtual event organized by Friends of the Global Fight on Friday.
From the vantage point of the White House coronavirus task force he sits on, the “extraordinary disruption" of disease treatment and prevention the U.S. and others have invested in is not on the radar screen, “when it really should be,” Fauci said.
This year's Gatekeepers report is based on imperfect data that its partner, the Institute for Health Metrics and Evaluation (IHME), has managed to gather so far. The full picture won't be available until 2021.
The data covering 2020 is based on a series of smartphone surveys and telephone interviews with 70,000 people in 82 countries, though they were not a representative sample for all countries. Other data considered includes information on the number of people receiving health services monthly, the number of tourist arrivals, employment data and human mobility patterns.
IHME modeled what will happen by the end of 2021 based on what has happened so far, including an assumption that people would react to new restrictions the same way they reacted at the beginning, among others.
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