Two pandemics: as we ease up, virus sweeps the world’s poor | Coronavirus

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World leaders have been warned that unless they act with extreme urgency, the Covid-19 pandemic will overwhelm health services in many nations in South America, Asia, and Africa over the next few weeks.

Only billions of pounds of aid and massive exports of vaccines can halt a humanitarian catastrophe that is now unfolding rapidly across the planet, scientists and world health experts said.

They fear that the terrible scenes now unfolding in India – where people are dying in hospital corridors, on roads and in their homes, while car parks are being turned into cremation grounds – could be repeated in many other economically fragile nations. Their fates now contrast sharply with those of well vaccinated countries such as the UK and the US where lockdowns are being lifted.

In the UK, the prime minister, Boris Johnson, has come in for particular criticism over his recent decision to cut overseas aid during the pandemic. This has only worsened the calamity that is enveloping low and middle income countries, it is claimed.

India’s surging death rate is driving a record shift in the burden of global Covid-19 deaths to poor and lower-middle income countries, according to Observer analysis, in what may be the start of a longer-term shift towards a greater concentration of virus deaths in the global south as wealthier nations begin to vaccinate their way out of the crisis.

Nearly one in three (30.7%) recorded deaths from Covid-19 worldwide are now occurring in poor and lower-middle income countries – a month ago they accounted for only 9.3% of global deaths.

But India is not alone in driving the shift, with higher Covid-19 death rates in countries such as Kenya (where mortality is up 674% since the end of January), Djibouti (550%) and Bangladesh (489%) also contributing to the highest proportion of recorded Covid-19 mortality in the global south since the emergence of the novel coronavirus in December 2019.

As host of next month’s G7 meeting, Johnson is now under intense pressure to ensure rescue packages, vaccines and drugs are dispatched from rich nations to halt the spiralling rates of Covid deaths in developing countries.

On Saturday, Jeremy Farrar, director of the Wellcome Trust, urged world leaders to make sure vaccine supplies are sent to vulnerable countries as a matter of urgency.

“If we fail to drive down virus transmission globally at this critical moment, our world will become even more inequitable, fragmented and far more dangerous, just at the time we need to come together to address the shared challenges of the 21st century.”

This point was backed by former prime minister Gordon Brown. “We’re in danger of having a completely divided world where half are vaccinated and half are not vaccinated,” he told the Observer. “This is life and death. If we don’t take this action, and we don’t do it urgently, the disease will spread. It will mutate. And it will come back to rich countries, as well as poor countries.”

These warnings came as it was revealed that South America, home to 5.5% of the world’s population, has suffered 32% of all reported Covid deaths. “What’s happening is a catastrophe,” said Argentina’s health minister, Carla Vizzotti.

Meanwhile, health experts in Africa warned that the crisis in India would soon be replicated across their continent. “We do not have enough healthcare workers, we do not have enough oxygen,” warned John Nkengasong, director of the Africa Centers for Disease Control and Prevention. It is among the lower-middle income band of countries where deaths have surged most in recent months, growing by 400%, according to Observer analysis of seven-day averages.

Hand holding vaccine vial.
Wealthy countries are being urged to make vaccines and equipment available to poorer nations. Photograph: Christophe Archambault/AP

The figures in some of these countries are likely to be worse than what is being reported due to less developed health surveillance systems, said Krutika Kuppalli, an assistant professor in infectious diseases at the Medical University of South Carolina.

“Some of these resource-limited countries don’t have the capacity to test and report as well, so there’s been this narrative that countries in the global south haven’t been hit as hard, but there’s always been some scepticism about their surveillance and recorded rates,” she said.

In India, some experts have accused the authorities of significant under-reporting. Murad Banaji, a mathematician who has extensively modelled India’s Covid-19 pandemic, said India’s death toll was probably at least three times higher than official figures.

For example, Banaji has discovered that in Mumbai, for every Covid-19 death which was recorded, there was one excess death not designated as caused by Covid. “Not all of those excess deaths may have been from Covid-19,” explained Banaji. “But from what we can gather from international data and studies, most probably were.”

The extent of the growing global crisis was stressed by David Nabarro, professor of global health at Imperial College London and an envoy for the World Health Organization on Covid-19. He told the Observer that people in many countries were facing severe problems caused by Covid-19, including Nepal and Bangladesh as well as India, countries in East Asia including Indonesia and Papua New Guinea, as well as nations in other regions including Latin America, the Caribbean and the Middle East.

“It is really unsatisfactory that a billion doses of vaccine have been given out with a very large majority of these going into the arms of people in wealthy settings. This skew in distribution will directly play through to lives being lost in places where the vaccine is not available.”

Other global health experts attacked the UK government for making major reductions in its overseas aid at a time when it had never been needed more desperately. “This means we are going backwards on all the progress that has been made over so many years in many diseases of poverty, such as malaria,” said Professor Trudie Lang, of Oxford University.

“The reduction in Britain’s overseas aid is biting hard. Critically important scientific programmes have been cancelled and this vital research capacity will be very difficult to get back and rebuild.”

Baroness Liz Sugg, who resigned as a minister after the cut to aid was announced, agreed: “With the virus escalating in some of the poorest parts of the world, it is the worst possible time for the UK to cut our support to the most vulnerable. It is clear that the cuts will make it harder for countries to respond to the Covid-19 outbreak, as we are seeing the closure of health centres and the cancellation of clean water programmes.”



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