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28 April 2021updated 12 Sep 2021 1:55pm

India’s nightmare shows Covid is becoming a primarily Global South pandemic

The daily Covid cases are now growing faster than at any point before – and the geographical make-up of those numbers is changing too. 

By Jeremy Cliffe

“I am terrified of checking my Facebook and WhatsApp accounts,” says ­Patralekha Chatterjee. “Every day brings news of the death of someone I know – a friend, a friend’s friend, a colleague.” Speaking from Delhi, the Indian journalist tells of a health system in meltdown as a new wave of Covid ravages the city. Residents are scrambling to locate intensive care beds and medical-grade oxygen for those in need. Cremation and burial grounds can barely cope, she says: “In Nigambodh Ghat, one of the largest cremation grounds in the city, the number of pyres has gone up from 36 to 63 to accommodate the swelling numbers of the dead.”

Only two months ago India was being hailed as a Covid success story. Daily new cases had fallen below 10,000 in this country of almost 1.4 billion. Narendra Modi, the prime minister of India, and his ministers declared the pandemic all but over. This played into a claim, made in the Western media too, that countries in the Global South are less susceptible to Covid. Younger and less ­obesity-prone populations, warmer ­climates and immunity conferred by other diseases have all been mooted as explanations. Such claims bred complacency.

India is a case in point. Recently, Modi was branding it as the “world’s ­pharmacy” for its extensive vaccine exports. His Bharatiya Janata Party was ­holding large, maskless rallies ahead of state elections. Millions of pilgrims flocked to the Kumbh Mela religious festival on the ­Ganges. Only belatedly, as infection numbers soared, did the government check its hubris. At the time of writing there are more than 300,000 new cases a day, the highest daily rate of any country at any point in the pandemic. In Delhi alone, one person is dying from Covid roughly every five minutes. “Every day [that] goes by [we are] trying to process the death and despair all around,” says Chatterjee.

A similar pattern played out in Brazil. Last autumn it was suggested that the Amazonian city of Manaus might have achieved herd immunity, having experienced a severe outbreak in April 2020. Researchers estimated that 76 per cent of the population had antibodies. Normality returned, encouraged by Brazil’s reckless president Jair Bolsonaro. Then, in December, came another wave. Oxygen ran out, the health system collapsed and the outbreak spread across the ­country. In March, Brazil’s daily infection rates peaked at more than 100,000 a day.

[see also: Brazil’s new Covid-19 variant points to a long, hard road out of the pandemic]

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The pandemic is changing. It is now growing faster than at any point before: by 26 April more than 825,000 daily new cases globally were reported, up from a peak of around 648,000 in 2020. But the geographical make-up of those numbers is changing too. Over the course of 2020 the continents of Asia, South America and Africa made up 44 per cent of total confirmed cases; in the past month they have made up 64 per cent. Shortly before the New Statesman went to press they accounted for 77 per cent of new cases reported that day. Out of 36 countries where death rates are currently rising, all but four are in the Global South. Even in Africa, where infection and death rates have remained low, fatality levels are rising. What was primarily a developed-world pandemic is now ripping through low- and lower-middle-income countries such as India.

This is likely to continue for three reasons. First, if a youthful population, warm climate and prior exposure to other diseases did not protect Indians, how can we be sure that they will continue to protect, say, Nigerians or Indonesians? The Global South may turn out to be more susceptible to the virus than previously thought. Second, while vaccination programmes in affluent countries are accelerating and pushing infection and death rates down, they have barely got started in countries such as Kenya and Pakistan, and it may take until 2022 or 2023 for vaccines to reach the bulk of many populations. Only 8.8 per cent of Indians have received one dose of the vaccine. In sub-Saharan Africa the ­proportion is around 1 per cent. Third, the more the virus circulates among populations in such countries, the more new variants – such as the P1 strain that came out of Manaus and the B1617 one first detected in India – will materialise.

On the indirect effects of the pandemic, too, the experiences of the rich and poor worlds are diverging. Developed countries can afford measures to help pupils catch up on missed schooling, clear backlogs of non-urgent medical treatments and relaunch economies after the lockdowns. In developing countries a prolonged pandemic may mean some children (especially girls) never return to education, routine immunisations against measles, polio and diphtheria being disrupted, and economies being permanently stunted and left with mountains of unmanageable debt. The cumulative effect may be to eradicate years of development. The UN estimates that the number of people at risk of starvation this year is more than 270 million – double the pre-pandemic figure. The World Bank expects the number of people living on less than $1.90 a day to increase by between 119 million and 124 million.

The global community is not doing nothing: the US has relaxed its embargo on the export of vaccine raw materials, the IMF is moving to issue $650bn “special drawing rights” to supplement the foreign reserves of fragile states, and developed countries have donated to the multilateral Covax initiative to buy vaccines for poorer countries. But of coordinated action on a scale proportional to that of the unfolding humanitarian calamity – the release of vaccine stockpiles, intellectual property waivers on vaccines, financial support for their local manufacture and distribution, an unprecedented debt jubilee – there is little evidence.

The story of the pandemic may well continue to bifurcate, with vaccinated societies returning to normality while the virus scythes through poorer ones, for as long as that remains the case. 

[see also: Leader: The catastrophe in India]

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This article appears in the 28 Apr 2021 issue of the New Statesman, The new battle of ideas