While EU leaders focus on addressing the Coronavirus pandemic within its own borders, those whose lives have been upended by conflict are preparing for the worst.
No country is immune to the virus, and the chaos created in European countries with some of the world’s strongest health systems stands as a stark warning for what could unfold in fragile states if action is not taken.
Precious weeks, that could have been used for preparation, have already been lost due to a lack of funding for preventative work. Calls for European solidarity with the world’s most vulnerable must be turned into action, now more than ever before.
We live in an era in which international humanitarian law appears optional and attacks on medical facilities are met with a shrug. At the very moment they are needed the most, health systems are being decimated.
For those living in these areas of active conflict and mass displacement, the Coronavirus pandemic is a nightmare scenario. Yet the first cases of Covid-19 have already been reported in several fragile contexts, including Libya, Syria, Yemen, Myanmar, Bangladesh, and the DRC.
Yemen has just marked five years of war, a grisly milestone that barely registered as the world grapples with the realities of the Coronavirus pandemic. While there are no confirmed cases so far, the virus has reached all Yemen’s neighbours and it is just a matter of time until it appears there.
Years of violent conflict have left the country’s health system on its knees, as unpaid public workers left clinics understaffed and reliant on support from NGOs.
"While EU leaders focus on addressing the Coronavirus pandemic within its own borders, those whose lives have been upended by conflict are preparing for the worst"
New analysis shows health facilities have been targeted 120 times by warring parties since 2015. The result: nearly half of Yemen’s facilities are non-operational and 19.7 million people lack access to basic healthcare.
The COVID-19 pandemic has reached Libya, where the IRC is working to strengthen a debilitated health system while providing healthcare services to Libyans, migrants, and refugees.
Since civil war broke out in April last year, there have been 62 confirmed attacks on health centres. Almost a fifth of Libyan hospitals and primary medical centres are closed; those that strive to function suffer from a lack of specialised staff, with only six per cent able to offer a full range of services.
The IRC’s health teams can attest that nine years of war in Syria have left the country’s health system in ruins. In Idlib, north west Syria, three million Syrians, nearly a million of whom have been displaced since December, have access to just three hospitals with intensive care units. Here again, health facilities were targeted 85 times only in the last year. No one has been held to account.
And those that have fled violence are not immune. Evidence from the Diamond Princess Cruise ship shows that the virus thrives in locations where populations live in close quarters with limited access to sanitation.
"With major outbreaks of Covid-19 looming, bold steps are needed to protect those living in the world’s most fragile contexts"
Imagine the reality for Rohingya refugees in Bangladesh where there are as many as 40,000 people per km2. Or for refugees and migrants in Moria, Greece, where in 2019 there were a staggering 203,800 people per km2, with as many as 1,300 sharing a single water tap in some parts of the camp.
In Al Hol, Syria, 68,000 people have as little space as 27m2 per person; the equivalent of two car parking spaces.
Hundreds of thousands of people displaced by fighting cannot stay at home, as they have none. They cannot wash their hands, as there is little or no access to basic water and sanitation structures. They cannot self-isolate, as they are cramped in refugee camps in squalid conditions or languish in ghettos or detention centres, already in dire need of humanitarian assistance.
With major outbreaks of Covid-19 looming, bold steps are needed to protect those living in the world’s most fragile contexts.
The European Commission has already taken an important initial step with the announcement of a new aid package to support the World Health Organisation and preparedness in Africa as well as mobilising extra funds to support countries hosting Syrian refugees. Yet more remains to be done.
"It is not too late for the EU to step up as a global leader in this crisis and take bold decisions on a broader response that matches the scale of this unprecedented emergency"
First, populations in conflict need immediate relief from the fighting. The United Nations’ call for a global ceasefire should be supported with robust, energetic EU diplomacy. But ceasefire commitments in Yemen and Libya have been undermined by continued fighting.
If health systems are to be supported and lives saved, the violence needs to stop immediately and any party conducting attacks on health infrastructure or workers must be held to account.
Second, the EU should ensure the provision of swift, flexible funding for organisations present on the ground, which have gained the trust of communities crucial to delivering vital health interventions.
Experience from the DRC Ebola outbreak clearly illustrates the risks of funnelling funds exclusively through UN agencies such as the WHO, where these funds became politicised, slowing the ability of those on the frontlines to respond.
Third, investments in health systems to support the Covid response should be maintained. The best time to invest in health systems is before a major threat like Coronavirus appears on the horizon, as for conflict-affected states disease outbreaks are not uncommon.
Negotiations on the new Neighbourhood, Development and International Cooperation Instrument create an opportunity to rethink the way aid is delivered, with multi-year funding going directly to the frontline, and a stronger focus on transitioning from an emergency to a development phase in health interventions.
The Coronavirus crisis hasn’t created the need for a ceasefire, for health system funding, nor for the respect of international law. It demonstrates just how urgently action is needed, and how high the human cost will be if there is a return to conflict as the virus takes hold.
It is not too late for the EU to step up as a global leader in this crisis and take bold decisions on a broader response that matches the scale of this unprecedented emergency.
It is not only a much-needed measure of solidarity and expression of the best of European values, but also as a necessary step to protect public health and prevent further loss of life in Europe and beyond.