The imminent public health crisis facing poorer countries as a consequence of COVID-19 will be further deepened by an associated global economic down… - Adam Hanieh

Even inside Europe there is extreme unevenness in the capacity of states to deal with this crisis — as the juxtaposition of Germany and Greece illustrates — but a much greater disaster is about to envelop the rest of the world. In response, our perspective on this pandemic must become truly global, based on an understanding of how the public health aspects of this virus intersect with larger questions of political economy (including the likelihood of a prolonged and severe global economic downturn). This is not the time to pull up the (national) hatches and speak simply of the fight against the virus inside our own borders.

Similarly disastrous scenarios face the many millions of people currently displaced through war and conflict. The Middle East, for example, is the site of the largest since the Second World War, with massive numbers of refugees and internally displaced people as a result of the ongoing wars in countries such as Syria, Yemen, Libya, and Iraq. Most of these people live in or overcrowded urban spaces, and often lack the rudimentary typically associated with citizenship. The widespread prevalence of and other diseases (such as the reappearance of cholera in Yemen) make these displaced communities particularly susceptible to the virus itself.

Yet, while we rightly point to the lack of ICU beds, ventilators, and trained medical staff across many Western states, we must recognize that the situation in most of the rest of the world is immeasurably worse. Malawi, for example, has about 25 ICU beds for a population of 17 million people. There are less than 2.8 critical care beds per 100,000 people on average across South Asia, with Bangladesh possessing around 1,100 such beds for a population of over 157 million (0.7 critical care beds per 100,000 people). In comparison, the shocking pictures coming out of Italy are occurring in an advanced health care system with an average 12.5 ICU beds per 100,000 (and the ability to bring more online). The situation is so serious that many poorer countries do not even have information on ICU availability. [...] Of course, the question of ICU and hospital capacity is one part of a much larger set of issues including a widespread lack of basic resources (e.g., clean water, food, and electricity), adequate access to primary medical care, and the presence of other (such as high rates of HIV and tuberculosis). Taken as a whole, all of these factors will undoubtedly mean a vastly higher prevalence of critically ill patients (and hence overall fatalities) across poorer countries as a result of COVID-19.