COVID-19 in fragile settings: Ensuring a conflict-sensitive response

Violent conflict often exacerbates the spread of infectious diseases , as seen in the recent resurgence of polio in Syria, cholera outbreaks in the conflict zones in Yemen, and the persistence of Ebola in insecure eastern regions of the Democratic Republic of Congo (DRC). Between 2009 and 2017, in fact, there were 364 disease outbreaks in 108 refugee camps. Fragility and conflict reverse hard-won development gains and stunt opportunities for children, youth, and the poorest people. In the process, they deeply weaken health systems, leaving societies more vulnerable to disease outbreaks.

The global health emergency created by the coronavirus (COVID-19) is particularly concerning: it could become even more dire as it spreads to countries affected by fragility, conflict and violence  (FCV). These countries are already seeing an increase in cases, and governments and international partners are taking unprecedented steps to save lives and mitigate the worst socio-economic impacts.

As of late April, the World Bank Group was already working to strengthen health systems and mitigate the pandemic’s risks in 19 of the most fragile settings across all developing regions , from the DRC, Mali and Niger, to Papua New Guinea, Haiti, Afghanistan, Yemen and the West Bank and Gaza.  Many more countries have requested support, and operations are being finalized quickly with three main aims during this unprecedented crisis: to help countries implement emergency health operations and strengthen economic resilience, protect the poorest and most vulnerable households and to support business and save jobs.

The United Nations COVID-19 Global Humanitarian Response Plan aims to fight the virus in the world’s poorest countries, and address humanitarian needs of the most vulnerable people. At the same time, the United Nations COVID-19 Response and Recovery Fund supports low- and middle-income countries to overcome the health and development crisis caused by the virus. In addition, the UN Secretary-General’s Peacebuilding Fund continues to provide timely and catalytic support to help prevent and mitigate conflict risks that may now be exacerbated by the pandemic. 

Tackling COVID-19 is doubly hard in countries where social and economic conditions were already unstable  -- because of weak governance and state institutions, unequal access to services for vulnerable populations and, very often, community mistrust of government.  These countries may also face compounding challenges, including climate change shocks, forced displacement and food insecurity. It is important that countries’ immediate response and longer-term investments address these realities to avoid exacerbating existing sources of fragility and instead help build resilience, both to this crisis and future shocks.

The UN-World Bank joint study, Pathways for Peace: Inclusive Approaches to Preventing Violent Conflict, as well as the recent World Bank Group Strategy for FCV, provide a set of critical principles that can help guide country-level response efforts in those challenging settings.

• Conflict sensitivity matters. Countries that are impacted by FCV, in active conflict or emerging from conflict all face distinct risks, and the new threat posed by the global pandemic will interact with existing inequalities and grievances, and gaps in institutional capacity. The pandemic, the socio-economic impact and the response, all can exacerbate existing risks of conflicts. There needs to be a clear understanding of the root causes of conflict and fragility and sources of resilience in each situation, keeping in mind that COVID-19 and response measures will disproportionately affect people who are already vulnerable or marginalized – including the displaced,  refugees and the communities that host them, nomadic or pastoralist groups, and minorities.  Supporting such populations and helping build resilience in communities at the local level through women’s groups and local social networks is essential, as has been done with the Refugee and Host Communities Support Project in Niger.  In some places, there may even be tentative new openings for peace, as has been seen in some countries in the last few weeks after the UN Secretary-General’s call for a global ceasefire.
   
• Trust and inclusion matters.  Basic services like health, social protection and education are of course critical in themselves, but they are also the main ways that people interact directly with the state, including local institutions. They are the primary vehicle to create trust and confidence in governments. Ensuring equal access to services, and avoiding the perception of exclusion of certain groups, help minimize the grievances that undermine the legitimacy of local and national authorities. Equitable service delivery reduces competition among groups and helps maintain the popular trust that is key to mobilizing society-wide efforts to combat the virus.
   
• Community engagement matters. Whether to address the immediate health threat or to support and maintain shattered livelihoods, governments need support so that they can publicly engage with broad swathes of society – including youth, women, trade unions, the private sector, and marginalized groups – in the emergency phase and well beyond it, to help with analysis, design, implementation and monitoring of programs. During the recent Ebola outbreak in eastern DRC, for example, addressing grievances and building trust by investing in jobs and social infrastructure through the Community Resilience Initiative was as important as the health interventions. Community engagement and effective communication are critical to combat the “infodemic” of false information that often drives fear and division.  They also help shore up support and understanding of the concerted emergency actions that are required now, as well as the difficult trade-offs that will be needed to manage the longer-term socioeconomic impact.
   
• Partnership matters. Working across the humanitarian-development-peace nexus is crucial to help governments in countries impacted by fragility, conflict and violence , both as they manage immediate health needs and as they work to strengthen governance and deal with the longer-term impact of the crisis.  Such partnerships are already at work: for example, in Yemen, a $26.9 million World Bank grant through IDA, its fund for the poorest countries, is being implemented with WHO to help limit the spread and mitigate risks associated with COVID-19.  Joint analysis and planning by governments with support from the UN, World Bank, and other multilateral and bilateral partners – in ways that reduce the risk of conflict, sustain peace and safeguard health systems – will be essential. This should build on existing capacities and institutions, rather than replace them or set up parallel response systems that would add to the burden on affected countries.

For countries and people impacted by FCV, recovery from COVID-19 includes economic growth and also stronger institutions and social cohesion that will help inoculate against the next crisis.  We must collectively support countries now to lay the foundation to “build back better”.