Coronavirus highlights the need to strengthen health systems


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This outbreak can be contained given our shared goals — but we must act fast

The rapidly evolving coronavirus outbreak has now spread to more than 60 countries, requiring urgent action to help them respond to, prevent and reduce the contagion and loss of life.  The response will be most effective if governments and the private sector take co-ordinated and rapid action. 

We know from experience with Ebola, Sars and Zika that with the right measures, taken quickly, countries can stop the transmission of diseases such as this one, which has been dubbed Covid-19, and protect lives. We also know that poorer countries with weak health systems are often hit hardest by such outbreaks and they disproportionately affect the most vulnerable populations that are least prepared to limit the spread of pathogens. 

Our shared goals are straightforward. We need to limit human-to-human transmission; identify, isolate and care for patients early; reduce transmission in communities; support community engagement and minimise social and economic impact. 

In this effort, countries face different levels of risk and vulnerability to this virus and will require different types of assistance and levels of financial support, so flexibility and responsiveness will be crucial. 

The World Bank and International Finance Corporation are moving quickly to help countries strengthen local health systems and primary healthcare  to safeguard people from the epidemic and make sure that they have access to disease surveillance information and public health interventions. We announced this week an initial package of up to $12bn for countries that need crisis financing of immediate needs from Covid-19. A key component involves the provision of trade finance to enable private sector imports. 

But addressing emergency health and economic impacts from this outbreak must be followed by longer-term investments to build stronger and more resilient health systems. 

This makes sense both from a health and an economic perspective. Putting more resources on the front lines to detect and treat conditions early, before they become more serious, saves lives, improves health outcomes, reduces healthcare costs and strengthens preparedness for when outbreaks occur. 

"If this outbreak continues to spread on the current trajectory, the second-order impacts will quickly become an economic emergency, pushing the world towards a recession that would have a severe impact on the poorest countries and people."
David Malpass' picture
David Malpass
World Bank Group President

With limited resources and low government capacity, many of the poorest countries don’t have the health infrastructure or adequate resources to prepare for disease outbreaks.  Yet swift detection of an outbreak and rapid emergency response can reduce avoidable sickness and deaths, and lower the economic, social and security impacts. 

All governments should increase their health security. Strong primary health systems are the most effective way to do that.  The common excuses of competing priorities, invisible outcomes, and a lack of funding for public goods make less sense now than ever. 

The costs of upgrading defences against health security threats are just a fraction of the resulting costs of epidemics.  Recent estimates suggest that most countries would need to spend $1.69 per person per year to achieve an acceptable level of epidemic preparedness. For most countries, this is less than 2 per cent of what they spend on healthcare. 

During the Sars and Mers outbreaks, we saw how weak healthcare systems and hospital management led to higher morbidity and mortality. To stop the spread of coronavirus in hospitals, countries will need isolation facilities, triaging and infection prevention and control. It is clear from the number of recent infections among front-line responders that we also need to help build the capacity of healthcare workers and ensure the availability of protective equipment at the local level. 

If this outbreak continues to spread on the current trajectory, the second-order impacts will quickly become an economic emergency, pushing the world towards a recession that would have a severe impact on the poorest countries and people.  The World Bank Group is working with the IMF and other institutions. We are prepared to use all our available instruments to the fullest extent possible. We have rapid financing mechanisms that, collectively, can help countries respond to a wide range of needs, including support for the poorest during economic turbulence. 

This outbreak can be contained. Actions taken now by countries and the international community can save lives. The breadth of the response will be crucial to its effectiveness. Countries must also strengthen their health surveillance and primary health systems, which are essential to stopping the spread of this and any future outbreaks. 

Originally published in the Financial Times.


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