Editorials

Lockdowns in the Global South

The impact of pandemic restrictions on developing nations requires much more attention

A few months ago I spoke to the mother of an old friend of mine, who I have known for 30 years. I’ll call her Sandra. Sandra lives in a lower-middle class district of the capital of Chile, Santiago. It’s an area where people struggle to make ends meet, and there can be security problems at night. But it’s also an area of very strong community spirit, and where everyone knows everyone.

When lockdowns hit the world in March 2020, people in Chile scrambled to form communal kitchens or ollas comunales. Many people found their livelihoods suddenly destroyed, and there were more ollas comunales in some places than even at the height of the economic crisis of the Pinochet government in the 1980s. Sandra told me what happened to the community-spirited older man who established one in her barrio: as more people came to eat, he contracted COVID, it passed through his household, and three members of the family died.

“The increased COVID mortality rates in poor countries that imposed lockdowns are, very sadly, only the tip of a massive public health iceberg.”

Sandra’s story can speak for billions of people around the world, for whom lockdowns did not help in the fight against COVID, but actually made it worse. For those with spacious homes and gardens, lockdowns can be a reasonable experience. But for poor people in rich countries and those in the Global South, they are enormously counter-productive. In poor countries, many people spend most of their time outside. Given COVID is a virus that circulates the most inside, confining people to cramped accommodations is a sure recipe for increasing contagion. This may explain the high COVID death figures in countries with significant levels of poverty that have imposed rigorous lockdowns, such as Chile, Colombia, Peru and South Africa.

The increased COVID mortality rates in poor countries that imposed lockdowns are, very sadly, only the tip of a massive public health iceberg which includes child malnutrition, excess deaths caused by poverty, and lack of attention to endemic diseases. These diseases – such as HIV, malaria, and tuberculosis – kill many more (usually younger) people than COVID-19 in countries across the African continent.

The impacts of global lockdowns on public health in the Global South is staggering. Child labour and malnutrition rates have soared. Tens of millions of childhood vaccination programmes have been stalled. Companies that used to manufacture rapid diagnostic tests for malaria have switched to making more profitable COVID tests. Supply chain problems caused by global lockdowns have made access to routine vaccines against measles, TB, and yellow fever increasingly hard to procure. And as the global pharmaceutical industry has focussed almost exclusively on COVID, there have been supply shortages for drugs needed to treat diseases such as malaria and HIV/AIDS, which kills up to 400,000 people a year in Eastern and Southern Africa alone. Meanwhile, increasing levels of debt taken on by poor countries to cope with the COVID economic crisis will have impacts on public health programmes for years to come as poor countries take on austerity measures to cope.

We do not yet know the extent or duration of the full impacts, but gathering evidence is the starting point. There is an urgent need for people on the ground to share their stories so that we can begin to get a human sense – beyond the statistics – of what the data means. Systematic studies will, in time, reveal a proper accounting of these unprecedented global health policies.

And, even though we cannot yet answer all of the questions surrounding cause and effect, we still need to talk about what is happening right now on a global scale because the impacts of the past 18 months on the world’s poor are so significant that silence is no longer an option.

Toby Green is Professor of Precolonial and Lusophone African History and Culture at King’s College London and a member of Collateral Global’s Scientific Advisory Board.

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