2 April 2020

Competition or Coordination: Coronavirus in the Developing World


How will the United States respond as the coronavirus spreads through the developing world, and what role will China play?

In times of crisis, the United States has always taken a global leadership role. In light of the spreading coronavirus, it should again lead a global coalition to address the crisis in the developing world. The coalition should include some of its closest allies, including France, Japan, Australia, Canada, the United Kingdom, Denmark, South Korea, and Germany. The United States is also undergoing an unprecedented crisis, and it is struggling to focus on the problems at home, much less abroad. But it should not ignore its central global role. The United States should not forget that it has the U.S. Agency for International Development (USAID) and the State Department with global reach, deep health expertise, and thousands of veterans of past outbreaks, such as H1N1, Ebola, and avian flu among others, and it should deploy them. The United States should help developing countries not only because it is the right thing to do but also because it is in its enlightened self-interest to do so as the coronavirus pandemic directly impacts U.S. foreign policy and national security interests.
Coronavirus in the Developing World

The coronavirus will hit developing countries hard in a few weeks, with the first wave of cases confirmed in Africa and the number of cases steadily increasing in Latin America and Southeast Asia. Health care systems in the developing world are already underfunded, understaffed, and unprepared to handle a high influx of patients. The World Health Organization (WHO) reported that 40 percent of the world’s population lacks access to basic handwashing facilities (soap and water), the vast majority of which are in the developing world. Many people can’t afford hand sanitizer.


The most vulnerable population in many of these countries will be the internally displaced people (IDPs) and refugees, including the Rohingya in Bangladesh, Venezuelans in Colombia and the broader region, and Syrians in Jordan and elsewhere. These people have nowhere to go and are often stuck in camps with little separation from their neighbors. With restricted travel, NGOs and international organizations, such as the UN High Commissioner for Refugees (UNHCR), will find it increasingly difficult to reach these populations in order to deliver food and basic supplies, let alone address a potential coronavirus outbreak.

The consequences of the coronavirus will be felt around the developing world and go beyond the already tremendous toll on human life. Although the number of cases in Africa is currently smaller than the rest of the world, many African leaders are concerned about the impact the virus could have on their countries’ fragile health care systems. They saw the devastating effect of Ebola and are trying to prevent a repeat. Nigeria, for example, made the decision to close all schools after just eight cases were reported.

Countries in the Middle East and their neighbors are taking forceful action as well. Jordan has decided to implement an indefinite curfew to protect its 10 million citizens and the 1.3 million Syrian refugees residing in the country who are particularly vulnerable. The Lebanese government declared a national medical emergency, in part to protect its already vulnerable economy, which was experiencing a five-month downturn that caused the government to default on its $90 billion debt . The coronavirus has further complicated an already unstable peace process in Afghanistan, with the government now preoccupied with coronavirus and face-to-face meetings between the Afghan government and the Taliban stalling.

In Latin America, Mexico is just now starting to take action in response to the coronavirus. Once the virus does spread more widely in Mexico, there could be a collapse in manufacturing and agricultural activities impacting the U.S. economy and its food supply, given how interlinked the two countries are. And although Brazilian president Bolsonaro’s son originally blamed the spread of the virus on China’s authoritarianism, the two countries have moved past this dispute to increase bilateral trade. China has also agreed to assist Brazil with medical supplies, material, and technical assistance in combating the virus.
China’s “Health Silk Road”

China is a major producer of the ventilators, masks, testing kits, and hazmat suits that countries need during this crisis and is both selling these supplies and making them available on a foreign assistance and public diplomacy basis. China is slowly developing a “Health Silk Road” and thereby deepening ties globally, including with some U.S. allies. In the European Union, there has been surprisingly little solidarity in fighting the virus, so countries are turning to China. Italy, the new epicenter of the virus, has found solidarity and assistance from China. Chinese officials arrived in Rome on March 12 with essential supplies, including respirators, masks, and medicine. Since China claims to have halted the spread of the virus at home, Italy is desperately looking for insights on how to accomplish this. Serbia’s president went to the airport to receive a shipment of medical supplies from his “brother and friend,” President Xi. The Czech Republic has also received supplies.

If China takes the lead on responding to the coronavirus, or even worse, is seen as the only country helping the developing world while the United States does nothing, the United States may lose its “license to operate” as a global hegemon. That license could be given to China. This shift could lead to medium- or even long-term economic, political, and security gravitation of some of these countries toward China. Although the United States is in an era of strategic power competition with China, it may be wise to engage in strategic coordination when it comes to coronavirus. A coordination the United States should lead.
The United States Should Lead

Beyond its relationship with China, the United States should step up and be a leader to the world in this global crisis, or it will pay unintended consequences. The danger of dozens of countries’ health systems and political systems failing in the developing world will have negative consequences for U.S. national security and foreign policy interests. These consequences include: (1) the inability of these countries to share the burden on global security challenges because their militaries are internally distracted or too sick to help, (2) a vast reduction in the capacity of these countries to buy U.S. goods and services because of a financial crisis induced by a public health crisis, (3) tens of millions of poor people being thrown out of work in developing countries in Africa, the Middle East, and Latin America, which could create the temptation to migrate for economic reasons to Europe, the United States, or elsewhere, and (4) the potential for the destabilization of friendly governments and an erosion of civil order or even coups over a failure of allies to respond adequately to this crisis.
What the United States Should Do in Response to the Coronavirus in the Developing World

The United States is a global health, global disaster response, and global development superpower. Without distracting from the overwhelming emergency at home, it should provide assistance, which will lead to several benefits, including strategic public diplomacy ones. Critical actions in natural disasters in the past have garnered the U.S. strategic benefits, in addition to being the right thing to do. Taking decisive action to help other countries has a direct impact on public opinion and can even help the United States “reset” its relationship with countries.

Once the United States has gained control of the virus at home, it should take concrete actions with its allies to support the developing world with the coronavirus. First, the United States should repurpose the 80-plus USAID missions overseas to focus on the virus. This should include delivering essential medical supplies including masks, medicine, and ventilators around the world. Second, the USAID Office of U.S. Foreign Disaster Assistance should take the lead in putting together Disaster Assistance Response Teams to deploy in dozens of countries.

The United States should also increase its engagement with NGOs and international organizations, especially those that help IDPs and refugees. As international travel has been dramatically cut, the World Food Programme will struggle shifting between countries as the virus spreads. Therefore, the United States could increase funding for the World Food Programme, which provides assistance to people in IDP camps. The U.S. government could also work with the UNHCR to help these particularly vulnerable populations.
Why This Is Important

It is the right thing to do. Most parts of the developing world have fragile health care systems that are less prepared than the United States to deal with the coronavirus. The United States should step in to potentially save millions of lives. It is also a health diplomacy opportunity that can have an immediate and positive impact on public opinion. In addition, it is in the U.S. national security interest to do so. The coronavirus could further destabilize the Middle East, an already volatile region by hurting its economies, including that of one of the United States’ closest allies in the region, Jordan. It could also pause indefinitely important peace talks in Afghanistan. The coronavirus could trigger an increase in migration from developing countries to the United States and its allies if economies collapse. The coronavirus raging through the developing world could have spillover effects in the United States.

Last, in an era of strategic power competition with China, the United States must be seen as a leader during this crisis, even if that means coordinating with China. Otherwise, China’s early aid moves could be the harbinger of the end of American global leadership.

Daniel F. Runde is senior vice president, director of the Project on Prosperity and Development, and holds the William A. Schreyer Chair in Global Analysis at the Center for Strategic and International Studies (CSIS) in Washington, D.C. William J. Garvelink is a senior adviser with the CSIS Project on Prosperity and Development. Janina Staguhn is a program coordinator with the CSIS Project on Prosperity and Development.

Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

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