By Debapriya Bhattacharya, Distinguished Fellow, Centre for Policy Dialogue (CPD), and Fareha Raida Islam, Programme Associate, Centre for Policy Dialogue (CPD)

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This blog is part of a series on tackling COVID-19 in developing countries. Visit the OECD dedicated page to access the OECD’s data, analysis and recommendations on the health, economic, financial and societal impacts of COVID-19 worldwide.

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The scourge of COVID-19 continues to devastate life and livelihoods across the world. While the global community assesses the possible impact of this pandemic and commits to take action, it is becoming evident that the consequences will be more pronounced in the weaker economies, and possibly catastrophic in the least developed countries (LDCs) – a group of countries that share multiple structural vulnerabilities. A targeted package of international support measures for LDCs, realigning existing programmes, is urgently needed.

Vulnerabilities of the least developed countries

About a quarter of the United Nations’ members (47 countries) are LDCs, accounting for 12% of world population, against less than 2% of global GDP and less than 1% of global trade and foreign direct investment (FDI). These countries, penalised by geography and history, host about 40% of the world’s poor. Almost all are climate-change affected nations, and a large number are fragile states. Only about 18% of the population in LDCs have access to internet – the vast majority are victims of the digital divide. LDC governments on average spend less than 2% of their country’s GDP on public healthcare.

Given multiple setbacks, including weak public health services and low resources to mitigate the spread of the virus, the repercussions of this pandemic could roll back the progress made in these countries in the first cycle (2015–20) of the Sustainable Development Goals (SDGs). The consequences of the pandemic could also slow down some countries’ prospects to graduate out of the LDC category – as envisaged in the UN Istanbul Programme of Action (IPoA) in 2011. The looming economic tsunami with concurrent health shocks could be catastrophic for these countries, leaving them further behind. 

After a slow start, the crisis is evolving fast

The spread of coronavirus in the LDCs had a slow start. Nepal was the first to report a confirmed case of infection as early as January 2020, followed by one case in Cambodia. In February 2020, Afghanistan reported one case. However, by end of March 2020, the virus has spread like wildfire throughout 26 African, seven Asian, one Caribbean (Haiti) and one Pacific Island (Timor-Leste) LDC. The number of confirmed cases has increased more than five folds to 6022 and the number of deaths has increased more than eight folds to 203 by 16 April 2020.

Figure 1: LDCs which have been affected by COVID-19 (as of 16 April 2020)

Source: Authors’ illustration based on data from the World Health Organization (WHO).

Note: Darker shades indicate higher number of cases in the affected LDCs 

The high incidence of ‘imported cases’ is an unfortunate by-product, among others, of cross-border economic activities. Ironically, geographical remoteness has worked as a security barrier against the virus for some LDCs. Five small island developing states (SIDS) – Comoros, Kiribati, Tuvalu, Vanuatu, and Solomon Islands; and one landlocked developing country – Lesotho have not yet reported any infections. However, this could be related to low availability of testing facilities. Data shows that LDCs in conflict and post-conflict status, like Afghanistan, Burkina Faso and Niger have reported some of the highest confirmed cases. However, Bangladesh – the most populous LDC – has confirmed the highest number of cases (1231) in the group so far.

On the other hand, 23 out of the 41 affected LDCs have reported deaths. Incidentally, LDCs may have a lower number of confirmed cases than other countries in Asia, Europe and North America, but the death rates in some affected LDCs are much higher. For instance, Sudan (15.63 %) and Mauritania (14.29 %) are experiencing higher death rates than some OECD countries.

Conflicts and internal displacement crises could aggravate the impacts of the virus. Some African LDCs have also suffered from localised epidemics and natural disasters recently. For instance, Democratic Republic of Congo has just come out of its battle against Ebola and Tanzania was recently overwhelmed by flooding.

Moreover, densely populated slums and refugee camps in LDCs are at high risk of uncontrollable outbreaks of COVID-19. Bangladesh, one of the most densely populated countries in the world, currently hosts more than 1 million Rohingya refugees.

The worst is yet to come?

Can LDCs’ young population – with an average median age of 18 – play in their favour against the virus? The population below 15 years of age in LDCs is about 39 %, compared to only 18% in OECD countries. However, this does not safeguard people in LDCs from the virus and once infected, they may not get the required medical attention.

LDCs have on average 0.6 nurses and midwives, 0.3 physicians and 1.1 hospital beds per 1,000 population. The figures for OECD countries are on average 8 nurses and midwives, 2.9 physicians and 4.7 hospital beds for every 1,000 population. It may be recalled that almost 75% of the population in LDCs lack access to basic necessities like clean water and soap, considered to be the most important deterrent of the disease. Given their low fiscal space, their immediate ability to augment public expenditure in healthcare is very limited. Lack of screening at the border will keep LDCs vulnerable to imported contamination.

A second wave of infections may also hit the LDCs suggesting that the full rage, ravage and range of COVID-19 is yet to unfold. In short, about 900 million people in LDCs continue to remain at risk of infection. However, effective state intervention in the area of preparedness and support from the global community may smoothen the peak of the curve, if not thwart it altogether.

Shaping a global response

COVID-19 will exacerbate pre-existing vulnerabilities of the LDCs and disrupt their pursuit for sustainable development.

First, to ascertain the impact of COVID-19 in the LDCs, it is necessary to systematically and substantively monitor the situation on the ground and reorganise existing programmes. The United Nations Committee for Development Policy (CDP) and the Office of the High Representative for LDCs, LLDCs, and SIDS (UNOHRLLS) are well placed to monitor this task. By realigning their programmes, various UN agencies, for example WHO and United Nations Development Programme (UNDP), would be able to better deal with the intensified privations of health care needs, social stress and economic recovery.

Second, this challenge requires a truly global comprehensive response. International development co-operation actors need to redeploy themselves to create a targeted package of international support measures for the LDCs – going far beyond the flow of official development assistance (ODA). It has to be global, involving actors from the North and South, public or private. South-South cooperation would be an essential element, with private philanthropies also significantly contributing. The package needs to be comprehensive and include effective access to different forms of investible resources and food aid, debt cancellation, market access of exports and facilitation of remittances, and availability of drugs and vaccines. The G20 Action Plan has already shown some efforts in this direction, but should deliver a more comprehensive response.

Third, international actors need to move fast. The discernible progress made by the LDCs in the recent past in improving productive capacities and human assets should not be allowed by the international development community to recede into oblivion because of COVID-19. The Fifth UN Conference on LDCs is due to take place in 2021, but with the virus spreading like wildfire, and recent estimates projecting a soaring magnitude of lives lost due to COVID-19, there is no time to lose.