Swift action to contain the spread of coronavirus would save at least three million lives in sub-Saharan Africa and south Asia according to new research from Imperial College, but this prediction understates the number of lives at stake, warns Save the Children.

The Imperial College modelling compares different scenarios for the Covid-19 response. The first is early and decisive action to test and isolate cases, promote social distancing, and treat affected populations. This predicts 800,000 deaths. Delayed action increases that figure to almost four million deaths.

Save the Children’s CEO Inger Ashing said:

“If we act now and act decisively, we can prevent and contain the pandemic threat facing the poorest countries. Delay will cost at least three million lives and it will also create new risks for the whole world – this is not a crisis that respects borders.

“Delaying prevention and containment in South Asia and sub-Saharan Africa will not only claim many lives in those regions, it will potentially fuel the pandemic in Europe, North America and other regions. Failure to act now will increase the numbers infected by coronavirus in South Asia and Sub-Saharan Africa by almost one billion.”

Preventing transmissions through population-wide social distancing could reduce the number of deaths by around one third but this could still lead to a collapse of the health systems in low-income countries, with peak demand for critical care beds 25 times higher than the available numbers of beds.

Data from the London School of Hygiene & Tropical Medicine confirms that the window of opportunity for containing the crisis in the poorest countries is closing. Currently, none of these countries has more than a thousand cases. By the end of the June, no country will have fewer than 10,000.

African governments have already responded to the Covid-19 outbreak, including through major public awareness and sanitation campaigns, flight bans, lockdowns and curfews. However, given the fast rise in confirmed cases, Save the Children believes that more needs to be done with the support of International Community.

Sub-Saharan Africa has the world’s weakest health systems and highest levels of poverty. Half the population has no access to robust health services. Child and adult malnutrition, coupled with endemic malaria, are risk factors that could lead to higher levels of Covid-19 mortality than experienced in the wealthier countries.

In modelling the global impact of Covid-19, Imperial College assumes there is no substantive difference in general health prevalence and morbidity between Chinese and other populations. However, with one third of children in south Asia and sub-Saharan Africa being stunted and the high burden of infectious diseases children and adults face in those countries, populations are likely to be much more vulnerable.

Also, the model does not sufficiently consider the low standard of medical care in many of the poorest countries.

Save the Children is actively involved in providing child and maternal health care across many of the poorest countries in sub-Saharan Africa and south Asia. These are countries with health systems struggling to provide universal immunisation, in many places.

Millions of children die as a result of the inability of their parents to get treatment for basic diseases like malaria, sepsis and diarrhoea. Over 800,000 children die from pneumonia alone, many of them because there is no medical oxygen available.

Save the Children is calling for international cooperation in five areas:
• A single global plan to get support to the front-lines where it is desperately needed.
• Global finance for recovery and protection.
• Putting families and children at the centre.
• Education and learning.
• Protecting the most vulnerable.

Coronavirus is already overwhelming health systems in the world’s richest countries. The effects will be far more severe in the poorest. Public health spending averages just $17 per person in south Asia and $16 in sub-Saharan Africa (when excluding South Africa) – far short of the $86 per person needed to finance basic health provision.