article · International Journal of Infectious Diseases
Coronavirus disease 2019 poses severe risks to the least developed, fragile, and conflict-affected countries due to vulnerable populations, limited national preparedness, and difficulties complying with community mitigation measures. This dynamic threatens decades of health promotion and economic gains while risking the creation of disease reservoirs that could repeatedly re-infect other nations once international trade and travel resume. To counter this, equitable access to medical countermeasures and dedicated pandemic mitigation funding are required. A transformative global development approach, modelled on the post-World War II Marshall Plan, is proposed alongside a dedicated global financing mechanism. This framework supports integrating these nations into a global interdisciplinary pandemic taskforce, thereby strengthening in-country surveillance, early detection capabilities, workforce training, and pandemic management research to protect vulnerable communities globally.
Pandemics do not respect borders, and leaving vulnerable nations without adequate support threatens health security worldwide. Failure to control transmission in fragile settings risks undoing decades of economic progress and causing recurrent global outbreaks. Establishing equitable financing and early detection mechanisms protects both local populations and international health stability, ultimately delivering substantial global economic and social benefits.
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The relentless spread of coronavirus disease 2019 (COVID-19) and its penetration into the least developed, fragile, and conflict-affected countries (LDFCAC) is a certainty. Expansion of the pandemic will be expedited by factors such as an abundance of at-risk populations, inadequate COVID-19 mitigation efforts, sheer inability to comply with community mitigation strategies, and constrained national preparedness. This situation will reduce the benefits achieved through decades of disease control and health promotion measures, and the economic progress made during periods of global development. Without interventions, and as soon as international travel and trade resume, reservoirs of COVID-19 and other vaccine-preventable diseases in LDFCAC will continue 'feeding' developed countries with repeated infection seeds. Assuring LDFCAC equity in access to medical countermeasures, funds to mitigate the pandemic, and a paradigm change in the global development agenda, similar to the post-World War II Marshall Plan for Europe, are urgently needed. We argue for a paradigm change in strategy, including a new global pandemic financing mechanism for COVID-19 and other future pandemics. This approach should assist LDFCAC in gaining access to and membership of a global interdisciplinary pandemic taskforce to enable in-country plans to train, leverage, and maintain essential functioning and also to utilize and enhance surveillance and early detection capabilities. Such a task force will be able to build on and expand research into the management of pandemics, protect vulnerable populations through international laws/treaties, and reinforce and align the development agenda to prevent and mitigate future pandemics. Lifting LDFCAC from COVID-related failure will offer the global community the best economic dividends of the century.
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DOI: 10.1016/j.ijid.2020.10.055
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