Poorer countries pushed aside in Covid-19 scramble
For developing nations the ruthless competition for resources could become a ‘global catastrophe’
Developing nations in Latin America and Africa cannot find enough materials and equipment to test for coronavirus, partly because the United States and Europe are outspending them.
Crates of masks snatched from cargo planes on airport tarmacs. Countries paying treble the market price to outbid others. Accusations of “modern piracy” against governments trying to secure medical supplies for their own people.
As the United States and European Union countries compete to acquire scarce medical equipment to combat the coronavirus, another troubling divide is also emerging, with poorer countries losing out to wealthier ones in the global scrum for masks and testing materials.
Scientists in Africa and Latin America have been told by manufacturers that orders for vital testing kits cannot be filled for months, because the supply chain is in upheaval and almost everything they produce is going to America or Europe. All countries report steep price increases, from testing kits to masks.
“There is a war going on behind the scenes, and we’re most worried about poorer countries losing out,” said Dr Catharina Boehme, the chief executive of Foundation for Innovative New Diagnostics, which collaborates with the World Health Organisation in helping poorer countries gain access to medical tests.
In Africa, Latin America and parts of Asia, many countries are already at a disadvantage, with health systems that are underfunded, fragile and often lacking in necessary equipment. A recent study found that some poor countries have only one equipped intensive care bed per million residents.
Testing is the first defence against the virus and an important tool to stop so many patients from ending up hospitalised. Most manufacturers want to help, but the niche industry that produces the testing equipment and chemical reagents necessary to process lab tests is dealing with huge global demand.
“There’s never really been a shortage of chemical reagents before now,” said Doris-Ann Williams, chief executive of the British In Vitro Diagnostics Association, which represents producers and distributors of the lab tests used to detect coronavirus. “If it was just one country with an epidemic it would be fine, but all the major countries in the world want the same thing at the same time.”
For poorer countries, Boehme said the competition for resources is potentially a “global catastrophe”, as a once-coherent supply chain has rapidly devolved into an arm-twisting exercise. Leaders of “every country” are personally calling manufacturing chief executives to demand first-inline access to vital supplies. Some governments have even offered to send private jets.
In Brazil, Dr Amilcar Tanuri cannot offer private jets. Tanuri runs public laboratories at the Federal University of Rio de Janeiro, half of which are “stuck doing nothing”, because he said the chemical reagents he needs are being routed to wealthier countries.
“If you don’t have reliable tests, you are blind,” he said. “This is the beginning of the epidemic curve so I’m very concerned about the public health system here being overwhelmed very fast.”
Brazil is Latin America’s hardest hit country so far, with more than 10,000 confirmed cases and a testing backlog of at least 23,000. It is also the region’s most controversial player in the pandemic, with a president, Jair Bolsonaro, who has been an outspoken sceptic of the risks posed by the coronavirus.
But below the political noise, the country’s scientists began trying to ramp up testing hours after the country’s first case was announced.
Yet within weeks, Tanuri was left to frantically call private firms on three continents, trying to source the chemical reagents needed for the 200 testing samples his labs receive every day — only to be told that the United States and Europe had already bought up months of production.
The situation is similar for some African countries.
After reporting its first death on March 27, South Africa moved swiftly, introducing a strict lockdown and announcing ambitious house-to-house canvassing that has already seen 47,000 people tested. South Africa has more than 200 public labs, an impressive network that surpasses wealthier countries like Britain and was developed in response to past outbreaks of HIV and tuberculosis.
But, like Brazil, it is reliant on international manufacturers for the chemical reagents, and other equipment, needed to process the tests. Dr Francois Venter, an infectious diseases expert who is advising the South African government, said the struggle to acquire the reagents was endangering the country’s response.
“We have the capacity to do large testing, but we’ve been bedeviled by the fact the actual testing materials, reagents, haven’t been coming,” he said. “We’re not as wealthy. We don’t have as many ventilators, we don’t have as many doctors, our health system was in a precarious position before coronavirus.”
For poorer countries, the supply problem is bigger than just testing.
Zambia is at the very beginning of its epidemic curve with only one death so far, but it is already struggling to source masks, as well as testing materials like swabs and reagents, says Dr Charles Holmes, a board member of the Centre for Infectious Disease Research in Zambia and the former chief medical officer for the Obama administration’s President’s Emergency Plan for Aids Relief, known as Pepfar.
When Zambia tried to place an order for N95 masks, Holmes said, the broker tried to sell them for “five to 10 times” more than the usual cost, despite checks revealing the masks expired in 2016.
He said manufacturers have told Zambian officials that they cannot guarantee a delivery date for supplies because “most of them are being snapped up by the US and Europe”.
While few would criticise governments for looking out for their own people, health experts believe it is in everyone’s interest to help poorer countries get the supplies they need.
“An infection with a highly transportable respiratory virus anywhere in the world puts all countries at risk,” Holmes said. “Wealthy nations not only have an obligation to look out for countries that are going to struggle, but they should also have some self interest in ensuring that the pandemic is contained in developing countries.”