Seite - 519 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

519“Flattening the Curve” Through COVID-19 Contagion Containment developed countries to immediately help less developed countries to bolster their health systems and capacity to check disease, especially COVID-19 transmission. Failure to do so, he warned, would contrib- ute to “the nightmare of the disease spreading like wildfire in the global South with millions of deaths and the prospect of the disease re-emerging where it was previously suppressed.” Weak Health Systems Health systems in most developing countries are unevenly inad- equate, even in normal times. Despite several pandemics in recent years, most countries remained poorly prepared, let alone for the specific challenges posed by COVID-19. Even most health systems in Europe and North America faced major shortages of doctors, respira- tors, basic infection prevention (BIP) gear, PPE, and testing kits.10 A recent survey of the availability of four BIP and four PPE items in seven poor countries (Afghanistan, Bangladesh, Democratic Republic of Congo [DRC], Haiti, Nepal, Senegal and Tanzania) found less than a third of clinics and health centres in Bangladesh, the DRC, Nepal, and Tanzania had any face masks.11 In all seven countries, clin- ics, and health centres, often the first point of public contact with the health system, had, on average, just 2.3 (of four) BIP items and two (of four) PPE items. Most countries surveyed scored poorly on health workers’ preparedness in terms of the 2005 IHR to prevent the spread of diseases. online: United Nations <https://www.un.org/sg/en/content/sg/press-encounter/ 2020-03-31/transcript-of-un-secretary-general%E2%80%99s-virtual-press- encounter-launch-the-report-the-socio-economic-impacts-of-covid-19>. 10. The WHO’s shortened list includes (a) guidelines for infection prevention; (b) pourable water and soap or hand disinfectant; (c) surface disinfectant; and (d) a waste bin. WHO’s guidance on PPE for those in direct contact with patients includes: (a) gloves; (b) face masks; (c) gowns or aprons; and (d) eye protec- tion. See “Service Availability and Readiness Assessment (SARA)” (2015), online (pdf): World  Health  Organization <https://www.who.int/healthinfo/sys- tems/SARA_Reference_Manual_Chapter3.pdf?ua=1>; and “Rational Use of Personal Protective Equipment (PPE) for Coronavirus Disease (COVID-19)” (19 March 2020), online (pdf): World  Health  Organization <https://apps.who. int/iris/bitstream/handle/10665/331498/WHO-2019-nCoV-IPCPPE_use-2020.2- eng.pdf>. 11. Anna Gage & Sebastian Bauhoff, “Health Systems in Low-Income Countries Will Struggle to Protect Health Workers from Covid-19” (2020), online: Center for Global  Development <https://www.cgdev.org/blog/health-systems-low-income- countries-will-struggle-protect-health-workers-covid-19>.