Badirujjaman

Rethinking the health security in South Asia: Lessons from the Covid-19 pandemic

 

  1. Introduction  

The COVID-19 pandemic is disrupting the lives of millions globally, and South Asian people are one of them. In South Asia, cases are rising, doubling almost every week. Many policies, tough or soft, have been taken by the countries of South Asia with respect to the WHO. Lockdowns are the harshest on poor families and migrant workers.  

Moreover, the availability of food has become a growing concern, especially for the poor. Economic growth in South Asia is projected to be between 1.8 and 2.8 percent this year, potentially the lowest in 40 years. COVID-19 hits all South Asian countries, triggering a recession in some that could linger into 2021. 

At the very beginning, in South Asia, the infected rate was much lower than that of others, but due to its vulnerable position in health sectors, the region has faced the ultimate experience of the COVID-19 pandemic. And this will not end here, as WHO says. So this all compelled the region to rethink health security.   

However, in this writing, we will try to discuss health security and the COVID-19 pandemic, how COVID-19 affected the world, particularly South Asia, and why it is important to rethink South Asian health security during and after the COVID scenario. 

  1. Covid-19: epidemic to pandemic  

COVID-19 has affected people’s daily lives since its outbreak. Day by day, it becomes worse than before. Everyone is in fear of this pandemic, which they haven’t experienced yet. It begins as an epidemic and later transcends to a pandemic. So we need to know the three faces of this virus: outbreak, epidemic, and pandemic. 

Illnesses can happen normally based on the season or geography within a population at some specific periods. An outbreak basically represents the sudden increase of sick people, but in specific diseases. Such as one or two kids can normally be sick of illness, but if 15-20 children have to come to the hospital for diarrhea, then it is called an outbreak.

However, when a novel disease comes to people with zero past experiences and a noticeable outbreak, it creates fear among people. As in the case of COVID-19, this remains the same. It emerged as a new disease and spread among market cities in Chinese Wuhan

After a few days, there was an outbreak. The government officials identified the  outbreak and defined the SARS-CoV-2 virus as a coronavirus. And the state officials take every possible step to prevent and contain this outbreak.

But when state mechanisms fail to contain the outbreak, it spreads over larger areas, creating a fearful situation for the people of the state. This happened for COVID-19. Wuhan market areas suffered from this unknown outbreak, and the Chinese health sector was unable to do something efficient. Then the SARS-CoV-2 virus spread all over Wuhan and later across China as an epidemic.

And then to the whole world, because China has remained a business hub in this globalized world. So when any epidemic has transnational effects, it becomes considered a pandemic. The World Health Organization sought aggressive policies to contain such a high-level virus, but no one has yet succeeded, whether developed or underdeveloped. Since 2019, almost 8 million people and 1.8 million people have been affected and died, respectively, owing to COVID-19. 

In addition, socio-economic conditions for every state are on the rise, and most of them think about the post-COVID scenario and reconstruct their views on transnational threats, particularly health security. 

  1. What is ‘Health Security’?: 

Health Security refers to sovereign actions to prevent, contain, and counter public health-related diseases to ensure their (and their subjects) safety [1]. In strategic studies or international relations studies, nowadays, health security is taken as their area of study because this discourse has shown equal significance in both traditional and non-traditional security fields. Scholars in this particular field emphasize sovereign actions towards protecting its subjects through health security.

According to the World Health Organization (WHO), health security encompasses the “activities required to minimize the danger and impact of acute public health events that endanger the collective health of populations living across geographical regions and international boundaries” [2]. WHO also said that states are sovereign in their actions, so they have major roles and responsibilities in ensuring the health security of their inhabitants. 

The world is changing, and so are its ingredients, and public health, whether global or domestic, has been an important part of it. This systematic change created many new security challenges, and most states, especially peripheral ones, face these challenges as a question of surviving. 

So their vulnerable position makes them unable to stop the entrance of infectious diseases, and this high level of disease can only be solved through global commitment and collaboration.

The World Health Organization (WHO) is regarded as the mother institution of global health security. WHO claims that health issues have transnational effects, and because of globalization, these issues have become international in nature. WHO’s GHSA (Global Health Security Agenda) was created for the prevention and detention of such infectious diseases. 

Besides, many organizations, like the Red Crescent Society, supported the GHSA in banning conventional weapons using chemicals, bacteria, biologics, hydrogen, etc. According to the WHO, health security is very essential to attaining the UN mandate for establishing peace and security around the world.

  1. Covid-19 and Health Security:

Pandemic COVID-19 has been catastrophic for human life. The death toll continues. Though the recent declaration of inventory of COVID vaccines reemerges, the hopes that we shall overcome this unseen-untouched giant. But despite such wonderful achievements in science, the pandemic situation remains unchanged. The speed of COVID-19 and inflection rates are getting higher day by day.

Suppose vaccines against pandemics get approval in a short time, but the availability of these vaccines for most of the world remains impossible. If you think about East and South Asia, with more than half of the world population, the availability of vaccines will make the situation in these regions more catastrophic. And vaccine politics emerges, or will emerge, as a great impediment to the availability of vaccines, according to the WHO.

COVID-19 is making the situation worse for tackling other major diseases like HIV, malaria, or diarrhea. The governments have to focus on pandemics only, which creates a vacuum for others. Even doctors are affected by death. This is going to be a great blow to populated regions like East and South Asia. This region badly needs regional integration and global collaboration to fight against this pandemic.

But global leaders are very far from collective action. Few are doing suspicious things, like US President Donald Trump, and others are doing great. Their main concern is to define health security from the very beginning and never undermine any non-traditional security threats; otherwise, it would be transnational and later, international. 

  1. Covid-19 and South Asian health security: 

However, as South Asia is home to one-fifth of the world’s population, the pandemic put this poor region in catastrophe. Infected and death tolls rise, respectively, due to poor health facilities in South Asian countries. Pakistan, from the beginning, has begun preparing medical facilities, but in a country whose hospitals were both underfunded and overcrowded long before the crisis.  

The health sector has urged the government to do more. There have been attempts to convince people about the benefits of social distancing. Police were posted outside mosques in major cities to turn away worshipers. Besides, she had closed the Afghan-Pak borders, which have recently opened.          

In Afghanistan, another vulnerable health system has been weakened by decades of war. Many are questioning whether the war-affected country can handle any outbreak, let alone pandemic COVID-19. In major cities, the Afghan government has taken measures to disinfect public places. 

In Bangladesh, migrant workers from COVID-affected countries were returning home. Even the government says that the situation is under control. The medical workers insisted that they don’t have adequate PPE, and Space 2 treats such huge infected people. And they were compelled to warn that the health system simply cannot cope with the outbreak. 

Recently, as there has been a lack of medical doctors, nurses, and space to support such infected people, hospitals have been turning away patients with COVID-19 symptoms. Besides, slum areas in Dhaka and Rohingya refugee camps in Cox’s Bazar are very vulnerable to this pandemic.

The COVID-19 pandemic-infecting cases are growing the fastest in India. In March 2020, only 500 cases were filed. Then, all of a sudden, the Modi government declared a complete lockdown all over the country.

Thousands of migrant workers were left out of jobs after India announced one of the world’s most stringent lockdowns with just four hours notice. As there were no transportation systems available the migrants were cursed with no choice but to go to their village on foot or some other way. But many died before they reached their home villages.

Besides, in India, misinformation and disinformation are used by social media for some specific interest and that’s what creates communal violence, most probably creating Islamophobia countrywide. And when dozens of religious congregations found positives for Corona, this disinformation has grown faster. Besides Sino-Indian conflicts or border tension, reach for Indian people. And in the meantime, in June, there were almost 500,000 cases of COVID-19-affected people in India. 

Like other South Asian states, the Indian health system has been in crisis; hospitals have had to turn their patients away, and now more than 8 million people have already been infected, and the rate is growing rapidly. WHO believes that if the rates continue like that, India will surpass the US as the world’s worst-infected and affected country.

  1. Rethinking Health Security in South Asia

All we have discussed above implies that the global public health system needs to be revised, and this thought is not only emerging from our parts of the world, but all the countries, affected or not, are going to deconstruct the existing system to identify the problems in it. Both globally and regionally, states need to collaborate; isolation or exploitation won’t bring about any positivity for any one. COVID-19 can be the best example.

Moreover, specialists are predicting growing regionalism in the post-COVID scenario, and that can be a solution for various issues that couldn’t get many chances to be discussed on a global forum. South Asia as a region has to be integrated to tackle or mitigate such a world-class virus as COVID-19. So regional integration is very essential in this pandemic to rethink regional health security. 

Non-traditional security (NTS) threats have become crucial for every region of the world to both prevent and counter. Trafficking of drugs and humans, health and food security, environmental degradation, enhancement of extreme violence, etc. are counted as NTS. This threat has transnational effects. Like many other regions, South Asian countries are facing such threats, and the recent COVID-19 pandemic threatens the whole health and security of the region.

And like others, South Asian countries also seem from the beginning that this is someone else’s problem—a Chinese internal issue. But they forgot about the transnational effects of the health crisis, and now they are suffering. They (South Asian countries) need to rethink not only health security issues but also non-traditional security measures as much as possible. Because the COVID-19 pandemic, from a health and security perspective, shows how an outbreak can be transnational, international, or global.  

Health security is always political, as it depends on every state to do its business. Blame games often result from insecurity about health. In South Asia, blame politics has been established, particularly in India and Pakistan. In India, major political parties directly or indirectly accused China of such a pandemic. Disinformation has been continuing since the beginning of COVID-19. And as vaccines are developed in core states, which creates uncertainty over small states or peripheral states,

Are they going to have it or not? This vacuum needs to be solved for the betterment of all, and here it needs political cooperation irrespective of your existence—South or North.

For rethinking health security in South Asian states, regional cooperation with international organizations like the World Bank and WHO and regional organizations such as the EU, ASEAN, etc. is very essential. These organizations have been supported in maintaining world peace and security. Peace without security and security without peace are unattainable. To ensure the health security of South Asian countries, these organizations can be good partners. 

As major states in this region don’t have much capacity to mitigate such threats, they can get technical expertise through mutual collaboration. They can raise their voice in the world community that these transnational threats can pandemic within a very short time. So in this globalized world, as all are connected, no one claims they are secure, at least not this time when COVID-19 shows its destruction.

South Asian countries need to redefine the concept of health security. Though WHO prescribed one definition, the core-peripheral dilemma remains obvious. Without becoming a pandemic, we all know that, like other regional diseases such as malaria, Ebola, dengue, etc., COVID-19 may not get such importance, funding, or media highlighting.

To counter or contain this COVID-19 pandemic, many other seasonal and regional diseases struggle to find funding and even get visibility. And South Asia as a region needs to cooperate or collaborate with other regional forums to redefine the character of health security that will incorporate all the geographic diseases for human security, funding more and more from core states to the most marginalized and vulnerable people in the region.

The COVID-19 pandemic demonstrates how the world is weak at crisis management. When the core states fail to do so, the peripheral states remain more vulnerable to being affected. International relations on crisis management are also dissatisfied with developing ones. So the states understand the essentiality of crisis management not only for traditional security threats but also for transnational, non-traditional security threats.

South Asia, as a developing region with a huge population, badly needs a better crisis management policy. Every state should encourage others to do so. Besides political cooperation, public consciousness is very essential. This region could use SAARC as an actor in conducting such management.

  1. Conclusion 

The COVID-19 pandemic has been disastrous to all the states in the world, and one of the most populated regions, South Asia, is suffering a lot. This pandemic showed us how essential it is to be cooperative globally and regionally to deter such destructive forces. 

South Asian states need cooperation. They need to rethink their socioeconomic and political structure. Like all the reasons in the world, South Asian states also need to emphasize non-traditional security threats like health. Because in this globalized world, these threats tend to be transnational; if they cannot be countered, they can be international, and COVID-19 is a prime example of this. 

So South Asian states need to rethink their health systems,  go into integration for the development of health-related infrastructure and technologies, and exchange information regarding these issues. This integration can benefit a region like South Asia.

[1] “Health Security”. World Health Organisation. 2021. https://www.who.int/health-topics/health-security#tab=tab_1

[2] “Health Security”. World Health Organisation. Retrieved March 19, 2020 https://www.who.int/health-topics/health-security/

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