The webinar on COVID-19 experience of countries ahead of the global curve: country-to-country learning and South-South cooperation held on April 30, 2020, was the 8th in the webinar series on Social protection responses to COVID-19. It was co-organized by the United Nations Office for South-South Cooperation (UNOSSC), United Nations Children’s Fund (UNICEF) and the International Policy Centre for Inclusive Growth (IPC-IG), in collaboration with GIZ, on behalf of the German Federal Ministry of Economic Development and Cooperation (BMZ), and the Australia Government’s Department of Foreign Affairs and Trade (DFAT).
With emerging examples around the world of governments responding and continuously adapting their measures to ease the impacts of the COVID-19 pandemic, the aim of the webinar was to contribute to the global exchange of experiences to increase the understanding of challenges and solutions, improve the effectiveness of cross-disciplinary responses, and promote country-to-country learning and cooperation amongst countries, including through South-South and triangular cooperation.
The event was moderated by Ms. Martha Santos, Programme Manager, South-South/Horizontal Cooperation, UNICEF and featured presentations from:
- Mr. Jorge Chediek, Director of UNOSSC and Envoy of the UN Secretary-General on South-South Cooperation
- Mr. Mihir Bhatt, Director of All India Disaster Mitigation Institute (AIDMI)
- Mr. Taidong Zhou, Head of Global Development Division, Center for International Knowledge on Development (CIKD)
- Prof. Young June Choe, Department of Social and Preventive Medicine, Hallym University, Republic of Korea
- Ms. Xiaojun Grace Wang, Deputy Director, UNOSSC
After welcoming the participants and introducing the panelists, Ms Santos highlighted that COVID-19 has now spread to more than 180 countries, with devastating impact. Firstly, on health; and subsequently, as economic activities shut down, on the livelihoods and wellbeing of population groups, especially those who were already vulnerable before the crisis but also groups made vulnerable by the pandemic; and then on the national economy, and potentially, risks to the global economy.
She introduced that the topic of this webinar was on countries’ experiences and how health, social protection and economic measures - at national and regional levels - come together for a “whole of Government” response. China, the Republic of Korea and India were not only ahead of the global pandemic curve, but these were also countries that demonstrated some success in flattening the curve and mitigating the impact of COVID-19. More than ever, Ms Santos noted that country-to-country learning had become not only timely but also essential. Governments agreed that this was unchartered territory and they looked to other Governments for lessons learned and good practices.
From UNICEF’s perspective, the delivery of basic health services in times of health crisis such as COVID-19 is a concern. The World Health Organization reported that due to health system failures during the Ebola outbreak, the number of deaths caused by measles, malaria, HIV/AIDS and TB exceeded deaths from Ebola in countries hardest hit by the virus. UNICEF’s Executive Director, Mme Henrietta Fore, cautioned that “we cannot save a child from COVID-19, and then lose many to pneumonia, measles and cholera.”
The new normal of international cooperation
In his opening remarks, Mr Jorge Chediek highlighted how the effects of the pandemic go far beyond the health sector and have cascaded into massive social and economic impacts that are threatening billions of jobs. Nevertheless, fiscal and monetary policies have been radically transformed to confront the freezing of economies.
The speaker emphasized the implications that the new normal following the pandemic will have for international cooperation, highlighting the importance of South-South cooperation (SSC), which have led to increased coordination among countries of the South at national and regional level. However, some of the ongoing good integration initiatives in the South have been threatened by the very measures that Governments have taken in response to COVID-19, such as the closing of borders and the repositioning of trade and financial restrictions.
In this environment, Mr Chediek reiterated that UNOSSC remains committed to getting the minds of the South and friends of the North to think about how to respond to the impact of the crisis, but also to think about the future and how to restore the evolution of Southern integration and reinvigorate the change cycles of South-South cooperation.
Lessons from Kerala, India
Mr Mihir Bhatt started the presentation by highlighting that when talking about the overall situation in India, it is important to remember that out of the country’s 1.3 billion population, many but not all are covered by social protection measures. India is also the third-largest economy in the world in terms of purchasing power parity.
Mr Bhatt highlighted that within India, the aim of flattening the curve has been approached through the main tool of social, or physical, distancing. A national lockdown was imposed on 24th of March, which, while addressing the outbreak, was causing major economic turmoil. Estimates suggest that the impact of the national lockdown and overall of COVID-19 may cause the GDP to drop from 6.3 percent to 1.8 percent. Meanwhile, damage to existing social protection schemes and emerging demand for social protection services are increasing. In order to mitigate the impact, for example on the 400 million workers in India’s informal sector who are directly affected, the social protection response has included the mobilization of USD 4.48 billion to be distributed through direct cash transfers under the “rural benefit program” and the distribution of INR 1.7 trillion to provide cash and food support.
Following the description of the general context in India, Mr Bhatt explained that the state of Kerala has seen the highest number of recoveries and lowest mortality rate out of all states in India. The State Government has responded to COVID-19 by developing eighteen specifications of standards, expanding existing social protection measures and subsequently adding additional measures. Furthermore, the surge has been approached locally and decentralized across various districts, and with decisions pertaining to the implementation of measures being taken through the Panchayats’ local elected bodies.
Although it is hard to make predictions during the early stages of the outbreak, it is clear that one of the effects of COVID-19 in India is increased movements of people, including guest workers, that has been unprecedented in scale. In response to the movements of people, the Public Distribution System (PDS), early pensions, childcare, food for children in school and cash transfers are being offered to support these large numbers of people.
The lessons learned originating from Kerala itself that was shared by Mr Mihir Bhatt included insights such as:
- Higher public spending on labor and public health, or social protection measures, generally reduces the impact of pandemics.
- Better economic and social care of guest workers are in everybody’s interest. Offering social protection services to these groups could have a significant impact on, for example, contractors, the local community and people back at home.
- Leadership and convergence of Kerala’s three key agencies (Kerala State Planning Board, Kerala State Disaster Management Authority, Rebuilding Kerala Initiative) improved the responsiveness to challenges arising from COVID-19, including by integrating long-term and short-term development objectives into the response.There is no one way of doing a lockdown in the whole country. However, a lot of knowledge is being produced on lockdowns elsewhere as well as the impact of economic relief measures.
A comprehensive Government and society approach - lessons from the People’s Republic of China
Mr Taidong Zhou shared experiences from the People’s Republic of China. He divided the overall response and management of the epidemic into four stages, since the novel coronavirus was first detected in December 2019 in Wuhan, characterized by different strategies.
During the first stage, from the detection of COVID-19 in Wuhan to 20th of January, the strategy focused on collecting information and monitoring cases on a local level to analyze transmissibility and treatment methods.
The second stage, from 20th of January to 23rd of February, was a critical period for the containment of the virus, marked by thorough testing and the adoption of the most comprehensive strategy, including the lockdown of Wuhan and certain villages and regions. It was a whole Government and society approach to combat the virus through early detection, reporting, isolation diagnosis and treatment. The following third stage, stretching until mid-March, meant a move from a nationwide restriction, prevention and control approach to a risk-oriented and differentiated approach.
Since late March and in the fourth stage, China has largely cut-off the domestic chain of transmission, and shifted focus towards “imported cases”. With the situation largely controlled, efforts are undertaken to resume work and production.
Following the background of the four different phases, the speaker emphasized affordable health care as one of the most important social protection and economic measures that were put in place to support vulnerable populations. During the early stages of the outbreak, policies were adopted to provide free of charge testing, diagnosis and treatment of COVID-19 related cases. China also adopted a policy on comprehensive Health care reform that sought to establish a multi-level medical security system to integrate prevention, testing and treatment measures within social health protection packages. Additionally, smaller scale efforts included the encouraging of health insurance to reimburse online consultations for chronic and common diseases in order to avoid physical contact. People contracting the virus at work were also made eligible for employment injury benefits.
In terms of employment protection, Mr Zhou mentioned that special attention was paid to Small and Medium-sized Enterprises (SMEs), that employed 80% of Chinese laborers, through measures including modified social security contributions and tax payments.
He also highlighted the following points from the People’s Republic of China’s response to COVID-19:
- There was a critical need for a comprehensive approach that involved the whole Government and society. Compared with the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, experiences from COVID-19 have demonstrated how people are working together across sectors and groups.
- Experts were, and should be, enabled to guide the responses to protect health workers and vulnerable groups.
- Digital technologies were utilized in innovative ways to enable people to check each other’s health status and sustain learning through online education.
- By nurturing trust between the Government, the public and the private sector it was possible to combat misinformation during the emergency.
- International cooperation proved indispensable and will provide important opportunities for South-South cooperation in the next steps of facilitating the reopening of economies, but also in terms of knowledge sharing on health system building, digital technologies and, as mentioned, nurturing trust through public communication.
Examples of research & evidence-guided policies in action - lessons from the Republic of Korea
Prof. Young June Choe shared the experiences of the Republic of Korea, where the epidemiological curve (see slide below) displayed the development from the detection of the first case in the country on 19th of January, to the surge of the epidemic and the different phases leading to the flattening of the curve.
Prof. Choe explained that before the outbreak of COVID-19, the Republic of Korea saw the largest outbreak of Middle East Respiratory Syndrome (MERS) outside of the Middle East, providing the country with preparedness capacity to deal with an outbreak of a respiratory epidemic. The previous experience of MERS demonstrated some problems such as inadequate public health capacities which led to the preparation for the next introduction of a novel pathogen. Hence, the Republic of Korea’s preparedness had been practiced continuously, and previous experiences enabled the set-up of the country’s infrastructures in the early scaling of testing during the first wave of the COVID-19 outbreak.
Authorities became alerted early on when radiological evidence showed the presence of pneumonia despite the absence of any signs of symptoms in some of the first cases, and a viral kinetics study demonstrated how contagious the virus was during the very early phase of the illness. From these pieces of evidence, it became apparent that COVID-19 was not like SARS or MERS and policymaking focused on initiating vigorous contact tracing in the early days of the outbreak. Prof. Choe mentioned that there were still cases of super-spreads that were linked to mass gatherings, causing incidents to skyrocket in mid-February.
Since then, more than 100 clusters of infections have been tracked and investigated, through the classic shoe-leather epidemiology coupled with support from the IT infrastructure (see slide below). The scaling of testing also saw some innovative approaches such as drive-through screening centers and walkthrough centers originating in the private sector and consequently adopted by the public sector. Demonstrating the strong Public-Private partnership in responding to COVID-19. In addition to strong community engagement in the response, the Government has been basing the development of guidelines and policymaking on available evidence, including guidelines for children developed by the Korea Society of Pediatric Infectious Diseases (KSPID).
While the Republic of Korea has seen a relatively low case mortality rate in relation to other countries, it is hard to make comparisons between countries due to differences in, for example, testing. However, in the Republic of Korea, there seem to have been a good triage system that sent high-risk patients to National Designated Isolation Units at designated hospitals and middle- and low-risk patients to community treatment centers, while those staying at home were closely monitored by public health officers (see slide below).
Prof. Young June Choe emphasized that reducing transmissibility, minimizing contact rate and decreasing the duration of infection through using masks and washing hands, social distancing, mass testing, and contact tracing isolation are some of the main takeaways from the Republic of Korea. These are underpinned by the following lessons adopted by the government:
- Research & evidence-guided policy at the heat of the response
- Scaling-up of testing & results turned around quickly
- Landmark advances in contact tracing, early isolation/quarantine
- Social and community engagement integrated into the response
South-South knowledge sharing to save lives and lighting up the future
In her closing remarks, Ms Xiaojun Grace Wang highlighted lessons from the three countries:
- Targeting – The importance of targeting based on local needs and phases of the pandemic that will require different responses. The targeting also has to take into consideration the different needs of peoples, including migrant workers, children, elderly, and people with disabilities.
- Coordination – While the responses have relied on community and local action, the lessons emphasize national coordination as key, where the whole society act together.
- Cooperation – The lessons show strong examples of in-country solidarity, taking the form of village-to-village or city-to-city cooperation, that show that people are working both within and beyond borders.
Looking ahead and focusing on the importance of South-South cooperation as a complementary implementation modality to achieve progress in human development, Ms Wang mentioned several aspects of South-South and triangular cooperation that could add value to international cooperation among countries and partners.
- SSC offers developing countries a platform to collectively advance common concerns adapted to their particular needs through policy advocacy. There are several mechanisms, including the High-level committee on SSC, to advance an agenda for more solidarity, coordination and cooperation which will be needed in upcoming COVID-19 discussions.
- South-South knowledge sharing in this time of crisis has the power of saving lives but may also have the power of lighting up the future. Southern thinkers will remain important in sharing their wisdom on how to address issues and advance progress in human development once the new normal has been established.
- Another aspect of the value of South-South cooperation is the opportunity of connecting partners and funding mechanisms for countries to coordinate with each other, particularly during the critical phase of recovery from the pandemic and on topics such as trade, health and migration. The South-South Galaxy exists as an example of a digital platform for global partnership brokering and knowledge sharing that enables partners to share their demands, but also what they offer.
Center for International Knowledge on Development (CIKD): Fighting the COVID-19: 100 Q&As
This blog post is part of the Social protection responses to COVID-19 webinar series. The series is a joint effort initiated by the IPC-IG, GIZ on behalf of the German Federal Ministry of Economic Development and Cooperation (BMZ), and the Australia Government's Department of Foreign Affairs and Trade (DFAT) collaboration with the socialprotection.org platform, and in cooperation with partners from different organisations. Join our online community ''Social protection responses to COVID-10 [Task force]" to learn more about the initiative and future webinars.