An outpouring of international humanitarian aid to China has alleviated the severe shortage of key medical supplies in its fight against an outbreak of COVID-19. This highlights the role humanitarian aid plays in managing the risk of pandemics.
By Lina Gong*
The severe shortage of critical medical supplies was a prominent challenge in the initial phase of China’s domestic response to the COVID-19 outbreak. International humanitarian aid provided by foreign governments, international organisations, non-governmental organisations, the private sector and individuals have helped to narrow the gap.
As the world responds by focusing on containment policies, epidemiological research and transmission of the virus, the ongoing fight against COVID-19 highlights the obvious vulnerability of critical medical supplies and the role humanitarian aid can play in enabling better national and global response.
Severe Shortage and Consequences
The Chinese Foreign Ministry spokesperson appealed on 3 February 2020 that China urgently needed surgical masks, protective suits and safety goggles. Later, a Deputy Mayor of Wuhan, the epicentre of the outbreak, noted that there was a daily shortage of 56,000 N95 masks and 41,000 protective suits in the city.
The scarcity of these items threatened China’s response in several ways. First, it increased the risks facing frontline staff. The Chinese representative at the press conference of the WHO-China Joint Mission on COVID-19 on 24 February pointed out that over 3,000 health workers were infected, with the vast majority of cases in Wuhan.
The need to hospitalise infected staff and quarantine the suspected ones aggravated the acute shortage of trained medical personnel and increased the already high level of stress of those still working in the hospitals. The inadequate supply of personal protective equipment and fatigue were likely contributing factors of infection among healthcare workers, according to the Chinese representative.
Second, the inability to provide adequate protection for frontline staff erodes public confidence in the government’s ability to tackle the epidemic successfully and thus undermines the efforts to contain the spread of the disease. In China, public concern over the safety of medical workers reached its peak as several medical professionals passed away in Wuhan within a few days in mid-February.
The adverse consequences of the shortage in China highlights the significance of international aid in supporting countries in their fight against the disease, and doing so in a sustainable manner.
International Donations to China
The surge in foreign contributions since late January has alleviated the shortage of key medical items in China. According to the Chinese Foreign Ministry, as of 14 February, over 50 countries and five international organisations have offered or promised to offer assistance in this regard.
Japan for instance was among the first countries that responded to China’s need, offering medical supplies, funds and support in different forms. Iran donated over one million masks and other essential items, with the first batch arriving on 1 February.
Singapore sent two batches of humanitarian aid which included three polymerase chain reaction (PCR) machines for screening COVID-19 patients and S$6 million in relief funds raised by the Singapore Red Cross, in addition to staple personal protective equipment items and sanitising and disinfecting agents. These have contributed meaningfully to China’s existing efforts.
Humanitarian Aid amid Pandemics
The challenge facing China in the initial phase of its response shows that an unexpected outbreak of infectious disease can lead to humanitarian needs in a country that is believed to have a well-functioning health system. As such, it is necessary for the international community, particularly the humanitarian system, to reconsider its preparedness for and response to humanitarian needs in epidemics, if not pandemics.
Because conflicts and extreme weather events have been seen as the primary causes of humanitarian emergencies, current humanitarian aid is geared towards such needs in these two settings, including medical supplies which primarily include essential and life-saving medicines as well as surgical and trauma kits.
Even though infectious diseases are considered as a growing risk of humanitarian emergencies, the focus has been on helping countries that have weak health systems and poor water and sanitation and lack access to vaccinations.
Conventional stocks of humanitarian aid as aforementioned are unable to meet the specific humanitarian needs in an outbreak due to the special characteristics of infectious diseases. For instance, in the case of COVID-19, not all types of masks but only surgical masks, N95 masks and the equivalent are effective for preventing the spread.
The COVID-19 outbreak serves as a reminder for the international humanitarian community to review its inventory of aid so as to be better equipped for similar situations in the future.
How Prepared is Our Humanitarian System?
With WHO having recently raised the global risk of COVID-19 spread to the highest level, the question arises as to how prepared is the humanitarian system in responding to multiple emergencies at such a massive scale all at the same time.
As more countries have seen a domestic outbreak, major donor countries may have to battle on two fronts, namely containing domestic outbreak and offering humanitarian aid to countries in need. China for instance dispatched medical experts and key medical supplies to Iran on 28 February, which was an early responder to China’s need in late January.
Moreover, the outbreak has significantly strained the supply chains of certain medical items and this has increased the difficulty to mobilise aid. As China is the primary manufacturer of many medical supplies, the shortage within China and the adverse impact of the containment policies on the Chinese economy has already disrupted the market.
This is worsened by the possibility of some governments tightening or even banning exports of certain medical items to meet domestic needs. It is therefore necessary to diversify the sources of key items of humanitarian aid amid a possible outbreak of pandemics, or even beforehand.
Facing the Future
The COVID-19 outbreak highlights the importance to prepare for a scenario that a public health emergency of international concern first occurs in a low-risk country and subsequently affects global response to other parts of the world. In such a scenario, countries face a shortage of key medical items and global response is constrained as key donor countries are preoccupied with domestic outbreaks.
To cope with such challenges, firstly, it is essential to strengthen preparedness at national and regional levels. Simulated exercises that involve governments, hospitals, the private sector and non-governmental organisations that play different roles in producing, mobilising, distributing and using key medical items are useful for preparing for future pandemics. Establishing and strengthening the infrastructure and networks for the storage and distribution of key items also contributes to more effective pandemic response.
Secondly, an anticipatory approach is needed. Mechanisms that translate early warning signals to mobilisation of human resources and proper stockpiling of key medical items should be put in place at national and regional levels. Early deployment of needs assessment team to communities that face the risk of outbreak and are willing to accept aid can better inform humanitarian response to pandemics.
Such expert teams can draw lessons from the work of the ASEAN Emergency Response and Assessment Teams in disaster management. Assessment results can facilitate timely adjustment of stockpiling of essential medicines, vaccines and medical equipment. In view of the growing connectivity and connectedness between countries, it is important that the international community and the humanitarian system plan and prepare for the future.
*Lina Gong is a Research Fellow with the Centre for Non-Traditional Security Studies (NTS Centre) at the S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University (NTU), Singapore.