Group items tagged

bloated, inefficient health-care system

Racist policies that have endured since the days of colonization and slavery left Indigenous and Black Americans especially vulnerable

decades-long process of shredding the nation’s social safety net

same social-media platforms that sowed partisanship and misinformation during the 2014 Ebola outbreak in Africa and the 2016 U.S. election became vectors for conspiracy theories

the COVID‑19 debacle has also touched—and implicated—nearly every other facet of American society: its shortsighted leadership, its disregard for expertise, its racial inequities, its social-media culture, and its fealty to a dangerous strain of individualism.

SARS‑CoV‑2 is neither as lethal as some other coronaviruses, such as SARS and MERS, nor as contagious as measles. Deadlier pathogens almost certainly exist. Wild animals harbor an estimated 40,000 unknown viruses, a quarter of which could potentially jump into humans. How will the U.S. fare when “we can’t even deal with a starter pandemic?,”

The U.S. cannot prepare for these inevitable crises if it returns to normal, as many of its people ache to do. Normal led to this. Normal was a world ever more prone to a pandemic but ever less ready for one. To avert another catastrophe, the U.S. needs to grapple with all the ways normal failed us

Many conservationists jump on epidemics as opportunities to ban the wildlife trade or the eating of “bush meat,” an exoticized term for “game,” but few diseases have emerged through either route. Carlson said the biggest factors behind spillovers are land-use change and climate change, both of which are hard to control. Our species has relentlessly expanded into previously wild spaces. Through intensive agriculture, habitat destruction, and rising temperatures, we have uprooted the planet’s animals, forcing them into new and narrower ranges that are on our own doorsteps. Humanity has squeezed the world’s wildlife in a crushing grip—and viruses have come bursting out.

This year, the world’s coronavirus experts—and there still aren’t many—had to postpone their triennial conference in the Netherlands because SARS‑CoV‑2 made flying too risky.

In 2003, China covered up the early spread of SARS, allowing the new disease to gain a foothold, and in 2020, history repeated itself. The Chinese government downplayed the possibility that SARS‑CoV‑2 was spreading among humans, and only confirmed as much on January 20, after millions had traveled around the country for the lunar new year. Doctors who tried to raise the alarm were censured and threatened. One, Li Wenliang, later died of COVID‑19. The World Health Organization initially parroted China’s line and did not declare a public-health emergency of international concern until January 30. By then, an estimated 10,000 people in 20 countries had been infected, and the virus was spreading fast.

it found a nation through which it could spread easily, without being detected

“By early February, we should have triggered a series of actions, precisely zero of which were taken.”

Even after warnings reached the U.S., they fell on the wrong ears. Since before his election, Trump has cavalierly dismissed expertise and evidence. He filled his administration with inexperienced newcomers, while depicting career civil servants as part of a “deep state.” In 2018, he dismantled an office that had been assembled specifically to prepare for nascent pandemics. American intelligence agencies warned about the coronavirus threat in January, but Trump habitually disregards intelligence briefings. The secretary of health and human services, Alex Azar, offered similar counsel, and was twice ignored.

countries “rely on bans to the exclusion of the things they actually need to do—testing, tracing, building up the health system,”

genetic evidence shows that the specific viruses that triggered the first big outbreaks, in Washington State, didn’t land until mid-February. The country could have used that time to prepare. Instead, Trump, who had spent his entire presidency learning that he could say whatever he wanted without consequence, assured Americans that “the coronavirus is very much under control,” and “like a miracle, it will disappear.” With impunity, Trump lied. With impunity, the virus spread.

A study showed that the U.S. could have averted 36,000 COVID‑19 deaths if leaders had enacted social-distancing measures just a week earlier. But better late than never: By collectively reducing the spread of the virus, America flattened the curve. Ventilators didn’t run out, as they had in parts of Italy. Hospitals had time to add extra beds.

Tests were in such short supply, and the criteria for getting them were so laughably stringent, that by the end of February, tens of thousands of Americans had likely been infected but only hundreds had been tested.

Sabeti’s lab developed a diagnostic test in mid-January and sent it to colleagues in Nigeria, Sierra Leone, and Senegal. “We had working diagnostics in those countries well before we did in any U.S. states,”

In response to the global energy crisis of the 1970s, architects made structures more energy-efficient by sealing them off from outdoor air, reducing ventilation rates. Pollutants and pathogens built up indoors, “ushering in the era of ‘sick buildings,’ ” says Joseph Allen, who studies environmental health at Harvard’s T. H. Chan School of Public Health. Energy efficiency is a pillar of modern climate policy, but there are ways to achieve it without sacrificing well-being. “We lost our way over the years and stopped designing buildings for people,”

The indoor spaces in which Americans spend 87 percent of their time became staging grounds for super-spreading events. One study showed that the odds of catching the virus from an infected person are roughly 19 times higher indoors than in open air. Shielded from the elements and among crowds clustered in prolonged proximity, the coronavirus ran rampant in the conference rooms of a Boston hotel, the cabins of the Diamond Princess cruise ship, and a church hall in Washington State where a choir practiced for just a few hours.

Between harsher punishments doled out in the War on Drugs and a tough-on-crime mindset that prizes retribution over rehabilitation, America’s incarcerated population has swelled sevenfold since the 1970s, to about 2.3 million. The U.S. imprisons five to 18 times more people per capita than other Western democracies. Many American prisons are packed beyond capacity, making social distancing impossible. Soap is often scarce. Inevitably, the coronavirus ran amok. By June, two American prisons each accounted for more cases than all of New Zealand. One, Marion Correctional Institution, in Ohio, had more than 2,000 cases among inmates despite having a capacity of 1,500.

America’s nursing homes and long-term-care facilities house less than 1 percent of its people, but as of mid-June, they accounted for 40 percent of its coronavirus deaths. More than 50,000 residents and staff have died. At least 250,000 more have been infected. These grim figures are a reflection not just of the greater harms that COVID‑19 inflicts upon elderly physiology, but also of the care the elderly receive. Before the pandemic, three in four nursing homes were understaffed, and four in five had recently been cited for failures in infection control. The Trump administration’s policies have exacerbated the problem by reducing the influx of immigrants, who make up a quarter of long-term caregivers.

the Department of Health and Human Services paused nursing-home inspections in March, passing the buck to the states. Some nursing homes avoided the virus because their owners immediately stopped visitations, or paid caregivers to live on-site. But in others, staff stopped working, scared about infecting their charges or becoming infected themselves. In some cases, residents had to be evacuated because no one showed up to care for them.

its problematic attitude toward health: “Get hospitals ready and wait for sick people to show,” as Sheila Davis, the CEO of the nonprofit Partners in Health, puts it. “Especially in the beginning, we catered our entire [COVID‑19] response to the 20 percent of people who required hospitalization, rather than preventing transmission in the community.” The latter is the job of the public-health system, which prevents sickness in populations instead of merely treating it in individuals. That system pairs uneasily with a national temperament that views health as a matter of personal responsibility rather than a collective good.

“As public health did its job, it became a target” of budget cuts,

Today, the U.S. spends just 2.5 percent of its gigantic health-care budget on public health. Underfunded health departments were already struggling to deal with opioid addiction, climbing obesity rates, contaminated water, and easily preventable diseases. Last year saw the most measles cases since 1992. In 2018, the U.S. had 115,000 cases of syphilis and 580,000 cases of gonorrhea—numbers not seen in almost three decades. It has 1.7 million cases of chlamydia, the highest number ever recorded.

In May, Maryland Governor Larry Hogan asserted that his state would soon have enough people to trace 10,000 contacts every day. Last year, as Ebola tore through the Democratic Republic of Congo—a country with a quarter of Maryland’s wealth and an active war zone—local health workers and the WHO traced twice as many people.

Compared with the average wealthy nation, America spends nearly twice as much of its national wealth on health care, about a quarter of which is wasted on inefficient care, unnecessary treatments, and administrative chicanery. The U.S. gets little bang for its exorbitant buck. It has the lowest life-expectancy rate of comparable countries, the highest rates of chronic disease, and the fewest doctors per person. This profit-driven system has scant incentive to invest in spare beds, stockpiled supplies, peacetime drills, and layered contingency plans—the essence of pandemic preparedness. America’s hospitals have been pruned and stretched by market forces to run close to full capacity, with little ability to adapt in a crisis.

“We’re designed for discrete disasters” like mass shootings, traffic pileups, and hurricanes, says Esther Choo, an emergency physician at Oregon Health and Science University. The COVID‑19 pandemic is not a discrete disaster. It is a 50-state catastrophe that will likely continue at least until a vaccine is ready.

American hospitals operate on a just-in-time economy. They acquire the goods they need in the moment through labyrinthine supply chains that wrap around the world in tangled lines, from countries with cheap labor to richer nations like the U.S. The lines are invisible until they snap. About half of the world’s face masks, for example, are made in China, some of them in Hubei province. When that region became the pandemic epicenter, the mask supply shriveled just as global demand spiked. The Trump administration turned to a larder of medical supplies called the Strategic National Stockpile, only to find that the 100 million respirators and masks that had been dispersed during the 2009 flu pandemic were never replaced. Just 13 million respirators were left.

The supply of nasopharyngeal swabs that are used in every diagnostic test also ran low, because one of the largest manufacturers is based in Lombardy, Italy—initially the COVID‑19 capital of Europe. About 40 percent of critical-care drugs, including antibiotics and painkillers, became scarce because they depend on manufacturing lines that begin in China and India. Once a vaccine is ready, there might not be enough vials to put it in, because of the long-running global shortage of medical-grade glass—literally, a bottle-neck bottleneck.

As usual, health care was a matter of capitalism and connections. In New York, rich hospitals bought their way out of their protective-equipment shortfall, while neighbors in poorer, more diverse parts of the city rationed their supplies.

Travel bans make intuitive sense, because travel obviously enables the spread of a virus. But in practice, travel bans are woefully inefficient at restricting either travel or viruses. They prompt people to seek indirect routes via third-party countries, or to deliberately hide their symptoms. They are often porous: Trump’s included numerous exceptions, and allowed tens of thousands of people to enter from China. Ironically, they create travel: When Trump later announced a ban on flights from continental Europe, a surge of travelers packed America’s airports in a rush to beat the incoming restrictions. Travel bans may sometimes work for remote island nations, but in general they can only delay the spread of an epidemic—not stop it.

the indiscriminate lockdown was necessary only because America’s leaders wasted months of prep time. Deploying this blunt policy instrument came at enormous cost. Unemployment rose to 14.7 percent, the highest level since record-keeping began, in 1948. More than 26 million people lost their jobs, a catastrophe in a country that—uniquely and absurdly—ties health care to employment

In the middle of the greatest health and economic crises in generations, millions of Americans have found themselves disconnected from medical care and impoverished. They join the millions who have always lived that way.

Elderly people, already pushed to the fringes of society, were treated as acceptable losses. Women were more likely to lose jobs than men, and also shouldered extra burdens of child care and domestic work, while facing rising rates of domestic violence. In half of the states, people with dementia and intellectual disabilities faced policies that threatened to deny them access to lifesaving ventilators. Thousands of people endured months of COVID‑19 symptoms that resembled those of chronic postviral illnesses, only to be told that their devastating symptoms were in their head. Latinos were three times as likely to be infected as white people. Asian Americans faced racist abuse. Far from being a “great equalizer,” the pandemic fell unevenly upon the U.S., taking advantage of injustices that had been brewing throughout the nation’s history.

Of the 3.1 million Americans who still cannot afford health insurance in states where Medicaid has not been expanded, more than half are people of color, and 30 percent are Black.* This is no accident. In the decades after the Civil War, the white leaders of former slave states deliberately withheld health care from Black Americans, apportioning medicine more according to the logic of Jim Crow than Hippocrates. They built hospitals away from Black communities, segregated Black patients into separate wings, and blocked Black students from medical school. In the 20th century, they helped construct America’s system of private, employer-based insurance, which has kept many Black people from receiving adequate medical treatment. They fought every attempt to improve Black people’s access to health care, from the creation of Medicare and Medicaid in the ’60s to the passage of the Affordable Care Act in 2010.

A number of former slave states also have among the lowest investments in public health, the lowest quality of medical care, the highest proportions of Black citizens, and the greatest racial divides in health outcomes

As of early July, one in every 1,450 Black Americans had died from COVID‑19—a rate more than twice that of white Americans. That figure is both tragic and wholly expected given the mountain of medical disadvantages that Black people face

Native Americans were similarly vulnerable. A third of the people in the Navajo Nation can’t easily wash their hands, because they’ve been embroiled in long-running negotiations over the rights to the water on their own lands. Those with water must contend with runoff from uranium mines. Most live in cramped multigenerational homes, far from the few hospitals that service a 17-million-acre reservation. As of mid-May, the Navajo Nation had higher rates of COVID‑19 infections than any U.S. state.

Americans often misperceive historical inequities as personal failures

the largely unregulated, social-media-based communications infrastructure of the 21st century almost ensures that misinformation will proliferate fast. “In every outbreak throughout the existence of social media, from Zika to Ebola, conspiratorial communities immediately spread their content about how it’s all caused by some government or pharmaceutical company or Bill Gates,”

Rumors coursed through online platforms that are designed to keep users engaged, even if that means feeding them content that is polarizing or untrue. In a national crisis, when people need to act in concert, this is calamitous. “The social internet as a system is broken,” DiResta told me, and its faults are readily abused.

Like pandemics, infodemics quickly become uncontrollable unless caught early.

In 2016, when DiResta spoke with a CDC team about the threat of misinformation, “their response was: ‘ That’s interesting, but that’s just stuff that happens on the internet.’ ”

The WHO, the CDC, and the U.S. surgeon general urged people not to wear masks, hoping to preserve the limited stocks for health-care workers. These messages were offered without nuance or acknowledgement of uncertainty, so when they were reversed—the virus is worse than the flu; wear masks—the changes seemed like befuddling flip-flops.

the United States underperformed across the board, and its errors compounded. The dearth of tests allowed unconfirmed cases to create still more cases, which flooded the hospitals, which ran out of masks, which are necessary to limit the virus’s spread. Twitter amplified Trump’s misleading messages, which raised fear and anxiety among people, which led them to spend more time scouring for information on Twitter.

By tying career advancement to the publishing of papers, academia already creates incentives for scientists to do attention-grabbing but irreproducible work. The pandemic strengthened those incentives by prompting a rush of panicked research and promising ambitious scientists global attention.

In March, a small and severely flawed French study suggested that the antimalarial drug hydroxychloroquine could treat COVID‑19. Published in a minor journal, it likely would have been ignored a decade ago. But in 2020, it wended its way to Donald Trump via a chain of credulity that included Fox News, Elon Musk, and Dr. Oz. Trump spent months touting the drug as a miracle cure despite mounting evidence to the contrary, causing shortages for people who actually needed it to treat lupus and rheumatoid arthritis. The hydroxychloroquine story was muddied even further by a study published in a top medical journal, The Lancet, that claimed the drug was not effective and was potentially harmful. The paper relied on suspect data from a small analytics company called Surgisphere, and was retracted in June.**

Science famously self-corrects. But during the pandemic, the same urgent pace that has produced valuable knowledge at record speed has also sent sloppy claims around the world before anyone could even raise a skeptical eyebrow.

No one should be shocked that a liar who has made almost 20,000 false or misleading claims during his presidency would lie about whether the U.S. had the pandemic under control; that a racist who gave birth to birtherism would do little to stop a virus that was disproportionately killing Black people; that a xenophobe who presided over the creation of new immigrant-detention centers would order meatpacking plants with a substantial immigrant workforce to remain open; that a cruel man devoid of empathy would fail to calm fearful citizens; that a narcissist who cannot stand to be upstaged would refuse to tap the deep well of experts at his disposal; that a scion of nepotism would hand control of a shadow coronavirus task force to his unqualified son-in-law; that an armchair polymath would claim to have a “natural ability” at medicine and display it by wondering out loud about the curative potential of injecting disinfectant; that an egotist incapable of admitting failure would try to distract from his greatest one by blaming China, defunding the WHO, and promoting miracle drugs; or that a president who has been shielded by his party from any shred of accountability would say, when asked about the lack of testing, “I don’t take any responsibility at all.”

Trump is a comorbidity of the COVID‑19 pandemic. He isn’t solely responsible for America’s fiasco, but he is central to it. A pandemic demands the coordinated efforts of dozens of agencies. “In the best circumstances, it’s hard to make the bureaucracy move quickly,” Ron Klain said. “It moves if the president stands on a table and says, ‘Move quickly.’ But it really doesn’t move if he’s sitting at his desk saying it’s not a big deal.”

everyday Americans did more than the White House. By voluntarily agreeing to months of social distancing, they bought the country time, at substantial cost to their financial and mental well-being. Their sacrifice came with an implicit social contract—that the government would use the valuable time to mobilize an extraordinary, energetic effort to suppress the virus, as did the likes of Germany and Singapore. But the government did not, to the bafflement of health experts. “There are instances in history where humanity has really moved mountains to defeat infectious diseases,” says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “It’s appalling that we in the U.S. have not summoned that energy around COVID‑19.”

People suffered all the debilitating effects of a lockdown with few of the benefits. Most states felt compelled to reopen without accruing enough tests or contact tracers. In April and May, the nation was stuck on a terrible plateau, averaging 20,000 to 30,000 new cases every day. In June, the plateau again became an upward slope, soaring to record-breaking heights.

It is no coincidence that other powerful nations that elected populist leaders—Brazil, Russia, India, and the United Kingdom—also fumbled their response to COVID‑19. “When you have people elected based on undermining trust in the government, what happens when trust is what you need the most?”

Drawn to novelty, journalists gave oxygen to fringe anti-lockdown protests while most Americans quietly stayed home. They wrote up every incremental scientific claim, even those that hadn’t been verified or peer-reviewed.

The virus was never beaten in the spring, but many people, including Trump, pretended that it was. Every state reopened to varying degrees, and many subsequently saw record numbers of cases. After Arizona’s cases started climbing sharply at the end of May, Cara Christ, the director of the state’s health-services department, said, “We are not going to be able to stop the spread. And so we can’t stop living as well.” The virus may beg to differ.

The long wait for a vaccine will likely culminate in a predictable way: Many Americans will refuse to get it, and among those who want it, the most vulnerable will be last in line.

It is almost unheard-of for a public-health measure to go from zero to majority acceptance in less than half a year. But pandemics are rare situations when “people are desperate for guidelines and rules,” says Zoë McLaren, a health-policy professor at the University of Maryland at Baltimore County. The closest analogy is pregnancy, she says, which is “a time when women’s lives are changing, and they can absorb a ton of information. A pandemic is similar: People are actually paying attention, and learning.”

As the economy nose-dived, the health-care system ailed, and the government fumbled, belief in American exceptionalism declined. “Times of big social disruption call into question things we thought were normal and standard,” Redbird told me. “If our institutions fail us here, in what ways are they failing elsewhere?” And whom are they failing the most?

It is hard to stare directly at the biggest problems of our age. Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. We have no choice, though, but to grapple with them. It is now abundantly clear what happens when global disasters collide with historical negligence.

America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.

the hype around the disarmament of Colombia’s largest guerrilla group was short-lived. The government couldn’t effectively occupy the territories where former fighters operated, providing combatants with another opportunity to join dissident groups or create new groups with the aim of taking over illegal trades.

Residents of the western department of Chocó are particularly vulnerable to displacement by armed groups. Deserted jungles and a network of rivers running to the Pacific Ocean make it a profitable region for illegal trades such as mining and drug trafficking, and a hotbed of conflict between armed groups including the ELN and the Gaitanista Self-Defence Forces of Colombia.

The statements by armed groups apparently siding with the government and threatening to enforce the curfew not only intimidate residents, but also compromise the credibility of the authorities. “They are trying to supplant the authorities,” said Col. Henry Galán of the Chocó police department

Cauca is a remote and mountainous region on Colombia’s Pacific coast with limited state presence, where ethnic Indigenous communities have a long history of organizing themselves. “Everyone knows that if that disease reaches us, there is no possibility of survival because there is no medical infrastructure,” said Lisifrey Ararat, a leader from the town of Suárez. For Ararat and other leaders, the lack of hospitals, telecommunications, roads, and infrastructure in their region puts their communities at higher risk—forcing them to make difficult decisions such as placing biosecurity checkpoints and sealing off outsiders. Such measures have increased tensions with armed groups which fight to control the region, and further isolated the communities from basic health services and food supplies.

Waters has no health insurance when he’s back in the U.S. (even as a nurse). Working on the front lines during a global pandemic is probably not the best place for an uninsured nurse. Like most expats, Waters has private health insurance that will cover him in literally any country in the world… except the U.S.

David’s visa is entirely tied to his job, which he fears will be axed soon in a country economically crushed by this pandemic. He could theoretically apply for other jobs before his visa expires, but not in reality. “The police won’t even let me leave my house!” If he loses his job, he’ll be forced to go home, though he hasn’t a clue where “home” would be. That and he would have no job, place to live, or health insurance. 

The uncertainty around visas is also hard on couples and families who have visas tied exclusively to their relationship, even though these are oftentimes the most secure ones to have

“Immigrants are the ones blamed during economically hard times,” says Schober, “and people look for a scapegoat.” It’s pretty universal for humans to have less compassion for people they don’t have something in common with, he says, so foreigners around the world are often the most vulnerable.

Immigration lawyer Diana Moller of Seattle says she’s concerned about green card holders who are stuck abroad. Legally, they can return to the U.S., but many are under lockdown due to the virus. In order for them to apply for citizenship, they can’t be overseas for long. “If a client is outside the U.S. more than six months, their continuous physical presence is at risk of being broken.” If they’re gone for a year, they’ll have to wait four years and one day before eligible again for citizenship.

Before any of the virus chaos started, the U.S. has notoriously made it hard for many (not rich) foreigners to live, work, or permanently immigrate here, but the pandemic has led some to just abandon ship entirely and go home.

Stéphane’s most recent visa was up for renewal again this spring, but the pandemic forced him and his wife to consider the risk of him losing his work contract, thus being locked into NYC illegally with no job, no way to pay rent, and no health insurance. “The U.S. looked like the worst place to be an illegal immigrant,” he says—especially during a pandemic. So he gave up the American life he spent five years building and took his family back to France, even though it means he’s now starting over. “The French health care/social net is way better and higher education is relatively cheap and good quality,”

Like every single American I spoke with, Sarah is pretty scared of getting sick in the U.S. due to lack of good insurance. “Honestly, my life would have been so much easier if me and my boyfriend had just gotten married two years ago,” like they’d considered. France is her home but she’s not allowed there any time soon. “I wish I’d just stayed in France.” She would have been illegal until getting married, but she would have at least been with him. And insured. 

“A good thing about having an ineffective Congress is that immigration changes are slow,” says Schober. “They can never agree on anything.”

important to remember that people working in immigration are doing their best to care for such a vulnerable group of people right now. Some are even putting their lives and health at risk to show up at court for their clients. Schober says it’s especially important to remember that the present situation will take a lot of patience from both the attorney and client. But for now, it’s a waiting game for millions of people in limbo around the world, all wondering if the countries they have built their lives in will soon change the rules and make them return home… wherever that is. 

Total global foreign direct investment has not returned to its highs more than a decade ago.

globalization is complex, and not every indicator points in the same direction. The intensity of trade in goods is down, but in services it’s up. The flow of data across borders has risen dramatically, even as countries like China and Iran seek to restrict it. International travel and study abroad were at all-time highs before the coronavirus pandemic

Globalization is often blamed for financial crises—not only the global one of 2008, but also the 1997 Asian crisis and others in Russia, Turkey, Ecuador, Cyprus and elsewhere

expanded inequality both among nations and within them

consume more energy and produce higher greenhouse-gas emissions

since 2003, the world has seen successive outbreaks of SARS, swine flu, MERS, Ebola, and the Zika virus

many of those benefits are diffuse and taken for granted, while the costs—lost manufacturing jobs, for instance—remain concentrated. And those on the losing end of globalization now have a new political voice: populist parties promising sovereignty, nationalism, and local solutions, as well as a weakening of elite-led, seemingly unaccountable international institutions

Many see COVID-19 not as a cause around which the world’s governments should rally, but rather as the most dramatic example of an already broken globalized system.

it is easy to imagine governments around the world broadly rethinking international travel, migration, supply-chain risk, export controls, information sharing, and more—in short, key components of globalization itself. The new watchword is likely to be risk reduction rather than cost reduction.

Fragile supply chains are not an indictment of globalization per se, but of the way companies have become dependent on single sources of supply

economic integration will still take place, but it will continue to shift from the global to the regional and bilateral level

How to protect workers without undermining globalization’s economic benefits, including a higher standard of living, remains an unsolved question.

Closed borders, travel bans, paralyzed supply chains, and export restrictions have prompted many to ask whether globalization itself might fall victim to the coronavirus.

globalization was already in decline well before the outbreak, having reached its peak before the 2008 global financial crisis and having never recovered since then

The worldwide interconnectedness of goods, services, capital, people, data, and ideas has produced undeniable benefits. But during this pandemic, the risks of dependency have fully entered the public consciousness

the pandemic has demonstrated the fragility of supply chains, prompted national responses rather than cooperative international ones, and reinforced nationalist arguments for reshoring manufacturing and more limited migration

“You have an increase in economic inequality, stigma, separation from family, the death of family members,” she said, “all of which are well established risk factors for trafficking, and all of which are also the results of both major and localized outbreaks.” The influx of UN peacekeepers (as seen during local and regional outbreaks such as yellow fever in Brazil and Lassa fever in Nigeria) poses an additional risk,

funding cuts may be exacerbating the very thing that anti-trafficking actors are working to confront: Earlier this month, the World Food Program was forced to slash its food distribution programs by up to 50 percent in trafficking hot spots including conflict-stricken Yemen and refugee camps in Uganda, positioning already socially and economically vulnerable communities on even shakier ground

Restrictions on movement during the coronavirus pandemic won’t stop trafficking. Millions of people are still in captivity, and it’s a common misconception that trafficking must involve crossing international borders.

numerous leading humanitarian organizations have no specialized anti-trafficking training available for their staff members. Others are still discussing and debating their strategies—months into the pandemic and at a time when international lockdowns mean an estimated 75 percent of humanitarian operations are temporarily on pause.

“Trafficking data is unreliable, and so is outbreak data,”

Within two and a half years of the first diagnosis of Ebola in 2014, more than 11,000 people in Guinea, Liberia, and Sierra Leone had died after contracting the virus, and over 16,000 children had lost one or both of their parents. Child sexual exploitation soared: the United Nations Development Program reported that teenage pregnancy increased by 65 percent during the outbreak in Sierra Leone, while research by Plan International, World Vision and Save The Children revealed 10 percent of young people knew of girls who were being forced into prostitution following the loss of a family member. The U.S. Department of State also acknowledged in its 2016 Trafficking In Persons Report that governmental anti-trafficking activities were on pause in Ebola-affected countries—leaving thousands of people at risk.

despite reports of trafficking during the pandemic, governments are redirecting resources away from counter-trafficking activities—placing added pressure on the humanitarian sector to step up

“It’s what happens when people don’t have livelihoods, don’t have social support, cannot afford health care, cannot afford child care. Even in normal circumstances we would say we need to address the factors that make people vulnerable to trafficking. This pandemic has made these things very obvious.”

It may not be possible to predict exactly when an outbreak such as the coronavirus will strike, but it’s not the first time a crisis has seen family structures collapse and left vulnerable groups at risk of exploitation. “It concerns me that this trafficking risk is not being integrated in any systematic way to humanitarian response plans right now,”

Because states often go to war out of sense of overconfidence (however misplaced it sometimes turns out to be), pandemic-induced pessimism should be conducive to peace.

even an impulsive and headstrong warmaker like Saudi Arabia’s Mohammed bin Salman has gotten more interested in winding down his brutal and unsuccessful military campaign in Yemen.

One familiar argument is the so-called diversionary (or “scapegoat”) theory of war. It suggests that leaders who are worried about their popularity at home will try to divert attention from their failures by provoking a crisis with a foreign power and maybe even using force against it. Drawing on this logic, some Americans now worry that President Donald Trump will decide to attack a country like Iran or Venezuela in the run-up to the presidential election and especially if he thinks he’s likely to lose.

This outcome strikes me as unlikely, even if one ignores the logical and empirical flaws in the theory itself. War is always a gamble, and should things go badly—even a little bit—it would hammer the last nail in the coffin of Trump’s declining fortunes. Moreover, none of the countries Trump might consider going after pose an imminent threat to U.S. security, and even his staunchest supporters may wonder why he is wasting time and money going after Iran or Venezuela at a moment when thousands of Americans are dying preventable deaths at home

states do not start wars unless they believe they will win a quick and relatively cheap victory. As John Mearsheimer showed in his classic book Conventional Deterrence, national leaders avoid war when they are convinced it will be long, bloody, costly, and uncertain. To choose war, political leaders have to convince themselves they can either win a quick, cheap, and decisive victory or achieve some limited objective at low cost. Europe went to war in 1914 with each side believing it would win a rapid and easy victory, and Nazi Germany developed the strategy of blitzkrieg in order to subdue its foes as quickly and cheaply as possible. Iraq attacked Iran in 1980 because Saddam believed the Islamic Republic was in disarray and would be easy to defeat, and George W. Bush invaded Iraq in 2003 convinced the war would be short, successful, and pay for itself.

Another familiar folk theory is “military Keynesianism.” War generates a lot of economic demand, and it can sometimes lift depressed economies out of the doldrums and back toward prosperity and full employment. The obvious case in point here is World War II, which did help the U.S economy finally escape the quicksand of the Great Depression. Those who are convinced that great powers go to war primarily to keep Big Business (or the arms industry) happy are naturally drawn to this sort of argument, and they might worry that governments looking at bleak economic forecasts will try to restart their economies through some sort of military adventure. I doubt it. It takes a really big war to generate a significant stimulus, and it is hard to imagine any country launching a large-scale war—with all its attendant risks—at a moment when debt levels are already soaring

Economic downturns can encourage war in some special circumstances, especially when a war would enable a country facing severe hardships to capture something of immediate and significant value. Saddam Hussein’s decision to seize Kuwait in 1990 fits this model perfectly:

Even conquering an oil-rich country—the sort of greedy acquisitiveness that Trump occasionally hints at—doesn’t look attractive when there’s a vast glut on the market

a sustained economic depression could make war more likely by strengthening fascist or xenophobic political movements, fueling protectionism and hypernationalism, and making it more difficult for countries to reach mutually acceptable bargains with each other

Nationalism, xenophobia, and authoritarian rule were making a comeback well before COVID-19 struck, but the economic misery now occurring in every corner of the world could intensify these trends and leave us in a more war-prone condition when fear of the virus has diminished.

launching a war has to be one of the least efficient methods available. The threat of war usually spooks investors too, which any politician with their eye on the stock market would be loath to do

The bottom line: Economic conditions (i.e., a depression) may affect the broader political environment in which decisions for war or peace are made, but they are only one factor among many and rarely the most significant. Even if the COVID-19 pandemic has large, lasting, and negative effects on the world economy—as seems quite likely—it is not likely to affect the probability of war very much, especially in the short term.

I can’t rule out another powerful cause of war—stupidity—especially when it is so much in evidence in some quarters these days

Former President George W. Bush explicitly stated that the United States was not at war with Islam, but nativist voices embraced the clash of civilizations narrative, and the ensuing war on “Islamic terrorism” enabled and perpetuated Islamophobia at home and abroad

while both terrorism and the coronavirus are themselves nonhuman entities, their invocation as foes has fueled dangerous xenophobia with very human consequences

one of the key lessons of the 9/11 period is the ease of viewing the military as the tool of first resort, despite its powerlessness in solving political or humanitarian problems

neither the coronavirus response nor the war on terrorism created xenophobia; rather, they exacerbated existing prejudices and inequities

another pair of post-9/11 measures that are once again on the table: an increase in what the government knows about the public and a decrease in what the public knows about the government.

Data-mining firms like Palantir already have contracts in place with the Centers for Disease Control and Prevention and the National Institutes of Health. Some U.S. analysts argue that the coronavirus vindicates the highly surveilled Chinese internet. Others have urged the adoption of tracking methods similar to those used by the government of Singapore, pointing out that U.S. governors can use post-9/11 legislation to force citizens to comply.

the 9/11 era showed that government surveillance—especially when implemented hastily—has the tendency to expand inertially. The Patriot Act’s scope grew in the years after its adoption, resulting in the mass collection of millions of Americans’ metadata (which a government oversight board later deemed not only illegal but also of minimal effectiveness in fighting terrorism). That law has also been applied well beyond its initial counterterrorism intent, including in cases of mortgage and food-stamp fraud.

The post-9/11 era was rife with anti-democratic secrecy, and today, the executive branch is again claiming emergency powers to evade accountability. Trump used the coronavirus as a pretext for suspending immigration—not for health reasons but, he claimed, to prevent competition from immigrant labor. He also decapitated the watchdog panel tasked with overseeing $2.2 trillion in economic relief and named a partisan ally to fill a critical inspector general role. In a haunting echo of the post-9/11 era’s habeas corpus debates, last month the Justice Department requested authorization from Congress to be able to detain Americans indefinitely during a state of emergency such as a pandemic.

Free flows of news and information create political pressure to make smart and life-saving decisions. Policymakers avoid corruption if they know their constituents are watching. By clamping down on hallmarks of democratic accountability, post-9/11 policies curtailed valuable liberties while making the United States less safe

On a planet that shares a single atmosphere, concepts like "here" and "there" are misleading. The steak we eat "here" threatens a farmer’s harvest "there". The plane someone catches "there" makes the water levels rise "here".

Each and every individual, organisation and country that reduces its carbon footprint is a small but indispensable link in the fight against global warming. Eventually, we will reach the tipping point: so many people will have switched to zero-carbon energy sources that fossil fuels will be "overcome".

The elderly, people of colour, immigrants, low-educated adults, people in debt, people on lower incomes, people in developing countries, refugees, the uninsured, the unemployed: all these groups have an above-average risk of falling prey to this pandemic, both physically and socio-economically

those who contribute least to the climate crisis are most severely affected by it – and vice versa

a sustainable society is not a pandemic bunker. The similarity is that the change that is needed will affect every aspect of society. There really isn’t an app for it.

The coronavirus pandemic shows that “keeping distance” and similar measures are primarily for the privileged, only available to people who “can afford to retreat in individualism”, as OluTimehin Adegbeye, our correspondent in Nigeria, put it so powerfully.

These flaws are more visible now than ever before. The way we deal with animals is untenable. Patent laws in the pharmaceutical industry pose a real threat to public health. The fossil fuel industry, like the financial sector, is only able to exist by the grace of privatised profits and socialised losses.

the unequal distribution of the climate emergency is a crisis in its own right.

Continuing to see Earth as an infinite resource and the sky above us as an infinite garbage bin, in order to artificially boost quarterly profits, with CEOs sitting in reality-proofed boardrooms comparing the size of their bonuses while begging for taxpayer bailouts but refusing to pay taxes themselves: no, that’s a “normal” we simply can’t afford going back to.

Thousands of deaths and intensive care units (ICUs) flooded with patients struggling to breathe cannot be denied for very long, even by the most persistent manufacturers of alternative facts – unlike climate refugees (“fortune seekers!”), loss of biodiversity (“the dinosaurs died out too, right?”), and global warming itself (“temperatures have risen before!”).

we are, in fact, capable of bringing about sweeping societal change to protect us all. Now is the time to resolve not one crisis but two. Starting with sustainable spending of the trillions (!) being allocated to coronavirus-related measures right now.

No government bailouts for fossil industries without an exit strategy towards a zero-carbon business model within 30 years. No government bailouts for companies with primary bank accounts in tax havens. And even more government funding for truly sustainable alternatives. How about giving that a try?

Despite testing far less than its neighbors, Somalia has the highest death toll in East Africa. On April 17 and 18, 72 people were tested, out of which 55 were confirmed positive, a staggering 76 percent infection rate. Since this revelation, the Somali government has stopped sharing the numbers of people tested with the public.

Anecdotal accounts of COVID-19 symptoms and a spike in burials abound. “There is extraordinary community transmission. Infections and deaths are out of control,” explained a Mogadishu doctor on the condition of anonymity. “And why visit a hospital if they can’t treat you?” Somalia’s health infrastructure is mere scaffolding: scarce public hospitals struggling with a lack of equipment, unaccredited doctors in private facilities offering unaffordable services, and medication that is as low-grade as it is scarce.

Somalia’s best-equipped medical institution, Erdogan Hospital in Mogadishu, was shut down in April after 3 of its doctors were infected. Martini Hospital—kitted with 76 beds—is the only medical facility in the whole country designated to treat the infected

Answers to this acute health crisis lie in part with the government’s 2020 budget, which allocated $9.4 million for health spending, a mere 2 percent of the national budget. A whopping $146.8 million was reserved for security institutions—a telling indication of a cash-strapped state facing widespread security threats.

The group heralded the disease as divine punishment for the treatment of Muslims globally. Weaponizing the disease, al-Shabab ushered in Ramadan with an attempted vehicle-borne explosive attack at a military base on the first full day of the holy month.

Like the virus, al-Shabab transcends national borders and presents risks not only to Somalia but to its pandemic-weakened neighbors, particularly Kenya, which has weathered violent attacks from the group for years. Born out of a power vacuum itself, al-Shabab will capitalize on lapses in states’ security apparatus as governments redirect resources from preempting terror attacks to enforcing curfews

risks reversing critical security gains

Kenya’s northeastern towns lying on its border with Somalia have been particularly vulnerable to devastating al-Shabab attacks. In response to the illegal smuggling of people and goods from both Somalia and Ethiopia, Kenyan security authorities have recently ramped up aerial surveillance along its borders, in part, to curtail cross-border infection. Ethiopia’s health minister announced last week that 13 of its new cases were imported via illegal migration from Djibouti and Somalia

More than 80 percent of global trade passes through the Gulf of Aden

the resurgence of piracy can be expected

For more than a year now, the central government has been embroiled in a rancorous fight with two of its federal states. This being an election year, the fledgling Somali state finds itself at a critical juncture. It remains to be seen whether federal elections will be postponed, following in the footsteps of neighboring Ethiopia.

The disappearance of remittances—a lifeline for millions on the continent and estimated at $1.4 to $2 billion annually in Somalia alone—makes the situation all the more desperate. These critical cash flows have dried up as a global recession sets in and incomes of workers in the diaspora shrink.

harrowing statistics from across Europe show that Somali communities have been disproportionately affected by COVID-19. In Sweden, Somalis are dying from the virus at “an astonishing high rate” according to the BMJ despite accounting for only 0.69 percent of the population. The World Bank is calling on governments to designate remittance companies as an essential service, a crucial step to easing restrictions on these financial flows.

The populations most at risk in Somalia are those living in the densely populated camps scattered across the country. More than 2.5 million internally displaced people live in these cramped conditions, already weakened by malnutrition and compromised immune systems, and with limited access to clean water, soap, or bathrooms.

According to the World Food Programme, the number of food-insecure people in East Africa is projected to reach up to 43 million in the next few months—more than double what it is now—sparking fears of conflict over scarce resources.

The specter of drought and famine, alongside the unforgiving plague of locusts that has ravaged crops in recent months

deadly flash floods

will force more people to move, compounding the internal displacement crisis and heightening intercommunal tensions  even as it spreads the disease further

Border closures across the region have throttled migration flows, making it ever harder for people to escape conflict or starvation. This will simply force migration into the shadows, opening up avenues for human trafficking and exploitation. Irregular movement of refugees has already been observed across the Horn of Africa’s highly porous borders.

During  Friday prayers at Mogadishu’s Marwazi mosque on April 10, armed forces tried to forcibly disperse a congregation of worshippers without notice. A massive demonstration broke out, and shoulder-to-shoulder prayers continue across the country today

Riots swept the streets of Mogadishu again on April 24 in response to the fatal shooting of two innocent civilians by police as they tried to enforce a curfew. Ramadan, replete with nightly rounds of public taraweeh prayers, is likely to catalyze disease spread in the absence of clear communication with communities and Islamic leaders.

The virus demands self-sufficiency. Countries are forced to make do with their own systems, however broken.

government’s restrictions on press freedom and access to information about the novel coronavirus to the detriment of its own people

As has often been the case in the disaster-prone country, it will be up to grassroots community groups, the private sector, and members of the diaspora to mobilize en masse to contain the crisis.

Two officials at the Ministry of Health have already been arrested on corruption allegations related to COVID-19 response donations, denting public confidence.

With domestic flights suspended, it is all the more critical to invest in hospital and testing capacity across the country. This cannot be achieved without genuine collaboration between the federal government and its constituent member states.

“A halt or a drastic slowdown in processing visas will have an immediate domino effect of the domestic food supply of this country,” said David Scaroni, vice president of Fresh Harvest, the country’s largest private contractor of H-2A workers. “No emergency declaration or short term provision will change this fact.”

“We believe because of what’s planted and what’s going to be harvested that we can meet the demand and maintain the continuity of the food supply,” Valadez said. “The question is the labor equation. The crops are going to be there. But what are we going to be able to do to get the crops out of the ground?”

labor contracting surges dramatically as produce shifts from the winter desert regions of California and Arizona and gets underway along the central coast. That region hosts the bulk of the state’s strawberry production and much of its spring and summer leafy greens, broccoli and cauliflower, among other crops.

Any shortfall or slowdown, however, would have a cascade effect across production, harvest, processing and distribution within weeks, Scaroni said. “Plants already in the ground do not know that there is a pandemic occurring. It is crucial to keep this process going as close to the prior normal to ensure a stable food supply for the coming months.”

deep, short-term dependency within crops and harvest areas

There is no evidence that contact with produce is contributing to the spread of coronavirus, federal health and safety agencies have said.

“Historically, farmworkers are so used to not having healthcare they just put up with being sick,” said Armando Elenes, secretary-treasurer of the United Farm Workers. “They’re going to go to work, and on the way to work, they’ll be in a car with four, five or six workers. So ‘social distancing’? Forget that.”

An agriculture industry source said operations dependent on food-service clients could suffer irreparable economic harm. The inability of the retail side to absorb the unused supply could leave a paradox of empty bins in grocery stores while food rots in the fields.

Rabobank Research predicts that effects of the pandemic will last several months. It already has affected parts of the food economy few think about, such as the boxes it’s packed in — cardboard production largely halted in China in January and February, driving up prices.

Wholesalers report that unusually heavy rains have created an “extreme” market for many produce items, including carrots, peppers, squash, potatoes and cauliflower. California’s citrus industry has had to slow or pause harvest during the prolonged rains of the last week, according to California Citrus Mutual. The industry had hoped to overcome most of the supply imbalances as it shifted production north and into additional states. Then the pandemic hit.

U.N. relief officials and aid organizations are bracing for what they fear could be a cataclysmic second phase of the pandemic: spreading in the close-quarters encampments of the world’s more than 25 million refugees and another 40 million internally displaced people.

More than 3 billion people lack access to hand-washing facilities, depriving them of one of the most effective first lines of defense against the spread of the coronavirus, according to UNICEF

the effort to ramp up an international aid response is being hampered by the quest to ensure the safety of international staff. Those concerns have been amplified by the announcement last week that David Beasley, the executive director of the Rome-based World Food Program, had been infected with the coronavirus. Some international relief agencies have recalled senior field officers, fearing they could be infected.

Konyndyk, who worked on the response to the Ebola epidemic in West Africa for the U.S. Agency for International Development, said that U.N. and relief agencies are having to balance ensuring the health of their own staff with delivering care to needy communities.

“You would have a hard time designing a more dangerous setting for the spread of this disease than an informal IDP settlement,” he said. “You have a crowded population, very poor sanitation … very poor disease surveillance, very poor health services. This could be extraordinarily dangerous … and I don’t think that’s getting enough global attention yet.”

In conflict-riven countries from Afghanistan to South Sudan to Yemen, dismal health care infrastructures are already overburdened after years of fighting

After five years of war, with millions of people on the brink of famine, Yemen’s population is more vulnerable to a coronavirus outbreak than those of most other countries. The conflict has left most of the country’s population effectively immunocompromised,

“For many population groups, living in overcrowded conditions, social distancing is a challenge or impossible,” according to the Assessment Capacities Project report. Many countries that host refugee camps, such as Afghanistan and Bangladesh, are likely to be overwhelmed by the health needs of their own citizens. Nations with weak health systems “may struggle to screen, test, and contain the epidemic for the host population let alone the refugees,”

In Gaza, the U.N. Relief and Works Agency (UNRWA), which provides primary care for about 70 percent of the territory’s more than 1.8 million people, is bracing for the likely arrival of the coronavirus in one of the most densely populated place in the world. The U.N. agency—which the Trump administration defunded last year and has sought to dismantle—has some 22 medical clinics in Gaza, putting it on the front lines of the defense of the coronavirus.

“I’m told that there are 60 ICU beds in the hospitals,” Matthias Schmale, the director of Gaza’s UNRWA operations, told Foreign Policy. “If there is a full-scale outbreak the hospital sector won’t cope.”

The leaders of major relief organizations are pressing donors to grant them greater flexibility to redirect funding from existing programs that are likely to be paralyzed by the pandemic and use that money for programs—including clean water and sanitation projects—that could help stem the crisis.

“As bad as it is now in the well-organized and affluent north, with health systems, good sanitation, and big infrastructure, imagine how it will be when it will hit crowded camps with refugees and displaced people,” said Egeland, who spoke by telephone from quarantine in Norway.

sweeping U.S. and U.N. economic sanctions imposed on governments in Iran, North Korea, and Venezuela are hampering relief efforts.

Egeland acknowledged that most U.N. sanctions regimes, including those for Iran and North Korea, include exemptions for the import of humanitarian goods. But the sanctions have scared financial institutions from providing vital financial services to relief agencies. “Not a single bank had the guts to transfer money, because they were all afraid to be sued by the U.S. government,”

The World Health Organization announced earlier this year that more than $675 million will be required through April—including $61 million for its own activities—to mount an international campaign against the virus. Though WHO’s Director-General Tedros Adhanom Ghebreyesus said recently that more money would be needed. On Feb. 17, UNICEF issued an urgent request for $42.3 million to support the coronavirus response. It will be used to reduce transmission of the virus by promoting distance learning for kids who can’t attend school and public information aimed at shooting down misinformation.

Guterres, meanwhile, expressed concern that the pandemic could claw back decades of efforts to raise international health standards and to scale back the most extreme levels of poverty, and undercut U.N. sustainable development goals, which are designed to improve the standard of living around the world by the year 2030.

“COVID-19 is killing people, as well as attacking the real economy at its core—trade, supply chains, businesses, jobs,” Guterres said. “Workers around the world could lose as much as $3.4 trillion.”

“We need to focus on people—the most vulnerable, low-wage workers, small and medium enterprises,” Guterres said. “That means wage support, insurance, social protection, preventing bankruptcies and job loss. That also means designing fiscal and monetary responses to ensure that the burden does not fall on those who can least afford it. The recovery must not come on the backs of the poorest—and we cannot create a legion of new poor. We need to get resources directly into the hands of people.”

In South Africa, one of the hardest-hit countries on the continent by the pandemic, a mutated and more transmissible variant of the virus emerged less than two months ago, leading to a massive spike in both the number of cases and deaths.

Experts and humanitarian workers fear that even as high-income countries in the developed world get a handle on cases and begin distributing vaccines, poorer and developing countries in Africa will be left behind.

Data from the Africa Centres for Disease Control and Prevention released on Tuesday shows that the African continent has tracked more than 3.6 million COVID-19 cases and some 91,500 deaths. That number is expected to increase further in the coming weeks.

Last month, then-U.S. Ambassador to South Africa Lana Marks announced that she had spent 10 days in an intensive care unit after developing COVID-19 in late December. Marks, a luxury handbag designer and Trump political appointee, drew fire from embassy staff last March when she returned to the country and did not self-isolate after attending an event at the former president’s Mar-a-Lago resort despite some attendees later testing positive for COVID-19. 

South Africa has a highly developed health care system, but in poorer countries in the region embassies are relying on medical evacuation to deal with severe cases. One official in the region said medical evacuations have been taking 48 to 72 hours, adding, “In terms of COVID, that could be a death sentence.”

According to an internal USAID memo, patients in Eswatini, which borders South Africa, were dying due to a lack of oxygen supplies

emphasize the overriding importance of some combination of sovereignty, territorial borders, and national identity and culture. They routinely claim that efforts, spearheaded by sinister external forces, to undermine all three constitute an existential threat to the political community

in order to implement their policies, populists need to shield themselves from pressure to, variously, protect human rights, maintain the rule of law, combat corruption, and respect domestic pluralism

populists in Europe rightly see the liberal values that undergird the EU as an obstacle to their political programs

Even as he depends on EU subsidies to maintain his patronage networks, Orban positions himself as defending Hungary against EU efforts to subvert its sovereignty and values.

populists have converged on the idea that a multipolar international system will best serve their interests and is therefore something to both welcome and advance

Leaders argue that, unlike Western donors, China and other new patrons do not demand intrusive conditions such as economic conditionality or respect for individual rights. However, these deals involve opaque schemes and private payoffs, as well as expectations of future support. Beijing, for example, expects recipients to back its foreign-policy priorities and support—or at least not overtly criticize—China on matters such as respect for human rights in general or its current policies toward Uighurs in Xinjiang in particular.

This “goods substitution” is significant on its own terms because the provision of international club and private goods is the main mechanism by which great powers order international politics. But countries such as China and Russia often do not, in fact, provide superior goods and bargains to those offered by the United States and its allies. China’s behavior surrounding the BRI and its preexisting aid programs has led recipients to accuse Beijing of neocolonialism, and growing evidence suggests that Chinese development projects are more problematic than Western ones.

A critical part of the domestic politics of goods substitution is that populists claim that their pragmatic courting of illiberal or authoritarian states affords them a wider range of partnerships and international networks. The fact that new partners like China and Russia are authoritarian becomes a net political positive: a signal that populist leaders are pragmatic and committed to protecting national interests—because they are flexible enough to find new partners who can deliver the goods.

Leaders, and populists especially, now increasingly see partnership with the United States—once viewed as an indispensable pillar of foreign policy—and its Western allies as overly constraining. For example, Duterte, Erdogan, and Orban all came to power in states that were fully integrated members of the U.S.-led security order. All three now point to potential security relations with Russia and China as providing the possibility of greater balance with, if not outright exit from, that order.

The difference now is that elites in multiple, and otherwise very different, countries are actually implementing policies that distance themselves from the U.S.-led security order. In all of these cases, populist leaders are invoking multipolarity as a rhetorical commonplace, taking advantage of the growing shift toward a multipolar order, or both. In doing so, they contribute to a power transition away from the United States by reducing its influence.

invoking multipolarity also makes it easier for populists to reject external, mostly Western, criticism of their domestic governance practices. When the West was dominant, even autocrats had to accept significant incursions on their domestic sovereignty—such as critical election monitors, foreign-sponsored NGOs, and members of the Western press. Now, emulating the practices of China and Russia, populists are much more comfortable with banning or repressing these same actors—and in justifying their actions as ways of protecting their national values and interests

The global impact of the COVID-19 pandemic, at first glance, strengthens and fuels these dynamics. The closing of borders and the curtailment of international economic exchange increase the appeal of national fortress narratives conjured by populists about the perils of globalism

It’s one thing to use exit options to reduce external liberalizing pressure, but it’s another when new patrons start calling in favors. Despite Beijing’s defense of sovereignty as an international principle, its practices toward clients suggest that, eventually, it will use its leverage in ways no less coercive than other great powers. Moscow has already demonstrated its lack of concern for the sovereignty of clients and partners

the COVID-19 crisis underscores that international goods provision abhors a vacuum

As many countries begin partially reopening their economies, traffickers may now be in a position to become more powerful than ever. With economies in distress and many businesses facing ruin, cash-rich narcos may be able to cheaply buy their way into an even bigger share of the legitimate economy.

“There has always been a stock, it’s a very organized chain. It’s the way to control everything, especially the price. The stocks are on beaches such as Tarena [near the border with Panama], banana plantations, in the jungle. The stashes are everywhere,”

Traditionally, smugglers have used small, very fast speedboats, as well as fishing vessels and submarines, to ply their northern route. Lockdowns have made these methods harder to use, mainly for logistical reasons. So instead, smugglers are turning back to older, slower routes that are often broken up in parts.

Unlike exports to the United States, cocaine bound for Europe is typically moved in legal air and sea cargoes, especially fast-moving fresh goods such as flowers and fruit. The latter, as food, has continued to move unimpeded during the pandemic, helping feed Europe’s 9.1 billion euro-a-year cocaine habit. Colombia’s banana industry, for example, has been exempt from local lockdown measures, allowing cocaine to keep moving through the crop’s supply chain. “[Anyone] in the authorities or security that meddles with this route goes down,” said Rául, the Gulf Clan member, adding that people who are paid off to facilitate the smuggling of cocaine have an incentive to keep the drugs flowing. “Everybody eats,” he said.

Mexican cartels have used the crisis as a public relations opportunity. People associated with the cartels, including the daughter of imprisoned Sinaloa cartel chief Joaquín “El Chapo” Guzmán, have publicly distributed food and other essential items to the poor. Meanwhile, the country’s drug violence continues unabated, claiming an average of 80 lives per day.

In March and April, Spain seized over 14 tons of cocaine in inbound shipments — a figure six times higher than the same period the previous year, said Manuel Montesinos, the deputy director of Customs surveillance at the Spanish Taxation Agency. “We are very struck by the frenetic pace,” Montesinos said. “Almost every day we receive alerts of detections of suspicious operations.”

Ramón Santolaria, the head of anti-narcotics at Spain’s national police in Catalonia, said cocaine traffickers may have mistakenly assumed that the pandemic would have reduced monitoring at ports. The cartels “have to continue exporting,” Santolaria said. “They are like a company. They can’t store everything in their countries, since it would be very risky.”

Italy has fallen silent as a point of arrival, despite being home to mafia groups that dominate Europe’s cocaine trade. Seizures dropped by 80 percent over the months of March and April compared to the same period last year

“Italy did not receive much via ports or airports and that is because during lockdown we have been controlling them a lot,” said Marco Sorrentino, the head of anti-mafia department of Italy’s financial police, the Guardia di Finanza. Italian crime groups have shifted their operations to Spain, where they have large “colonies” according to Sorrentino. “Italian mafias and their partners thus sent cocaine mainly to Algeciras or Barcelona, and then from there they moved it on wheels to the rest of Europe and to Italy,” he said. “As cover-up they used trucks filled with fresh fruits or also soy flour,” which resembles cocaine.

At the street level, lockdowns have played havoc with cocaine sales — but have also failed to stop the trade. But in some cases at least, dealers’ adaptations may have actually put them in a more profitable position than before, as cocaine users are desperate and confined at home. “Even though they don’t lack product, they have raised prices a bit and are cutting it more,”

The solution? Delivering it to customers in the guise of food orders, or couriered by essential workers carrying documents that give them permission to move around freely. Dealers have also staked out positions in socially distanced queues outside supermarkets — one of the only permitted places to gather in public under Italy’s strict lockdown rules, which began easing up in early May.

The main dark web marketplaces have seen an increase in sales of roughly 30 percent since lockdown measures started coming into effect worldwide

“Private citizens who are in need and won’t have access to a bank loan will be victims of loan sharks,” he said. “But what worries us the most is that licit companies might be in need, and be approached by mafia organizations that will propose to become minority shareholders.” “And once this happens, they actually take over the whole company,”

Modi’s efforts to spark international responses to the coronavirus may also be rooted in a desire to alter the way his government is perceived abroad. New Delhi has suffered blow after blow to its global image in recent months following a series of controversial policy moves. These include the revocation of the autonomy of India-administered Kashmir; the passage of a new citizenship law that critics believe discriminates against Muslims; and the government’s silence in the face of India’s most deadly communal violence in several decades. This has garnered negative international media coverage and criticism from political leaders around the world who fear New Delhi is taking the world’s largest democracy in an authoritarian direction.

While his regional initiative has enjoyed some forward movement, thanks to several SAARC states having pledged modest contributions to the new emergency fund and India’s deployment of assistance to South Asian states, it will inevitably be hobbled by the India-Pakistan spat. During the videoconference, Pakistani Health Minister Zafar Mirza called on India to change its policies in Kashmir in order to prevent the spread of the coronavirus there—a comment that didn’t sit well with New Delhi.

Modi’s push for the G-20 videoconference could end up benefiting Beijing—a G-20 member with more capital and resources for global outreach than India—by giving it a high-powered forum to amplify its messaging

most countries are understandably too focused on the coronavirus at home to focus on coordinated responses abroad

In a review of Covid-19 social response programmes, cash transfer programmes were found to be: Short-term in their duration – lasting just over three months on average Small in value – an average of $6 (£4.30) per capita in low-income countries Limited in scope – with many in need remaining uncovered

The world’s food systems endured numerous shocks in 2020, from economic impacts on producers and consumers to desert locust swarms and erratic weather. All indicators suggest that this may be the new normal. The ecosystems we rely on for water, air and food supply are under threat. Zoonotic diseases are on the rise owing to growing demographic and economic pressures on land, animals and wildlife.

A warming planet is contributing to costlier and more frequent extreme weather events. And as people pack into low-quality housing in urban slums or vulnerable coastal areas, more are living in the path of disease and climate disaster.

We need sustained financing for approaches that prioritise human, animal and planetary health; restore landscapes and diversify crops to improve nutrition; reduce food loss and waste; strengthen agricultural value chains to create jobs and recover lost incomes; and deploy effective climate-smart agriculture techniques on a much greater scale.

Focusing on food security would address a basic injustice: almost one in 10 people live in chronic hunger in an age of food waste and plenty. This focus would also strengthen our collective ability to weather the next storm, flood, drought, or pandemic – with safe and nutritious food for all.

By exploiting governance gaps, terrorists and insurgents gain valuable propaganda victories

by launching public health campaigns and dispensing information and advice on how to avoid being infected, terrorist and insurgent groups can position themselves as a trusted voice on these issues.

Good governance and competent public administration are the best medicine for pandemics and insurgencies alike.

amid this crisis, the Trump administration has ordered U.S. military commanders to prepare a campaign to destroy Iranian-backed militias in Iraq, as part of an overall effort—spearheaded by Secretary of State Mike Pompeo and national security adviser Robert O’Brien—to weaken the regime in Tehran

the top U.S. commander in Iraq, Lt. Gen. Robert White, wrote a rare dissenting memo, objecting that the campaign would require sending thousands of additional troops to Iraq and would distract from the main U.S. mission in the country: training Iraqi troops to fight ISIS.

other Pentagon officials and officers have raised concerns about another problem with the plan—sending U.S. armed forces, some of whom may already be infected with the coronavirus, to a region where the virus is spreading like wildfire.

mericans aren’t the only ones at a disadvantage right now. It’s time to step up diplomatic efforts to deal with our various crises and conflicts. Too bad we have so few diplomats.

A Reuters correspondent is reporting that the Navy will relieve Capt. Brett Crozier, the commander of the USS Theodore Roosevelt who wrote the leaked letter, asking his superiors to deal more speedily with the pandemic spreading across his ship. The navy bosses are citing a “loss of confidence” in the captain for his presumptuousness. One wonders how many sailors, to say nothing of their anxious families, will lose confidence in the Navy. A truly responsible president or defense secretary should fire the admiral who made this decision—and replace him with Crozier.

it is particularly worrying how far the coronavirus is spreading within the political elite in countries where many senior politicians are over 60, making them especially at risk. In Burkina Faso, a country that has experienced more than its fair share of instability in recent years—and which is currently struggling against an insurgency—the ministers of foreign affairs, education, the interior, and mines have all tested positive.

In Nigeria, one of the most economically and politically important countries on the continent, Abba Kyari, the chief of staff to 77-year-old President Muhammadu Buhari, has come down with the disease. Although media outlets have reported that Buhari tested negative, this has not stopped damaging rumors that the often ill president has been incapacitated from circulating in Twitter.

The world should also be paying close attention to Iran, where media censorship has obscured the extent of the crisis. So far, two vice presidents and three cabinet officials are known to have gotten the virus. It is also estimated that 10 percent of parliament and many prominent figures within the Islamic Revolutionary Guard Corps are sick—including a senior advisor to the 80-year-old supreme leader, Ayatollah Ali Khamenei, raising questions about his health.

A leadership crisis is just one of the potential sources of political instability the coronavirus could spark. Others include the risk of popular unrest and the debt crises that will soon engulf many countries around the world. Along with the fact that some of the main providers of foreign aid are now preoccupied with their own financial crises, there is a serious risk that politically and economically weak states will face a perfect storm of elite deaths, debt, mass unemployment, and social unrest

In countries where poverty is widespread, health systems are weak, and the cost of food is high, citizens are already under intense financial pressure. Despite earning the least, those who live in slum areas around capital cities often have to pay more for access to water and food than those who have valuable properties in the city centers. While the cramped conditions of slum living make it implausible to self-isolate, limited and inconsistent income make it impossible to buy in bulk—or to stay home for weeks on end without working and risk starvation. For many of the poorest people in the world, hunger is just a few days away

Already, there have been sporadic incidents of unrest in a number of countries, including prison protests in Italy. Meanwhile, heavy-handed efforts to enforce the curfew threaten to further erode public confidence in the government and the security forces. There are reports of widespread human rights abuses being committed in Kenya and South Africa, where the police have been using water cannons and rubber bullets to enforce the lockdown.

Unless the deferral of debt goes hand in hand with debt cancellation and long-term rescheduling, the end of the coronavirus crisis could be followed by a series of economic collapses across the developing world. In turn, this will undermine the ability of governments to provide affordable fuel and food, further increasing the risk of public unrest.

Civil wars, political instability, and poverty kill millions of people every year. These deaths rarely elicit the kind of comprehensive media coverage that COVID-19 has received, but they are no less important. It is possible to prevent the worst political consequences of the coronavirus but only if governments and institutions act now. Wealthy nations must increase their aid budgets rather than cut them, and international organizations must anticipate and work to avoid political crises more proactively than ever before. That is the only way to collectively survive the present in a way that does not undermine the future.

In the middle of the most serious global pandemic in a century, South Korea’s politics caused the nation’s foremost experts in infectious disease to cease advising the president.

Of course, culture is a real thing that guides people’s actions. It is entirely possible to have a sophisticated debate on, for example, how Confucianism influenced the South Korean public’s reception of the government’s response to the coronavirus. (The ancient Confucian philosopher Mencius provides rich material on practical governance in accordance with the Confucian web of obligations between ruler and subject.) But curiously, the Western media’s discussion of South Korea’s Confucian heritage never makes any reference to the actual Confucian texts. Instead, Confucianism is merely an excuse to introduce tired old stereotypes about Asians as mindless drones, ignorant to the true meaning of freedom.

South Korea’s success is thanks to competent leadership that inspired public trust.

Just as South Korea did, the United States and Europe could have moved in the earliest stage of the outbreak to implement a mass-scale test-and-quarantine program and minimize the damages of the coronavirus. By writing off South Korea’s response as culturally bound, the West is once again making the same mistake, failing to recognize that Asia’s solution could be its solution too.