COVID-19 in South and Southeast Asia: a quick guide

7 September 2020

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Dr Angela Clare
Foreign Affairs, Defence and Security Section

This quick guide provides an update of the COVID-19 crisis in South and Southeast Asia, with a focus on India, Pakistan, Bangladesh, Afghanistan, Cambodia, Malaysia, Myanmar, the Philippines and Vietnam.

The Parliamentary Library’s quick guide, COVID-19 in the Region, provides an overview of the pandemic in Australia’s nearest neighbours—Indonesia, Timor Leste, Papua New Guinea and Pacific Island countries.

South Asia

The pandemic reached South Asian countries a little later than other parts of the world, but the last two months have seen case numbers accelerate. India now has the world’s fastest growing caseload, recording 4,202,562 cases as at 7 September—second only to the United States. Daily new cases have reached record highs in recent days, with 91,723 reported on 6 September. According to a recent serological survey nearly 30 per cent of residents in New Delhi may have been exposed to coronavirus infection, suggesting infection numbers are far higher than officially recorded.

In Pakistan, the world’s fifth most populous country, the tally of infections stands at 298,509 and deaths at 6,342. For now the pandemic appears to have passed its peak: the highest number of new cases was recorded on 14 June, with daily case numbers having now fallen to a seven-day average of 411. But analysts warn that the health system will be overwhelmed if case numbers continue to climb.

Bangladesh, one of the most densely populated countries in the world, has recorded 325,157 cases and 4,479 deaths, with the highest tally of new cases recorded on 2 July. Daily cases numbers have eased slightly but remain stubbornly high, while unusually heavy rain since July has displaced an estimated 1.5 million people, adding to the difficulties of containing the virus.

Several South Asian countries have to date recorded lower than expected numbers of deaths from the virus. Some have suggested that the region’s younger demographics may be a contributing factor, in addition to substantial undercounting.

High rates of poverty, patchy social protection, poor health infrastructure and wide economic and social disparities present vast challenges to the effective implementation of public health measures across the region. The pandemic is already aggravating existing inequalities as the more vulnerable are disproportionately affected by shutdowns and loss of income. High levels of debt limit the capacity of governments to mitigate impacts. Lack of nutrition and access to basic health services—including immunisation—are the overriding threats, leaving governments grappling with how to lift restrictions while minimising overall loss of life.

South Asia’s economic growth estimates for 2020 show an 8.8 per cent drop as a result of COVID-19. The collapse in key labour-intensive export industries such as garment-making, handicrafts and fisheries as well as the loss of revenue from tourism and foreign remittances has caused widespread income and job losses. Micro, small and medium enterprises—the mainstay of South Asian economies—have also been hit hard, with many at risk of permanent failure.

Western donor countries have shown little interest in providing significant support to the region’s response to the crisis. For most countries development banks have been the major source of finance for the response, although China has provided a US$500 million loan to Sri Lanka.

Some argue that the pandemic presents a rare opportunity to address longstanding inequalities in South Asian countries in regard to access to health and other basic services. An IMFBlog post has proposed a ‘new deal’ for informal workers in Asia, who make up around 80 per cent of the total workforce in the lower income countries. This would involve:

Getting the basics right. If international assistance and internal financing can be found, countries in developing Asia should use this to mount an effective public health response, shoring up public health infrastructures and expanding coverage, and correcting deficiencies in clean water, and sanitation.

Setting up more expansive and inclusive safety nets. Governments could use citizen identification systems and digital technologies, … so that social protection programs can reach the people most at risk more quickly and efficiently, with the ability to scale up in times of crisis. The temptation to introduce universal cash transfers by “giving money to everybody” should be tempered by the goal of ensuring adequate support for the most vulnerable at a reasonable fiscal cost.

Investing in digital capacity and bandwidth. … expanding the availability of digital platforms for education and financial services would help to ensure greater and more equitable access for all.

The United Nations Development Programme (UNDP) is lobbying business and political leaders to establish a universal basic income and to support the flow of remittances, which are vital to the economies of many lower income countries. The United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP) argues that stimulus packages between 7 and 14 per cent of GDP are needed to cover public health infrastructure needs, social protection and economic revival in the region, far higher than the packages of around 1–3 per cent of GDP announced to date.

India

Pakistan

Bangladesh

Afghanistan

  • As at 7 September 38,398 people across all provinces in Afghanistan had tested positive for COVID-19, while 1,412 had died. New cases are on a downward trajectory but this may be due to low testing rates: by 23 August only 100,960 people had been tested out of a population of 37.6 million. Local government reports suggest hundreds of people may be dying of suspected COVID-19 without ever seeing a medical professional. Of the total reported cases, 10 per cent are health workers.
  • Health facilities report a lack of basic protective equipment, testing kits and medical supplies, and a shortage of trained staff.
  • Afghanistan is ranked among the highest risk countries in terms of health and humanitarian impacts from the virus, with the International Committee of the Red Cross warning that ‘rising violence and attacks on healthcare facilities amid the pandemic have put millions of people at risk’. Medical NGO Médecins Sans Frontières announced it was withdrawing from a Kabul hospital after its maternity ward was targeted by gunmen on 12 May.
  • The UN Office for the Coordination of Humanitarian Affairs argues that ‘Complacency and failure to follow public health advice is creating grave risks in the community with people generally not observing physical distancing protocols’. One analyst has suggested that the Government has given up trying to contain the virus and is resting its hopes on herd immunity. But ‘With the role of herd immunity still uncertain, public numbness is helping Afghanistan get through the pandemic instead’.
  • The Government announced on 6 June that it was extending the national lockdown for three months, and issued new health guidelines. It has also announced a series of emergency relief packages for the health sector, economic support and social protection measures. The impact of the lockdown on the most vulnerable is of broad concern, such as steep rises in the cost of food.
  • The IMF has approved US$220 million of emergency assistance, noting that the pandemic is inflicting heavy damage on the country’s economy. The World Bank has approved a US$400 million grant to sustain its economic reforms and help the country manage the COVID-19 crisis.

Southeast Asia

The health impacts from COVID-19 have not been as severe in Southeast Asia as elsewhere around the globe, and, with some exceptions, most countries have so far been successful in suppressing the virus. Observers have suggested a number of reasons for this success, including early and decisive lockdowns, transparent communication, and response measures that ‘impose minimal financial costs on their populations’. Some studies suggest that people in parts of Southeast Asia may have some natural immunity to COVID-19, while others note that the region is experienced in fighting other infectious diseases such as SARS and dengue fever. Several Southeast Asian countries have also achieved high levels of mask wearing.

Concerns have been raised in regard to the erosion of democracy and human rights across the region, seen particularly in increased action against government critics. Observers have conceded however that even the more repressive countries in the region have ‘displayed impressive levels of transparency about COVID-19 and the government response’.

The region’s economies are being severely affected by lockdown measures, disruptions to global and regional supply chains, and the loss of income from key sectors such as tourism and remittances. As in South Asia, the informal sector is one of the hardest hit. The UN has warned the region faces a socio-economic crisis that could reverse decades of poverty reduction.

Analysts have also argued that millions of migrant workers in the ASEAN region have been neglected in national policy responses. Support for these workers is critical as economies re-open, they contend.

China has been one of the major providers of COVID-19 related assistance to the region, supplying medical equipment and technical expertise from early February. Relief packages were delivered with considerable publicity, prompting the label ‘mask diplomacy’. Foundations linked to billionaire Jack Ma and state-owned enterprises have also engaged in large donations of medical supplies. It is difficult to assess the total value of China’s donations.

For many countries in the region development banks are the major source of concessional finance (loans) for the COVID-19 response. The US is one of the largest donors, so far earmarking US$76.9 million to train medical workers, boost screening capabilities and strengthen national health systems. Non-government assistance has also been substantial. The EU, Japan and Taiwan have also provided support, while Singapore and Vietnam have provided assistance to their regional partners.

Vietnam is chairing the Association of Southeast Asian Nations (ASEAN) in 2020 and has organised a number of virtual meetings for member states to share information about the pandemic. Efforts to establish an ASEAN travel bubble have been hampered by disparities in the pandemic’s status, with hardest hit countries Indonesia and the Philippines unable to join travel corridors.

Australia’s assistance to the region includes the ASEAN-Pacific Infectious Disease Prevention Program ($28 million, 2019–22) and other support through its new development policy, Partnerships for Recovery—Australia’s COVID-19 Development Response. Australia also contributes to global health and financing organisations that are actively engaged in supporting the response, including Gavi, The Vaccine Alliance; the Global Fund; the World Bank; ADB and AIIB.

The US Center for Strategic and International Studies (CSIS) tracks COVID-19 policy responses in Southeast Asia.

The Philippines

Vietnam

  • As at 7 September the country had recorded 1,049 cases and 35 deaths. Up until mid-July the country had reported no COVID-related deaths and gone months without a locally transmitted case. With its proximity to China and suboptimal healthcare system the low numbers have surprised many.
  • A spike in cases in late July looks to have been brought under control through a tightly coordinated response from central and local governments, with daily new cases dropping to a weekly average of two on 7 September.
  • The government response, hailed as one of the most successful in the world, was early and effective. Travel restrictions were introduced in late January and quarantine in mid-February. It used extensive and strict tracing, testing, isolation and active treatment regimes, and mandated community protection measures such as social distancing and the use of face masks. In the face of outbreaks the Government extended its lockdown to only 12 high-risk locations for up to the maximum incubation period of two weeks.
  • ‘Exceptionally strong’ community engagement and national pride in controlling the pandemic have also been cited as reasons for Vietnam’s success.
  • Both economic stimulus packages and social protection measures have been implemented for the poor and unemployed. An estimated 5 million people had lost their jobs as at mid-April, with workers in the textile and garment industries suffering the most severe impacts.
  • Vietnam was the first ASEAN country to begin lifting lockdown measures. Given its success in controlling the epidemic, the World Bank argues that Vietnam’s economy is well placed to bounce back after the pandemic if it can identify new drivers of growth to consolidate the recovery.
  • While it is hard to verify official data analysts note that the country’s authoritarian system of government allowed the immediate implementation of social restrictions and security measures, including the control of social media. Others have argued that the country’s COVID-19 success was made possible by the transparency of information, potentially increasing the demand for transparency across other areas of government.
  • The case of a Scottish pilot who spent more than two months on life support in Vietnam after contracting COVID-19 made international headlines when he eventually recovered and was able to return home.

Malaysia

  • As at 7 September the country had seen 9,397 cases and 128 deaths. Very low rates of new infections have been recorded for some weeks.
  • Despite some missteps, analysts acknowledge that the Government’s response has been largely effective. Since mid-March the country has been under relatively strict movement restrictions. Commentators observe that clear messaging, a well-resourced public service, competent health leadership and active contact tracing and testing have seen good results, despite the country’s ‘insecure borders, significant mobile and vulnerable populations, larger households in denser living conditions and less than ideal political situations’.
  • The Government has announced economic stimulus and social support packages worth around US$60 billion, or 15.5 per cent of GDP. The economy has been hit hard, and is expected to contract by between 3.5 and 5.5 per cent in 2020.
  • On 16 April the Government denied entry to a boat carrying 200 Rohingya refugees on the basis that they might spread the virus. Malaysia does not recognise refugee status, but has often been a destination for Rohingya seeking resettlement. It recently announced plans to shut its borders and threatened to push boats back to sea.

Myanmar

Cambodia

Singapore

  • As at 7 September 57,022 cases and only 27 deaths had been recorded. After initial success at containing the virus the city state saw an explosion of cases associated with foreign worker dormitories, which make up the bulk of active cases. The rate of new infections has eased but community transmission continues at a low level.
  • Singapore’s second quarter GDP shrank by 12.6 per cent on a year-by-year basis, largely due to the slump in global demand. Analysts note signs of recovery but caution that low consumer confidence and uncertainty over the pandemic and future Government stimulus measures could all affect economic growth.

[1].   An estimated 360 million people in India live below the poverty line. Eighty per cent of the non-agricultural labour force consists of daily-wage earners in the informal sector, and 76 per cent of India’s workforce is classified as ‘vulnerable’ by the ILO.

[2].   On 1 May 2020 the UNHCR estimated that 167 countries have partially or fully closed their borders to contain the spread of COVID-19, and 57 of these are not making exceptions for people seeking asylum. See H Spinks, ‘Seeking asylum in the time of coronavirus: COVID-19 pandemic effects on refugees and people seeking asylum’, FlagPost, Parliamentary Library blog, 19 May 2020.

 

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