The unforeseen challenges and uncertainties caused by the Covid-19 pandemic have taken a significant toll on people across the world. Critical decisions in this time of uncertainties are taken based on little or no information. For instance, incompatible decisions may be taken at times under this circumstance in an unintended manner. Generally, political toughness implies no change of decisions, but flexibility is required in a pandemic. There should be no regret when decisions have to be reversed depending on updated data. Also, this does not imply the inefficiency or incapability of policy makers under this unique pandemic that the whole world is experiencing as a completely new phenomenon, rather strength of the decision-making process which quickly adjusts with the situation.
The epidemiological models that are used to assess impacts depend on a host of assumptions for which data are still not available. The situation will only succeed if politicians and government are trusted by the stakeholders and the society at large. Additionally, a clear, concise, and smart communication system among politicians and government authorities may enhance the acceptability of straight or reverse decisions to be taken when required.
The tremendous uncertainty about what lies ahead can cripple policy makers' ability to take strategic actions. Public policy regarding financial interventions, for example, and the timing of the reopening of local economies is often ambiguous and is constantly being revised. EU policy makers have already introduced scenario-based decision making strategies and many other nations are building scenarios right now. Bangladesh may start thinking in this line with an example of the footstep of Bangladesh Delta Plan 2100. Going through actions compiled in "government action trackers during Covid-19", we have picked following no-regret actions that may be applicable for any developing country and may need to customise as per the context. At this point of time, we are proposing that developing countries and development agencies can take the 'no-regret' policy to combat the pandemic. These policies are not exhaustive and chosen based on successful application in apparently better managed countries during the crisis.
SAVING LIVES THROUGH COMMUNITY HEALTH: The viciousness of Covid-19 means that there is no treatment yet. Even in more advanced countries, evidences suggest that hospitals can do little, beyond strengthening the body to fight the disease, through oxygen and-for example- appropriate nutrition. Given the worldwide shortage and predatory buying of diagnostic test kits by some, there is little hope that developing countries can do this at the scale it demands. In this context, decision-makers can boost the support for community health workers and local health centres (i.e., private and publicly owned clinics). Furthermore, the basic services and information updates (e.g., need for additional or new ventilators, specialised hospitals, isolation centres etc.) provided by the health centres can enhance quick and effective decisions. However, no one will certainly regret investing in the community health services now to improve medical services during the crying need.
ENSURING TREATMENT FOR PATIENTS NOT HAVING COVID SYMPTOMS: Economically advanced countries have promoted lockdowns to protect existing health care systems, which may otherwise risk more deaths in other diseases. The advice for lockdowns in developing countries seems valid so that the existing healthcare systems may not experience a flood of patients at a time to treat beyond capacities. For this, pre-Covid medical facilities are required to function properly without hindering non-Covid treatments in the health care centers. Immense risk of Covid-19 may exacerbate due to lockdown as several medical services may be restricted and thus increasing vulnerability of the local people at remote areas. There is no perfect response mechanism so far balancing all the trade-offs in favour or against the lockdowns.
MORE CARE AND VIGILANCE FOR VULNERABLE GROUPS: Within the current lockdowns of various forms, uneven enforcement, high population density, and poor water and sanitation may expose vulnerable people to greater risks. For instance, it is critical to invest in water and sanitation systems to remain functional under this pandemic. Additional resources may require investing sensibly in this sector to promote consistent services at this point of time. Furthermore, additional resource should be employed immediately through establishing check points for infectious disease controls. These check points could be geographically distributed around the country depending on population density and number of infected people.
INVEST IN THE EXIT, ESPECIALLY THROUGH VACCINES: Every country wants to get out of this crisis, but the nature of Covid-19 is such that even if we flatten the incidence, through lockdowns or other measures, it is unlikely to make the disease go away completely. The only total exit point is a vaccine (as per most experts' view), which is likely that therapeutics and increased diagnostics will only mitigate impacts. This requires substantial investment and research support, especially by G7 and G20 countries. However, extensive collaboration and coordination is required both from the emerging and developing countries around the world. Getting vaccines delivered is never an easy task. As long as there is shortage of vaccines, the prospect of the developing world- and especially the poorest countries-to lose out is real. No global deal for accessing vaccines for such countries in the coming 12 or 24 months seems credible unless manufacturing is boosted at the required scale. However, some others, such as India and even Bangladesh, may well have the required production or local trial capability and have proven experience to produce in a short notice.
It is also highly likely that in the following months after a successful vaccine has been discovered, there will be chaotic demand against the limited supply. In this circumstance, development partners can help directly by assisting manufacturing capabilities to countries in need. World Bank Group (WB), IFC and similar development partners may enhance the manufacturing capability of companies in different countries who are willing to go for a production if the patents are available.
BALANCING HEALTH AND ECONOMY: Just as for the disease, there is no miracle cure for the economy. The way global economic activity has suffered, it may plunge into a deep recession worldwide. Governments opt to balance economic activity considering health sector in the centrepiece. As recession looks eminent, government should act immediately with a short-term and a long-term vision in order to save the economy, lives of people, livelihoods, and health.
MAKE SURE THE POOR GET CASH: The only way to assist this segment of population is to provide cash directly through digital banking channel without employing any third-party intervention. Bangladesh is doing great in this regard, and recently transferred Tk 2500 per head to 5.0 million families and might need to do so again. The temporary transfer of direct deposit will save many poor people, and allow them to avoid being permanently trapped into poverty, even after the crisis.
INVESTING IN DATA : So far, people know little about the recovery framework of the present crisis. Once it comes to allocating resources for the next month, it is unclear exactly where in the economy to spend for the most. Also, it is not well-documented about the high priorities in the economy. As a result, it is important to invest in data management protocols to prioritise needs. Moreover, telephone surveys of firms and individuals are possible and maybe used widely, and systematically with clear protocols to assess needs. UNDP Bangladesh and some research organisations are already doing this successfully.
INCREASED BUDGETARY ALLOCATION: Budgetary allocations for health and social sector in developing countries are often less prioritised where infrastructure gets large chunk of the resources. In the current situation, it must be reversed and easy pick for the policy makers. For example, in Bangladesh spending on health and social safety net programmes is much less than communication or energy sector, though allocations have been increased substantially in recent times. Health and social safety net programmes currently consume around 2.0 to 2.5 per cent of GDP in total which needs to be doubled in the upcoming budget. A new and quick emergency related programme/project formulation and approval system need to be established where project approval within 10 working days can be ensured. A pool of efficient project management officials can be chosen right now to be deployed immediately as soon as the project receives allocation.
INTERNATIONAL COOPERATION: It is difficult to identify the precise approach of the Covid-19 crisis in developing countries (like Bangladesh). Each week, the world seems to be a different place-everyone is forced to learn extremely fast. The benefit of hindsight is a great tool for criticism. It seems that no one is conclusive about the necessary strategy required for tomorrow or the next week. This is an unprecedented situation and there is little evidence to build on, even from other countries. Also, it is evident that soon, several stakeholders will regret diverse decisions taken recently worldwide. The advanced countries may have the option of blanket spending to mitigate this, updating policy upon pinpointing the gaps. However, developing countries may struggle in assessing actual needs, balancing economy, and safeguarding health and safety of citizens as resources are very limited.
Developing countries will enter the recovery phase with more liabilities, like lack of assets and pressure of debt. The governments should start maintaining a strong network with the development partners for a potential debt relief and pinpoint the priority lists as soon as possible to balance the monetary sheet.
Dr. Md. Taibur Rahman is a development planner, a civil servant of Bangladesh, currently working with UNDP Bangladesh on lien. trsumon@gmail.com.
Dr. Khan Rubayet Rahaman is an Assistant Professor, Department of Geography and Environmental Studies, St. Mary's University, Halifax, NS Canada.