Today, we all are sitting near the tips of an iceberg, the sea of millions of microbes around us. It is uncertain when, where and what type of pathogens will be the next threats. However, it is certain the spread of infectious diseases will be much faster than ever before. Such unprecedentedly rapid pathogen spread has now been seen during the novel coronavirus outbreak (COVID-2019). Early this year, an unexpected single instance of COVID-2019 outbreak has added a layer of uncertainty to Wuhan city in the central part of China. Thanks to the government’s commitment and people's devotion, the new cases have started to decline in China. Conversely, across the globe, the outbreak has entered a completely new stage, raising fears as it attained the status of a global health emergency.
As the outbreak frequently made headlines, the World Health Organization (WHO) has also swung into action, calling for firm support to curtail the virus. WHO has declared the COVID-2019 outbreak an international health emergency not because China had responded poorly but due to strained, fragile and chocked health systems of many developing countries. WHO is aware of the imploded health systems in developing countries. Insufficient public health infrastructure, frail health monitoring systems, weak laboratory networking and poor health information management make developing countries highly prone to disease outbreaks. Developing countries primarily rely on foreign aids and technical support due to their limited health budgets. Disease burdens can easily overwhelm their scarce public health capacities. As of today, more than 57 countries worldwide have reported cases of COVID-2019. Due to the fragile public health infrastructure in the region, COVID-2019 have made headlines in neighboring countries like Iran, Pakistan, Sri Lanka, Nepal, and Afghanistan. As of March 08, 2020 Altogether, 6578 confirmed cases and 194 deaths were reported in these countries and the outbreak seems to be on the loose.
Today China is defeating the COVID-2019 outbreak for three reasons: strong government commitment and intervention, efficient health services and innovative diagnostic platforms. To safeguard people's lives, the Chinese government’s commitment and robust response helped the decline of COVID-2019 cases. Stringent measures included closing down Wuhan city and adjacent areas and putting the 51 million people under quarantine. The government has banned the wild animal trade, and shall soon make it illegal through a new stringent law. To deal with the high number of patients and improve health services, successively, a 1,000-bed Huoshenshan Hospital and a 1500-bed Leishenshan Hospital were built in a short time. Moreover, More than 43000 medical doctors and nurses from other provinces, including 3000 military medics with experience of Ebola outbreak control, were deployed into the outbreak epicenter. Besides, China has a strong diagnostic platform. The pathogen was identified within three days; back in 2003, the SARS-CoV pathogen identification took more than a month. The virus was fully sequenced by the third generation sequencing (TGS) technology, and the virus genome was publicly available. Based on that, virus genome detection kits were developed to diagnose patients accurately. Chinese experts are working frantically, and have successfully isolated the virus strain for the development of vaccines and therapies. As part of the medium- and long-term plan, the Chinese government has mobilized various resources and injected 66.74 billion RMB (US$9.58 billion) into basic research to screen anti-viral drugs and develop a vaccine against the deadly pathogen. To cap it all, the Chinese government is mounting all-out efforts to stop the outbreak.
Today, South Asian countries are highly prone to COVID-2019. The region is the home to a quarter of the world's population. The world’s top three densely-populated countries India, Pakistan and Bangladesh reside here. A large number of people here are in impoverished living conditions, and have less than $1 income per day. Despite the severe consequences of diseases in these countries, they spend less than 3.6% of their gross domestic products (GDP) on health as compared to 8.2% of the global average. The Human Development Index (HDI) ranks revealed that unprecedented epidemics of infectious diseases are the leading cause of morbidity and mortality in these countries. Early disease warning systems and the ability to timely respond to a disease outbreak are critical but challenging for these countries. In a disease emergency, making basic personal protective equipment (PPE) such as masks and gloves available to a vast population will be a real challenge. The availability of laboratory-related PPE such as goggles, hazmat suits and special N95 masks for paramedics, nurses, clinicians and infectious diseases experts will be a real challenge too, as these countries have limited indigenous production and rely on import.
Amid the present outbreak, WHO has warned about the chronic shortage of such PPE worldwide, and calls for concerted efforts. Most South Asian countries lack technical expertise and advance biomedical facilities, especially Biosafety Level-3 and -4 laboratories, which are essential for novel pathogen detection. Inside the laboratories in these South Asian countries, there is a lack of molecular-based equipment for pathogen genome sequencing, primer synthesis, and early diagnostic assay; belated provision of such types of equipment will hinder timely response. Moreover, the supply chain management system is inactive in these countries. South Asian countries are desperate for health care facilities and services. In the current scenario, all South Asian countries invoke help from China. It is important to know whether there is any road map of cooperation existing between China and South Asian countries, and indeed, China plays an important role in global health cooperation under its Belt and Road Initiative (BRI) that really benefits developing countries. China has provided ten thousand diagnostic kits for the detection of COVID-2019 to Pakistan. Moreover, to bar COVID-2019 transmission in the neighboring country Iran, the Chinese government, apart from providing diagnostic kits, is planning to send a group of experts to barricade the outbreak. Alongside this, it is a good opportunity for South Asian countries to learn from China, and how it has been confining the COVID-2019 outbreak. To tame the burden of COVID-2019, other countries need to upscale financial and technical assistance to South Asian countries. More robust regional cooperation is required to effectively intervene dissemination of the virus. All countries should encourage preparedness and improve health-monitoring systems to predict, identify, and respond to future public health crises. Most importantly, international collaborations, partnerships, and communications should be enhanced.
The author is a CAS-TWAS fellow from the Chinese Academy of Sciences, and was a visiting scholar at Fudan Development Institute of Fudan University, Shanghai China (2018.9-2018.12). He can be reached at fawadmhd@gmail.com.
