COVID-19 will hit the developing world’s cities hardest. Here’s why

developing world

(Credit: Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Robert Muggah, Founder, SecDev Group and Igarapé Institute & Richard Florida, Professor of Business and Creativity, Joseph L. Rotman School of Management, University of Toronto

  • The world’s poorest cities aggregate factors that facilitate the spread of COVID-19 easier – and make it harder to contain.
  • These include high population densities, overcrowded accommodation and lack of access to basic services.
  • Here’s what national governments must prioritise to prevent a worsening of this growing health crisis.

The COVID-19 pandemic has brought some of the world’s wealthiest global cities to their knees. In the current epicentre, New York, roughly one-fifth of all residents are infected and more than 20,000 have died. London has reported more than 55,000 cases and 6,000 fatalities. Yet the spread and impacts of the disease are an even greater threat to poorer cities and slums in developing countries.

Informal settlements like Orangi Town in Karachi, Payatas in Manila, Kibera in Nairobi, or Rocinha in Rio de Janeiro have witnessed a silent surge in infections. Without proper interventions, they could become urban morgues. Combined with heavy-handed lockdowns and rising food prices, steep rises in excess deaths and social unrest could follow.

Mega-slums are incubators of disease transmission. Although some cities in Latin America, Africa and South Asia have learned the lessons of past pandemics and have at least temporarily dodged the first wave of COVID-19, many others are exposed. The world’s poorest cities and their informal settlements aggregate risk factors that accelerate the spread of infection.

One such risk is extreme density. Informal settlements are typically 10 times more dense than similarly located formal areas of a given city. The Dharavi slum in the centre of Mumbai has more than 270,000 residents per square kilometre. This compares to around 43,000 people per square kilometre in Manila, the world’s densest city.

Even worse than density is severe overcrowding and uneven access to basic services. In many lower- and middle-income cities, the poor are crammed into substandard and poorly ventilated buildings, making disease easier to spread. Far too many lack access to clean water, basic sanitation and even regular electricity. They are often squeezed into packed buses to get to and from work. Insecure property rights ensure that the urban poor lack access to many basic public services or banking and credit facilities.

Because they have few savings, the world’s roughly 1 billion slum dwellers – both young and old – are forced to work to survive, despite the stay-at-home orders. Today, developing countries account for 70% of the planet’s population aged 60 or over. Many of them suffer from pre-existing health conditions including obesity, diabetes and hypertension as well as cholera, dengue, hepatitis, malaria, pneumonia, tuberculosis and HIV. Chronic health problems are aggravated by poor nutrition and constant exposure to pollution.

New hotspots

With Brazil en route to becoming the global epicentre of COVID-19, its favelas will suffer most. In Rio de Janeiro, where at least 1.6 million people live in around 1,000 informal settlements, over 70% of households have already experienced a decline in income since the outbreak. The city government is advising the population to stay at home and take health precautions, yet the poorest residents lack piped water with which to wash their hands. Hundreds of residents have tested positive, but the queue for ICU facilities is in the thousands. Deaths are rising, though these are still vastly under-reported.

Brazil is fast becoming a COVID-19 hotspot
Brazil is fast becoming a COVID-19 hotspot
Image: Our World in Data

The situation is equally complicated in Lagos, Africa’s largest city, which has just over 3,500 reported COVID-19 infections to-date. Roughly 60% of Lagotians are poor, many of them packed into the city’s 100 slums. Almost 70% of the city’s residents depend on informal jobs – as street vendors, waste recyclers and artisans, for example – with no safety nets. Local buses run well beyond capacity, cramming 80 into spaces reserved for less than 20.

A similar scenario is playing out in Dhaka, Bangladesh’s capital, which has recorded more than 4,000 registered infections. There, at least 90% of the population relies on the informal economy. But Dhaka has less than 100 public ICU beds for a population of more than 8.5 million. Due to weak vital registration data, no one knows the real death toll of COVID-19.

Governments in some developing countries are responding to the spread of disease in slums as they often do – with top-down measures and a heavy fist. In city after city, lockdowns and curfews are imposed without regard to the impossibility of adhering to basic physical distancing. Where they are provided at all, food handouts are insufficient to meet local demand. In Kibera, the distribution of relief assistance has triggered riots and police violence.

Filling the vacuum

And in Rocinha, residents are fending for themselves. Informal settlements have essentially been abandoned by political elites, and local residents tend to rely on residential associations and self-help groups instead. Not surprisingly, cartels, gangs and mafia groups are stepping in to provide services and exploit the poor. Around the world, criminal groups that are already substituting for the state are further eroding the limited trust locals have in their public authorities.

Aggressively enforced quarantines are making a difficult situation much worse. This is because repressive containment could exacerbate social tensions, unleashing pent-up grievances and potentially violence. The suspicion with which locals view the political elite and public authorities helps explain the emergence of alternate systems of power and influence – including criminal groups. Managing these complexities is central to effective detection, treatment, isolation and, eventually, recovery from the disease.

coronavirus, health, COVID19, pandemic

What is the World Economic Forum doing to manage emerging risks from COVID-19?

The first global pandemic in more than 100 years, COVID-19 has spread throughout the world at an unprecedented speed. At the time of writing, 4.5 million cases have been confirmed and more than 300,000 people have died due to the virus.

As countries seek to recover, some of the more long-term economic, business, environmental, societal and technological challenges and opportunities are just beginning to become visible.

To help all stakeholders – communities, governments, businesses and individuals understand the emerging risks and follow-on effects generated by the impact of the coronavirus pandemic, the World Economic Forum, in collaboration with Marsh and McLennan and Zurich Insurance Group, has launched its COVID-19 Risks Outlook: A Preliminary Mapping and its Implications – a companion for decision-makers, building on the Forum’s annual Global Risks Report.

Companies are invited to join the Forum’s work to help manage the identified emerging risks of COVID-19 across industries to shape a better future. Read the full COVID-19 Risks Outlook: A Preliminary Mapping and its Implications report here, and our impact story with further information.

Lockdowns are only feasible when they are tailored to local realities. The reason is obvious: informal workers simply cannot afford the luxury of staying at home or giving up work. Given the array of deprivations facing the 60% of the world’s labour force that works in the informal economy, the notion of “shelter-in-place” is preposterous.

National governments must prioritize the delivery of water, food and sanitation to vulnerable populations, and support solid waste collection. Relief efforts should involve cash transfers to the poorest households and city officials should impose moratoriums on evictions. An early priority for local governments should also be to bolster primary healthcare systems and to train and deploy community health workers as they have in cities throughout Sierra Leone, Uganda and Vietnam.

In order to limit future infectious disease outbreaks, regular immunizations are essential. These and primary health measures should be underpinned by a strong communications campaign involving trusted neighborhood leaders, community radio stations, targeted television spots, convincing phone messages and especially social media.

All of this requires working directly with local organizations and coalitions that can help scale these interventions where they are most needed. Groups like UN-Habitat and Slum Dwellers International are playing a key role in galvanizing grassroots networks around the world. Global pandemics require global responses, and international organizations, philanthropy, city networks, and private businesses must all do their part. Ultimately, control of this pandemic crisis and the next one depends on what happens in the world’s slums. Many of them are showing remarkable resilience, but too many are being neglected.

The COVID-19 pandemic has been traumatic in advanced cities with hundreds of thousands of lives lost. It is likely to be much worse in the mega-cities and slums of the developing world, many of which are forming the new frontline.

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

These technologies are playing a major role at the Cricket World Cup

Eurozone: The crisis hit countries are again subsidizing the German and French banks

A Sting Exclusive: Paris Climate Change Summit, a defining moment for humanity, by Ulf Björnholm Head of UNEP Brussels

This is how climate science went mainstream

UN rights chief ‘appalled’ by US border detention conditions, says holding migrant children may violate international law

EU Top Jobs summit ended with no agreement: welcome to Europe’s quicksand!

We won’t win the online security war without people power

Which EU countries have to correct their economic policies?

Golden Pen of Freedom Awarded to Murdered Saudi Journalist Jamal Khashoggi during World News Media Congress 2019

Two rhythms and a sharpened pencil: how art can help us heal and make sense of the world

1 million citizens try to create a new EU institution

Neither side stands to benefit in US-China trade spat, UN says

GSMA Announces New Speakers for Mobile 360 Series – MENA, in association with The European Sting

‘Favour dialogue’ over violence, UN chief urges all parties following clashes in Mali’s capital

Europe slammed by Turkey’s shaky Erdoğan; both playing with immigrants’ agony

Easing fears and promoting gender equality in Chad’s girls-only classrooms

Farmers on the frontline in battle against drug-resistant microbes: UN health agency

When should you self-isolate, self-quarantine or social-distance?

The EU Commission to fight unemployment tsunami with a…scoreboard

Do not confuse food charity with ‘right to food’, UN expert tells Italians, labelling food system exploitative

Doctors are humans too: the benefits of embracing your mental status

Climate change is a disruptor. Here’s how to harness it for innovation

Metrics of the Sustainable Developments Goals: Can we trust our data?

At UN forum, Asia-Pacific countries highlight importance of transport for sustainable development

Writing a greener story in Asia and the Pacific amidst COVID-19 outbreak

Ensure that widows are ‘not left out or left behind’, UN chief urges on International Day

MEPs propose ways to boost plastics recycling

How cocoa farming can help stop deforestation

5 priorities for leaders in the new reality of COVID-19

Who’s promised net-zero, and who looks likely to get there?

Good grub: why we might be eating insects soon

Donald Trump’s victory is a great opening for global EU leadership on the sustainability agenda

Gaza investigators call on Israel to review ‘rules of engagement’ as Gaza protest anniversary looms

The European Commission to stop Buffering

As human genome editing moves from the lab to the clinic, the ethical debate is no longer hypothetical

Commission challenges Council over EU 2014 budget

UN chief appoints Luis Alfonso de Alba as Special Envoy for the 2019 Climate Summit

Practicing healthcare: Skills of a good healthcare professional and its effects

Landmark agreement will protect 100 European Geographical Indications in China

A neo-liberal toll free Paradise for the super rich and tax hell for wage earners

This simple digital solution could streamline global travel and boost trade during COVID – here’s how

FROM THE FIELD: What do you want to be when you grow up? One day I will…

MWC 2016 LIVE: Ford trumpets new in-vehicle system, “fundamentally rethinks” transportation

Health equity and accessibility for migrants is a peremptory demand

MWC 2016 LIVE: Ingenu steps up efforts to build LPWA networks across the globe

European Union disenchanted with Turkey

UN Member States overwhelmingly support end of US embargo against Cuba

To recruit younger people, you have to understand them. Here’s a guide

When is necessary understand the cultural marks in health-disease process

Realise the beauty of unity in diversity

Take medical use of cannabis seriously, say MEPs

European Semester Autumn Package: Creating an economy that works for people and the planet

African economies sustain progress in domestic resource mobilisation

Heart attacks and strokes are more common on high pollution days, data shows

Boris ‘single-handed’ threatens mainland Europe; can he afford a no-deal Brexit?

Trump declares emergency and WHO urges speed – latest coronavirus updates

How face masks, gloves and other coronavirus waste is polluting our ocean

Saudi Arabia, China, among 14 nations under UN human rights spotlight: what you need to know

Mixed news about the Eurozone economy

Remembering Kofi Annan

More Stings?


Speak your Mind Here

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s