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COVID-19 and debt in the global south: Protecting the most vulnerable in times of crisis III

Added 16 Mar 2020
This is the third part of a blog series covering the impact of COVID-19 on vulnerable countries in the global south. Part 1 analyses the impact of debt burdens on health services. Part 2 discusses how the economic crisis will affect countires in the global south. Part 3 highlights the degree of vulnerability of countries in the global south to the COVID-19 epidemic. Part 4 provides a discussion on policy responses to tackle the risks posed by the epidemic. 

Eurodad analysis of the interplay between health, trade and financial factors shows the high degree to which countries in the global south are vulnerable to a systemic crisis. Within a sample of 69 LIEs, it is estimated that at least 84 per cent have vulnerable health care systems (58 countries)1 ; 80 per cent present trade vulnerabilities (55 countries)2 and a further 46 per cent have debt vulnerabilities (32 countries).3 In at least 30 per cent of cases (21 countries) these 3 sources of vulnerability are present at the same time. The majority of cases of high vulnerability are concentrated in Sub-Saharan Africa (13 countries) (Figure 1). 

Figure 1 – Geographical distribution of simultaneous health, debt and trade vulnerabilities to COVID-19

* Scale denotes the number of vulnerabilities present by country
Source: WHO Global Health Observatory, IMF country DSA, World Bank WDI, UNCTADStat.


Countries classified as highly vulnerable are in a very fragile position. Even if they manage to avoid a COVID-19 outbreak, the presence of risk factors makes them highly vulnerable to a debt crisis. What’s more, a closer look at the sources of this vulnerability indicates a relationship between the risk of debt distress and the overall degree of vulnerability (Figure 2 – Box 1). 78 per cent of countries classified to be in a situation of debt distress by the IMF are also in a situation of high vulnerability.4 Meanwhile, 38 per cent of countries at high risk of debt distress (9 countries) are in a situation of high vulnerability. This figure drops to 13 per cent (3 countries) and 15 per cent (2 countries) for countries with moderate and low risks of debt distress, respectively. 

Figure 2 – Health, debt and trade vulnerabilities in Low Income Economies by risk of debt distress (% of countries by debt risk group)*

* Figures in chart denote number of countries by type of vulnerability
Source: WHO Global Health Observatory, IMF country DSA, World Bank WDI, UNCTADStat 

The overlap between the risk of debt distress and health service-vulnerability points once more to the negative impact of debt on health care. For countries in debt distress, debt service reached 11.5 per cent of GDP, on average, while public health care expenditure represented only 2.2 per cent of GDP. Delayed and complex debt restructuring processes that last for 2 years or more (Congo, Gambia, Mozambique, Zimbabwe) have inflicted additional economic damage onto these countries. By extension, this has limited their capacity of response to the COVID-19 epidemic. There is a real risk of a rapid surge in the number of countries experiencing these same types of problem. The urgency of this situation highlights the need to reform the current debt resolution system and make progress towards the creation of a multilateral debt workout mechanism, which allows for an orderly, fair, transparent and durable debt crisis resolution to reduce the economic and social costs of debt crises. 

Box 1 - Highly vulnerable LIEs to the COVID-19 epidemic by risk of deb distress (Red indicates presence of active reported cases)5

In debt distress:Congo, Gambia, Mozambique, São Tomé and Príncipe, Somalia, Sudan, Zimbabwe
At high risk: Afghanistan, Cabo Verde, Dijbouti, Mauritania, Sierra Leone, Ghana, Tajikistan, Zambia
At moderate risk: Kenya, Togo, Yemen
At low risk: Senegal, Tanzania

Given the severity of the current risks to public health and economic stability, bold actions will be needed to: a) respond to the direct threat posed by COVID-19, and b) minimize the impact of debt on populations in the global south. We will look further at potential responses in the final part of this blog series.

Read parts one and two 

1 Defined as countries with health care systems with either capacity or performance limitations. For a complete definition, data sources and country by country figures, please refer to the methodological annex. 
2 Defined as countries with large trade exposure to either China or commodity exports. For a complete definition, data sources and country by country figures, please refer to the methodological annex.
3 Defined as countries with either large short term public external debt stocks or public debt stocks. For a complete definition, data sources and country by country figures, please refer to the methodological annex.
4 Country groups are defined according the latest debt risk assessment performed by the IMF. List of countries per risk group available at: https://bit.ly/2VJbaOh
5 As of March 15, 2020. Data available from: https://bit.ly/3czU5fE