Trump’s withdrawal from WHO will hurt African women and children

Since President Trump announced at the end of May that he was “terminating” U.S. support for the World Health Organization (WHO), analysts have been trying to parse out the consequences. Is the U.S. formally withdrawing from the WHO, which would require a year’s advance notice and payment of back dues? Will Trump’s decision help or hurt China’s global clout? Some experts argue it will ultimately make the U.S. less influential and more isolated globally. But one thing seems certain: It will be devastating for Africa, which depends heavily upon the WHO’s expertise and leadership in the fight against pandemics.

While COVID-19 has struck much of the world with the force of a Category 5 hurricane, the impact on Africa so far has been far less deadly. But Africa is extremely vulnerable. The number of confirmed cases exceeds 276,000, and the consensus is that the continent’s testing rates are distressingly low, distorting our understanding of the actual spread of the virus. If the coronavirus is not adequately contained, it will likely afflict the continent for a very long time. And while all segments of society will suffer, women and children, in particular, could be severely impacted by what one U.N. official calls “the crisis within a crisis.”

Models still vary widely, but the WHO now estimates that up to a quarter of a billion Africans could contract the coronavirus in the first 12 months of the pandemic and 190,000 could die. That’s lower than many initially feared. Tight restrictions are evidently having some success, and Africa’s youthful age structure may provide an added layer of protection. However, Africa’s battle with COVID-19 is far from over, and the collateral damage is mounting. The secondary impacts — poverty, hunger, disease and violence — disproportionately suffered by women and children, could be staggering.

A UN University analysis warns that the economic impacts of COVID-19 could push as many as a half billion people into poverty, reversing three decades of economic gains. Sub-Saharan Africa and South Asia, in particular, could see substantial increases in severe poverty. If so, women will be especially vulnerable, as women in sub-Saharan Africa are 27 percent more likely to suffer from extreme poverty than men. Women also comprise 54 percent of Africa’s health care workforce, so many of them will be on the frontlines in the fight against COVID-19, often without personal protective equipment.

As incomes shrink, many households in Africa will not have enough money to purchase food. The U.N.’s World Food Programme (WFP) warns of a looming “hunger pandemic,” as an additional 265 million people, the majority women and children, could be on the brink of starvation by the end of 2020, with the severest impacts in Africa. In a recent survey cited by the U.N. Economic Commission for Africa, 85 percent Africans under stay-at-home orders said they are either skipping meals or eating less because of the shutdowns. UNICEF this month warned that an additional 6,000 children could die every day from preventable causes over the next six months as a result of the pandemic. Many of those deaths will occur in sub-Saharan Africa, which accounts for nearly half of all childhood deaths under the age of five.

Women’s access to reproductive health care, deemed essential by the WHO, is also threatened by the pandemic and the lockdown. In many parts of Africa, clinics are closing, transportation is limited, and providers and supplies are scarce. According to DKT, a major provider of contraceptives in the developing world, many countries could be facing shortages of condoms and oral contraceptives.

Disruptions in the reproductive health supply chain caused by COVID-19 will have tremendous consequences for millions of women and girls. The United Nations Population Fund (UNFPA) estimates that 47 million women in low- and middle-income countries will be unable to obtain modern contraceptives if the lockdown continues for six months. That could boost unintended pregnancies by seven million and produce a significant increase in unsafe abortions and maternal deaths.

It’s also widely anticipated that COVID-19 lockdown restrictions could generate a spike in gender-based violence. As part of its Sustainable Development Goals (SDGs), the U.N. was making notable progress towards ending gender-based violence by 2030. But according to UNFPA, 31 million additional gender-based violence cases can be expected if the lockdown continue for six months. 

UNFPA is also warning that, with schools closed and many girls stuck at home, Africa could see a massive increase in female genital mutilation (FGM), setting back by as much as one-third the progress that had been made in reducing FGM since 2015: there could be two million additional cases over the next decade as a result of COVID-19 restrictions. Progress towards eliminating child marriage could also be reversed: an additional 13 million child marriages could take place between 2020 and 2030.

The WHO plays a leading role in curbing both the pandemic and its broader impacts on the health and economic wellbeing in Africa. As the Trump administration “terminates” U.S. support for the WHO, Africans, and particularly women and girls in Africa, will pay a steep price.

Bridget Kelly is the Director of Research with the Population Institute, a nonprofit based in Washington, D.C. that supports reproductive health and rights.