The risk of fracture: Coronavirus in the Middle East

The rate of coronavirus in the Middle East is growing rapidly and governments are acting to contain and mitigate its spread — including curtailing or limiting international travel, prohibiting mass gatherings, and invoking universal quarantines. Qatar has banned hookah cafes in public places to stem the outbreak, one day after closing schools and universities. Iranians are adapting to new greetings while it has also buried hundreds of its citizens. Even though these mitigation strategies are helpful, most of the Middle East will be unable to cope with the pandemic. Coronavirus in the Middle East likely will have two potentially catastrophic public health consequences.

First, the pandemic will likely overwhelm failed public health systems in Yemen and Syria. The international community cannot adequately contain the virus in these complex emergencies particularly in Idlib, Syria, Houthi-controlled territories of northern Yemen, and cross-border refugee camps in Jordan and Turkey. Incredibly, neither Yemen nor Syria has recorded a single coronavirus case, which almost certainly is not a function of its superior health care system but rather because of its governing dysfunctionality. Literally millions of the world’s most vulnerable could be at risk with mortality rates much higher than in sophisticated health systems in wealthier countries.

Second, coronavirus will stress fragile public health systems in densely populated urban centers such as Baghdad, Beirut, Cairo, and Gaza. With poor health institutions coupled with marginal water and sanitation systems, coronavirus could prove deadly to core population centers. Both failed and fragile health systems will likely accelerate the spread of the virus to the point where the Middle East could emerge as an unmitigated hotspot.

More broadly, widespread transmission could have political, economic, and national security implications that may trigger further destabilization in an already volatile region.

Politically, the coronavirus is spreading in areas of Iraq, Saudi Arabia, and Bahrain. Any discrepancy in public health service or outcomes along sectarian lines may trigger political grievances against central governments and ruling authorities exacerbating religious/ethnic tensions.

The pandemic — along with increased political risk — will likely drive an economic downturn. The price war over oil between Saudi Arabia and Russia has severe economic consequences for the Middle East. Iraq, for example, will be stretched financially in its public health response. The continuing spread of coronavirus in Iran will continue to transmit to the Gulf, causing economic retrenchment in its wealthiest markets. Israel, Palestine, Jordan, and Saudi Arabia are experiencing a near zeroing out of tourism and pilgrimage travel during its peak season. Widespread job losses and firm bankruptcies would undermine the weak economies in the Levant region.

A pandemic, heightened political risk, and economic collapse would seed increased opportunities for adversaries including ISIS, Al Qaeda, Hezbollah, Hamas, or Iranian-backed militia groups to seek advantage or direct attacks against American interests as experienced in Camp Taji in Iraq last week. A perception of a weakened, chaotic America will green light further attacks.

From a national security, foreign policy, and humanitarian perspective, the U.S. has dual challenges.

Of course, American public health efforts must first and foremost concentrate on mitigation strategies in the United States, including increased testing, more rapid care, and aggressive social distancing. But Congress recognized in its $8.3 Billion Coronavirus Preparedness and Response Supplemental Appropriations Act that the U.S. could target fragile and failed health systems in poorer countries to mitigate the risk of coronavirus hot spots in the Middle East and elsewhere.

Coronavirus started in Wuhan, China, a provincial capital unknown to most Americans two months ago. Helping stem the pandemic in Wuhan or emergent hot spots matters to the citizens of Seattle and New Rochelle. Pandemics do not, obviously, respect borders.

The State Department and the U.S. Agency for International Development (USAID) can take four steps now.

First, the U.S. must provide immediate analytical support to the World Health Organization (WHO) under its recently announced $37 million assistance package so that the international community has fully vetted pandemic data. Second, Secretary of State Mike Pompeo should direct embassy country teams, along with regional and global task forces, to partner with other nations to share best practices in reducing and mitigating the spread of coronavirus. Third, USAID Administrator Mark Green should leverage funding for WHO, other United Nations agencies, and international NGOs from Saudia Arabia and the United Arab Emirates. Finally, USAID should require that global health funding and international disaster assistance include fast response, piloted innovations designed to improve global pandemic containment and mitigation strategies.

The world is facing a serious challenge with the coronavirus pandemic, economic collapse, and frayed international political systems. Our collective humanity requires that America lead a global response.

R. David Harden is managing director of the Georgetown Strategy Group and former assistant administrator at USAID’s Bureau for Democracy, Conflict and Humanitarian Assistance, where he oversaw U.S. assistance to all global crises. Follow him on Twitter @Dave_Harden.