Introduction

As nations struggle to contain and mitigate the effects of the Covid-19 pandemic, many international and political consequences are difficult to discern as yet. A particular concern is the future of humanitarian aid in conflict zones. With sustained austerity and the rise of populism being salient features of the last decade, Covid-19 threatens to decelerate the donations from rich countries to conflict-affected areas as governments in the West harbor more resources for internal purposes.

There is a growing concern that coronavirus could compound instability in several Middle East and North Africa (MENA) countries and neighboring regions. Although cases of Covid-19 haven’t been reported in significant numbers in conflict zones in Iraq, Libya, Syria, Yemen, and Afghanistan as yet, the risk of a widespread outbreak remains. In the MENA context, the United Nations Office for Coordination of Humanitarian Affairs (OCHA) has identified countries requiring prompt and substantial humanitarian assistance given the threat posed by the pandemic to vulnerable populations.

All the countries identified by OCHA are threatened by a pandemic that may exacerbate existing conflict and failures of governance. With health infrastructure damaged and degraded by conflict in these countries, there is a pressing need for solutions that draw on the capacities of regional, international and multilateral donors. This Insight examines the efforts currently being made by these actors to help vulnerable countries prepare for the outbreaks of Covid-19. In addition to examining the humanitarian aid currently being given, there will also be an assessment of the political and diplomatic factors involved.

The pandemic and vulnerable populations

In the immediate aftermath of the pandemic, many countries around the world have understandably been working on issuing national response plans to tackle Covid-19. However, the rapid spread of the virus means that a renewed global effort is needed to improve inter-agency coordination, synergy in plans and trans-national flow of information to help develop optimized solutions for countries of concern. It is worth remembering that due to active conflict, general insecurity, poverty, massive forced migration or natural disasters, more than 100 million people already rely on UN agencies’ support.

Global action and solidarity initiatives coordinated by international agencies are key steps in ensuring that the world addresses the Covid-19 threat in the most effective manner.  National governments, donors, private sector partners, international institutions and local communities all have a role to play in this. While the current crisis will eventually subside, albeit with massive consequences and casualties, the choices made today will determine the outcome of the post-crisis period and the impact on vulnerable communities worldwide.

In just over two months, Covid-19 has progressed from an outbreak in the Chinese Hubei province to affect more than 208 countries around the world through outbreaks that have put considerable strain on struggling healthcare infrastructure.

• Healthcare: The pandemic has led to a measurable decrease in the treatment of other pathologies and fewer services being offered relating to preventive healthcare, including prenatal and post-natal care. Many countries, especially those in insecure regions and active conflict zones, have insufficient resources to enable health-care staff to work effectively and also do not have enough space or necessary supplies to treat the sick. In other words, the pandemic has uncovered many pre-existing incongruences and insufficiencies in the existing healthcare systems around the world.
• Socio-economic impact: Many vulnerable countries identified by OCHA had already been dealing with a large number of issues, including conflict, food insecurity, forced migration, climate change, and socio-economic shocks. Coupled with the task of recalibrating already limited government budgets to respond to the Covid-19 pandemic, diminishing fiscal revenues will negatively impact already overstretched social programs and services in countries affected, essentially leaving the most vulnerable communities without access to basic services and livelihood.
• Curbed protection needs: The Covid-19 pandemic has induced a de facto mobility crisis, wherein the world is witnessing rapid changes in patterns of acceptance toward migration, airline services, attitudes toward foreigners, and border and migration management systems. In addition to potential spikes in hate crimes and xenophobia-fueled attacks, national and regional measures to restrict the movement of people may increase the risk of denial of access to territories for those seeking protection and asylum, thus leaving many without access to healthcare, education and social security.

Moreover, the impact of the Covid-19 pandemic has been felt differently across various vulnerable communities around the globe. Four primary groups can be identified:

• Chronic patients: Those with the greatest risk of developing a severe condition include people with chronic diseases and under-nutrition due to food insecurity, lower immunity, disabilities and old age, all of which increase their susceptibility to disease.
• The displaced: The second group at high risk encompasses refugees, asylum-seekers, returnees, internally displaced persons (IDPs) and those who lack sufficient economic resources to access basic healthcare. Many within this group might be denied access to healthcare or might refuse to seek health assistance through official channels due to fear of stigmatization and discrimination.
• Minors and unaccompanied children: The third group includes those separated from their parents or primary caregivers due to quarantine or confinement measures. Children remain at great risk of being neglected, abandoned and exploited. Moreover, they might have reduced access to healthcare services, which is crucial for curbing Covid-19.
• Women: The fourth group includes women and girls, given their role as a health and social welfare responders and caregivers within the family, which makes them particularly at risk of potential contamination and more susceptible to the virus. Pregnant women have a heightened risk of contracting many transmissible and viral diseases, including the Covid-19 virus. Also, gender-based violence, while not only aimed against women, is projected to increase due to containment measures and the disruption of support services. Some efforts, however, have been made to place victims of domestic abuse in separate housing during the current crisis. For example, France has started to place victims in hotels in mid-March after reports of an exponential rise in reported cases.

While Covid-19 is indiscriminate in terms of the effects it has on human physiology, it is also clear that vulnerable and marginalized people are disproportionately affected by the socio-economic risks that accompany the pandemic. The threats faced by the people in need are factors that must be taken into account in the humanitarian programs currently being developed by regional, international and multilateral donors.

The Global Humanitarian Response Plan (HRP)

In the context of the current spread of the pandemic to most of the countries, the Covid-19 Global Humanitarian Response Plan (HRP) represents a comprehensive inter-agency response mechanism that seeks to aggregate and update relevant and existing humanitarian programs run by the UN and non-UN entities, including WFP, WHO, IOM, UNDP, UN-Habitat, UNFPA, UNHCR, UNICEF. The plan also takes into consideration the work currently being done by the International Red Cross and Red Crescent Movement (ICRC).

Published in mid-March, the HRP focuses on optimal ways in which the international community can address the spread of the Covid-19 virus for the April-December period in 2020. The report has three strategic priorities:

(i) containing the spread of the pandemic, which includes collaborative efforts to decrease morbidity and mortality; (ii) decreasing the deterioration of human assets and rights, social cohesion and livelihoods, as caused by the pandemic; and (iii) protecting, assisting and advocating for vulnerable populations particularly vulnerable to the pandemic (Table 1).

Table 1 showcases the three strategic objectives (Source: United Nations Office for the Coordination of Humanitarian Affairs OCHA)

Guided by humanitarian principles, this blueprint for a coordinated global humanitarian response to the COVID-19 pandemic estimates the financing requirements for the plan over nine months in 2020 at USD 2.012 billion, a sum including expanded funding for ongoing humanitarian response projects. The plan encompasses 24 priority countries, including Yemen, Syria, Iraq, and Libya in the Middle East region.

Against the backdrop of the ongoing crisis, countries with high levels of food insecurity, including those in the Middle East, are assessed as being more vulnerable before the virus outbreak and continue to be less prepared to tackle the pandemic given their healthcare sector deficiencies and general food shortages. While there are two broad scenarios, one envisioning quick containment and the other a long-lasting crisis, the future will bring a lot of uncertainty in key areas of human development. Besides, the nature of funding for the leading humanitarian agencies presupposes a continued willingness of national governments worldwide to support such efforts. This is particularly the case with those major powers that provide a substantial proportion of these funds.

Major global powers and humanitarian assistance to Middle East conflict zones

While major global powers take a close and often active interest in the various conflicts in the MENA region, their aid strategies and humanitarian projects remain entangled in the geopolitical rivalry and competition for influence. Because of their domestic priorities, the key issue is whether or not the main external players can adjust and/or supplement their existing programs given the urgency of the crisis. Concerning Covid-19 spread patterns, there are particular fears that the virus will run out of control in areas with insufficient health services. The principal question is whether or not the major external powers will be willing to prioritize assistance over national interests.

In terms of assistance to regional conflict zones, US priorities have been shaped by the extent of their military commitment and stabilization efforts in specific countries, notably Afghanistan and Iraq. In the year of a US presidential election, the Trump administration is seeking to fulfill pledges to scale down the country’s military and financial commitments in the MENA region. In contrast, the bulk of the European Union’s (EU) efforts have been devoted to provide aid to countries on the Mediterranean littoral that have been the sources of significant numbers of displaced people seeking aid in Europe. Nevertheless, Brussels’s approach is also dictated by short-term political calculations based on national state hostility to further influxes of migrants and the resultant risk of a public backlash.

United States

While the Trump administration initially pledged extra funds to assist vulnerable countries in tackling Covid-19, US policy has remained subject to domestic calculations and the particular circumstances of MENA conflict zones. On 27 March, the US State Department announced a $274 million emergency health and humanitarian package aimed at assisting afflicted countries in their efforts to tackle the coronavirus pandemic. Out of the total aid package, $40 million was set aside for MENA countries. $15.5 million was allocated to Iraq to “help prepare laboratories, implement a public-health emergency plan for points of entry, activate case-finding and event-based surveillance for influenza-like illnesses, and more.” Besides, nearly $17 million was provided for humanitarian aid to Syria, while $6 million was reserved for Libya.

The State Department’s package was notable for the exclusion of Yemen. In 2019, the US donated more than $700 million to the UN and other organizations working in Yemen. Much of this assistance was distributed in northern areas controlled by Houthi rebels. Nevertheless, US assistance in the country has been drastically scaled-down in recent weeks due to accusations that the Houthis are restricting and attaching conditions to the distribution of humanitarian aid in those areas of the country that it currently controls. On 27 March, the US Agency for International Development stopped $70 million in assistance from being delivered to northern Yemen; other funds earmarked for the country’s south were not affected. In the near-term, the decision is likely to lead to serious shortfalls of funding for programs run by the UN and other private aid groups assisting the Yemeni healthcare sector. Humanitarian groups and some Congress members protested against the decision, citing the imminent threat of the spread of Covid-19 to Yemen.

In the case of Afghanistan, the US is currently seeking to cut $1 billion from its annual aid package of $4 billion in security aid and $500 million in civilian aid to Afghanistan’s central government. The move is primarily a consequence of continued US frustration at the political impasse in Afghanistan caused by rivalry between President Ashraf Ghani, Afghanistan’s president, and Dr. Abdullah Abdullah, Afghanistan’s Chief Executive, which intensified as a result of the disputed results of the country’s presidential election in late 2019.

The US is anxious to create a united front in Kabul to boost the prospects of successful peace talks with the Taliban. Although the US withdrawal of aid is not directly related to the Coronavirus pandemic, the move comes at a sensitive time given Afghanistan health ministry warnings that as many as 80 percent of the population could be vulnerable to the virus. Due to the danger to foreign forces in the country, the NATO military mission screened 1,500 of its personnel after four members of the force tested positive for the virus.

The European Union

The European aid policy toward MENA in recent months has sought to build on existing programs. In response to the outbreak of Covid-19, the EU allocated an additional $262 million aiding refugees and people of concern in Syria, Iraq, Jordan, and Lebanon, bringing the total amount it provides through its “EU Regional Trust Fund in Response to the Syrian Crisis” to more than $2 billion. The extra funds provided by Brussels are aimed at supporting healthcare provision in the countries targeted to help mitigate the risks of the pandemic spreading. The bulk of the aid is intended to enhance social safety, strengthen local education provision and improve health care for Syrian refugees in Jordan and Lebanon.

While the EU is not providing specific coronavirus-related aid to Yemen, the union is maintaining its ongoing humanitarian assistance to the country. In 2019, the EU provided a total of $177 million in aid, bringing the total funds given to Yemen since the start of the country’s civil war in 2015 to $776 million. The money is specifically targeted to help local Yemeni communities develop their health services and ensure better access to drinking water and food, improved sanitation, and additional educational opportunities.

The European Union also provides aid to Afghanistan, though the total is dwarfed by the sums committed by the US. In 2019, the European Commission gave a total of $84 million in emergency assistance to help with the worsening humanitarian situation in Afghanistan and also aid Afghan refugees in neighboring Pakistan and Iran. Overall, however, the provision of EU funds, in this case, is subject to the extent of the US commitment to Afghanistan and the potential future of the NATO training mission currently operating in the country. If the Trump administration manages to advance the Afghanistan peace process and scale down its troop deployments and financial assistance to Kabul, it is likely that the EU will also seek to reduce its aid spending in a country where it has no vital interests.

China and Russia

While the extent of assistance given by China and Russia to MENA conflict zones is dwarfed by the funds provided by the US and the EU, both Moscow and Beijing have provided limited cases of practical aid to help regional countries tackle Covid-19. In this context, the Chinese government delivered 10,000 coronavirus kits to Palestine and also dispatched a medical team to the territories to help Palestinian medical teams and hospitals counter the coronavirus pandemic.

Similarly, in Iraq, a Chinese medical team helped set up a new PCR (polymerase chain reaction) laboratory in Baghdad to improve the local medical services’ ability to confirm the cases of coronavirus in patients suspected of having the disease. The newly-built lab is designed to be capable of carrying out up to 1,000 tests per day.

Russia has so far limited its assistance for Syria. Following a visit by Russian Defense Minister Sergei Shoigu to Syrian President Bashar al-Assad in late March, the Russian navy delivered medical aid including specialized equipment to help detect and treat cases of coronavirus in Syria. As the Syrian health system has been severely damaged during the civil war, President Vladimir Putin’s government is seeking to demonstrate its willingness to help the country’s people at a time of crisis. Russia is aware that providing aid will also boost the stability of the Assad regime.

This is already evident in Russian diplomacy at the United Nations, when the Permanent Representative of Russia told a Security Council meeting on 30 March that only Damascus and not the Syrian Kurds or other opposition forces should be allowed to control the distribution of humanitarian aid. Moscow’s assistance is being provided with an awareness of the geostrategic context in the region, as Putin is well aware of the benefits of being seen in the Middle East as a reliable partner, a helpful benefactor and a dependable alternative to the Western countries.

While being generally beneficial, the isolated deliveries of practical assistance delivered by Moscow and China are undoubtedly being given with an eye to the propaganda value of the quick provision of emergency aid. Such dramatic interventions also reinforce the impression that the EU is slow and cumbersomely bureaucratic in its response to humanitarian crises. At the same time, impulsive actions of the Trump administration also reinforce the impression that the Western powers are working at cross-purposes in their efforts to help tackle the pandemic. In the aftermath of Trump’s sudden decision to cut off US funding for the World Health Organization (WHO), China, Russia, and Iran all sought to highlight the US’s alleged willingness to sabotage joint international efforts to fight the crisis.

Major power rivalries have therefore impacted their humanitarian aid efforts in the MENA region. While US and EU funding has been maintained or even enhanced in several cases, the provision of this aid has been affected by political factors and there has been little coordination in ensuring that it is more effectively targeted.

It is also evident that Russia and China are framing their humanitarian assistance efforts to gain credit with governments and populations in need. In the case of Afghanistan, the threat of Covid-19 is yet another addition to the challenges facing the Kabul authorities as they seek to develop a tentative peace process and ensure security following a likely NATO and US withdrawal.

Gulf Cooperation Council (GCC) efforts to aid the regional fight against Covid-19

The rivalries between the major powers that have influenced their humanitarian aid policies have to an extent overshadowed effective interventions at a regional level. In the MENA countries, the humanitarian aid currently being provided by the GCC countries, in particular, the United Arab Emirates (UAE), to regional conflict zones builds on a long-standing legacy of generous regional assistance. With their donations amounting to some of the largest sums provided by national governments, the leading Arabian Gulf states have quickly responded to the threat.  Moreover, GCC governments have been able to apply lessons from combatting the pandemic in their countries.

In the MENA region, existing GCC development assistance for other countries has taken diverse forms ranging from grant assistance for health and education projects to technical schemes to assist with renewable energy innovation. The current pandemic, although unprecedented, has demonstrated that Arabian Gulf states have been able to quickly adjust to changing circumstances and provide emergency help to those in need. Since the inception of the outbreak, the UAE, Saudi Arabia, and Kuwait have been aiding developed and developing nations alike in combating the spread of the pandemic.

The doctrine that multilateral humanitarian cooperation in times of crisis is essential is reflected by the foreign policies of leading GCC donor countries during the present crisis. In this context the UAE, Saudi Arabia, and Kuwait have led a substantial humanitarian response to the crisis that has built on their previous aid efforts:

United Arab Emirates

The UAE’s foreign aid policy is focused on sustainable human development. While the UAE aims in its foreign aid to reduce poverty, promote stability and build peace in the MENA region and invest in developing countries, it also concurrently aims to build collaborative, strong relationships with other nations. In recent years, the UAE has been ready to help when unprecedented global health emergencies emerged, most recently with the outbreak of cholera in Yemen, and previously with the onset of the Ebola crisis in West Africa.

A substantial proportion of the UAE’s foreign aid is directed toward the MENA region. Aid has been principally directed to conflict-affected areas such as Iraq, Libya, Syria, and Yemen, along with Afghanistan, as a reflection of the country’s foreign aid policy designed to bolster stability and peace in the region and beyond (Table 2).

Additionally, following its vision of sustainable human development, the UAE’s Ministry of Foreign Affairs and International Cooperation (MoFAIC) has prioritized projects involving construction, health, education, and energy as the most important sectors requiring assistance in several countries. Besides, the Abu Dhabi Fund for Development (ADFD) has played an active part in supporting local projects through foreign assistance aimed at empowering recipient national governments and local communities to accelerate economic growth (Table 2).

Table 2. UAE’s Government Foreign Assistance between 2016-2018 (source: MoFAIC)

Table 3. Abu Dhabi’s Fund for Development Foreign Assistance between 2016-2018 (source: MoFAIC)

Despite the UAE’s efforts to develop MENA countries subject to conflict, these countries remain affected by factional political rivalries, insurgencies and civil conflicts, and corruption. Nevertheless, the UAE has been quick to expand its humanitarian response. During the G20’s virtual meeting in March 2020, the UAE underscored its preparedness to play a leading role in global humanitarian efforts.

In early March, the UAE evacuated Arab nationals and their families from China’s Covid-19 epicenter, Wuhan; these evacuees, many of them Iraqi, Syrian and Yemeni citizens, were flown to Abu Dhabi and given medical care. In this manner, the UAE’s gesture demonstrated solidarity in answer to the request of their respective governments to assist citizens unable to leave China.

Also, the UAE government, in coordination with the Red Crescent, have increased their efforts in Yemen, starting with awareness and city-wide sterilization campaigns as well as doubling the flow of nutritional and medical supplies. The United Nations’ attempts to de-escalate the situation in Yemen were also strongly backed by the UAE. To this end, the UAE’s Minister of State for Foreign Affairs, Dr. Anwar Gargash, called in early April for the implementation of the Riyadh Peace Agreement as an urgent measure to enable Yemenis to manage the pandemic regardless of the ongoing factional rivalries in the country.

The UAE has also been ready to assist humanitarian efforts regardless of frozen relations with the Damascus government since the beginning of the Syrian civil conflict in 2011. There has been particular global concern over the vulnerability of internally displaced persons to a Covid-19 epidemic in the congested refugee camps near the Syrian-Turkish border. With this in mind, the UAE extended its offer to assist the Syrian government in tackling the virus and provide much-needed assistance regardless of the conflict in the ground.

Saudi Arabia

As one of the world’s largest donors of its kind, Saudi Arabia has distributed aid in sums comparable to the leading Western donor states. Though Islamic and Arab nations are the primary recipients of Saudi Arabia’s contributions, Saudi assistance has also been given without regard to religion and ethnicity to help tackle humanitarian emergencies, as was seen in the aftermath of the devastating earthquake that struck Haiti in 2010.

Most recently, Yemen has been Saudi’s largest recipient of humanitarian assistance (Table 4). In addition, Riyadh renewed its commitment to aid Yemen’s health sector in late March when critical medical supplies were transported to the country to combat the threat of a Covid-19 outbreak along with a further $10 million donated to fund WHO projects in the country. Saudi Arabia has also donated $10 million to assist other Middle Eastern states affected by the conflict in their efforts to contain and mitigate coronavirus (Table 4).

Table 4. Saudi Arabia’s total aid funding per country  (source: King Salman Humanitarian Aid and Relief Center)

Kuwait

Kuwait also has been active in regional aid through significant humanitarian efforts in Syria, Iraq, and Syrian refugee camps in Jordan. Despite the country’s complicated history with Iraq, Kuwait has been ready to help its neighboring state. The country has directed its aid to strengthen Iraq’s development efforts by investing in healthcare, education, and the reconstruction of its urban areas. Moreover, given Baghdad’s tentative response to Covid-19 and the country’s debilitated healthcare sector, there is an urgent need for additional help if the sporadic instances of coronavirus are to be prevented from spreading widely. Kuwait has pledged $10 million directly to Iraq and an additional $40 million to the WHO to fight the outbreak.

Recommendations

In response to the universal threat of Covid-19, the international community must combine efforts on multiple fronts simultaneously in the short- and medium-term period to tackle the immediate crisis and adopt preventative measures for the future.

To this end, several steps can be taken in the immediate future:

• Given that one of the main characteristics of the Covid-19 pandemic is its rapid and exponential spread across the globe, one of the most important steps to be taken is implementing appropriate monitoring mechanisms at a local level to track achievements and, if necessary, provide immediate intervention in the most vulnerable areas;
• The international community, including host-countries of vulnerable populations and international organizations, should work together to address information deficits, misinformation, discrimination based on fear, lack of transparency in procedure and stigmatization: all of which minimize vulnerable populations’ access to healthcare;

Table 5: COVID-19 plan (source: United Nations Office for the Coordination of Humanitarian Affairs OCHA)

Conclusion

The decisions that countries around the world make today to aid the fight against the Coronavirus will help shape the communities around the globe in the future. The consequences for healthcare systems, economies, political regimes, cultures, and norms will be lasting. Foreign aid is multifaceted; so are its motives. Besides its clear altruistic aim of promoting economic development and human welfare, aid can also be employed as part of diplomatic “soft power” and more aggressive propaganda strategies, with the result that its misuse and politicization is inevitable in many cases.

Nevertheless, systematic humanitarian relief is needed for MENA conflict zones for sound strategic imperatives alone. On the one hand, the social impact of the outbreak could decrease cohesion and further deepen inequalities in areas where violent conflict is already ongoing. On the other, imaginative assistance efforts could prevent the worst socio-economic impacts of the pandemic by protecting vulnerable populations through security and improved healthcare as the basis of a better quality of life. To achieve the latter outcome, effective global cooperation between national governments is needed now to foster intensified efforts to suppress Covid-19 and ensure readiness to defeat future threats to all people at risk.