Inquiry on the Impact of Coronavirus: Written submission on behalf of Bond
International Development Committee inquiry
Humanitarian crisis monitoring: Impact of Coronavirus
Written submission on behalf of Bond on the current situation and immediate risks and threats
Friday 17 April 2020
1.1. Bond is the UK network for organisations working in international development and humanitarian aid. It unites over 400 organisations, ranging from small specialist charities to large international non-governmental organisations (INGOs) with a world-wide presence. As COVID-19 continues to spread worldwide, we are supporting our members to adapt their programmes and operations and keep their staff safe and organisations secure. We are responding to the needs of our members by mobilising the sector, advocating for additional support for civil society, and providing the latest information and insights on the crisis.
2.1. In order to effectively respond to the global health and humanitarian crisis posed by COVID-19, the UK Government should:
2.1.1. Lead a coordinated global response: The COVID-19 outbreak is a global crisis that demands a global response. The Department for International Development (DFID) has a reputation for being one of the most effective development agencies in the world, and the UK’s leading reputation for development is built on a strong record of applying our expertise and leadership to some of the world’s toughest problems. The UK Government should utilise this experience and lead a coordinated global response to the crisis, working with other governments to ensure the UN system is coordinated, has clearly defined roles and takes a leading role in the immediate humanitarian response and in assisting and protecting populations most at risk including people with disabilities, older people, those with pre-existing conditions, refugees and internally displaced people, women and girls, and children and young people. DFID must lead by example with a response focussed on preservation of life, non-discrimination and respect for human rights. The UK should also use its role on the United Nations (UN) Security Council to push for maintenance of humanitarian access and use its role in the G20 to advocate for the cancellation of all external debt payments due to be made in 2020, rather than a suspension as it currently stands.
2.1.2. Learn from previous global health crises: We are concerned that the international community stands to repeat the mistakes of the past with a slow response implemented mainly through multilateral institutions. Whilst multilateral agencies like the UN and the World Health Organisation (WHO) play a critical role, the Ebola response demonstrated the importance of rapid and agile funding for civil society already on the ground, and the risks of funnelling funds exclusively through multilaterals. NGOs have the expertise, reach and links to the local community which means they can respond and scale up rapidly. DFID should accelerate localisation through fast tracking funds to national and local civil society organisations (CSOs) on the frontline and press multilateral institutions to adapt their compliance and due diligence processes so that local organisations can accept and implement funds.
2.1.3. Support a rapid response with funding support and flexibility: DFID should urgently look to increase flexible use of funds to pivot and re-programme existing awards and portfolios to respond to COVID-19, accelerate funding and procurement processes to mitigate the disruption caused by COVID-19, and ensure that funding policies support organisational survival. The £200m announced by the Government on 12 April 2020 to fight COVID-19 globally is a welcome step however only £20 million of this is pledged for supporting NGOs fighting this disease in developing countries. This does not go far enough to reflect the scale or nature of the response needed. We urge DFID to increase the amount of funding allocated to £100 million, an amount commensurate to the needs on the ground as well as the delivery capacity and reach of NGOs. UK INGOs will not benefit from the £750 million fund announced for charities by the Chancellor of the Exchequer, many will not survive if they don’t receive financial support. We therefore also urge DFID to commit to a stabilisation fund of £320m based on the reduction income for three months to enable INGOs to respond.
2.1.4. Invest in local public health systems: Health systems in many developing countries are fragile, poorly resourced and lack capacity to respond to the effects of COVID-19. The UK Government must urgently expand and scale up investments in strengthening public health systems, health workers, preventative and community-based interventions, ensuring that humanitarian responses strengthen rather than undermine local health systems. DFID should also sustain all support to all existing health and health-related programmes and step up investment in water, sanitation and hygiene (WASH), particularly hygiene behaviour change, including handwashing.
2.1.5. Protect civil society space: Some governments are taking advantage of the crisis to restrict human rights and civic freedoms, close civic space, and criminalise criticism and dissent. We urge DFID to work with the Foreign and Commonwealth Office (FCO) to show leadership on the international stage and help protect civil society by speaking out against any excessive, unjustified or discriminatory measures imposed by national authorities to constrain human rights under the pre-text of COVID-19 responses.
3.1. Overview
3.1.1. The rapid spread of COVID-19 has created an unprecedented global health crisis which will impact people in the UK and across the globe. When the virus takes hold in in poverty stricken, densely populated areas of developing countries it will be devastating. It will hit the most vulnerable hardest, especially older people, people living with disabilities, women and girls, children and young people, and displaced people. Unless urgent action is taken, the pandemic will devastate already stretched health systems, overwhelm social safety nets, push half a billion more into poverty[1] and send fragile economies into tailspin. All this will severely undermine progress towards the UN Sustainable Development Goals (SDGs) and have a lasting impact on development outcomes globally.
3.1.2. We are particularly concerned about the impact on people living in fragile and conflict affected states, which have the weakest capacity to cope with the added stress of a pandemic such as COVID-19. One study has shown that states such as Somalia, Central African Republic, South Sudan, Yemen, Afghanistan, Chad, Syria, the Democratic Republic of Congo, Iraq, Ethiopia, Nigeria, Sudan, Niger, Haiti and Uganda face three times the risk of COVID-19 exposure yet their access to healthcare services is six times lower[2]. We will see crisis piled upon crisis as the virus hits countries like Yemen and refugee camps such as Cox’s Bazaar (See section 3.3).
3.2. Impacts on health systems
3.2.1. Health systems in many developing countries are fragile, poorly resourced and lack capacity to respond to the effects of COVID-19. During the last decade, the proportion of aid spent on healthcare by all donors has been below 6%[3] and the WHO has been heavily underfunded. Donors must urgently expand and scale up investments in strengthening public health systems, health workers, preventative and community-based interventions in low- and middle- income countries, while ensuring that humanitarian responses strengthen rather than undermine public health systems. At the same time, donors must sustain all support to all existing health and health-related programmes, including through supporting the resilience of public health systems, ensuring a continued supply of all essential medicines and commodities, and ability to maintain basic essential services to prevent further, indirect, loss of lives.
3.2.2. In many low- and middle- income countries, people must pay to access healthcare services. We are concerned that this will prevent people, especially those living in poverty and from vulnerable and marginalised groups, from accessing care and treatment for COVID-19. Donors must work with the WHO and governments to support and enable them to remove all financial barriers to people accessing healthcare and deliver free testing and treatment to all that need it. DFID should use the CDC Group to enable private sector health companies they have invested in to align to the national effort and provide free treatment and care and if necessary, pass their stake in private healthcare providers to national governments with the requirement they be used for public use.
3.2.3. As we have seen in the UK, frontline health workers are key to an effective response and take great risks to provide care and treatment to those in need. Many developing countries face severe challenges in training, employing and retaining adequate health workforces. Donors must support a bold and dramatic scale-up of frontline health workers, as well as ensuring any public spending caps, including wage bill ceilings are immediately removed from low- and middle-income countries. Donors should also encourage and help finance low- and middle-income governments to recruit and provide refresher training to unemployed or retired health workers keen to re-enter the workforce, as well as ensure their safe and decent working conditions.
3.2.4. Handwashing is the first line of defence against COVID-19 so WASH infrastructure and practices are critical. We are concerned that in many developing countries, poor WASH conditions and hygiene practices will contribute to the spread of infections and make it very difficult to control the spread of COVID-19. We welcome the commitment to spend £50 million on a global handwashing campaign. DFID and other donors must continue to invest in WASH, particularly hygiene behaviour change, including handwashing. In the short-term, they must provide rapid, flexible funding and technical assistance to government-led efforts to promote good hygiene and build WASH systems.
3.3. Humanitarian impacts
3.3.1. Unless urgent action is taken, the current health crisis will turn into a global humanitarian emergency on a scale unlike any we have witnessed before. We are particularly concerned about the effects on women and girls (see 3.5), refugees and internally displaced persons (see 3.6), older people (see para 3.7), children and young people (see 3.8) and other vulnerable groups such as people with disabilities (please see the separate Bond Disability and Development Group submission) or pre-existing health conditions and those who are more likely to face discrimination in healthcare settings such as homeless people. In order to tackle this global crisis, DFID must step up and demonstrate humanitarian leadership, working with bilateral and multilateral actors to press for a bold, principled, joined up, rights based, intersectional and gendered humanitarian response that is focused on need. This response should use established response mechanisms wherever possible. DFID should work with other governments, especially EU counterparts, to ensure the UN system is coordinated, has clearly defined roles and takes a leading role in assisting and protecting populations most at risk including older people, those with pre-existing conditions, refugees and internally displaced people, women and girls, and children and young people.
3.3.2. Case study 1 (Yemen): In Yemen 80 percent of the population is in need of humanitarian assistance; two-thirds of the country lacks adequate access to clean water and sanitation; millions are experiencing chronic and acute hunger; close to 20 million people lack access to adequate healthcare; and other diseases such as cholera and dengue are widespread. Together these factors create an environment which will facilitate the rapid and wide spread of COVID-19. Millions of displaced people, vulnerable refugees and migrants lack adequate access to water and sanitation, healthcare or the ability to ‘self-isolate’, putting them at increased risk. COVID-19 makes an already complex operating environment increasingly challenging for aid organisations to maintain critical life-saving programmes and access to populations in need, and scale up activities to prevent, mitigate and contain the virus.
3.3.3. Case study 2 (the Sahel region): Chronic hunger is widespread across countries in the Sahel and their weak health systems are already under stress from seasonal epidemics (especially cholera and malaria) and peaks in acute malnutrition[4]. NGOs are concerned that the impact of COVID-19 on already stretched health systems and precarious livelihoods, could exacerbate existing vulnerabilities in food security and nutrition and result in more people dying of the consequences of hunger or of a mortal disease that will not be treated. Governments in the region are working hard to contain and control the spread of disease through border closures, market closures and restriction of movements. However, these measures will affect poor people who depend on the informal economy for their already fragile livelihoods and day-to-day survival. Restrictions of movement make it harder for people to move if there is a security crisis and they will limit the ability of pastoralists to move to find pasture or water, potentially affecting herd concentrations and increasing conflicts between pastoralists and farmers in some areas.
3.3.4. Case Study 3 (Syria): As the world responds to the COVID-19 pandemic, Syrians brace for yet another disaster on top of the humanitarian catastrophe caused by violent conflict. Nine years of war have left the fractured health care system barely functional and at risk of total collapse, which could lead to a crisis that will imperil the lives of hundreds of thousands of people. The Early Warning and Alert Response Network (EWARN) has predicted that 40-70% of the population could become infected, yet it is estimated that there are only 325 ICU beds in the whole of Syria[5]. In the provinces of Idlib and Aleppo the destruction of hospitals means that four million people - hundreds of thousands of whom are living in precarious circumstances in IDP sites and temporary shelters - have minimal or no access to health services[6]. Clean water is hard to come by in many parts of the country. There is an immediate need for increased water trucking, and provision of hygiene supplies such as soap. 6.5 million people are experiencing food insecurity[7]. Many people, especially those who are displaced, live in dense urban centres, informal settlements, or overcrowded camps, making it nearly impossible to implement the social distancing measures necessary to mitigate the spread of the virus.
3.4. Humanitarian protection
3.4.1. Stigmatisation and discrimination pose a very real threat, especially for already vulnerable and marginalised groups and those people who have, or many be perceived to have, contracted COVID-19. We are concerned that some governments will use the pandemic as an excuse to violate basic human rights and protections, through denying people the right to asylum, stigmatising entire groups, or imposing disproportionate, unjustified and exclusionary policies. Responses to COVID-19 must be based on fundamental human rights principles. We urge DFID to take a leading role in highlighting and addressing protection concerns, and publicly back statements from OHCHR and UNHCR telling governments not to exploit COVID-19 to deny assistance, discriminate or deny asylum, or using emergency measures to suppress human rights. COVID-19 will have a disproportionate impact on vulnerable and marginalised groups that already face significant barriers when it comes to accessing healthcare and humanitarian assistance and are more likely to face discrimination. DFID must lead by example with a response focussed on preservation of life, non-discrimination and respect for human rights. This includes supporting strong gender and protection analyses and a data and evidence driven approach to targeting in response actions, prioritising the preservation of life and protecting those most at risk.
3.5. Women and girls
3.5.1. The current crisis will have a disproportionate impact on women and girls. Most health sector jobs globally are held by women, and women and girls also play a disproportionate role caring for sick family members, meaning that they are more likely to be frontline responders and face increased risk of exposure to the virus. Confinement and isolation at home increases the risk of domestic and sexual violence[8], while women and girls are cut off from essential protection services and social services and social networks. The economic fallout will heavily impact women and girls in the most deprived communities, with a sharp rise in the burden of unpaid domestic care work. Donors must ensure a robust gendered analysis of the crisis and response measures, including by carrying out meaningful consultation with local organisations – including frontline women’s rights organisations that know best what the top priorities, threats and risks are for women as well as what instruments and processes must be put in place to uphold their rights.
3.5.2. The crisis may also affect access to sexual and reproductive health information services including contraception, safe abortion and HIV medications. This will further exacerbate the risks to women and girls. Donors must invest in strategies to manage the secondary effects of the pandemic including classifying sexual and reproductive health (SRH) services, including contraceptive, safe abortion services and HIV medication, as essential health services and ensuring their inclusion in basic packages of health services provided as countries respond to COVID-19. If SRH services are not provided in times of crisis, subsequent health outcomes and strains on the health system can be severe.
3.6. Refugees and internally displaced people (IDPs)
3.6.1. We are gravely concerned for the lives and wellbeing of displaced people living in overcrowded conditions and extreme poverty with limited or non-existent access to health services. The situation is particularly acute for those living in camp or camp-like settings and in hard to reach areas. Displaced people are amongst the most vulnerable and least able to protect themselves from the direct and indirect consequences of a pandemic. They are at greater risk of contracting the virus and will also be severely impacted by the negative consequences of policy decisions. Consequently, the pandemic will also have far reaching social and economic consequences for displaced people. Their access to healthcare, clean water and other essential services was already limited and may be exacerbated by increased pressures on healthcare systems, the introduction of discriminatory or disproportionate measures, a lack of social safety nets and poor access to food and basic hygiene products as a result of limitations imposed by governments to curb the spread of the virus. Donors must press governments to include displaced people, in any national public health response, social safety nets or compensation plans in light of the fact that those plans cannot be effective unless they include the entire population, even if they lack legal documentation or registration.
3.6.2. We are also very concerned about border closures that will either stop vulnerable populations from seeking safety, leaving them more exposed to serious risks, or force them to resort to illegal trafficking routes with all the protection consequences that entails. UNHCR has called on states to continue to grant asylum whilst putting in place appropriate measures at border crossings to protect public health.
3.7. Older people
3.7.1. The evidence is clear that people in older age are among those most at risk of complications from COVID-19. Initial research in China based on over 44,000 cases of COVID-19, showed a mortality rate of 2.3% for the general population, rising to 8% in those aged 70-79 and nearly 15% in those 80 and over. Ninety five percent of those who have died from COVID-19 in Europe were over 60, and more than half of those were over 80. Health systems in lower- and middle-income countries have responded inadequately to the changing requirements of older populations[9], and older people face unacceptable barriers to accessing services. In humanitarian situations, older people face well documented barriers accessing information and humanitarian assistance.
3.7.2. The rights of older people are also under threat as a result of the pandemic. Public discourses that portray COVID-19 as a disease of older people can lead to social stigma and exacerbate negative stereotypes about older persons[10]. Ageist stereotypes, prejudices and hate speech on social media[11], in the press[12] and in statements made by politicians[13] isolate and stigmatise older people. [14] Discriminatory policies based on age, including triage protocols that use arbitrary age criteria as the basis for allocating scarce medical resources are already a feature in countries dealing with the pandemic.[15] There are also reports of Do-Not-Resuscitate orders being placed on older people without their consent[16] and curfews and self-isolation policies imposed on older people on the basis of their age, disproportionately restricting their freedoms.[17]
3.7.3. In addition to the primary health impacts, access to health services and human rights implications of the health response, older people face significant risk of indirect consequences from the crisis. Most people in lower- and middle-income countries rely on multiple income sources in older age including pensions, employment, small businesses, assets, savings, and financial support from family and friends. Even in good times, these income sources are irregular and unreliable, and will likely diminish as a result of economic contractions induced by COVID-19.
3.7.4. Rapid needs assessments in humanitarian situations[18] reveal high levels of income insecurity and borrowing among older people, food insecurity and perceived risks of violence and abuse. All of these are likely to worsen as a result of COVID-19. Older people are also reporting high levels of stress and anxiety about the immediate effects of the virus and the longer-term impact on their lives, as well as increased distress due to physical distancing and isolation measures. Many older people are reporting concerns about their ability to get medicine they need to manage ongoing conditions.[19]
3.8. Children and young people
3.8.1. One billion children each year are already exposed to violence. Previous epidemics like Ebola indicate that COVID-19 will result in additional wide-ranging physical, emotional and health harms to girls and boys, including increased risk of physical violence and other forms of abuse. As the inability to meet basic needs increases, there is a heightened risk that children and families will turn to negative coping mechanisms, with millions of children possibly being driven into child marriage, hazardous labour, trafficking and survival sex by poverty and a recession. As the risks of violence increase, the capacity of reporting and support mechanisms will be limited as the pandemic strains education, health and social protection systems. Donors must maintain or scale up investments in programmes aimed at ending violence against children and encourage governments and other stakeholders to integrate life-saving child protection interventions into their response measures from the onset and integrate these with sectoral health, education and other responses.
3.8.2. The virus has led to school closures in 185 countries, and an estimated 1.54 billion children and youth are out of school or university. Many of them, especially girls and children with disabilities, will never return to school. In contexts of extreme poverty, vulnerability or crisis, where education was already a struggle, there is even a greater need to ensure every child and young person can access education and learning – particularly the most excluded. Stakeholders must prioritise education responses that keep children and youth safe, supported and learning, during and after the pandemic. Civil society organisations have long-standing experience in the formal, non-formal and informal education sector, including in inclusive methods of distance learning. Donors should also maintain and increase support for public education systems and provide financial support to close the education financing gap in the COVID-19 Humanitarian Response Plan. As Education Cannot Wait and Global Partnership for Education scale up their support, DFID should top up existing support to these funds.
3.9. Impact of emergency powers on civil society space
3.9.1. Some governments are taking advantage of the crisis to restrict human rights and civic freedoms, close civic space, and criminalise criticism and dissent. COVID-19 response measures must be designed in a way that minimises limitations on rights and freedoms and impact on civic space. Where such constraints are needed to curb the spread of the disease, states should clearly articulate the specific threats that emergency powers are intended to address, and all such measures should be limited to the extent strictly required by the urgency of the situation. Extended states of emergency and prolonged emergency measures correlate with an increase in human rights violations, so states should, when possible, adopt short-term, renewable measures and include automatic sunset clauses. States must also publicly announce a state of emergency and any measures restricting right and freedoms and formally derogate from human rights treaty obligations. We urge DFID to work with the FCO to help protect civil society by speaking out against any excessive, unjustified or discriminatory measures imposed by national authorities to constrain human rights under the pre-text of COVID-19 responses. This will help to ensure that any restrictions are in line with international law and respect the principles of legality, necessity, proportionality.
3.10. Access to information
3.10.1. We know from past health crises that misinformation and poor access to trusted, independent and reliable sources of news and public information can hamper efforts to tackle the spread of infectious diseases. Everyone, including children, must have access to clear, accurate, age-appropriate and inclusive information on how best to protect the people who are at highest risk and minimise the further spread of the virus. Important decisions, the number of cases geographically disaggregated, availability of equipment and supplies, clear advice and other important information should be made available to local populations quickly and proactively. Independent media organisations and trusted local sources, such as faith leaders, women’s groups and youth groups, can play an important role in ensuring information is widely available to all and should be include in responses from the outset (see Section 6). This is particularly important in contexts where communities have limited trust in the state and/ or security institutions, such as fragile and conflict affected settings. DFID must work with other donors, governments, media providers and civil society to make information about the outbreak available to local populations.
3.10.2. In many affected countries the media are struggling to operate under lockdown. They face financial pressures and lack the health expertise to provide accurate health information. We are concerned that some governments may also use the crisis as an excuse to reduce media freedom. Media outlets are worried that their request to pivot to provide urgent health information is diverting activity away from reporting on other important governance issues. DFID should ensure that governments protect journalists and media freedoms and it should continue to support media interventions that address critical governance issues.
3.11. Conflict sensitivity and support for social cohesion
3.11.1. Humanitarian responses must adapt to shifting contexts and changing needs. Ongoing analysis is essential in order to avoid doing harm and reflect on mid to longer term consequences. Applying a conflict sensitive lens is key to ensuring that any humanitarian response can rapidly and adequately adjust activities to the new reality. A conflict sensitive approach is also important for ensuring that new resources and players do not drive further tensions and violence. In some places, the response to the pandemic will create triggers for new conflicts and violence. For example, we are already seeing mistrust, discrimination and violence directed at health workers in many countries, due to fears that they are carrying the virus, and violence directed at police officers seeking to enforce quarantine. With the situation in any location changing daily, regular review and scenario planning must be central to the activities of the UK Government and their implementing partners in order to help identify and manage risks. Appropriate time and resources for this must be included within programmes. The UK Government could also consider establishment of a mechanism for monitoring the situation in fragile contexts.
3.11.2. Donors must also be careful to avoid empowering security sectors with poor human rights records and ensure that valuable efforts to mediate conflicts and support peacebuilding face minimum disruption, including through ensuring deployment of women peace and security principles. We urge the UK to join the 54 countries who have already backed the UN Secretary General’s call for a global ceasefire in light of COVID-19.
4.1. Summary of DFID commitments so far
4.1.1. As of 15 April 2020, the UK has pledged up to £744m in new aid to combat the COVID-19 pandemic. A full list of the most recent confirmed UK aid pledges, ordered by value follows:
4.1.2. In addition, there is some uncertainty regarding the current status of the following aid commitments announced on or prior to 6th March:
4.1.3. DFID’s press release of 27th March on UK aid support for the COVID-19 response provides the following information on these spending allocations, which suggests that there has been a total reduction of £20 million (from £51 million to £31 million) in the value of UK aid committed to at least two of the initiatives previously announced between 6th March and 26th March:
4.1.4. DFID must ensure funding is not diverted from existing priority areas and consider more medium-term planning for the response as soon as possible. It is important that existing work on maternal, child and adolescent health, health systems strengthening, nutrition and quality diets, conflict prevention, livelihoods and the value of recovery lending, education, addressing gender-based violence and modern slavery, and child protection system strengthening do not fall through the cracks. The gains the UK has made in these areas will be lost unless the work continues. It is also critical that medium term planning for the response commences now, for example working on options for livelihoods support.
4.2. Rapid Response Facility (RRF)
4.2.1. DFID activated the RRF on 7 April 2020. The RRF is an emergency response fund for international NGOs, which enables pre-registered organisations to apply for humanitarian funding following a disaster, a conflict or a sudden spike in an ongoing emergency. 36 international NGOs are pre-registered with DFID and thus eligible to apply for RRF funding[20].
4.2.2. This call for proposals will prioritise the following target countries: Somalia, Afghanistan, South Sudan, Yemen, Central African Republic, Chad, Niger, Syrian Arab Republic, Sudan, Democratic Republic of Congo, Nigeria, Mali, Kenya, Pakistan, Bangladesh[21]. The total amount available is £20 million. The activation of the RRF is a welcome step towards making funding available directly to international NGOs who are well placed to get assistance to those who need it quickly and at scale.
4.2.3. However, the £20 million pledged so far does not reflect the size or nature of the response needed. We urge DFID to increase the amount of funding allocated to an amount commensurate to the delivery capacity and reach of NGOs. Taking into account previous RRF activations for single-country responses of approximately £5m for a shorter time-period, we believe that a 15-country call for 6-month projects merits a £100 million investment from DFID. If DFID is not in a position to increase the funding level immediately, it is imperative that the Conflict, Humanitarian and Security Department (CHASE) within DFID seeks to secure a second allocation urgently before proposals are outdated, and that this is used to fund strong proposals from the first round of bidding, with no requirement that NGOs should develop new proposals. Where proposals to the RRF are strong but cannot be funded due to limited resources, that CHASE staff work with DFID country offices to identify adequate resources at country level that can fund these responses while ensuring existing humanitarian programmes may continue.
4.3. Localisation and funding for civil society
4.3.1. Responding to the primary and secondary effects of the COVID-19 pandemic requires a whole of society approach – everyone must work together to curb the spread of and ultimately eliminate this disease, as well as address its wider humanitarian, social and economic impacts. Bilateral development agencies, multilateral donors and CSOs all have a critical role to play. However, the current global response is overwhelmingly focused on multilateral organisations with only $100 million out of the $2.01 billion global appeal set aside for direct funding to non-UN actors[22]. The Ebola response demonstrated the importance of rapid and agile funding for CSOs already on the ground in fragile contexts - and the risks of funnelling funds exclusively through multilateral agencies (please see Section 6 for more information).
4.3.2. CSOs, internationally but especially at national and local levels, provide a lifeline to many people around the world living in countries with weak public health and social services infrastructure. They have a critical part to play in responding to the primary and secondary effects of the COVID-19 pandemic. These roles include working as frontline responders or assisting frontline responders, supporting and strengthening health systems, delivery of humanitarian assistance and protection, dissemination of public health advice, ensuring access to reliable information, promoting inclusion (e.g. ensuring vulnerable and marginalised have access to care), monitoring restrictions on human rights, addressing secondary impacts (e.g. rise in Sexual and Gender-Based Violence and Violence Against Children), and tackling hate crimes and exclusion.
4.3.3. The complexity of this crisis and restrictions on travel mean that local and national CSOs have an especially important role to play. CSOs that are embedded in local communities already have access to vulnerable groups and are trusted by local people and authorities, making it easier for them to get assistance to those who need it quickly and effectively. However, most of these organisations, especially small grassroots groups, do not have strategic partnerships with UN agencies and are not registered to access funding through the UN Pooled Funds. DFID should accelerate localisation through fast tracking funds to national and local CSOs on the frontline and press multilateral institutions to adapt their compliance and due diligence processes so that local organisations can accept and implement funds.
4.3.4. There is a risk that many CSOs, both large and small, international and local, who will be critical to the fight against COVID-19 will find themselves unable to survive this crisis as fundraising revenue collapses (see 7.3). Donors must provide urgent short-term support to keep these vital organisations afloat, make changes to grant conditions that enable them to pivot existing programmes to respond to the pandemic, as well as providing additional funds that enable them to address the primary and secondary impacts of the crisis (see 7.2.2)
4.4. Debt cancellation
4.4.1. Many countries were in debt crisis before the COVID-19 crisis began. Many more will emerge from this crisis with even higher unsustainable debts. Immediate cancellation of debt payments should therefore be linked to a more comprehensive and long-term approach to debt crisis resolution. We urge the Government to reconsider its position on debt relief to go beyond suspension, as agreed by the G20 on 15 April 2020, and advocate instead for the cancellation of all external debt payments due to be made in 2020.
4.4.2. Bond together with more than 200 other organisations[23] asked the UK Government and other lending governments and multilateral organisations to cancel all external debt payments due to be made in 2020, provide emergency additional finance which does not create debt. All principal, interest and charges on sovereign external debt due in 2020 should be cancelled permanently, they should not accrue into the future. Cancelling debt payments is the fastest way to keep money in countries and free up resources to tackle the urgent health, social and economic crises resulting from the COVID-19 global pandemic. The UK Government should also advocate that any new IMF and World Bank finance should be in the form of grants not loans, and require other lenders to reprofile the debt where sustainability is uncertain, or restructure their debt where it is unsustainable, to help ensure money is used to support public policy priorities in response to the COVID-19 crisis, rather than to repay other lenders.
4.4.3. It is estimated that cancellation of external debt payments in 2020 for 69 countries classified by the IMF as Lower Income Economies and for which data is available, would save $19.5 billion in external debt payments to bilateral and multilateral lenders in 2020, and $6 billion in external debt payments to private lenders. If it was extended to 2021 it would save a further $18.7 billion in multilateral and bilateral payments and $6.2 billion in external payments to private lenders.[24]
5.1. Humanitarian access
5.1.1. Maintaining humanitarian access will be critical to the delivery of an effective response, however the complexity of the crisis and measures required to curb the spread of the virus, especially restrictions on movement globally as well as within borders, pose serious challenges. International NGOs are considering how to continue vital humanitarian support while minimising risk and fulfilling the obligation to do no harm. This includes shifting to remote management where possible and scaling back some operations where necessary. However, life-saving humanitarian operations will continue to be necessary and ensuring humanitarian actors are granted exemptions in any curfew or lockdown scenarios (including closed borders, movement restrictions, visas, existing sanctions regimes, and other administrative processes and restrictions) will be vital. These exemptions are also critical to scaling up responses to new needs. DFID can support these efforts by offering flexibility to delivery partners, allowing them to adjust ways of working to allow them to maintain humanitarian operations while undertaking mitigation measures to reduce the risk of outbreaks. The UK should also use its role on the UN Security Council, to push for maintenance of humanitarian access for affected communities as a global priority and to ppursue humanitarian derogations in sanctions regimes for COVID-19 affected countries. This must also include ensuring the continuity of humanitarian and commercial supply chains necessary for the delivery of humanitarian assistance to affected populations.
5.1.2. We have particular concerns regarding UNHAS flights which are a lifeline for aid workers on the frontline, and also for the ability to reach communities in remote or insecure locations. With the drop in commercial flight availability and airport closures, any decisions to suspend humanitarian flights will have a massive impact on the response. Logistics supply chains are also under enormous pressure and may require special pipelines to allow for the movement of goods. The closure of banks in some countries is a major concern and will have chronic consequences for programming. We urge the UK Government to work with financial services providers, multilateral institutions, and national governments to maintain financial access and ensure that bilateral donors and international NGOs can transfer funds to national and local partners delivering on-the-ground humanitarian relief in countries affected by COVID-19.
6.1. Importance of early intervention
6.1.1. We know from the Ebola response that not investing enough, early enough, in frontline response costs lives. Immediate response at community level is needed to scale-up programmes which meet both the primary and secondary impacts of the pandemic in already vulnerable communities. We know from Ebola and from multiple humanitarian contexts that UN agencies cannot always act quickly enough, with an approximate 90-day turnaround to disburse funds to partners. By the time this process has taken place, outbreaks will have gathered pace in our operational areas, and we will have missed the vital window of opportunity to stop the spread. By contrast, international NGOs can respond within 48 hours if the resources are available and can scale up rapidly. NGOs have the reach, established trust among communities, and the local partners and networks to get understandable and accepted messaging into households both rapidly and consistently. NGOs are uniquely placed to deliver disease prevention, vital system strengthening at community level, critical food and cash interventions, right now, when the biggest impact in preventing and containing disease is still possible.
6.2. The importance of community engagement and the role of faith leaders
6.2.1. The Ebola response highlighted the added value that came from seeking to respond to crises using a community-based approach and in a holistic manner, and the important role that faith and other community leaders can play in this. Faith leaders, in particular, often play a significant role in communities in many developing countries and must be in the response from the outset. Most people in Liberia and Sierra Leone are practising believers and faith leaders enjoy significant trust and respect. But there was a lengthy delay in engaging them at the start of the epidemic. In the initial weeks after the outbreak there was a lack of information about the disease and hostility towards draconian measures that went against cultural values and religious practices and those who promoted them. Many of those with Ebola chose to remain with their families and burials were undertaken in secret and the disease continued to spread. Following significant community engagement, faith leaders went on to play an important role in helping to promote safe and dignified burials and encouraging community acceptance of these practices. This resulted in an increased reporting of the number of deaths and reduced the spread of the virus.[25] Donors and governments must include faith leaders at all stages of the response, including planning for health emergencies and strengthening health systems. Given their embeddedness in communities and their unparalleled knowledge of local-level needs, it is essential they are proactively engaged in planning processes for programming that both prepares, prevents and responds to such outbreaks.
7.1. NGOs are experiencing a severe shortfall in funding as a result of the crisis, which is making it difficult for them to deliver vital work in the communities that they work in. The problem has been bought about by two key issues. Country programmes are stalling because of COVID-19 and spend on DFID grants and contracts is slowing resulting in lower cost recovery rates, which are required to sustain organisations (see 7.2). Unrestricted fundraising has stopped for many charities, so they do not have the funds to contribute to core organisational costs (see 7.3). The result is that many organisations are approaching acute shortfalls in cash and reserves. For some organisations with limited reserves this could mean the possibility of not surviving the next 3-6 months.
7.2. Lower cost recovery rates from DFID grants and contracts as a result of programme implementation challenges
7.2.1. DFID should pivot and re-programme existing awards and portfolios to enable recipients to respond to COVID-19. By doing so DFID can sustain the capacity of their partners so that they can continue to respond in-country and stop the spread of COVID-19. Currently DFID’s approach to adapting existing programmes has been happening on a case by case basis, with the official guidance being a discussion with individual staff members. This results in mixed messages, inconsistency, slow and time-consuming decision making which undermines our response. We believe it is important for DFID to bring comprehensive clarity to the situation to reassure charities and enable them to begin to plan for the new environment we are all in.
7.2.2. There are steps that DFID can take to support civil society organisations in receipt of DFID grants and contracts during the COVID-19 crisis. These are:
7.3. Drop in unrestricted income
7.3.1. A survey of 550 charities in the UK undertaken by NCVO, Institute of Fundraising and the Charity Finance Group in March 2020 showed that income from voluntary giving (i.e. unrestricted income) is predicted to fall by an average of 48%, and that total income would fall by a third. Institute of Fundraising reported that the survey was disproportionately populated by organisations with an international focus. Bond’s own survey of its members undertaken on 27-31 March and completed by over 15% of the total membership, shows that 87% of members are cutting programmes. In terms of staffing, 60% have already made cuts to staffing costs, either through lays off, redundancies, cutting salaries or freezing posts, and a further 25% are in the process of doing the same. Only 15% of organisations are likely to leave their staffing untouched.
7.3.2. Charities do not operate under a single business model. Different operating models may include a blend of income from investments, grants, contracts, fundraising events, retail, service provision and voluntary donations. Charities who contract for services will typically also rely on other income streams, such as trading and fundraising. Virtually all charities have seen their main income sources plummet: income from fundraising and trading has stopped to protect the public; simultaneously charity investments have been negatively affected by the wider economic impacts of COVID-19 and those charities contracting to deliver public services in many cases are already subsidising the cost of running the services.
7.3.3. This means that charities are having to make use of their reserves. Reserve levels are based on risk and on average are set at around three months of usual operating costs. We are not in usual times, with major income sources stopped overnight, the value of investments plummeting and demand increasing. Reserves are not all held in liquid assets and cannot be rapidly accessed. Those with once healthy free reserves are seeing those resources rapidly depleting and their financial resilience eradicated. We know that international development organisations are particularly exposed in terms of their low levels of free reserves. A HaysMacintyre survey in October 2019 revealed that 24% of a selected group of 189 Bond members had reserves sufficient to continue operating for three months. Our survey shows that 15% of our members have funds only sufficient to survive for the next three months, 45% have sufficient reserves to survive between 3 and 6 months, of Bond members with sufficient funding to survive beyond 6 months, without the input of further new funding.
7.3.4. UK INGOs will not benefit from the £750 million announced for charities by the Chancellor of the Exchequer on 8 April 2020. Recognising the economic impact of the crisis on UK based INGOs, which is already impairing their ability to operate programmes in their countries of operation, we urge the UK Government commit to a key stabilisation fund or loan mechanism enabling UK INGOs to continue operating at this critical time and enabling the retention and deployment of staff. We propose the amount available for a stabilisation fund should be based on reduction in income for three months and is around £320 million. The Government should also make regulatory changes to some of the existing schemes announced by government to allow charities to become eligible by increasing the flexibility of the furlough scheme or access for CSOs to small business funding.
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[1] Half a billion people could be pushed into poverty by coronavirus, warns Oxfam, Oxfam International, 09 April 2020
[2] CARE Analysis: Vulnerable countries face 3 times the risk of COVID-19 exposure, yet have 6 times lower access to healthcare services, CARE International, 27 March 2020
[3]Total flows by donor, OECD DAC
[4]Sahel: Évaluation de la résilience des systèmes de santé face aux urgences sanitaires et nutritionnelle, Action Against Hunger, July 2018
[5] COVID-19 Pandemic: Syria’s Response and Healthcare Capacity, LSE, 25 March 2020
[6] Recent Developments in Northwest Syria Flash Update, OCHA, 05 March 2020.
[7] FAO/WFP Crop and Food Security Assessment Mission to The Syrian Arab Republic, OCHA, 5 September 2019
[8] UN backs global action to end violence against women and girls amid COVID-19 crisis, UN News, 06 April 2020
[9] Global AgeWatch Insights 2018: Report, summary and country profiles, HelpAge International, 2018
[10] Issue Brief: Older Persons and COVID-19, UN Department of Economic and Social Affairs, April 2020
[11] What is 'boomer remover' and why is it making people so angry?, Newsweek, 13 March 2020
[12] Telegraph journalist says coronavirus ‘cull’ of elderly could benefit economy, Metro, 11 March 2020
[13] Texas' lieutenant governor suggests grandparents are willing to die for US economy, USA Today, 24 March 2020
[14] Coronavirus: Older people in low- and middle-income countries must be protected to prevent global humanitarian catastrophe, HelpAge International
[15] See for example: Italy page 5; Maryland page 851.
[16] The fight against Covid-19: Whose life counts?, The British Institute of Human Rights, 02 April 2020
[17] See for example: Serbia; Sweden; UK; Israel; Ireland; Bosnia-Herzegovina;
[18] Country level reports, HelpAge International
[19] Older People’s Inclusion in the Global Humanitarian Response Plan (HRP) for COVID-19, HelpAge International
[20] Current RRF partners, Department for International Development
[21]UK NGOs 'deeply concerned' about £20M for COVID-19 work in 15 countries, Devex, 15 April 2020
[22] Global Humanitarian Response Plan: COVID-19, United Nations Coordinated Appeal, 28 March 2020
[23]A debt jubilee to tackle the Covid-19 health and economic crisis, Jubilee Debt Campaign, 07 April 2020
[24] A debt moratorium for Low Income Economies, Eurodad, 24 March 2020
[25] Protecting the living, Honouring the dead, CAFOD, Catholic Relief Services (CRS) and World Vision UK