One year into the spread of COVID-19 in the MENA region: the fate of the ‘best performer’


Written by Yasmina Abu Al-Zuhur

One year after countries in the Middle East and around the world declared national health emergencies due to the Coronavirus pandemic, hundreds are protesting Jordan After at least six patients died from COVID-19 due to lack of oxygen in the hospital. Elsewhere in the MENA region, some countries are doing relatively well: six Rank Among the 20 countries that have provided the largest number of COVID-19 vaccines per 100 residents (Israel, 103.6 doses per 100 residents; the United Arab Emirates, 66.9 doses; Bahrain 33.6; Morocco 15.6; Qatar 13.4; Turkey 13.2).

A closer look at the cases of Morocco, Tunisia and Jordan reveals that the best performers in the MENA region benefited early on from strong and preemptive measures, but then struggled to control the outbreak during the second wave as they loosened restrictions in their favor. To restore their economies. These countries now face the challenge of securing doses of the vaccine and administering it to the majority of their population to limit the spread of the outbreak and the loss of life.

Strong initial response

Morocco, Tunisia, and Jordan have had largely similar responses to COVID-19, likely due to structural similarities between them: They are middle-income economies with strong coercive devices, with public health systems and economies that cannot withstand the pressures of prolonged outbreaks. During the initial period of the pandemic, between March and September 2020, they managed the medical emergency well, thanks to robust and proactive security and public health responses.

As a result, compared to many of their regional neighbors, Morocco, Tunisia, and Jordan maintained relatively low numbers of cases and deaths during the initial phase of the outbreak (see figure below). In fact, between March and August 2020, these countries were three of the best performers in the MENA region in terms of injuries and deaths, compared to world leaders such as Australia and South Korea. At this point, Jordan consistently reported fewer than 10 injuries per million people per day. Tunisia reported fewer than 20 new daily cases per million people during this time frame. Also, daily new infections were controlled in Morocco for every million people, and did not exceed 40 cases before September 2020.

A graph showing daily COVID-19 cases in Morocco, Jordan and Tunisia

This success is largely attributed to their strong initial responses to security and public health. JordanAnd the Tunisia, And the Morocco, West, sunset It has adopted some of the most stringent security responses of any country in the region. The three declared a national emergency in early March 2020, shutting borders and halting flights, shutting schools, enforcing curfews, banning public gatherings, enforcing a mandatory general lockdown, and enforcing strict social distancing. In the three countries, these measures have been effectively implemented (although some regional The differences In the case of Morocco) and communicates extensively with the public on a daily basis.

The other major strength these three countries shared was their effectiveness Institutional coordination Of their response to COVID-19. Tunisia, which boasts one of the most advanced health systems in the MENA region, has strong pre-existing institutions such as the National Observatory of New and Emerging Diseases as well as national and regional committees responsible for disaster prevention and response. The government has also established a special committee – the National Coronavirus Response Authority – to deal with the epidemiological aspects of the outbreak and coordinate other institutions. Jordan has also benefited from strong pre-existing structures, notably the National Epidemiology Committee, which has led its response against the pandemic and has advised the government on strategy. Similar to Tunisia, another body – the Coronavirus Crisis Cell – was established within an existing management body, aiming to manage and coordinate institutions and responses during national crises. In Morocco, two committees were formed in March 2020 to deal with the health and economic dimensions of the pandemic, respectively. While they suffered from poor communication with the public regarding their decisions, they were successful in advising the system on economic and health policy, including securing early vaccine doses.

The second wave and the pollen race

Like many countries inside and outside the MENA region, Morocco, Tunisia, and Jordan only benefited from their robust responses during the initial phase of the outbreak. As the outbreak and associated measures exacerbated their already fragile economies, the three countries ultimately came under pressure to strike a balance between easing restrictions to save the economy and curbing loss of life. As they struggle to alleviate the health and economic dimensions, the medical situation has turned into an alarming and uncontrolled outbreak, overwhelming the public health sector beyond its capacity.

The numbers of injuries and deaths increased between September and January in the three cases, despite Morocco controlling these numbers since January, followed by Tunisia since February (see figure). However, injuries in Jordan peaked in March 2021: mentioned 9,535 new cases on March 17th, compared to 766 in Tunisia and 466 in Morocco.

Today, Morocco, Tunisia and Jordan hope to contain the outbreak by vaccinating the majority of their population. They aim to do so in or by the spring of 2021. However, they will face significant obstacles, mainly due to the insecurity of vaccines and uncertainty at the global level, as the difficulty has now shifted from developing successful and safe vaccines to producing and purchasing them.

So far, 193 countries have it Command More than 20 billion vaccine doses will be delivered by the end of 2021. In comparison, the production capacity of all vaccines in this time frame is 9.2 billion doses. This means that many countries will have to wait one to two years to vaccinate the majority of their populations and control the spread of the disease. Meanwhile, soaring infections and deaths will overwhelm these countries’ public health systems beyond their capacity and put pressure on their already fragile economies.

In fact, even Morocco – which has preemptively acquired vaccine stocks and has already vaccinated 5.7 million people (out of a target of 25 million) in about six weeks – faces the problem of depleting vaccine stocks and the difficulty of accessing new stocks. For Tunisia, which has administered 0.02 doses per 100 people so far, the difficulty is securing any stock, and it only did so in mid-March 2021. Jordan has administered nearly 200,000 doses since it started its campaign one month ago (that is, two doses per 100 people) . It is set on Receive 2.2 million doses during the month, which will allow her to speed up the vaccination program. The latter may be complicated by the large number of refugees in Jordan; The Kingdom is the first country in the region to start vaccinating refugees.

Outlook: Upgrading the Public Health Sector

In this regard, the past 12 months of fighting the coronavirus pandemic have highlighted significant gaps that must be addressed in the Moroccan, Jordanian and Tunisian public health sectors. All of them are currently overstretched due to limited intensive care units and equipment, regional disparities in access to healthcare, and a shortage of medical professionals.

Once the outbreak is brought under control, these governments will have to devote greater resources to public health, invest in training more medical workers, expand emergency wards and intensive care units, increase the number of hospital beds, improve data and monitoring, focus more on prevention, and adopt reforms that will. Address regional inequality in health care. In the meantime, they must urgently secure more vaccine stocks and double social distancing measures to avoid further loss of life.

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