In some places in the United States and other developed countries hit hard by COVID-19, the question is when might it become possible to start getting back to work. For much of the rest of the world, the nightmare is yet to start. And part of the horror is that many poorer countries won’t have the means to do much about it. Nor, given the international community’s lack of organization and leadership in the face of a global crisis, can they count on richer nations to help them.

With the exception of Iran, the countries hardest hit up till now are among those with the world’s most advanced economies, scientific establishments and medical services – and even Iran has a relatively functional medical system. What probably lies ahead is the spread of the coronavirus through countries ravaged by conflict, through packed refugee camps and detention centres in places like Syria or Bangladesh, through teeming cities like Mumbai, Rio de Janeiro or Monrovia, where social distancing is impossible and government is not trusted, through nations without the fiscal capacity or health services to mount a viable response.

That would be disastrous not only for them but also for the rest of the world as supplies of raw materials are disrupted, fragile economies collapse, strongmen grow stronger and the virus doubles back to reinfect northern regions.

Unreliable reporting or deliberate denial

So far, the most vulnerable regions have reported comparatively few cases – one in Yemen, a smattering across Africa and the Middle East. But that may be partly a function of unreliable reporting or deliberate denial. The numbers are growing, and as the world has learned, they are likely to swell radically and swiftly.

A survey by the International Crisis Group said the full impact is hard to anticipate, but, “If the disease spreads in densely packed urban centres in fragile states, it may be virtually impossible to control. The dramatic economic slowdown already underway will disrupt trade flows and create unemployment that will do damage at levels that are hard to forecast and grim to contemplate.”

For a sense of the scale of the plight of some developing nations, consider one of the most critical pieces of medical equipment used in treatment: the ventilator. The United States has some 160,000 ventilators, according to one estimate. Sierra Leone has 13. South Sudan has four. Central African Republic has three. In Venezuela, where 90 per cent of the hospitals already face shortages, there are only 84 intensive care unit beds for a population of 32 million, according to a report from the International Rescue Committee.

Weak links

“The lesson of the crisis is that the weakest links in the global health chain are a threat to health everywhere,” said David Miliband, the group’s president. “We cannot afford these weak links, and must strengthen the efforts in war-torn countries and communities to lift their life chances.”

In the United States and Europe, governments and businesses have been able to pay many furloughed workers at least part of their salaries, and others are eligible for unemployment benefits. But billions of people in Africa, Latin America and South Asia have no safety net and no savings. The United Nations has warned that income loss in developing countries could exceed $220 billion.

The impact will not be uniform. The International Monetary Fund and the World Bank have moved quickly to offer billions in emergency loans to poorer countries, though they’ve warned this will not be enough. Countries with relatively stable governments, like Peru, have been quick to mount countermeasures, while battered nations like Haiti and Venezuela have few defences available.

Across the Southern Hemisphere, the pandemic’s effects may be cushioned by young populations. In such African countries as Niger, Angola, Chad, Mali, Uganda and Somalia, nearly half the population is 15 or younger. In the United States, that share is 19 per cent.

‘True fight of our lives’

UN Secretary-General Antonio Guterres and Pope Francis have both called for a cessation of all global conflicts to focus on what Guterres called “the true fight of our lives.” Last week Saudi Arabia announced a cease-fire in its war against Al Houthi rebels in Yemen, and armed groups have indicated a desire to stop fighting in Colombia, Cameroon and the Philippines. The Afghan government and the Taliban have both begun efforts to stem the spread of the virus. And Russia may find the burden of supporting Syrian troops or secessionists in western Ukraine excessive if COVID-19 begins to take a heavy toll on the economy.

But Daesh has called on its followers to ramp up their efforts. Al Houthis have not reciprocated Saudi Arabia’s cease-fire, and fighting has escalated in parts of sub-Saharan Africa.

It is understandable that governments of rich nations have focused first and foremost on the crisis within their own borders. Nothing like the coronavirus has ever overwhelmed so much of the world in such short order, or with such cataclysmic force. Yet it is dismaying that a danger that confronts the entire world, that is likely to hurt the entire global economy, has led to so little global cooperation and has been met with so little global leadership.

This is a crisis in which the United States could have emerged as the leader, and it still may do so. But on top of the widely chronicled failures at home, the Trump administration has provided little inspiration for the world.

The response in Europe has also been marked by confusion and disunity: The head of the European Union’s main science organization resigned last week to protest the bloc’s handling of the crisis. The World Health Organisation, meanwhile, is under heavy fire from critics who say its complicated relationship with China may have undermined its mission.

American presidential election year

That is not likely to change, especially while the disease continues to ravage the United States, Italy, Spain and many other countries in the Northern Hemisphere, and especially in an American presidential election year, when the struggle against COVID-19 is likely to become more politicized.

But Washington’s weakness should not stop the brain trust of the developed world – the think tanks, news media, universities and nongovernmental organisations – from focusing on a strategy for the next and possibly most brutal front in the struggle against the scourge of the coronavirus. Many organizations have already begun to do so, recognising that this may be the defining struggle of our era, and that if ever the world demanded a global response, this is it.