WWS reacts: How developing countries might grapple with COVID-19

Thursday, Apr 16, 2020
by B. Rose Huber and Patricia Yelavich, Woodrow Wilson School

Melissa M. Lee

Melissa M. Lee, assistant professor of politics and international affairs at Princeton’s Woodrow Wilson School. (Photo Caption: Sameer Khan, Fotobuddy)

Covid-19 is present in rich and poorer countries alike, but the looming crisis in developing countries — where dense, vulnerable populations make social distancing nearly impossible and access to clean water and health care resources are often scarce — is far more dire, threatening unprecedented mortality rates, economic devastation, and increased inequality.

We asked faculty expert Melissa M. Lee, assistant professor of politics and international affairs at Princeton University’s Woodrow Wilson School of Public and International Affairs, to comment on how these countries can best respond, what tools they need most, and what could hamper their efforts to contain Covid-19.

Lee specializes in the international and domestic politics of state-building and state capacity. Much of her work examines how external actors shape the development of the state and disrupt political order. Her first book, “Crippling Leviathan: How Foreign Subversion Weakens the State,” is now available from Cornell University Press.

Q. How can countries that are weeks or months behind the U.S. in terms of Covid-19’s  course prepare for and minimize the spread of this pandemic?

Lee: Government responses to the current pandemic typically involve some combination of border closure, contact tracing, testing and self-isolation, and large-scale lockdown. These measures are likely to be most effective if states implement them early and comprehensively. Countries less integrated in the global economy have not yet had large-scale outbreaks of Covid-19, so they have an opportunity to detect and contain the disease before it escalates.

Much of the conversation in the popular media has been about political will or decisive government action to pursue policies like aggressive testing regimes. The United States teaches us a stark lesson about political will, because it squandered valuable lead time through denial and inaction. Analysts are right to focus on political will, but political will is only part of the story. It assumes a basic degree of underlying state capacity to execute the basic tasks of government. Many countries do not have the right kind of state capacity that is necessary for responding to this pandemic.

Q. In your work, you write about "information capacity." What does this mean?

Lee: Information capacity, or what I call “legibility,” refers to the state’s ability to collect and process information about the population. It involves not just raw data collection but also organization and classification. This capacity is important because most government functions — including, crucially, responding to disease outbreaks — depend on the state having information about who its people are, where they are, and what they are doing. That information is crucial for monitoring and enforcement. Most kinds of state activity involve monitoring, enforcement, or both.

Q. How does information capacity affect pandemic response?

Lee: Information capacity affects disease surveillance (reporting) and disease containment and control. Accurate reporting involves testing, reporting, and outcome follow-up. Although U.S. media outlets and research centers now track confirmed positive cases, we also need to know the number of confirmed negative cases as well as the subsequent health outcomes of the positive cases (recovery or death). Without this information and without standardized data (a classic example of legibility), we cannot know the true prevalence or virulence of the disease. That makes it hard to deploy resources effectively.

Disease containment and control also rely on information capacity. Contact tracing is easier to implement when the government can rely on existing databases or systems to find people. Lockdowns will be more likely to succeed if the government knows who is permitted to move about and who is not; which businesses should be forced to close, and whether they are compliant.

Q. What countries struggle with information capacity, and which countries are doing better? Where will these challenges be the greatest? And, turning to the developing world, what could hamper efforts to contain and control Covid-19?

Lee: The countries that face the greatest information capacity challenges are the developing states in sub-Saharan Africa, the Pacific, and parts of South and Southeast Asia. These are places where civil registration systems, national identification cards, and birth and death registries do not exist or are not up-to-date. They are also places where legibility is uneven: where states can “see” some parts of their territories but not others. Urban slums, informal settlements, and remote rural villages don’t usually have named streets or dwelling numbers. Those places may not even be mapped. Imagine trying to engage in contact tracing without location information! Or trying to enforce lockdowns if you do not know who is compliant and who is not, whose work is essential and whose is not. Travel bans are meaningless in places where borders are porous and movement is illegible.

Q. It may be hard to say now, but what will happen when Covid-19 arrives in Africa or other parts of Asia? Can you make any predictions now?

Lee: Low-income developing states have risks and opportunities. The risks stem in part from their legibility deficits. They are going to have a harder time with basic disease surveillance and response. They also have under-resourced public health systems. We have seen how Covid-19 has overwhelmed the more developed health care systems in Lombardy and New York City; if Covid-19 escalates out of control where systems are less developed, the effect will be devastating. Lockdowns are not very practical in countries with large informal economies where individuals depend on earnings from daily agricultural or street vending work. The illegibility of this kind of economic activity will also make Western-style economic relief programs challenging to implement.

The opportunities stem from the lessons of the prior infectious disease outbreaks. Several African states have experience fighting Ebola. The disease monitoring, isolation protocols, and public health infrastructure originally developed for Ebola can be repurposed for combating Covid-19.

Q. What must states do in the long-run? What are the policy implications?

Lee: The current pandemic highlights the importance of having strong state capacity fundamentals. In the long-run, states must strengthen their information capacity. They should invest in vital registration systems, national identification cards, comprehensive population censuses, and mapping technology, and they should endeavor to make their entire populations legible. These investments will lay important groundwork for all kinds of public services, not just disease management.

In the short-run, states must take decisive action to slow and contain Covid-19. Screening and testing at international ports of entry can help. So, too, will efforts to educate citizens about preventative measures and the importance of self-isolation — and proactive reporting of cases.

Q. Can you address civil liberty concerns about a state government without legal protections putting in legibility protocols, like Singapore or China?

Lee: All forms of state capacity are forms of power. That power can be used to enhance human welfare, to protect and provide. But it can also be used to repress. The technologies of legibility are no exception. Italy uses cell phone tracking data to monitor its lockdown. China, which recently lifted the Wuhan lockdown, imposed an invasive surveillance regime requiring frequent reporting of their movements with state authorities. Limiting abuses will be challenging, especially in a time where people fear for their basic safety and security. The event of 9/11 showed us the lengths to which democratic regimes will go to make their own populations legible in the name of security. The potential for repression and abuse is not an argument against investing in information capacity. Rather, it is a reminder that safeguards like a free media and robust civil society are essential for ensuring that the state uses its power responsibly.

WWS Reacts is a news-focused series produced by Princeton University’s Woodrow Wilson School of Public and International Affairs and featuring faculty who present their views on current events.