After the initial coronavirus outbreak in Wuhan, China, attention quickly turned westward. Lombardy, the wealthiest region in Italy, captured global headlines in March as the new epicenter of the pandemic. Death rates in Spain soon surpassed even those of China. Botched responses by governments in the US and the UK ensured similarly deadly outbreaks on both sides of the Atlantic. The rest of the year saw the basic trend continue—rich countries experienced the highest fatality rates and dominated news coverage of the pandemic. 

This has obscured what was nevertheless a truly awful year for much of the Global South. Shoddy data makes the direct health effects of COVID in many countries nearly impossible to measure, but under-reporting appears widespread. Shutdowns and rising food prices brought an enormous economic toll, and tens of millions slid into extreme poverty. Without the benefit of trillion dollar stimulus bills, there was little to slow their fall. 

Instead, the very wealth that has allowed some measure of relief—however inadequate—against the pandemic in the West has left the Global South to face the added threat of a changing climate. Emissions that have made some countries rich have produced climate outcomes felt most immediately and severely by countries that have emitted very little. The same regions that have seen the biggest jumps in poverty in the pandemic are also those that are projected to produce the most climate migrants in the years to come. It is easy to draw conclusions about how climate change and COVID-19 have made us interconnected. More discomforting and important is to remember just how disconnected our experiences of both crises—and their political contexts—remain. 

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For epidemiologists, the mystery of the past year is how it wasn’t even worse for the global poor. Many predicted early on that countries like India and Nigeria would experience the deadliest outbreaks. As Siddhartha Mukherjee explains in the New Yorker, “the usual trend of death from infectious diseases—malaria, typhoid, diphtheria, H.I.V.—follows a dismal pattern. Lower-income countries are hardest hit, with high-income countries the least affected.” The poor tend to have more exposure to pathogens and less access to the health services needed to treat them. These inequalities have been realized to brutal effect at the local level—just look at Los Angeles. Yet at the international level, the pandemic appears, at first glance at least, to have bucked the trend. As of March 2021, the countries with the highest COVID death rates are Czechia, Belgium, Slovenia, the UK, and Hungary. Many poor countries, meanwhile, have reported death rates that are just a fraction of their Western counterparts. 

Any generalization across so many countries is bound to be crude and somewhat misleading. Still, certain themes can be discerned. One is age. The median age in much of Africa is under 20; in Europe it is over 40. Combined with a lack of comorbidities such as obesity and diabetes, the overwhelmingly young populations of most poor countries has helped keep their fatality rates down. Another theme is government response. Doctor and anthropologist Paul Farmer spent over a decade working in Rwanda, and explains that when the pandemic arrived they did “many of the things the United States has failed to do: flattening the curve, preventing widespread dissemination of the virus, promptly testing and tracing and treating patients, and marshalling the forms of social support needed to permit isolation and quarantine.” This competence was often combined with creativity. Both Senegal and Ghana, for example, developed new and efficient testing strategies before many of their western counterparts. As Afua Hirsch has argued in The Guardian, “the reason you probably haven’t heard about [these success stories] is because of patronising attitudes towards African innovation.” 

Yet demographic advantages and quick government action only account for some of the discrepancies. Evidence also points to a more ominous explanation: systematic under-reporting of COVID deaths across much of the Global South. Sparse medical infrastructure means that many die at home, before they have a chance to be tested. And stigmas around COVID mean that those who suspect they may have the virus are often reluctant to report their sickness. A recent study in Zambia found that the bodies of at least 15 percent of people in one of the country’s main morgues contained traces of the coronavirus. Yet barely any of them had been tested before they died. The findings hint at a larger problem, and “cast doubt on the assumption that COVID-19 somehow skipped Africa or has not impacted the continent as heavily.” The false comfort of that assumption calls to mind Chilean theologian Pablo Richard’s warning at the fall of the Berlin wall: that we must avoid the construction of “another gigantic wall…in the Third World, to hide the reality of the poor majorities…a wall of disinformation.”  

Economic data is similarly difficult to obtain for many poor countries, but the rough outline is clear. It’s estimated that somewhere between 88 and 115 million people have been pushed into extreme poverty by the pandemic. Even with quick responses and smart containment strategies, many low-and-middle income countries were forced to employ quarantine measures similar to those seen in Europe and the US. The difference is that where lockdowns were inconvenient for the rich, they were calamitous for the poor, who often live day to day on jobs incompatible with social distancing (stimulus checks and remote work are Western consolations). That supply constraints have pushed global food prices to their highest level in nearly a decade has not helped. A study published in February in Science Advances examined survey data across nine countries and three continents and found signs of extensive suffering. Over 80 percent of households in Bangladesh, Colombia, Rwanda, and Sierra Leone saw income drops due to the pandemic. For many already on the edge of subsistence, this has meant going hungry. In all but two of the countries surveyed, more than a quarter of families reported missing or reducing meals due to the pandemic. 

Their trial is not likely to end anytime soon. As rich countries turn a corner on COVID with the help of vaccines and massive government stimulus, those without access to either will continue to suffer. The World Bank has projected that by 2030, extreme poverty reductions will still be six to seven years behind pre-pandemic forecasts. And the “catastrophic moral failure” of uneven vaccine distribution means that many poor countries will have to wait until 2024 for mass immunization and the economic revival it promises. 

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All of this has occurred within a climate that is becoming increasingly uninhabitable. The basic irony and injustice of climate change is that the rich who have done most to bring it about will be the last to feel its effects. The US, China, and Europe combined have caused over 70 percent of global carbon emissions since 1751. Yet it is the global poor nearer to the equator whose lives and livelihoods are most immediately threatened by warming. Part of this has to do with simple facts about temperature distribution. Humans are healthiest and most productive within a finite temperature range. Climate change is pushing many of the poorest countries in the world away from this happy range, even as it pushes some more developed countries towards it. On this divergence alone, Stanford professors Noah Diffenbaugh and Marshall Burke have found that climate change may have already exacerbated between-country economic inequality by 25 percent in the last half century.  

Climate disasters also fall disproportionately on the poor. Risk maps for floods, droughts, blights, forest fires, extreme weather, and other forms of disaster naturally vary. But context often counts for more than exposure, and in this dimension the poor are at a structural disadvantage. Their added vulnerabilities are plentiful: fragile infrastructure, exposed assets, weak social protection, overdependence on agriculture, susceptibility to rising food prices, etc. Disasters under these conditions bring significantly more distress and dislocation than they do otherwise. 

Combined with steady warming, this produces a bleak outlook for many of the regions already suffering from COVID. Climate change is projected to push up to 132 million people into extreme poverty in the coming decade. Most of these will be in South Asia and Sub-Saharan Africa, where the economic pain of the pandemic has been most acute. Millions of people in both regions are likely to become climate migrants, uprooted but unable to find refuge in overcrowded cities or across impenetrable borders. Over the long run, we risk what UN Special Rapporteur on extreme poverty and human rights Philip Alston has described as a “climate apartheid scenario,” in which rich countries “pay to escape overheating, hunger and conflict” while closing their doors to those who can’t. 

The past year has required us all to close our doors. As we begin to move beyond the pandemic, we would do well not just to open them but to think more seriously about what we owe to those on the other side.