As more COVID-19 cases emerge in developing countries, a new analysis by the international aid agency CARE highlights the 15 countries most at risk.

Using data from the INFORM Global Risk Index, CARE has found the countries which are generally at “very high risk” of crisis have three times higher exposure to epidemics and six times higher risk in terms of their access to healthcare.

The 15 “very high risk” countries are Syria, Iraq, Yemen, Afghanistan, Somalia, Sudan, South Sudan, the Democratic Republic of Congo, Ethiopia, Nigeria, Uganda, the Central African Republic, Chad, Niger and Haiti.

CARE Australia CEO Peter Walton said the analysis offered a glimpse into the future of the COVID-19 pandemic.

“While developed countries currently have the most reported cases of COVID-19, poorer and more unstable countries are likely to be the worst hit as time goes on,” Mr Walton said.

“Even wealthy countries’ health services are struggling to cope at this time, so we are very concerned about what will happen if COVID-19 gets out of control in countries where health services are drastically under-resourced.”

CARE International’s Head of Emergency Operations, Sally Austin, said the COVID-19 fallout was also likely to strain the already limited supply of food in high risk countries.

“Many countries on this list are already food insecure, with large parts of their populations reliant on international aid for survival,” Ms Austin said.

“Add on COVID-19 and it is not only national health systems that will struggle to cope, but the entire infrastructure and basic services. This is a truly terrifying thought for all of us working in the humanitarian sector.”

Many countries on the list, such as Syria, Yemen and South Sudan, are in the midst of armed conflict.

CARE Turkey’s Tue Jakobsen, who is coordinating CARE’s relief effort for northwest Syria, said nine years of war had decimated Syrian health services.

“With limited testing capacity, it is highly likely that the virus has been spreading around without our knowledge, so we might be weeks behind in our response,” Mr Jakobsen said.

“Only around 900 testing kits have been made available this week in Idlib and there is only one lab that can handle about 20 tests per day. Since this is a global crisis, countries are prioritising their own responses and Syria has been completely neglected.

“An outbreak will cause mayhem in an area that has already gone through so much suffering.”

CARE’s analysis found that in comparison to countries considered at “very low risk” of crisis generally, the 15 “very high risk” countries had:

• Three times higher exposure to epidemics
• Six times higher risk in terms of access to healthcare
• Over four times higher risk of food insecurity
• Almost nine times higher risk of socioeconomic vulnerability

“This data shows a stark and chilling picture of what we can expect as we start to see the COVID-19 pandemic spread to many African and Middle Eastern countries,” Ms Austin said.

“If coronavirus has shown us one thing it is that we are all in this together. The sense of community this pandemic has created is truly heart-warming.

“We are asking people to go one step further and not just care for their local communities, but also to think about their global community, and those likely to be affected even worse.”

Donate to CARE’s COVID-19 emergency appeal.

For interviews contact Iona Salter on 0413 185 634. Images are available on Dropbox.

Notes on methodology:

CARE used data from the INFORM Global Risk Index for this analysis. INFORM is a composite indicator that identifies countries at risk of humanitarian crisis and disaster that would overwhelm national response capacity. CARE analysed risk indicators associated with vulnerability, lack of coping capacity and hazard and exposure, comparing averages for “very high risk” countries against “very low risk” countries across these indicators

Very high risk countries are: Syria, Iraq, Yemen, Afghanistan, Somalia, Sudan, South Sudan, the Democratic Republic of Congo, Ethiopia, Nigeria, Uganda, the Central African Republic, Chad, Niger and Haiti.

Very low risk countries are: Singapore, Finland, Estonia, Liechtenstein, Luxembourg, Norway, Denmark, Czech Republic, Iceland, Slovenia, Bahrain, Qatar, Ireland, Lithuania, Netherlands, Switzerland, Latvia, Sweden, Austria, Brunei Darussalam, New Zealand, Portugal, Slovakia, Poland, Grenada, Kuwait, United Kingdom, Uruguay, Barbados, Belarus, Belgium, Hungary, Kazakhstan, Malta, Saint Kitts and Nevis, and United Arab Emirates