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A sigh of relief before the storm: Sudan in the eye of the COVID-19 storm

As of Tuesday, March 31, Sudan has officially reported only six confirmed cases of the novel coronavirus disease (COVID-19). All confirmed cases of COVID-19 in the country currently are from people who recently arrived from outside of the country. Thus, as of this writing, instances of community spread appear to be non-existent. Similarly, in Sudan’s much more populous neighbor to the East, Ethiopia, the number of cases has reached 25 with nine new cases in the last forty-eight hours alone.

These numbers put Sudan and many African countries well below the large number of cases reported in Egypt, Sudan’s northern neighbor, where officials estimate the number of cases has reached almost 700 or South Africa with more than 1,300 cases, the highest number on the continent. These numbers may change, as current diagnostic testing capacity for coronavirus remains limited and governments in Africa work rapidly to strengthen surveillance.

These small published estimates of COVID-19 cases in Sudan have allowed many Sudanese to express sighs of relief that the rate of coronavirus spread has yet to overwhelm their country as it has Asian and Western nations. Sudanese leaders have generally received high marks for learning to take this current medical crisis seriously based on the past experience of other African countries plagued by the Ebola pandemic in 2014.

Yet, the crisis itself has exposed the vulnerabilities of the new civilian led transitional government in Sudan. This government came to power only in August of 2019 following more than 30 years of a violent authoritarian dictatorship led by General Omar El-Bashir.

In November of last year, the new Finance Minister Ibrahim El-Badawi, a former World Bank Official with vast international experience, was forced to admit that the transitional government had little hope of surviving without at least $5 billion in international support. This support — which Sudanese officials hoped would come from international financial institutions, the Arab Gulf states, as well as Western governments — will, in the face of what is beginning to be a sharp global economic downturn, now be increasingly hard to deliver.

An absence of financial support would call into question whether the transitional government in Sudan will be able to address the demands of the masses of Sudanese who protested for months to bring down the former regime and to find a solution to the needs of the nearly half of the population who live in poverty.

The success of Sudan’s public health officials can be explained in part by their decision to close the country’s borders on March 16, including Khartoum International Airport and the northern border with Egypt to most travelers. Like many less developed countries, Sudanese authorities have made the brutally honest and responsible assessment that the country’s medical and public health facilities, weakened by decades of sanctions and underinvestment, would be quickly overwhelmed if an outbreak were to occur inside of the country. Therefore, the only hope for treating the virus has been to try to stop it at the border.

Yet, Sudan faces two acute challenges at the moment. The first is that this crisis has exposed weaknesses in the country’s public health infrastructure that are now much more glaring. An acute shortage of doctors and other health professionals exists in much of the country. The price of medications has increased by 150 to 300 percent. Public hospitals lack basic supplies and medical professionals are paid poorly.

Public sector doctors in Sudan make only $200 dollars a month and are expected to buy their own medical supplies to say nothing of the new personal protective equipment needed to combat the virus that has been in such short supply around the world. For years, Sudanese doctors have had to dispatch families to purchase each individual item necessary to provide care to their sick loved ones, including needles, drips, and even oxygen tanks and blood.

The second is the shortage of hard currency, especially dollars, that the country needs not only to meet its medical and public health bills, but also for basic imports like food and fuel. This year alone, the Sudanese Minister of Health, Dr. Akram Ali al-Tom, has requested a budget of 51 billion Sudanese pounds, or approximately $1 billion, as a first step in trying to rebuild the country’s ravaged public health system. Similarly, for the last five years, Sudan has needed upwards of $800 million in emergency donor aid simply to meet its basic needs such as importing food and purchasing critical medicines.

While there are only 5,500 cases of confirmed coronavirus infections across the African continent at the moment, analysts at institutions such as the African Centers for Disease Control and Prevention, the United Nations Economic Commission for Africa (UNECA), and the African Development Bank estimate that many African countries are two to three weeks away from a massive outbreak of the virus.

Addressing this challenge could require a coordinated effort from countries across the continent to spend more than $100 billion in order to bolster shaky public health systems. While some of this money can come from multilateral lending — such as  $3 billion in new coronavirus bonds raised by the African Development Bank — the vast majority of this new funding will have to come from new lending and grants from external donors.

Experts from the UNECA have suggested that at least half of the necessary funds could come from waiving interest payments to the international financial institutions and other multilateral organizations. This would allow many countries the breathing space necessary to prepare their public health sectors for the onslaught of cases likely to emerge over the next two to three weeks. It would also create breathing space for African countries to prepare for the severe downturn in the world economy.

However, Sudan’s case is complicated by the persistence of U.S. sanctions against the country. Though many of these sanctions have been lifted or relaxed over the last few years, a large number of sanctions remain in place, such as Sudan’s listing as a state sponsor of terrorism. The U.S. sanctions against Sudan date back to the 1990s and were imposed as punishment for a regime that waged wars in South Sudan and Darfur as well as harbored Islamic terrorists. It does not reflect that security cooperation with the United States that has blossomed in the years since 2001 or the fact that the previous regime was overthrown in a popular revolution last year that has brought to power a pro-American government.

Instead, the current sanctions against Sudan are preventing the government from negotiating with the International Monetary Fund and World Bank over the more than $50 billion in arrears that the country owes these two organizations, preventing Sudan from fully making use of multilateral lending in order to get through this transitional period.

The hesitancy to lift existing sanctions against Sudan in the United States comes from an increasingly punitive view of foreign policy, where despite the fact that the U.S. foreign policy establishment recognizes the huge gains made in Sudan over the last year, many U.S. government officials continue to argue that sanctions and restrictions on the country should not be removed before the Sudanese prove that they can be trusted.

However, the fragile transition to democracy in Sudan has no hope of succeeding if punishing financial sanctions remain in place, driving the country further into despair in the midst of an impending global economic recession.

The United States’ ambivalence toward Sudan’s recent progress threatens the very viability of the new democratic government in Sudan. The U.S. sanctions block access to desperately needed economic aid from the World Bank and the International Monetary Fund.

Without economic aid, the government will be unable to stymie economic collapse, leading to civic unrest, and upending democratic governance. Beyond governance, lives will be lost as financial pressures hinder any attempts the country could make to prepare its health infrastructure for the looming tide of the coronavirus pandemic.