“The world is at risk of losing millions of women and children due to reductions in coverage of essential services, reversing hard-earned progress towards the SDGs [Sustainable Development Goals] to date and posing catastrophic consequences for households and communities,” said Dr. Koki Agarwal, Project Director of the United States Agency for International Development’s (USAID) MOMENTUM Country and Global Leadership award, at a recent event on the importance of ensuring continuity of maternal, newborn, and child health services, voluntary family planning, and reproductive health care during the COVID-19 pandemic. The event was the first in a series of virtual country knowledge exchange discussions organized by USAID’s MOMENTUM Country and Global Leadership, led by Jhpiego and partners.

Not since COVID-19 burst onto the scene a few months ago have so many individuals and institutions, outside the business, military, and intelligence communities, woken up to the need for a smart way to characterize and communicate uncertainty. The overwhelming choice for many is scenario planning. Today, scenario planning applies to a wide spectrum of issues, not just international development. It has been used to anticipate changes in higher education, rethink workforce composition, and explore options for individual financial planning.  

In just a single year, a 10 percent decrease in sexual and reproductive health services in low- and middle-income countries could lead to another 49 million women with unmet need for contraception, according to Guttmacher Institute estimates from April 2020. Other possible effects include another 15 million unintended pregnancies, another 28,000 maternal deaths and 168,000 newborn deaths due to untreated complications, and another 3 million unsafe abortions and 1,000 maternal deaths due to unsafe abortions. The implications are staggering in terms of unmet needs, unintended pregnancies, unsafe abortions, and maternal and newborn deaths in 132 countries that are home to more than 1.6 billion women of reproductive age (15–49 years).

In India, COVID-19 has put the spotlight on migrant workers’ precarious working conditions. First, the sweeping lockdown left many workers jobless, forcing them to walk hundreds of kilometers to their native villages. Now, in a reaction to the coronavirus, states are loosening labor laws in a bid to get their economies up and running. As a consequence, migrant laborers have to work even more hours. 

Punjab and Gujarat amended their Factories Act in April, increasing the work time to 72 hours every week. Rajasthan has upped working hours from 8 to 12 hours per day. Uttar Pradesh (UP) has exempted companies from almost all labor laws for the next three years. The relaxed UP laws relate to occupational safety, health, and working conditions, and those that pertain to contract workers and migrant laborers. 

The coronavirus has everyone weighing risk and security within a sliding scale of geographic connections and boundaries. Dots and circles of infection pack our virus maps. We more clearly see the fragility of commodity chains that structure our food systems and energy supplies. The virus easily crosses state borders while security protocols within states have been focused on boundaries between individuals and speech droplets. In many ways, human interaction with this microbe illustrates why an environmental geopolitics perspective is powerful.

With the arrival of COVID-19, countries are experiencing disruptions of health services of all kinds— health workers have been redeployed, supplies already in short stock are even more difficult to find, scarce financial resources for health are being reallocated, and routine health services are less, if at all, available. COVID-19 is causing facilities to lockdown in some settings, in part because many providers lack sufficient personal protective equipment (PPE) to safely provide services. At the same time, many clients—particularly those seeking family planning and reproductive health (FP/RH) services—cannot access services at all. This is due to a confluence of factors: police action is preventing movement; facilities are shutting their doors; many people are fearful of contracting the virus; in some cases, women are forbidden from leaving their homes by a partner. 

The global coronavirus pandemic, now in its third month, is precipitating a financial crisis for water utilities in low- and middle-income countries as many of these service providers face drastic cuts in revenue and rising costs to respond to the public health emergency.