National Geographic
National Geographic 25 Sep 2020

Bill Gates: COVID-19 has Set Back Global Health for Years


National Geographic's Susan Goldberg talks to Bill Gates about Goalkeepers, and how COVID-19 has radically upended our global health.

"COVID-19 has had a profound effect on people living with HIV," said the head of the WHO Dr Tedros Ghebreyesus at the press briefing in Geneva on Monday, adding that the increased risk from COVID-19 for people living with HIV is "compounded by disruptions in treatment."

"In a WHO survey of 127 countries earlier this year, more than a quarter reported partial disruption to antiretroviral treatment for people with HIV," said Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO. "However, with support from WHO and the work of health and community workers, the number of countries reporting disruptions in HIV services has declined by almost 75 percent since June."

"What we've seen in at least HIV services is that early on, we saw some dipping in terms of the number of people getting tested, the number of people getting put onto treatment, and that can have effects over the long-term of increased deaths, increased new infections. But we've seen over since June, up until November, sort of a rebound whereas the cases are lower, systems have been able to regroup and put more people back onto therapy, shore up their ARV stocks, make sure that they have adequate supplies. ensure that the healthcare workers are doing multiple tests," said Dr Meg Doherty, Director of Global HIV, Hepatitis, STIs Programme.

With the approaching holiday season, Dr Tedros warned "this is no time for complacency."

"We all want to be together with the people we love during festive periods," he said. "But being with family and friends is not worth putting them or yourself at risk. We all need to consider whose life we might be gambling with in the decisions we make."

Dr Mike Ryan, Executive Director of the WHO Health Emergencies Programme said "WHO does not "hold a position on whether something should be canceled or not canceled because the circumstances change in each and every jurisdiction. So, we would advise that all countries look at their ski season and other reasons for mass gatherings."
COVID-19 has disrupted all forms of human mobility through the closing of national borders and halting of travel worldwide. Preliminary estimates suggest that the pandemic may have slowed the growth in the stock of international migrants by around two million by mid- 2020, 27% less than the growth expected since mid-2019, according to a report by the UN released today.
Growth in the number of international migrants has been robust over the last two decades, reaching 281 million people living outside their country of origin in 2020, up from 173 million in 2000 and 221 million in 2010. Currently, international migrants represent about 3.6% of the world's population.
The report, International Migration 2020 Highlights, by the Population Division of the UN Department of Economic and Social Affairs (UN DESA), provides the latest estimates of the number of international migrants by country of destination, origin, age and sex for all countries and areas of the world.
The report found that two-thirds of all international migrants live in just 20 countries. The United States of America remained the largest destination, hosting 51 million international migrants in 2020, equal to 18% of the world's total. Germany hosted the second largest number of migrants worldwide, at around 16 million, followed by Saudi Arabia (13 million), the Russian Federation (12 million) and the United Kingdom (9 million).
India topped the list of countries with the largest diasporas in 2020, with 18 million persons from India living outside of their country of birth. Other countries with a large transnational community included Mexico and the Russian Federation (11 million each), China (10 million) and Syria (8 million).
Diasporas contribute to the development of their countries of origin through the promotion of foreign investment, trade, access to technology and financial inclusion. However, according to projections by the World Bank, the COVID-19 pandemic may reduce the volume of remittances sent to low-and middle-income countries from USD 548 billion in 2019 to USD 470 billion in 2021, a decline of USD 78 billion or 14%. The loss has affected the livelihoods of millions of migrants and their families, stalling progress in achieving the Sustainable Development Goals. National strategies and international cooperation will be needed to mitigate the effects of this loss.
Among the major regions of the world, the largest number of international migrants in 2020 resided in Europe, with a total of 87 million. Northern America hosted the second largest number of migrants, with almost 59 million. Northern Africa and Western Asia followed with a total of nearly 50 million.
In 2020, nearly half of all international migrants resided in the region from which they originated, with Europe accounting for the largest share of intra-regional migration: 70% of migrants born in Europe reside in another European country. The share of intra-regional migration among migrants originating in sub-Saharan Africa was 63% At the other end of the spectrum, Central and South Asia had the largest share of its diaspora residing outside the region, followed by Latin America and the Caribbean, and Northern America.
Nearly two-thirds of all international migrants live in high-income countries, in contrast with just 31% in middle-income countries and around 4% in low-income countries. On the other hand, low- and middle-income countries hosted 80% of the world's refugees in 2020. Refugees comprise around 3% of all international migrants in high-income countries, compared to 25% in middle-income countries and 50% in low-income countries.
In 2020, refugees accounted for 12% of all international migrants, up from 9.5% in 2000, as forced displacements across national borders continued to rise faster than voluntary migration. Between 2000 and 2020, the number that had fled conflict, crises, persecution, violence or human rights violations doubled from 17 to 34 million.
Migrant women are catalysts of change, promoting positive social, cultural and political norms within their homes and throughout their communities. Nearly half of all international migrants worldwide were women or girls. In 2020, the number of female migrants slightly exceeded male migrants in Europe, Northern America and Oceania, partially due to a higher life expectancy of women over men. In sub-Saharan Africa and Western Asia, males tend to significantly exceed the number of females, which is attributed to temporary labour migration.
International migrants often make up a larger proportion of working-age persons compared to the national population. In 2020, 73% of all international migrants were between the ages of 20 and 64 years, compared to 57% for the total population. In the absence of international migrants, the ratio of persons aged 65 years or above per 100 persons aged 20 to 64 years, or old age dependency ratio, in high-income countries would have been nearly 3 percentage points higher in 2020.
Claire Newell, travel journalist and president of Travel Best Bets, talked about COVID-19's impact on the global travel industry
Among those most severely impacted by Covid-19 in the United States are Hispanic migrants, who've been losing their jobs in significant numbers A few months ago just 5% of them were unemployed. Today nearly 20 % are out of work.
Perhaps suffering the most are undocumented workers in the U.S. state of California.
They benefit from neither unemployment insurance nor the $2.2 trillion stimulus signed in 2020 by U.S. President Donald Trump. Though they collectively pay over two and a half billion dollars in local and state taxes each year.
Large numbers of legal migrants are eligible to apply for unemployment benefits but they are afraid to because of a new policy that makes it more difficult for immigrants to gain permanent resident status if they seek public assistance.
Mike Kirsch reports from Southern California.

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