Introduction
Remdesivir, an antiviral drug
designed to treat both hepatitis and a common respiratory virus, seemed fated
to join thousands of other failed medications after proving useless against
those diseases. The drug was consigned to the pharmaceutical scrap heap, all
but forgotten by the scientists who once championed it. But on Friday, the Food and Drug
Administration issued an emergency approval for remdesivir as a treatment
for patients severely ill with Covid-19,
the disease caused by the coronavirus.
The story of remdesivir’s rescue and
transformation testifies to the powerful role played by federal funding, which
allowed scientists laboring in obscurity to pursue basic research without
obvious financial benefits. This research depends almost entirely on government
grants. Dr. Mark Denison of Vanderbilt University is one of a handful of
researchers who discovered remdesivir’s potential. He began studying
coronaviruses a quarter-century ago, a time when few scientists cared about
them the ones infecting humans caused colds, he recalled, and scientists just
wanted to know how they worked.
“We were interested from the biologic
perspective,” Dr. Denison recalled. “No one was interested from a therapeutic
perspective.”
Neither he nor the scores of other
scientists interested in coronaviruses foresaw that a new one would unleash a
plague that has killed nearly a quarter-million people worldwide. The F.D.A.
rushed to approve remdesivir under emergency use provisions, after a federal
trial demonstrated modest improvements in severely ill patients. The trial,
sponsored by the National Institute of Allergy and Infectious Diseases,
included more than 1,000 hospitalized patients and found that those receiving
remdesivir recovered faster than those who got a placebo: in 11 days, versus 15
days.
Vials of remdesivir at a Gilead Sciences facility in
La Verne, Calif.Credit...Gilead
Sciences, via Reuters
Implication
on Government
As Africa’s largest economy with a population of close to 200
million, Nigeria is critical to the COVID-19 response in the region. One in five
sub-Saharan Africans are Nigerians and the economic and social
impacts of the COVID-19 in the country will have major ripple effects across
the continent. With government revenues collapsing following the fall in oil
prices, mitigating the health emergency and subsequent economic ramifications
from COVID-19 will be an unprecedented challenge for Nigeria’s policymakers.
Fatalities from COVID-19 in Nigeria are currently relatively
low in the global context, standing at
12, with 267 active
cases. However, the Federal Government has warned that up to four
million people could be infected after six months if social distancing measures
are not well implemented and observed. This high burden of infectious disease
is likely to put extra strain on an already underfunded health sector.
The subsequent economic fallout for Nigerians will be severe.
GDP forecasts are suggesting that if oil prices stay low, GDP growth will be -3.4%
in 2020. Worryingly, this is the prediction if the outbreak is effectively
contained in the country. By contrast, if it is not contained effectively, then
Nigeria could see GDP growth in 2020 fall to -8.8%,
driven by declining consumer spending.
This will have a profound impact on employment. For instance,
Nigeria’s film industry, known locally as Nollywood, will face major
challenges. The industry is the second largest source of jobs in the country,
employing one million
people and producing an estimated 1500 movies a
year. Nollywood movies are popular across Africa, but with its
production hub, Lagos, in lockdown, movie production is likely to plummet.
Evidently, this will have a major knock-on effect on employment. Beyond
Nollywood, there is a major concern for the country’s huge army of informal
workers, over 80% of
the workforce, who have seen wages evaporate overnight as
restrictions are introduced.
Implication on Public
Wealthy Nigerians have often preferred travelling abroad for
medical treatment with the Minister of Health estimating that the country spends
over $1 billion
annually on medical tourism. But with borders shutting around the
world, Nigeria’s elite must now confront using their country’s own healthcare
facilities in battling COVID-19. They will be concerned by what they see.
Latest data
from Africa’s 10 largest economies show that only Ethiopia has fewer hospital
beds per capita than Nigeria, as depicted in figure 1 below. The most recent
WHO data
puts the number of hospital beds at only five per 10,000 people in Nigeria.
Implication on Educational Sector
The COVID-19 pandemic has affected educational
systems worldwide, leading to the near-total closures of schools, universities
and colleges.
As of 10 May 2020, approximately 1.268 billion learners
are currently affected due to school closures in response to the pandemic.
According to UNICEF monitoring, 177 countries are currently implementing
nationwide closures and 13 are implementing local closures, impacting about
73.5 percent of the world's student population.[1]
On 23 March 2020, Cambridge International Examinations
(CIE) released a statement announcing the cancellation of Cambridge IGCSE,
Cambridge O Level, Cambridge International AS & A Level, Cambridge AICE
Diploma, and Cambridge Pre-U examinations for the May/June 2020 series across
all countries.[2]
International Baccalaureate exams have
also been cancelled.[3]
In addition, Advanced Placement Exams, SAT administrations, and ACT administrations have been moved online
and canceled.
School closures impact not only students, teachers, and
families, but have far-reaching economic and societal consequences.[4][5]
School closures in response to COVID-19 have shed light on various social and economic issues,
including student debt,[6]
digital learning,[7][8]
food
insecurity,[9]
and homelessness,[10][11]
as well as access to childcare,[12]
health care,[13]
housing,[14]
internet,[15]
and disability services.[16]
The impact was more severe for disadvantaged children and their families,
causing interrupted learning, compromised nutrition, childcare problems, and
consequent economic cost to families who could not work.[17][18]
In response to school closures, UNESCO
recommended the use of distance learning programmes and open educational applications and
platforms that schools and teachers can use to reach learners remotely and
limit the disruption of education.[19]
Going to school is the best public policy tool available to
raise skills. While school time can be fun and can raise social skills and
social awareness, from an economic point of view the primary point of being in
school is that it increases a child’s ability. Even a relatively short time in
school does this; even a relatively short period of missed school will have consequences
for skill growth. But can we estimate how much the COVID-19 interruption will
affect learning? Not very precisely, as we are in a new world; but we can use
other studies to get an order of magnitude.
Two pieces of evidence are useful. Carlsson et al. (2015)
consider a situation in which young men in Sweden have differing number of days
to prepare for important tests. These differences are conditionally random
allowing the authors to estimate a causal effect of schooling on skills. The
authors show that even just ten days of extra schooling significantly raises
scores on tests of the use of knowledge (‘crystallized intelligence’) by 1% of
a standard deviation. As an extremely rough measure of the impact of the
current school closures, if we were to simply extrapolate those numbers, twelve
weeks less schooling (i.e. 60 school days) implies a loss of 6% of a standard
deviation, which is non-trivial. They do not find a significant impact on
problem-solving skills (an example of ‘fluid intelligence’).
A different way into this question comes from Lavy (2015),
who estimates the impact on learning of differences in instructional time
across countries. Perhaps surprisingly, there are very substantial differences
between countries in hours of teaching. For example, Lavy shows that total
weekly hours of instruction in mathematics, language and science is 55% higher
in Denmark than in Austria. These differences matter, causing significant
differences in test score outcomes: one more hour per week over the school year
in the main subjects increases test scores by around 6% of a standard
deviation. In our case, the loss of perhaps 3-4 hours per week teaching in
maths for 12 weeks may be similar in magnitude to the loss of an hour per week
for 30 weeks. So, rather bizarrely and surely coincidentally, we end up with an
estimated loss of around 6% of a standard deviation again. Leaving the close
similarity aside, these studies possibly suggest a likely effect no greater
than 10% of a standard deviation but definitely above zero.
Perhaps to the disappointment of some, children have not
generally been sent home to play. The idea is that they continue their
education at home, in the hope of not missing out too much.
Families are central to education and are widely agreed to
provide major inputs into a child’s learning, as described by Bjorklund and
Salvanes (2011). The current global-scale expansion in home schooling might at
first thought be seen quite positively, as likely to be effective. But
typically, this role is seen as a complement to the input from school. Parents
supplement a child’s maths learning by practising counting or highlighting
simple maths problems in everyday life; or they illuminate history lessons with
trips to important monuments or museums. Being the prime driver of learning,
even in conjunction with online materials, is a different question; and while
many parents round the world do successfully school their children at home,
this seems unlikely to generalise over the whole population.
So while global home schooling will surely produce some
inspirational moments, some angry moments, some fun moments and some frustrated
moments, it seems very unlikely that it will on average replace the learning
lost from school. But the bigger point is this: there will likely be
substantial disparities between families in the extent to which they can help
their children learn. Key differences include (Oreopoulos et al. 2006) the
amount of time available to devote to teaching, the non-cognitive skills of the
parents, resources (for example, not everyone will have the kit to access the
best online material), and also the amount of knowledge – it’s hard to help
your child learn something that you may not understand yourself. Consequently,
this episode will lead to an increase in the inequality of human capital growth
for the affected cohorts.
Implication
on Health Institute
In
the short-term, it is paramount that spending/resources to fight COVID-19 in
Nigeria are supplementary and not diverted from existing healthcare services
fighting other diseases. Studies
of the Ebola crisis in West Africa from 2014-2016 have found that as many
people died because of overwhelmed health systems’ inabilities to treat
malaria, HIV, and tuberculosis than from Ebola itself. A similar trend can only
be avoided in the fight against COVID-19 if funds are additional, and not
diverted from other crucial healthcare services.
Conclusion
The COVID-19 crisis is like no other. It has exposed flaws in
the response of governments to healthcare and social security in both the
developed and developing world alike. Nigeria is therefore not unique in facing
difficulties. Yet, its reliance on oil exports to fund government expenditure
has made the country particularly vulnerable following the collapse in oil
prices. It remains to be seen whether the aggressive steps the Federal
Government has taken will be enough to successfully mitigate the effects of the
crisis. A small silver lining is the belief that the oil price crash will act
as a catalyst for the economic diversification that Nigeria requires. The
country’s growing population, standing at close to 200 million already, is
counting on it.
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