The Covid-19 North-South Death Transfer – Transfert de mortalité

As illustrated in the project description, the North-South mortality transfer model is based on three relationships or propositions, each of which will be the subject of an elasticity estimate: income elasticity with respect to deaths avoided in developed countries, income elasticity of a developing country or group of countries (sub-Saharan African countries here) with respect to the income of developed countries, and the elasticity of recession on mortality in African countries. The combination of the three elasticities through a multiplicative relationship should make it possible to estimate or simulate how excess mortality in Africa corresponds to avoided mortality in developed countries, in a differentiated manner depending on the country. Emphasis can be placed on infant and child mortality, which is very sensitive to recession in sub-Saharan African countries, whereas it is not very sensitive to coronavirus in developed countries. To a certain extent, the shift is from lower mortality of the elderly in the North to higher child mortality in the South.
The first elasticity (income elasticity in relation to deaths avoided in developed countries) has been the subject of several studies since the first lockdown measures were introduced in developed countries. It will be a matter of scouring this literature to derive a range of estimated coefficients. The second elasticity (income elasticity of the South compared to the North) can be estimated in two ways. Indirectly by comparing the fall in income in African countries with the fall in income in developed countries; directly through an equation in which the fall in income in African countries as a function of the fall in income in developed countries, the share of tourism, migrant remittances, exports in the GDP of African countries and the remoteness of countries from world markets. As for the third elasticity, its estimation will use cross-sectional or panel regressions for analyses covering a large number of African countries and years. In addition to the usual treatments of control variables and endogeneity, estimates will usually need to be conducted in such a way as to show the difference in the downward and upward responses of mortality, depending on the magnitude of income change and their dependence on the level of income previously attained. These regressions will be complemented by a semi-parametric model to estimate the lagged values of the elasticity over time, but also to take into account the heterogeneous levels of recessions.

The COVID-19 pandemic is a serious challenge for humanity with massive health consequences, economic costs and social disruption. The virus started in China and spread very rapidly to Europe, America and the rest of the world. With growing concerns about the speed of transmission, most governments around the world have implemented drastic measures in the hope of slowing and moderating the spread of the virus in their communities. Specifically, in the Northern countries, the strategy of more or less stringent lockdowns has been adopted. This has led to a recession in these countries, whose effects are reflected in the decrease of the GDP of Southern countries.
This paper shows how the policy of controlling COVID-19 in Northern countries through lockdowns has the effect of transferring to sub-Saharan African countries the excess mortality imputable to the virus that is averted. It is based on the estimation of three elasticities: the elasticity of the mortality averted by the lockdown in the North with respect to lost per capita income, the elasticity of the income of sub-Saharan African countries with respect to the income of the North, and finally the elasticity of crude deaths and under-five mortality in sub-Saharan Africa with respect to the deep recessions most of them experienced.
The major recession caused by lockdown policies in the North and transmitted to the South has resulted in the transfer of excess mortality on the order of 574,000 to 724,000 deaths in one year to sub-Saharan Africa, including 150,000 to 189,000 children aged 0 to 5 years. This corresponds to a 6-8 % increase in the crude death rate and a 5-7 % increase in under-five mortality. These figures are still much higher than the number of deaths (or the increase of death rates) directly attributable to COVID-19 in the sub-Saharan African population.
These findings show the magnitude of the indirect impact of the COVID-19 pandemic on mortality in sub-Saharan Africa. The official figures for direct pandemic-related mortality are very low in sub-Saharan Africa, estimated at 65,000 for 2020. Even with a correction factor (2 to 3) as recommended by the Institute for Health Metrics and Evaluation (IHME) to control for underestimation bias, the direct pandemic mortality figures are still much lower than the indirect recession-induced mortality figures.
This paper highlights the lethal vulnerability of sub-Saharan African countries to exogenous economic shocks and calls for all efforts to increase the resilience of these countries. The lethal vulnerability identified here can thus constitute a criterion for the allocation of resources that the international community plans to mobilize to help countries cope with the direct and indirect effects of the COVID-19 pandemic, particularly those related to the recession transmitted to Southern countries by the North.

We will then perform a dynamic analysis of the propagation of effects over time. We will also highlight some countries or groups of countries, particularly the Sahelian countries.
Finally, the objective is to submit this research paper to a peer-reviewed academic journal.

Three policy briefs, a working paper addressing the broader impact of COVID-19 in sub-Saharan Africa, and a more comprehensive version for submission to a peer-reviewed academic journal.

The crisis generated by the coronavirus pandemic is unlike any other. Beyond the high mortality generated, it has plunged the world into uncertainty. In the first few months after the virus appeared, two strategies had emerged. The first was that the development of herd immunity was essential by allowing the virus to spread within the population. From this point of view, the only public policy to be put in place was one in which at-risk or infected patients had to be isolated and cared for. The second strategy that emerged very quickly was that of lockdown, in which the population of most countries had to stay at home to break the chain of contamination and thus avoid overwhelming the capacity of the intensive care units and, above all, the death of many people. Although some countries such as the United States or England had initially opted for the strategy of herd immunity, most governments around the world, especially those in the North, very quickly opted for the strategy of lockdown. It materialised in actions such as social distancing, closing schools and offices, and shutting down the productive apparatus of companies. By April 2020, more than 100 countries had instituted total or partial lockdown affecting and restricting the movement of billions of people.
While the lockdown strategy may have prevented deaths, its major consequence has been to provoke a recession. While in October 2019 the IMF estimated that world GDP growth in 2020 would be close to 3.4 per cent, the institution now projects that in 2020 world GDP will contract by 3 per cent. This is a change of 6.4 percentage points, with an even greater risk of a substantial decline. This recession caused by the pandemic and the means used to deal with it in the various countries, particularly developed countries, is being transmitted to the countries of the South. This external shock is likely to have severe effects on health there. Indeed, health in the South is much more sensitive than in the North to the evolution of income and activity, especially when this evolution is on the decline.
The research proposed here aims to explore the mechanism by which the policy of combating Covid-19 by lockdown in the North has the effect of transferring the risk of mortality to the South, particularly in fragile states, the majority of which are in sub-Saharan Africa. As theorised in Guillaumont (2020), this mechanism takes place in three phases: 1) the recession in the North, which is a function of the number of deaths avoided thanks to the lockdown policy; 2) the recession in the South, which is a function of the recession in the North and, above all, of the dependence or degree of connection of each country from the South to the North; 3) the high sensitivity of health indicators, particularly mortality in the South, in relation to deep recessions. The proposal is in line with the global challenges of the crisis. The research will then consist of estimating three parameters or three elasticities corresponding to each of the three phases of modelling the transfer of mortality from North to South.