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Updated May 8, 2020
COVID-19: Global Implications and Responses
Overview
medical conditions (such as high blood pressure, heart and
Congressional interest in the global implications of
lung disease, cancer, and diabetes) are more likely to be
pandemics and the novel coronavirus pandemic is high,
severely sickened or die from COVID-19.
with over 50 pieces of related legislation introduced in the
Although more than 3.5 million COVID-19 cases have been
116th Congress to date (see CRS Report R46319, Novel
confirmed globally, many health experts suspect the true
Coronavirus 2019 (COVID-19): Q&A on Global
case count is significantly higher due to asymptomatic cases
Implications and Responses).The virus, which is believed to
and insufficient diagnostic testing in some countries.
have started in Wuhan, China, in late 2019, is now named
“
Globally, roughly 45% of reported cases and 59% of
severe acute respiratory syndrome coronavirus 2” (SARS-
reported deaths were in Europe. The United States
CoV-2) and is known by the disease it causes, “coronavirus
accounted for 32% of reported cases and 26% of reported
disease 2019” (COVID-19). The virus has spread across the
deaths worldwide.
globe and is now concentrated in the United States and
Europe (Figure 1). As of May 7, 2020, the World Health
While current diagnostic supplies are insufficient to meet
Organization (WHO) estimated that 3.6 million people had
global demand, scientists are creating tests that are cheaper,
contracted the disease, with over 250,000 deaths. WHO
more easily administered, and provide faster diagnosis.
declared the outbreak a Public Health Emergency of
Several have been authorized by the U.S. Food and Drug
International Concern (PHEIC) on January 30 and labeled it
Administration and other global regulatory bodies. No
a “pandemic” on March 11.
specific treatments or vaccines for COVID-19 exist. As of
May 7, roughly 200 COVID-19 therapeutics and vaccines
The Virus
were in development globally, including 123 candidate
vaccines. Through “Operation Warp Speed,” the Trump
Coronaviruses are a large family of zoonotic viruses—
Administration has identified 14 candidate vaccines for
viruses transmissible between animals and humans—that
accelerated development. Globally, at least eight groups
can cause illness ranging from the common cold to more
have launched safety trials of vaccine candidates, including
severe diseases such as Middle-East Respiratory Syndrome
in the United States, the United Kingdom, and China. Some
(MERS) and Severe Acute Respiratory Syndrome (SARS).
hope that a COVID-19 vaccine would be available by fall
The most common symptoms among confirmed COVID-19
2020, though experts caution sufficient supplies of the
patients include dry cough, shortness of breath, and fever.
vaccines will not likely meet global need for several years.
Data suggest that older adults and those with preexisting
Figure 1. Number of Confirmed COVID-19 Cases Reported in the Past Seven Days (May 1-May 7, 2020)
Source: WHO, COVID-19 Situation Report - 108, May 7, 2020.
https://crsreports.congress.gov
COVID-19: Global Implications and Responses
China’s Experience
Funds for Global COVID-19 Control. As of May 6, the
State Department and the U.S. Agency for International
The Wuhan city government first publicly acknowledged
Development (USAID) have pledged $900 million for
cases of pneumonia of an unknown cause on December 31,
COVID-19-related health and humanitarian assistance. The
2019, linking them to a local seafood market that sold live
USAID reports that these funds are being used to support
animals. Chinese authorities did not acknowledge that the
public health information campaigns; expand access to
virus was spreading from person-to-person until January 20,
water, sanitation, and hygiene; and bolster infection
however, and before then reprimanded medical workers
prevention and control in more than 100 countries.
who sought to warn colleagues about the dangers of
Resources available for international COVID-19 responses
infection. China is now widely seen as having “squandered”
an early window of opportunity to stem the virus’s
are available from additional sources. In January 2020, for
global
example, HHS made available up to $105 million from the
spread. After January 20, Chinese authorities began taking
Infectious Disease Rapid Response Reserve Fund
aggressive actions to contain the epidemic, including
(IDRRRF) for domestic and international COVID-19
painstaking efforts to find cases, isolate them, and trace
responses. In addition, Congress provided $8.3 billion for
their close contacts, plus controversial restrictions on
domestic and international COVID-19 responses through
movement. Reported infections “peaked and plateaued” in
the Coronavirus Preparedness and Response Supplemental
China between January 23 and January 27, and declined
Appropriations Act, 2020 (P.L. 116-123). Enacted March 6,
afterwards, except for a spike on February 1, according to
2020, the act included $300 million for the Centers for
the report of a WHO-China Joint Mission that investigated
Disease Control and Prevention’s (CDC’s) global health
the outbreak in China. A major focus for China now is
security programs and $1.25 billion for USAID and State
preventing importation of new cases from outside its
Department responses, including evacuations.
borders.
WHO Response
WHO Funding. On April 14, 2020, President Trump
announced that the United States would suspend funding to
PHEIC. On January 30, 2020, WHO Director-General
the WHO, pending a 60- to 90-day review of the WHO
Tedros Adhanom Ghebreyesus declared the pandemic a
response. The President and some world leaders assert that
Public Health Emergency of International Concern
the WHO had mishandled the early response to the
(PHEIC), prompting countries to take specific actions,
COVID-19 pandemic and are pushing for an investigation
including heightening surveillance and reporting of the
of the response. Congressional responses have been mixed.
disease. A PHEIC declaration can prompt countries to
Several bills have been introduced calling for the
provide additional resources for global and domestic
suspension of WHO funding until certain reforms are made.
response and enable WHO to access certain emergency
Other Members maintain that withholding funding during
funding, such as from the WHO Contingency Fund for
the outbreak might stymie pandemic control efforts and
Emergencies (CFE).
have introduced legislation aimed at simultaneously
“Pandemic.” WHO defines a pandemic as “the worldwide
investigating the WHO COVID-19 response while
spread of a new disease” for which most people do not have
maintaining financial support for global COVID-19
immunity. WHO began calling COVID-19 a pandemic on
containment efforts led by the WHO.
March 11, though the criteria were met earlier.
Travel Restrictions. Starting January 31, the President
WHO COVID-19 Plan. On February 5, 2020, WHO
issued a series of proclamations suspending entry into the
announced a $675 million COVID-19 plan for February
United States of most foreign nationals who, within the 14
through April to provide international coordination and
days prior to arrival, had been in mainland China (effective
operational support, bolster country readiness and response
February 2), Iran (effective March 2), the Schengen Area of
capacity—particularly in low-resource countries—and
Europe (26 countries; effective March 13), and the United
accelerate relevant research and innovation. The WHO
Kingdom or the Republic of Ireland (effective March 16).
issued an updated plan in April, though it did not include a
On March 21, the United States, Canada, and Mexico began
request for additional funding. As of May 6, donors
limiting nonessential travel across their borders. On April
provided $451 million for the plan, which the WHO has
20, they extended the measures for an additional 30 days.
used to purchase and ship Personal Protective Equipment
(PPE) to 133 countries and supply 1.5 million diagnostic
On March 19, the State Department issued a global Level 4
(“Do Not Travel”)
kits to 126 countries.
health advisory, advising Americans “to
avoid all international travel due to the global impact of
Access to COVID-19 Tools. On April 24, WHO, Gavi, the
COVID-19.” The department advised U.S. citizens outside
Vaccine Alliance, the Coalition for Epidemic Preparedness
of the United States to return home immediately, “unless
and Innovation (CEPI), and others announced the creation
they are prepared to remain abroad for an indefinite
of the Access to COVID-19 Tools (ACT) Accelerator, a
period,” and it advised U.S. citizens living abroad to avoid
framework to ensure equitable global access to COVID-19
all international travel. On March 14, the department
diagnostics, therapeutics, and vaccines. As of May 6, the
authorized “the departure from any diplomatic or consular
global community, led by the European Union, raised $7.4
post in the world of U.S. personnel and family members
billion for the ACT Accelerator and other global COVID-
who have been medically determined to be at higher risk of
19 responses. The United States neither participated in the
a poor outcome if exposed to COVID-19.” On March 27,
launch nor provided funding for the ACT Accelerator.
CDC issued a “Global COVID-19 Pandemic Notice,”
U.S. International Response
advising travelers to “avoid all non-essential travel to all
global destinations.”
https://crsreports.congress.gov
COVID-19: Global Implications and Responses
Frank Gottron, Specialist in Science and Technology
Policy
Sara M. Tharakan, Coordinator, Analyst in Global
Susan V. Lawrence, Specialist in Asian Affairs
Health and International Development
Tiaji Salaam-Blyther, Specialist in Global Health
IF11421
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