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Covid-19 risks and response in South Asia

BMJ 2020; 368 doi: (Published 25 March 2020) Cite this as: BMJ 2020;368:m1190

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  1. Zulfiqar A Bhutta, professor1,
  2. Buddha Basnyat, professor2,
  3. Samir Saha, professor3,
  4. Ramanan Laxminarayan, professor4
  1. 1Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
  2. 2Oxford University Clinical Research Unit-Patan Academy of Health Sciences, Kathmandu, Nepal
  3. 3Child Health Research Foundation, Dhaka, Bangladesh
  4. 4Center for Disease Dynamic, Economics and Policy, New Delhi, India
  1. Correspondence to: Z Bhutta Zulfiqar.bhutta{at}

The region is ill prepared for the crisis that lies ahead

Over the past few weeks we have seen political leaders, policy makers, and health managers grapple with the reality of a novel coronavirus outbreak and its potential for global spread.12 From what initially seemed like a localised outbreak in Hubei province of China in December 2019, it rapidly became clear that SARS-CoV-2 had pandemic potential.3 But it was almost two months before the World Health Organization declared a true global pandemic. The number of deaths from covid-19 in Italy now exceeds those reported from China, and the outbreak in Iran may have seeded cases in Pakistan and Afghanistan.4

The number of reported cases in South Asia remains relatively low, however, and the response patchy. By 24 March, authorities in the South Asian Association for Regional Cooperation (SAARC), which comprises India, Pakistan, Bangladesh, Nepal, Sri Lanka, Maldives, Bhutan, and Afghanistan, had reported just 1536 confirmed cases and …

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