Intended for healthcare professionals


Covid-19: how a virus is turning the world upside down

BMJ 2020; 369 doi: (Published 03 April 2020) Cite this as: BMJ 2020;369:m1336

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  1. Ilona Kickbusch, director1,
  2. Gabriel M Leung, dean of medicine2,
  3. Zulfiqar A Bhutta, co-director3,
  4. Malebona Precious Matsoso, director of health regulatory science platform4,
  5. Chikwe Ihekweazu, director general5,
  6. Kamran Abbasi, executive editor6
  1. 1Global Health Programme, Graduate Institute of International and Development Studies, Geneva, Switzerland
  2. 2Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
  3. 3Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
  4. 4Wits Health Consortium, University of Witwatersrand, Johannesburg, South Africa
  5. 5Nigeria Centre for Disease Control, Abuja, Nigeria
  6. 6The BMJ, London, UK
  1. Correspondence to: I Kickbusch kickbusch{at}

We may emerge from this with a healthier respect for our common humanity

The covid-19 pandemic is the biggest threat in living memory to health and wellbeing, social welfare, and the global economy. In a world shaped by neoliberalism the economy has always come first, but many leaders of rich countries are now explicitly prioritising people’s health over the economy. On 26 March, G20 leaders held an extraordinary summit on health, focusing on covid-19. In the face of the severe economic impact of necessary public health actions, financial rules that were considered sacrosanct are being bent with startling speed and force.

Germany’s chancellor, Angela Merkel, promised, “We will do what is necessary.” Germany has enough financial reserves and emergency instruments to release additional funds and maintain economic life.1 France is engaged in an economic and financial war, according to its finance minister: “This war will be long, it will be violent, and we must mobilise all our national, European, and G7 forces.”2 President Cyril Ramaphosa of South Africa believes that, “What we are witnessing is social solidarity in action, a defining feature of our nationhood.”3

Health before wealth

The global economy is braced for at least $2.7tn (£2tn; €2.5tn) in lost output, equivalent to the annual gross domestic product of the United Kingdom.4 Projections indicate that many economies will be crippled and unable to recover quickly, especially in the global South.5 The Organisation for Economic Cooperation and Development, created to implement the Marshall plan after the second world war, is calling for a global new deal.6 If economies and social order collapse in South Asia, Africa, or Latin America, no border, wall, or boundary will be enough to contain the consequences. At its emergency summit, the G20 committed “to do whatever it takes to overcome the pandemic,” …

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