The outbreak of COVID-19 was declared a pandemic by the World Health Organisation on 11 March 2020 after the virus had spread to at least 114 countries infecting more than 118,000 individuals, and leading to at least 4,290 reported deaths. COVID-19 will impact each country differently, depending on local health infrastructure, the severity of the spread of the virus, the country’s political, economic and social context, as well as the country’s level of preparedness.
Currently, there have been no reports of a COVID-19 outbreak in South Sudan. Preparedness and Prevention measures are therefore critical at present. In our collective responsibility to support the Government of South Sudan in its preparedness and response mechanisms in the event of an outbreak of COVID-19, we must ensure that these mechanisms are grounded in a human rights-based approach. These mechanisms must recognize, in particular, that the right to health is a fundamental part of the human rights framework and of our understanding of the human right to dignity. They must be cognizant of the fact that all human beings have an equal right to seek health care, and the right to health must be enjoyed without discrimination on the grounds of race, age, ethnicity or any other status (including refugees and internally displaced persons/IDPs).
It is also important to highlight that pursuant to Sustainable Development Goal (SDG) 3, South Sudan is committed to ensure healthy lives and promote wellbeing for all at all ages. Moreover,
SDG target 3.d, calls on the United Nations with the support of the international community, to strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks. Therefore, best practice in the prevention and response to COVID- 19 rest on a mutually reinforcing inalienable right to health, development and social protection and upholding the principle of leaving no one behind enshrined in the Agenda 2030 for Sustainable Development.
There are over 7.5 million persons in need of humanitarian assistance in South Sudan. More than 1.5 million are IDPs, while over 299,000 are refugees from other countries. Major flooding in late 2019, coupled with ongoing inter-communal clashes, food insecurity and subsequent displacement, have affected the resilience and coping mechanisms of families and individuals and strained the humanitarian response system as well. Lack of basic health-care services (with limited or no access to hospitals for supportive care and treatment of complications), compounded by factors including: a high prevalence of malnutrition, inadequate water and sanitation facilities, and communicable diseases; ongoing inter-communal clashes; logistical challenges resulting from the remoteness of locations or ongoing insecurity; inadequate surveillance/early warning systems to detect cases in remote locations; and poor links to national disease monitoring systems, will result in many civilians at heightened risk of not being able to exercise their fundamental right to health, exposing them to COVID-19 infections.
Additionally, health facilities and health care workers were not spared from the violence during the armed conflict and, in some circumstances, were directly targeted. Health facilities, in particular those away from urban centres have been destroyed or occupied and supply chains for medical equipment and medicines have been disrupted. Therefore, should the COVID -19 pandemic hit South Sudan, the population would be at substantial risk, particularly those with chronic medical issues, older persons, separated and unaccompanied children, persons with disabilities, persons in detention, pregnant women, and those living in refugee or IDP camps or informal displacement settings including congested urban areas.
The COVID-19 outbreak is a public health emergency, which in the context of South Sudan’s lack of any viable national social safety net, possess multiple protection challenges and threats to human rights. In large part as a result of the armed conflict, public health services are not able to provide prevention, treatment and control of epidemic, endemic, occupational and other diseases for all persons living in the country. Additionally, the prevention and response therefore cannot be only medical, but must also address human rights and protection challenges, whether they arise from the health crisis itself or measures to contain it. While recognizing the right of any state to place proportionate restrictions to preserve public health, the absence of due process of law in South Sudan may affect fundamental rights to freedom of movement, the right to leave and return to the country, including through the arbitrary closure of borders.
This paper therefore provides for a set of protection and human rights considerations for the international community, humanitarian actors, donors and the Government of South Sudan to take into account in their Prevention and Response (hereinafter referred to as Response) plans for COVID-19.