Jordan’s Response to the Coronavirus Pandemic

HEPL blog series: Country Responses to the Covid19 Pandemic

 

Jordan’s Response to the Coronavirus Pandemic

Elise Tancoigne
University of Geneva

 

Jordan reported 453 cases and 8 deaths from COVID-19 as of April 30, among the lowest number in the world. These numbers might come as a surprise, as Jordan has a middle ranking in the 2019 Global Health Security Index for global pandemic preparedness. The low numbers are often explained by Jordan’s prompt reaction during the epidemic.

 

Pandemic preparedness 

Jordan is a constitutional monarchy with 10.8 million inhabitants, and classified as a “low-middle income developing country”. The Jordanian health system is mainly based on public organizations which provide more than 70% of health services. It is funded at 7.7% of GDP, twice the level of other countries in its category, but generally less than developed countries and is currently under strain by the massive influx of Syrian and Iraqi refugees. The country has experienced several epidemics and built a pandemic response capacity in response: avian flu in 2006, SARS in 2012 and MERS-Cov in 2015. The WHO and the American CDC are the main proponents behind this strategy. Training programs in epidemiology have been offered each year since 1998. In compliance with 2005 regulations, the National Center for Security and Crisis Management (NCSCM) was established in 2005 and the Epidemiology Committee, a crucial body of expertise located within the Ministry of Health, was expanded in 2006. Both play a key role in the response to COVID-19. Throughout the crisis, government decisions are presented as subservient to the decisions of the Committee, a power recognized by the king himself.

 

Timeline of main events 

A phase of control and quarantine of travelers from Asia was initiated under the recommendation of the Epidemiological Committee as early as January 26th. This was two weeks before the WHO classified the new epidemic as a pandemic, at a time when both the country and its neighbours were COVID-19-free. These measures were gradually tightened and extended to travelers coming from South Korea, Iran (February 23rd), and Italy (February 25th). On March 3rd, the first case of COVID-19 was announced. The government decided to close the schools, ban gatherings and forbid travels to and from Europe as of March 14th, and recommended that Jordanians stay at home. On March 15th, 11 new cases were declared. On March 16th, the borders were closed to all foreigners and new arrivals were quarantined, raising the number of quarantined to 5,000. The Defense law was activated, giving the Prime Minister extensive powers, and since then, the army has been deployed in the country. By March 21st, 69 cases were reported, and a strict national curfew was decreed. No one was allowed to exit their house and offenders faced up to a year in prison; a drastic measure later changed to a $140 fine. A delivery service was set up and small food shops reopened with restrictions three days later. The first death was recorded on March 27th. A strict curfew has regularly been imposed on weekends since then. As the situation improves, businesses are slowly reopening and the curfew is being eased.

 

Authority on information 

One key strategy of the government consisted of establishing itself as an authoritative source of information. Two days after the first case, 6 people were arrested for spreading rumors, considered by the Minister of Health as “perhaps more dangerous than the virus itself”. A hotline was set up to answer questions from the population and a partnership with Facebook was established. This included blocking ads for false treatments, highlighting the publications of the ministry, and locating fake news. The Ministry of Health provided, and is still providing, a daily briefing about the situation. It includes the number of cases, locations, list of measures taken, and advice to follow. In mid-March, all press publications were suspended for 2 weeks, on the basis of limiting the spread of the virus. Two media executives were also arrested on April 10th for airing a report on the economic difficulties encountered by some Jordanians. Preventing panic events and enforcing governmental decisions were the motto behind these measures. Journalists, the government and many intellectuals repeatedly accused the population of lacking discipline and failing to understand the seriousness of the crisis. Both ideas were widely used to justify new measures or their renewal, as videos of people infringing orders and hundreds of recorded curfew violations were published daily on social media and in newspapers.

 

Centralized decisions and digital resources 

In mid-March, crisis management moved from the Ministry of Health to the National Center for Security and Crisis Management, which coordinated the global response to the pandemic throughout the country, in collaboration with regional epidemiological teams. National implementation of the decisions made by the NCSCM were assisted by several digital services. A website with numerous videos, explanations and advice was quickly designed after the first case was announced, and leaflets were disseminated. Distance teaching was implemented on new platforms targeting all years of the school curricula, as well as being broadcast on national TV channels. During the curfew, the government launched an app for shopping and delivery services. All permits issued during the curfew soon transitioned to an electronic format. Workers experiencing wage difficulties could fill a form on the website of the Ministry of Labor. By mid-April, 13,000 of 14,000 of wage delay-related complaints had been resolved. At the end of April, another platform enabled registration of all expats willing to return to their home countries and another for Jordanian students abroad.

 

Economic measures 

The government, the Ministry of Health and poor families benefited from more than $140 million donated by Jordanian companies, banks, businessmen, citizens, ministers and the king, as well as the UNHCR, the USA and other donors. Public sector employees are on paid official leave since March 18 and Defence order #6 granted most workers in the private sector their full wage until March 31st. Defence Order #9 issued on April 16th organized support to non-working employees, employers, and daily wage workers, who represent 53% of the market. Financial support for day laborers came through the National Aid Fund, a cash assistance program for low-income Jordanians. Measures also consisted in exercising strict control over the supply of masks, disinfectant products and essential goods through for example the control and closing of stores that inflate their prices.

 

Concluding remarks

Only one COVID-19 death has been reported in Jordan since April 9th. Jordan’s early response to the crisis now gives the country arguments to position itself as a model in the Middle East and in the world. On April 19th, the king offered to send doctors and export medical equipment, including masks, to the US and to other countries that need it. From an international perspective, the model, however, depended on infringements of the freedom of press and of speech. Its economic consequences also remain to be addressed – as for any other country in the world.

 

 

Health Economics, Policy and Law serves as a forum for scholarship on health and social care policy issues from these perspectives, and is of use to academics, policy makers and practitioners. HEPL is international in scope and publishes both theoretical and applied work.

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