BAGHDAD — In a country where most people believe that God will protect them but their government won’t, it has taken a popular Shiite cleric to give Iraq’s stumbling vaccination program a boost.
Iraq has been bracing for a dangerous summer, with widespread skepticism over coronavirus precautions, a limited vaccine supply and a troubled health care system.
But last week, Moktada al-Sadr, whose lineage from a revered Shiite family commands respect among millions of Iraqis, was shown on video rolling down his robe and baring his arm for a Chinese Sinopharm vaccine in the holy city of Najaf.
Vaccination clinics throughout Najaf Province had until then recorded only around 300 vaccinations a day. Two days after the video was released, that number climbed to almost 2,000 a day until clinics ran out of vaccines on Wednesday. They expect to receive more in two weeks.
Covax, the global vaccine-sharing partnership, has allocated 1.7 million doses for the country of 40 million people.
Covax, Chinese donations of Sinopharm, and purchases of the Pfizer-BioNTech vaccine funded through a $100 million World Bank loan.
The vaccination program was meant to start with the elderly, health care workers, those with chronic conditions and security forces. Yet a significant number of Iraq’s roughly 200,000 health care workers are refusing vaccines, according to officials.
a fire swept through a Baghdad hospital for Covid patients after an oxygen canister exploded, killing more than 100 people, most of them patients and their relatives. The hospital lacked smoke detectors or sprinkler systems.
The health minister was forced to resign and other officials were arrested. Iraqi ministries are divvied up among powerful political parties with the health ministry under the control of the Sadr political bloc.
Mr. Sadr, who has tried to portray himself as above politics while still playing a key role in Iraq’s political system, has said any officials convicted of wrongdoing should be punished.
The health ministry has struggled to get its message across.
“Some people still do not believe in the existence of the virus and they do not believe in the effectiveness of the vaccine,” said Dr. Ruba Falah Hassan, in the ministry’s media office.
At many vaccination clinics outside the Sadr strongholds, there has been so little demand that any Iraqi with ID or foreigner with a passport can be vaccinated after a few minutes wait.
Near central Baghdad’s Palestine Street, about 30 people waited for a Sinopharm vaccine on plastic chairs in the Al Edreesi health care center on Thursday. In this middle-class neighborhood most of those waiting appeared to be professionals or university students.
“We ask anyone who took the vaccine to send a message of reassurance in their groups. ” said Afraa al-Mullah, from the health center’s media department. “Anyone who took the vaccine must speak and say, ‘Here I am. I’m fine, get vaccinated.’”
The more that word spreads that vaccines are not harmful, she hopes, the more Iraqis would agree to be vaccinated.
“Iraq’s population is 40 million, 20 million must get vaccinated,” she said, calling the 400,000 who have been inoculated “a drop in the ocean.” She added: “We have people that do not believe in coronavirus. How can we convince them to vaccinate?”
Falih Hassan and Nermeen al-Mufti contributed reporting.
Many countries, prepared for the sort of childhood vaccination campaigns they carry out regularly, were startled to find that they could not rely on people simply to show up for a coronavirus vaccine.
“A lot of vaccine hesitancy issues could be addressed, though not all of them overcome, with timely operational funding in place,” said Benjamin Schreiber, the coordinator for Covid-19 vaccines at UNICEF, which is leading Covax delivery efforts.
Amid a race to fund vaccine purchases, though, money for getting them into people’s arms has been overlooked. Of the 92 poorer nations being supplied by Covax, eight have cut their health budgets because of virus-related economic losses, and several others are struggling to fund their health systems in part because they do not qualify for grants or more generous loans, Mr. Schreiber said.
The World Bank has promised $12 billion for vaccine rollouts, but has so far approved $2 billion in projects. In mid-March, the bank found that less than a third of low- and middle-income nations reported having plans to train enough vaccinators or campaigns in place to fight vaccine hesitancy, said Mamta Murthi, the bank’s vice president for human development.
Many countries’ needs are even simpler. Some cannot pay to print immunization cards. Malawi, which is planning to destroy 16,000 doses that arrived only shortly before they expired, has struggled to cover lunch allowances for health workers traveling from one facility to another to give vaccines.
The outlook is uncertain. More doses will breed more vaccine confidence, said Freddy Nkosi, the country director in the Democratic Republic of Congo for VillageReach, a health nonprofit. But if India’s outbreak keeps surging, the chief executive of the Serum Institute of India said recently, “We are going to have to keep supplying to India, and not anywhere else.”
Mr. Williamson attended the London School of Economics, graduating with a degree in economics in 1951. After completing two years of compulsory military service, he entered graduate school at Princeton, where he received his Ph.D. in 1963.
Though he had frequent offers from Oxford and Cambridge, especially later in his career, Mr. Williamson was drawn to the sort of creative research being done at some of the newly established, so-called plate-glass universities, after their modernist architecture.
He joined the University of York in 1963, the year it was founded, and later taught at the University of Warwick, founded in 1965. But he was increasingly drawn to policymaking. In 1968 he took a job as an adviser to the British Treasury, where he worked on economic relations with the European Economic Community, and later moved to Washington to work at the International Monetary Fund.
While at the I.M.F. he met Denise Rausch, a Brazilian economist. They married in 1974.
Along with his daughter and wife, Mr. Williamson is survived by two sons, Andre and Daniel; two sisters, Chris Evans and Wyn Jones; and seven grandchildren.
The Williamsons spent the late 1970s in Brazil, where she worked for a research institution and he taught at a Catholic university. Ms. Williamson taught her husband Portuguese, something he considered his greatest achievement, having struggled with foreign languages in school.
They returned to Washington in 1981, when the economist C. Fred Bergsten hired Mr. Williamson to be the first employee of the newly founded Institute for International Economics, later renamed the Peterson Institute for International Economics. He remained there until he retired in 2012. (In 1996 he took a leave from the institute to join the World Bank, where his wife worked, though he left after just three years, frustrated with the bank’s bureaucracy.)
Until he coined the Washington Consensus, Mr. Williamson was best known for his work on exchange rates. He was a passionate advocate for a middle ground between the rigidity of fixed rates — especially for developing economies — and the chaos of floating rates, which he believed put even developed economies at the mercy of global financial markets.
Mr. Malpass has ingratiated himself with World Bank staff with his steady, low-key approach and congenial manner. He has also benefited from low expectations. But with three years left to go in his term, some development experts want to see more.
Scott Morris, a senior fellow at the Center for Global Development, a Washington think tank, said it was unfortunate that the World Bank appeared to be leaving the door open for funding fossil fuel projects. He suggested that Mr. Malpass still had yet to lay out a clear strategic vision for the bank, but credited him for embracing climate change.
“It is remarkable to compare his statements today with his positions as a Treasury official in the Trump administration two years ago, when the official position was to strike the word ‘climate’ from any multilateral institution’s documents,” Mr. Morris said. “By that standard, he’s made a remarkable evolution toward being a climate leader.”
He added: “But it is a question of compared to what, and is he up to the task of being the leader of this critical institution for climate finance?”
The bank will accelerate its efforts in the coming months. Mr. Malpass, in a speech last month about “building a green, resilient and inclusive recovery,” said his team was integrating climate into all of the bank’s country strategies and would complete climate and development reports for 25 countries this year.
Mr. Malpass has more recently been working to curry favor with the Biden administration. He speaks regularly to Ms. Yellen and personally invited her to participate in the climate discussion this past week.
Asked what the transition from the Trump administration to the Biden administration had meant for the bank, Mr. Malpass answered carefully. He noted that under Mr. Trump, the United States had approved a capital increase for the bank. He said the new White House team was highly committed to the bank’s goals of reducing poverty, making food accessible and preparing countries for a changing climate.
“The Biden administration policies have been very supportive of that mission,” Mr. Malpass said.
Lisa Friedman contributed reporting.
How does a country deal with climate disasters when it’s drowning in debt? Not very well, it turns out. Especially not when a global pandemic clobbers its economy.
Take Belize, Fiji and Mozambique. Vastly different countries, they are among dozens of nations at the crossroads of two mounting global crises that are drawing the attention of international financial institutions: climate change and debt.
They owe staggering amounts of money to various foreign lenders. They face staggering climate risks, too. And now, with the coronavirus pandemic pummeling their economies, there is a growing recognition that their debt obligations stand in the way of meeting the immediate needs of their people — not to mention the investments required to protect them from climate disasters.
The combination of debt, climate change and environmental degradation “represents a systemic risk to the global economy that may trigger a cycle that depresses revenues, increases spending and exacerbates climate and nature vulnerabilities,” according to a new assessment by the World Bank, International Monetary Fund and others, which was seen by The Times. It comes after months of pressure from academics and advocates for lenders to address this problem.
downgraded its creditworthiness, making it tougher to get loans on the private market. The International Monetary Fund calls its debt levels “unsustainable.”
nearly $600 billion in debt service payments over the next five years. Both the World Bank and the International Monetary Fund are important lenders, but so are rich countries, as well as private banks and bondholders. The global financial system would face a huge problem if countries faced with shrinking economies defaulted on their debts.s
“We cannot walk head on, eyes wide open, into a debt crisis that is foreseeable and preventable,” the United Nations Secretary General, António Guterres, said last week as he called for debt relief for a broad range of countries. “Many developing countries face financing constraints that mean they cannot invest in recovery and resilience.”
The Biden administration, in an executive order on climate change, said it would use its voice in international financial institutions, like the World Bank, to align debt relief with the goals of the Paris climate agreement, though it hasn’t yet detailed what that means.
flurry of proposals from economists, advocates and others to address the problem. The details vary. But they all call, in one way or another, for rich countries and private creditors to offer debt relief, so countries can use those funds to transition away from fossil fuels, adapt to the effects of climate change, or obtain financial reward for the natural assets they already protect, like forests and wetlands. One widely circulated proposal calls on the Group of 20 (the world’s 20 biggest economies) to require lenders to offer relief “in exchange for a commitment to use some of the newfound fiscal space for a green and inclusive recovery.”
debts soared, including to China, and the country, whose very existence is threatened by sea level rise, pared back planned climate projects, according to research by the World Resources Institute.
The authors proposed what they called a climate-health-debt swap, where bilateral creditors, namely China, would forgive some of the debt in exchange for climate and health care investments. (China has said nothing publicly about the idea of debt swaps.)
sinking under huge debts, including secret loans that the government had not disclosed, when, in 2019, came back-to-back cyclones. They killed 1,000 people and left physical damages costing more than $870 million. Mozambique took on more loans to cope. Then came the pandemic. The I.M.F. says the country is in debt distress.
Six countries on the continent are in debt distress, and many more have seen their credit ratings downgraded by private ratings agencies. In March, finance ministers from across Africa said that many of their countries had spent a sizable chunk of their budgets already to deal with extreme weather events like droughts and floods, and some countries were spending a tenth of their budgets on climate adaptation efforts. “Our fiscal buffers are now truly depleted,” they wrote.
In developing countries, the share of government revenues that go into paying foreign debts nearly tripled to 17.4 percent between 2011 and 2020, an analysis by Eurodad, a debt relief advocacy group found.
Research suggests that climate risks have already made it more expensive for developing countries to borrow money. The problem is projected to get worse. A recent paper found climate change will raise the cost of borrowing for many more countries as early as 2030 unless efforts are made to sharply reduce greenhouse gas emissions.