COVID-19 and health security in Tunisia, Algeria, and Morocco : the impact of health diplomacy, trust and necropolitics on contagion and conflict

Abstract

The COVID-19 pandemic provided a large scale, real time “stress test” that fostered structural violence, reduced trust, and fomented conflict, while highlighting the importance of health security, trust, and necropolitics, and providing strong incentives to build regional cooperation in the Mediterranean and worldwide. In Tunisia, Algeria, and Morocco, the pandemic has cost lives, livelihoods, and even political freedom. A case comparative analysis of how health diplomacy, trust, and necropolitics impacted COVID-19 outcomes, and the relationship between trust – in government, in science, and in fellow citizens – and COVID-19 outcomes, healthcare capacity, economics and democratization in Tunisia, Algeria, and Morocco can illuminate opportunities for the conflict resolution field to reduce conflict and improve outcomes in future pandemics. Before the COVID-19 pandemic, national security was rarely focused on health security, health diplomacy, or science diplomacy. Likewise, the conflict resolution field has not focused on these areas either. In the COVID-19 pandemic, health diplomacy – as a subset of science diplomacy – played a major role in conflicts over scarce healthcare resources such as Personal Protective Equipment (PPE), ventilators and especially vaccines. The conflict resolution field likewise has previously paid scant attention to pandemics despite impacts on conflict worldwide. The COVID-19 pandemic can be viewed 1) as a conflict itself, that increased structural violence and was framed as a “war;” 2) as a factor and often major factor in creating and driving conflicts; and 3) as an incentive to engage in conflict resolution. A focus by the conflict resolution field on pandemics could help could save lives, resolve conflicts, and address structural violence. What has become clear is that underlying COVID-19 pandemic outcomes has been the issue of trust, and its relationship to leadership, science, economic performance, politics and democracy, as well as COVID-19 infections and deaths. Despite preparedness efforts ranging from non-existent to more robust efforts to develop healthcare infrastructure and secure resources – vaccines, hospital beds, equipment, trained medical personnel – the pandemic revealed how political leadership, social, and economic factors – necropolitics - were at least as impactful on infection rates and deaths. Research has shown trust – political trust, interpersonal trust, and trust in science – was closely correlated with pandemic outcomes, not only health but economic and political outcomes as well. While a multi-faceted appreciation for pandemic informs this paper’s approach, the focus is on science diplomacy, necropolitical, and conflict resolution perspectives. The goal of this paper is to highlight how health diplomacy both failed and succeeded in Tunisia, Algeria, and Morocco; how political structures and necropolitics impacted health, economic and political outcomes; and how trust was a major factor in driving – but also being driven by – COVID-19 outcomes, economic performance, and democracy itself. The failure of health diplomacy to ensure timely access to high quality COVID-19 vaccines, and the success of health diplomacy in ultimately securing vaccines for Tunisia, Algeria and Morocco, along with the failure of political and healthcare systems in these three countries to distribute vaccines effectively and equitably are examples of how the pandemic increased structural violence and decreased trust. In Tunisia’s case, this led to a return to authoritarianism. The COVID-19 pandemic made clear addressing transnational health security threats that can destroy trust, undermine economies, and destabilize democracies requires effective health diplomacy, trust-building, and conflict resolution.