Multilateralism as a Determinant of COVID-19 Outcomes in Small Island Developing States: Mitigating Disaster Impact Through Foreign Affairs Investment

• Published in: Prehospital and disaster medicine 2023-05, Vol.38 (S1), p.s98-s98
• Main Authors: Dookeeram, Darren, Borquez, Sabastian, Seetharaman, Hariharan, Bidaisee, Satesh, Maharaj, Sandeep, Dookeeram, Dave
• Format: Article
• Language: English
• Subjects: COVID-19; COVID-19 vaccines; Developed countries; Disaster management; Disasters; Emergency preparedness; Immunization; Lightning and Oral Presentations; Multilateralism; Outside the Box; Pandemics
• ISSN: 1049-023X; 1945-1938
• DOI: 10.1017/S1049023X2300273X

Introduction:The United Nations (UN) recognizes Small Island Developing States (SIDS) as a heterogenous group with common geographic and socio-economic challenges. Their vulnerability to disasters was exacerbated during COVID-19 because of emerging nationalism and protectionism towards supply chains and resources. This study aimed to determine if multilateralism engagement improved COVID-19 outcomes and if Foreign Affairs investment improved short term COVID-19 outcomes.Method:Metrics were developed to reflect country parameters, clinical impact of COVID-19, engagement in multilateralism, health systems strength and integration in the International Political Economy. Open-source information was used to quantify proxy measures with the calculated percent spent on foreign affairs being the major proxy of multilateralism and disaster impact as lag time to vaccination, case burden and deaths in the first six months of 2020. Data was collected for each of the 38 SIDS. SPSS was used to assess possible correlations with short- and long-term clinical outcomes of the COVID-19 pandemic.Results:SIDS were noted to have an average lag of 4.1 months to begin vaccination rollout compared with developed nations and prolonged below global average vaccination rates. Expenditure on Foreign Affairs reduced the vaccination lag (p=0.03), decreased short-term cases (p