David Miliband is taking refuge in North-west Connecticut during the covid-19 lockdown, but his thoughts are very much global, and inevitably political. 

The former UK foreign secretary heads up the International Rescue Committee (IRC), a humanitarian non-governmental organisation (NGO) that works in war-ravaged countries and helps resettle refugees. Refugees, who make up nearly 30% of the world’s 71m “forcibly” displaced people, are especially vulnerable to disease: they have limited access to healthcare, live in poor sanitary conditions and often suffer from pre-existing illnesses. So what needs to be done? 

“It's very, very basic,” Mr Miliband says. Are they counted? Are they covered when it comes to testing or healthcare access? Are they assisted by income support schemes or other mechanisms? Do they have rights? 

“If the answer to those questions is ‘No’, we know that the consequence is not just a lot of poverty and security violence,” he explains. It also elicits a survivalist response born of desperation. “[People] go underground and they try to make ends meet in any way that they can. And that obviously carries its own dangers, especially in the context of a public health pandemic.”

IRC is working at Cox’s Bazar in Bangladesh. Host to over 1m displaced Rohingya Muslims from neighbouring Myanmar, it is one of the world’s largest and most crowded refugee camps. Social distancing to contain the spread of covid-19 in such camps is, of course, hard. 

“I think it would be beyond unfortunate if this [pandemic] was used to further buttress the trend that we've seen in the past 15 years which is what people call democratic recession. And that is the retreat of countries from democratic models.” 

“It's easier for the rich than the poor,” Mr Miliband says. “[But] we shouldn't somehow take refuge in the idea that social distancing can't be done so we just shrug our shoulders.” 

Where social distancing is more difficult, Mr Miliband explains, hygiene, effective isolation measures and testing become more important: fever testing, at a minimum, and eventually covid-19 testing.

“I also think some social distancing is achieved through masks,” he explains. “It's important that we don't say that because masks are not the whole answer, that they're not any part of the answer. So, in other words, social distancing is more difficult but not impossible.” 

In many of the countries where IRC operates, however, Mr Miliband reports a “shocking” lack of covid-19 testing ability. He cites a recent video chat with the IRC team in Somalia who reported that “there have been 700 tests and 436 cases, so a very low number of tests but a very high hit rate”.  

Other resources, such as ventilators and intensive care beds, are also scarce. In South Sudan there are only four ventilators for its 11.7m population while Burkina Faso has only 11 for its 19.1m citizens. But the answer is not “trying to send 10,000 ventilators to South Sudan,” Mr Miliband explains.

“Not least because it'll be too late by the time they get there, but because it's a very skilled job to run a ventilator; it takes a whole set of health infrastructure to monitor and implement. So the truth is the prospects for someone who needs a ventilator in South Sudan are utterly grim.” 

Political response

Although he works for an international NGO, Mr Miliband remains a political animal. A request to grade the international political response to covid-19 hits a nerve. 

“If you are asking me to grade different actions, I have to be grading inactions.The G7 [group of the world's seven largest economies] couldn't agree on a statement because of a ridiculous argument about insistence on calling it a ‘Wuhan virus’. The G20 [which links governments and central banks from 19 countries and the EU] has had one virtual meeting [as of May 1st]. The UN Security Council has not yet been able to agree the resolution to back up the secretary-general’s call in respect of ceasefires. So, it's D-minus territory for the international political response.”  

Mr Miliband, whose ministerial tenure included the 2008 financial crisis, is slightly more positive about the economic response to covid-19. He believes there has been “some lesson-learning, but there obviously hasn't been something formally co-ordinated”. Regarding the scientific community, he comments that “there's been a lot of transparency from the scientists, including Chinese scientists, about presenting their data”.  

The World Health Organisation (WHO) has faced criticism for its handling of the crisis, but Mr Miliband is forgiving. “Every big organisation [...] will make mistakes, but the real lesson about the WHO is that it's got too little power and too little funding and too little independence—it needs to be able to rectify all three,” he says. 

“The lesson is that we need a stronger, better funded, more independent WHO that can speak truth to power.” He considers its year-by-year dependence on donor funding problematic, commenting that endowment with longer-term funding would allow for greater independence. 

Geopolitical rivals

The way in which countries have responded to covid-19 will be fuel for global rivalries, Mr Miliband predicts. “I think there’s undoubtedly going to be very significant geopolitical competition in trying to exploit and benefit from comparison coming out of this crisis.” 

China’s reputation could come under particular scrutiny, especially given the harsh criticism its handling of the outbreak has received from the US. “I think different parts of the world will trust [China] differently. And of course one question is, ‘How will the world trust China in absolute terms?’, and the second question is, ‘How will you trust China relative to other countries?’”  

Mr Miliband believes there was denialism in China at the outbreak of covid-19 and partly attributes this to its one party system. But there is continued denialism in the US, he adds. “Sadly, both democratic and autocratic countries have suffered from denialism.”

The US has reported a striking 79,000-plus deaths from covid-19 (as of May 11th), the highest death toll worldwide. Mr Miliband fears  the “continued chaos and [certain] aspects of the American response are going to be used by autocrats around the world to say the democratic systems can't work and can't cope”. 

By contrast, South Korea has reported only 256 covid-19 deaths out of a population of 51.3m. Germany, with its 83.7m population, has suffered 7,569 deaths (as of May 11th). Mr Miliband accredits this success to “the power of open societies” to build social trust and organise an effective national response.

“I think it would be beyond unfortunate if this [pandemic] was used to further buttress the trend that we've seen in the past 15 years which is what people call democratic recession. And that is the retreat of countries from democratic models.”

The UK response

So what about the covid-19 response in the UK, Mr Miliband’s home country and political proving ground? The country has the highest number of deaths in Europe at nearly 32,000 (as of May 11th).  

“It's really grieving to see the death toll in the UK,” he says. “I think I'm right in saying that around one-eighth of the global death toll is British, even though [less than 1%] of the global population is British. That’s a shocking mismatch.”

There are very serious questions to be answered, he says, about when the lockdown happened, how testing was organised, what happened with contact tracing and the alarm bell that should have been sounded regarding care homes. “Those are all questions which are going to need a very searching set of enquiries.” 

Is he confident that Keir Starmer, the new leader of the UK’s Labour party, will hold the government to account? “I think he'll be very good at that. He is a very accomplished lawyer. Britain has a proper opposition for the first time in five years.”

Does he miss politics? Yes, he says, with no hesitation. “In politics and government, you have more power than if you're an NGO—but you also have more obstacles.”

Solidarity in a crisis

Circling back to refugees, does he think attitudes towards them have improved or worsened over time?

“I think it is very mixed,” he says. “Two-thirds of the American public didn't want Jews to be allowed in from Europe in the late 1930s. So that's more or less some of the proportions on the before. But [...] crises [can] bring social solidarity”. 

While there are many stark obstacles ahead, Mr Miliband welcomes the fact that some countries are recognising how critical immigrants are to their healthcare systems and broader social structures.

“I think human nature is both fearful and intrigued by people who are different. And you've got to hope that those of us who think life is more interesting because we're not the same don't lose heart.