Advising low-income societies to use contact-less electronic or mobile payments instead of cash as a C-19 control measure is counter-productive and is likely to negatively affect health outcomes over the longer term.
Measures to suppress and control transmission of the Covid-19 (C-19) virus are seeing countries around the world resort to unprecedented levels of direct income support, much of it through the use of cash transfers to affected households. As the pandemic gathers momentum almost everywhere except China, the humanitarian sector faces particular challenges in how to facilitate this type of financial assistance to the world’s poorest and most vulnerable populations, most of whom lack the capacities and resources to respond appropriately.
In a guidance note circulated by the World Health Organisation (WHO) and the Global Health Cluster on 7th April 2020, advice was given on the role of cash and voucher assistance (CVA) to reduce financial barriers in the response to the C-19 pandemic for these particularly ‘at risk’ populations. Among the preventive measures recommended were the following:
In terms of reducing the risk of transmission, this is all intuitive and sensible advice. However, at no point in this otherwise useful paper is reference made to the practical implications for the one third of the planet’s population who either have no option but to use cash in their daily battle for survival or for whom digital payments are already having detrimental effects on health and well-being through increasing levels of household indebtedness.
The implication throughout – as it is with so many recent guidance notes circulating in the aid sector – is that physical currency is not preferred.
Whether or not this is intentional, those of us who come from the higher-income, more developed world must continually remind ourselves that, where cash is not generally accepted as a means of payment, the ‘payments divide’ between those with access to digital payments infrastructure and those without will only widen. This, according to the World Bank, is at least one quarter of the planet’s population. In recent Ebola outbreaks in Africa, where health workers were paid daily stipends and wages into mobile wallets, over 90% had to convert these digits into physical currency in order to purchase commodities in local markets because the electronic payments infrastructure, if it existed at all, was fragile, unreliable and expensive.
Linked to this practical reality is the lingering perception that the use of cash can spread diseases. This half-truth can result in changes to consumer payment behaviour that is detrimental to the health and well-being of those with no alternative means of payment. In theory, cash transactions can indeed increase the risk of transmission. But, as the Bank of International Settlements makes clear in a bulletin dated 3rd April 2020, “the probability of C-19 transmission via banknotes is low when compared with other frequently touched objects, including mobile phones and debit cards.”
To bolster trust in cash, several central banks around the world have actively communicated this message and demonstrated their commitment to guaranteeing money supply by sterilising, quarantining and sometimes even replacing their currencies.
With these practical realities in mind, WHO and the Global Health Cluster’s guidance note should be amended to counter any impression that physical currency is not preferred and that limiting cash use in society is likely to have indirect effects that will negatively affect the long-term health and well-being of low-income societies facing up to the C-19 crisis.
© James Shepherd-Barron
9 April 2020