Indonesia, the world’s fourth most populous country, has reported 136 deaths from COVID-19 but just 1528 cases, giving it one of the world’s highest fatality rates. President Joko Widodo has been resisting a nationwide shutdown, but schools and entertainment venues have been closed in Jakarta. Indonesian health experts say the fatality rate is due to inadequate medical facilities and a lack of testing, and the country is now facing a disaster.

Indonesia is Australia’s largest neighbour, but it is not the only nearby country facing a grave threat from COVID-19. Timor-Leste, Papua New Guinea and the Pacific island nations are all highly vulnerable and poorly equipped to respond to an outbreak. The federal government’s recent Pacific “step-up” strategy, designed to curb China’s influence in the region, must now be replaced by an urgent effort to ensure that Australia’s northern neighbours have basic food and medical supplies.

As Australia fends off its own domestic crisis, it may need to embark on a large-scale aid scheme similar to that delivered in the wake of the Boxing Day tsunami in 2004. John Howard pledged A$1 billion – equivalent to A$1.4 billion today – to support Indonesia’s reconstruction.

Australia’s yearly health spending amounts to more than US$5000 per person, the eighth highest in the world. Indonesia spends US$112 per person, Timor-Leste spends US$80, and Papua New Guinea spends US$55. These countries have relatively few intensive care beds, and many are already in use. In rural areas, many health clinics do not have access to running water, let alone ventilators or testing kits. A serious coronavirus outbreak would be catastrophic. 

The Spanish flu had its most devastating impact in poorer countries, including several in Australia’s neighbourhood. In Indonesia, at least 3 per cent of the population died – about 1.5 million people – a fatality rate more than ten times higher than that suffered in Australia. In Western Samoa, about 22 per cent of the population died, representing the pandemic’s highest fatality rate.

Pacific authorities, aware of the current risks, were quick to adopt some of the world’s strictest travel bans. But this virus is proving difficult to keep out. Papua New Guinea has recorded one case, but several cases have been recorded in West Papua, which shares a porous land border with Papua New Guinea. Elsewhere, Fiji has recorded five cases, New Caledonia and French Polynesia have together recorded forty-five cases, and Timor-Leste has recorded one case.

These countries will need support. Their lucrative tourism sectors have collapsed, international trade has been restricted, and remittances are drying up as unemployment increases in Australia and New Zealand. Business shutdowns and internal travel restrictions will cause further economic damage.

As Scott Morrison released Australia’s A$130 billion wage subsidy package on Monday, he said Australians “could see countries themselves fall into chaos”. He did not identify which countries are at most risk, but last Friday he specifically warned that Pacific countries face disaster. “We should brace ourselves for some very devastating images around the world and we are all going to have to do our part as a global community … Here, that means our Pacific family.”

Australia has slashed its aid budget in recent years, including a 25 per cent cut to aid health spending since 2013–14, according to development economist Stephen Howes. Assistance for Indonesia has also been cut, as funds were diverted to the Pacific step-up. But the step-up has largely been aimed at competing with China’s freewheeling loans and infrastructure projects. Its objectives will now need to change. In the so-called “arc of instability” to Australia’s north – the stretch of small states whose fragility has long been deemed a strategic threat in Canberra – the focus will now need to be on ensuring basic health and sustenance. 

Morrison appears to understand this, and Canberra has been boosting supplies to the Pacific. At a virtual summit of G20 leaders last week, Morrison urged the international community to support Pacific states and Timor-Leste. Unfortunately, he may also need to consider extending aid to Indonesia, a country that Canberra stopped including in its arc of instability more than a decade ago. In the event of a humanitarian crisis, such aid will be an end in itself; for those who worry about arcs and instability, it will also support Indonesia’s trajectory as a rising democracy and reduce the risk of a dangerous regression.