Though many experts agree that Morocco's decisive response to the pandemic is a case study of success, some say it was at the cost of civil liberties.
MARRAKECH, Morocco — When COVID-19 vaccines became available in Africa, Morocco acted fast.
On Jan. 22, 2021, the country acquired two million doses of the Oxford-AstraZeneca vaccine — days before it was approved for use in the European Union. Six days later, King Mohammed VI, the country’s ruling monarch, became the first recipient; his vaccination was broadcast on national television. Moroccans in Casablanca, Marrakech, and other cities said that seeing the king get vaccinated eased their fears.
"The king is the political leader and the spiritual leader. So when he did his first public statement on the vaccine, he set an example," Rachid Ait Addi, an epidemiologist at Cadi Ayyad University in Marrakech, said.
Within a month, Morocco received one million doses of Sinopharm and six million more doses of AstraZeneca, at a time when countries in Europe and North America were struggling to procure them. By early March 2021, Morocco had vaccinated more than 10% of its population. In comparison, France and Germany had each vaccinated less than 8%.
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Though many experts agree that the country's decisive response to the pandemic is a case study of success, some say it was at the cost of civil liberties and the country's autocratic regime may have underreported COVID-19 deaths.
A swift response
When the pandemic began, Morocco launched a rapid preliminary public health response, which included closing borders and mandatory lockdowns.
In March 2020, three weeks after Morocco's first confirmed COVID case, Morocco's king, Mohammed VI, declared a strict lockdown in which nearly all Moroccans were ordered to remain at home. At around the same time, then-United States President Donald Trump was still giving mixed messages claiming that the virus "will go away” and people should “just stay calm” before declaring a state of emergency three days later.
Three years after the start of the pandemic, the result of Morocco's swift actions is on display at the Moulay Youssef Hospital in Casablanca, just a stone's throw from the Atlantic Sea. A hospital ward that was once flooded with COVID-19 patients is now empty and quiet. No one wears masks, not even the nurses. Some days they have no new COVID-19 patients, according to the staff.
Today, two-thirds of Morocco’s 37 million people have received at least one dose of a vaccine, and just 16,300 people have died from the disease, according to data collected by the WHO. South Africa, by contrast, experienced four times as many deaths per capita, despite having a 25% higher testing rate than Morocco.
The power of the monarchy
Morocco ranks 108 out of 195 countries on the Global Health Security Index — which assesses global health security capabilities — and as a lower-middle-income country, it ought to have been at a disadvantage when dealing with COVID-19. After the pandemic began, a survey by the Moroccan Institute for Policy Analysis found that 74% of respondents didn't trust hospitals to cope with the pandemic. Although Moroccans are required by law to be enrolled in the nation's public health care system, those with the resources often opt for care in private hospitals and clinics instead.
However, some Moroccans believe they had one advantage that wealthier democratic countries did not — their monarchy. Morocco is a constitutional monarchy in which the king is the head of government and wields broad powers.
"In the U.S., you have a very democratic country, and when there are a lot of points of view, you have to fix that before you decide to impose a vaccine," Ait Addi said. "Fortunately for us, we have a monarchy, we have a king. It's one person. So you can implement measures very quickly."
A study that compared COVID-19 responses in 20 democracies and 20 autocracies found that the pandemic may have helped strengthen autocratic regimes by winning the trust of their citizens through their response. It found that early in the pandemic, "countries with a high individual appreciation of freedom vs. security" — generally, the democracies — "overreacted at the very beginning of the pandemic and relaxed their lockdown levels" later on to below those of more security-focused countries — the autocracies.
"Our findings highlight how the Corona crisis provides an opportunity for autocracies to … gain legitimacy in times of crises," the authors wrote.
Health at what cost?
But human rights activists said the successes in Morocco came at a cost, with some researchers arguing that the COVID-19 pandemic may have "widened the freedom divide between democracy and autocracy."
Freedom House, which collects data on civic and political freedoms across the world, classifies Morocco as only “partly free” and ranks the country just 37 out of 100 points for political rights and civil liberties, compared to 83 out of 100 for the United States.
"Reforms in 2011 shifted some authority over government from the monarchy to the national legislature,” according to a report. “Nevertheless, King Mohammed VI and his palace maintain full dominance" and "many civil liberties are constrained."
Within days of the king's emergency decree, authorities arrested tens of thousands of people for violating the lockdown, a number that increased to more than 80,000 within a year. One government official put the number at over 1.5 million.
Authorities also cracked down on the press. When the virus arrived in March 2020, Morocco and the Middle Eastern autocracies of Yemen, Jordan, and Oman ordered newspapers to cease publication under the auspices of stopping the spread of the virus by touch. When journalists lost their income, the Moroccan government created a fund that compensated some of them but excluded journalists from the opposition newspaper Akhbar el-Yom. The paper initially refused to adhere to the ban but was forced to close down a year later.
One of the paper's reporters, Hajar Raissouni, criticized Morocco's police and security chief, Abdellatif Hammouchi, "for his handling of the national lockdown in response to the then-emerging COVID-19 pandemic,” according to Human Rights Watch. Raissouni "remarked that the number of those arrested for violating the lockdown exceeded the number of those tested for the virus."
Fudging the data
A study published last year also found that Morocco had undercounted its COVID-19 deaths by a factor of ten. Morocco claimed 14,800 people had died from the disease by the end of 2021, but researchers who compiled mortality data from around the country estimated that around 157,000 excess deaths occurred during that time.
Israeli researchers who compiled a global database of "excess deaths" caused by COVID-19 found that authoritarian regimes were more likely to underreport COVID-19 deaths. Egyptian authorities likely underreported COVID deaths by a factor of 13 while Uzbekistan underreported by a factor of 31, they found. Another study from the London School of Economics and Political Science found that there was a clear gap between excess deaths in the overall mortality rate during the pandemic and reported COVID-19 mortality in autocratic countries, suggesting that they were more likely to "fudge" their data.
Other researchers agree that the data tells a different story. Writing for The Atlantic, Justin Esarey, associate professor of politics and international affairs at Wake Forest University, said: "The idea that dictatorships get things done while democracies dither" is misguided. Rather democracies had "the edge" when it came to the initial containment of the virus spread in the pandemic and compliance with measures to limit transmission. "They are also better at preventing deaths from COVID-19," he wrote.
Some leading thinkers, however, believe there is another aspect that determines how a country — whether autocratic or democratic — fared during the pandemic: It may come down to public trust in government.
And in Morocco, despite the curbs on civil liberties, culture may have made citizens more willing to do their part to slow the pandemic than in other parts of the world. The government made use of the country's religious devotion by asking imams to ask worshippers in mosques to wash their hands and wear masks and encourage people to get vaccinated, Ait Addi said. "The government did an amazing campaign in mosques."
But a country's cultural norms can both help and hurt its efforts to curb a pandemic. "We live in a community that socializes a lot," said Brahim Karrou, a journalist in Casablanca. "In our culture, we shake hands and hold each other."
Karrou recalled a video produced by the Moroccan Health Ministry that showed "everyone hugging this woman who was going to the hospital to be quarantined" — a blunder for a disease that can be spread by close contact with others.
And Morocco's success against COVID-19 may not last forever. As the virus continues to evolve and evade immunity offered by earlier vaccinations, so too are attitudes among the public, Ait Addi said.
"People say 'I got three shots and I still got COVID-19. So why do we have to get another one?'" he said. "It's an emergent virus. It varies and changes all the time."
Jaouad El Bakili and Kang-Chun Cheng contributed to this report.