Ecuador is home to the highest per-capita death toll from Covid-19 in Latin America and the Caribbean. Its largest city and commercial hub, Guayaquil, has seen a fivefold increase in mortality rates, with reports of corpses abandoned in the streets. The country entered into a recession after the price of oil—Ecuador’s largest single revenue source—crashed in 2014; amid a global demand drop and price wars, it’s now crashing again. Ecuador could soon come second only to Venezuela in terms of the dire economic outlooks in South America. President Lenín Moreno, meanwhile, has committed to paying off a $4.2 billion loan from the International Monetary Fund. Toward that end, he slashed investments in the public health system by 36 percent in 2019, part of a wave of cuts that sparked nationwide protests last October. This year, 3,680 people were laid off from the country’s health ministry. Buckling under a $17 billion debt load, much of it held by Wall Street, the government struck a deal with bondholders that may only postpone until August what many fear is coming: default. Ecuador is one of many places, then, where public health and debt crises are inflaming one another.

The scale of global devastation predicted to flow from the coronavirus crisis is almost unfathomable. As the death toll worldwide stretched past 165,000, the IMF last week projected an economic downturn 30 percent worse than the 2009 financial crisis and a $9 trillion hit to global gross domestic product. As with the climate crisis—the total scale of which will dwarf the ripples of Covid-19—the impact of this upheaval will be felt disproportionately through the so-called global south: emerging and developing economies frequently located in the tropics or the southern hemisphere. More capital has fled from poorer nations in the last three months than in any year on record, and the value of some Southern currencies has slid as much as 30 percent against an increasingly strong U.S. dollar. With demand and supply both seizing up generally, countries that were already struggling to make sovereign debt payments could soon face catastrophe.

As commodity prices tank, economies whose finances rely heavily on resource extraction, who were already facing headwinds before the shutdowns and price war between Russia and Saudi Arabia, are being hit especially hard. “Ecuador never recovered to anything like the commodity boom moment of growth. The long fallout from the [2014] oil price crash is still very much setting constraints on the government,” said Providence College political scientist Thea Riofrancos, whose research has tracked the country’s resource politics. “The oil crash recession is completely gutting their revenues.” They’re not alone. Nigeria—where oil accounts for over 60 percent of government income—is scrambling to make $7 billion in debt payments this year. Iraq had planned on covering 95 percent of its budget with oil revenues, assuming a $56 price per barrel; as of Tuesday evening, Brent Crude, the international price benchmark, was below $20 a barrel.

The IMF recently likened the economic fallout from the coronavirus to the Great Depression. But “there’s no Great Depression–like policy response, at least not to developing countries,” Richard Kozul-Wright, chief economist for the United Nations Conference on Trade and Development told me. “There’s a huge disconnect between the rhetoric of this being a once-in-a-lifetime global crisis and the kinds of things the leadership of the advanced economies seems to be willing to contemplate.”

Some initial steps have been taken to stop the bleeding. The G20 nations last week committed to a temporary moratorium on $20 billion worth of private and bilateral debt. With the group’s backing, the IMF and World Bank then announced that 77 of the world’s poorest countries would be eligible for a debt suspension from May 1 through the end of the year, with no clear next steps yet for the larger group of indebted nations. The IMF pledged around $215 million in grants to cover an initial list of 25 countries’ debt payments for the next six months and potentially up to two years; it has also encouraged countries to spend as much as is needed to deal with the crisis. And the IMF and World Bank have begun dispatching aid, with the former announcing it will issue $132 million worth of “pandemic bonds” over the weekend.