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At the beginning of 2020, Iraq faced domestic political crisis and an escalating conflict between the United States and Iran. To be optimistic was to hope that things would not get worse—and yet they have. Now, two new challenges have been added: a pandemic for which Iraq is one of the least prepared countries in the Middle East, and an early consequence of the pandemic in the form of a sharp decline in the price of oil, Iraq’s main source of income. Although many in Iraq likely wish that the pandemic would generate commitment among external and local players to deescalate tensions and address the crisis, that has yet to occur, unfortunately.

Years of conflict and mismanagement have contributed to the deterioration of the healthcare system in Iraq. Today, there are only 1.2 hospital beds per 1,000 people, which is among the lowest in the region, and only 0.9 medical doctors per every 1,000 people, compared to 3.4 in Jordan and 3.7 in Lebanon. However, reforming the health system has never been a priority for the ruling ethnosectarian groups that were more interested in power grabbing and rent seeking than development. In 2019, the government allocated no more than 2.5 percent of its budget to the Health Ministry, compared to 18 percent for ministries dealing with security and 13.5 percent for the Ministry of Oil.

The numbers of infections and deaths caused by the coronavirus in Iraq remain relatively low compared to Iran, with which it shares a long border and which was the source of early cases registered in the country. However, Iraq still reports a higher number of infections than most of its other neighbors, and there are indications that the actual number is much higher than the official one. Testing facilities are limited, and the country cannot process more than 4,500 tests per day as of April 1. Coronavirus response is increasingly politicized, as several factions compete with the Ministry of Health for control, including of foreign assistance funds.

Harith Hasan
Harith Hasan is a nonresident senior fellow at the Carnegie Middle East Center, where his research focuses on Iraq, sectarianism, identity politics, religious actors, and state-society relations.
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Further, Iraq is still led by a caretaker government that has limited powers or legitimacy, and consequently is less capable of managing a health crisis of this magnitude. It is unclear whether or when the Iraqi parliament can convene in order to vote on a new government, after the failure of two designated prime ministers, Mohammed Tawfiq Allawi and Adnan Al-Zurfi, to secure a political consensus for their nomination. On April 8, a new candidate for the position with broader political support, Mustafa al-Kadhimi, was chosen to lead the new government. In addition, the future of al-Kadhimi’s government seems increasingly contingent on the trajectory of competition between the United States and Iran. Iranian-allied factions reluctantly supported al-Kadhimi’s nomination as the less threatening choice than al-Zurfi, but they view him as pro-American. Washington has also threatened to halt the exemption given to Iraq from sanctions on Iran if the current or next government fails to distance itself from Iranian influence.

Both the United States and Iran have been hit hard by the pandemic and are still coping with its consequences, yet their domestic difficulties have not led them to deescalate their confrontation inside Iraq. Iranian-backed militias have continued their attacks on U.S. troops and have threatened to escalate their military operations until the last U.S. soldier leaves Iraq. Washington is accelerating its plans to redeploy its troops and is warning Tehran that it will face retaliation if its allied militias continue their attacks. Also, the Trump administration reportedly had considered taking military action against Kataib Hezbollah, the most hawkish pro-Iranian paramilitary group. Neither side seems to want open war, with Iran pursuing an attrition strategy of small but regular attacks and the United States entering a defensive posture and seeking to deter Iran. But neither side is abiding by formerly well-understood limits, and the uncertainty and lack of communication channels have increased the risk of a potential escalation.

Additionally, as a result of the local tensions and the fear of the spreading the coronavirus, several countries in the international coalition against the self-proclaimed Islamic State, including France and Canada, have decided to fully or partially pull out their troops from Iraq. This drawdown, along with the ongoing redeployment of U.S. forces and the shift in their priorities from fighting the Islamic State to confronting Iran, could jeopardize ongoing efforts to weed out the remaining Islamic State cells and provide a space for the group to breathe and reactivate its destabilizing actions.

The pandemic and the subsequent social distancing measures have substantially diminished the antigovernment protests that had been going on for several months. Although some activists were afraid that the protest movement would die if they left the streets, and even called for renewed protests, most others in the movement have opposed such public health risks. This pause may give the political elite room to continue their usual bickering without the rumble of popular dissent, but the looming economic disaster caused by the decline of oil prices places them under a different kind of pressure.

Ordinary Iraqis naturally will be hardest hit by the health crisis. Low-income families are concerned that the restrictions on movement intended to slow the spread of the virus will deplete their cash and food supplies. Considerable numbers of Iraqis resisted the restrictions on movement: some have chosen to continue their pilgrimages and religious gatherings, and others must leave home for economic reasons, especially those who work in the informal economy and can only provide for their families on a daily basis. Although religious and philanthropic organizations have been providing aid and food deliveries, the social safety net remains very weak. With 95 percent of government revenue coming from petroleum exports, if oil remains under $40 a barrel, the government could consume its reserves and in ten to fifteen months fail to pay full salaries, pensions, and subsidies for about 7 million people.

Iraq’s main hope is that early social distancing, and the awareness of the damage produced by the pandemic in much more prepared countries, could help contain the spread of the coronavirus to manageable levels. Economically, the Iraqi government’s only hope is for a quick recovery of oil prices, at least to a level that could prevent a humanitarian disaster. As for the long-term implications, the country may wish that the pandemic would produce a degree of restraint and urgency among external and local players, but such a beneficial response has yet to materialize.