Pharmacovigilance practices in South Asian Association for Regional Cooperation countries: the need for collaboration

Objectives: One-fifth of the world's population lives in eight countries that constitute the South Asian Association for Regional Cooperation (SAARC). There is very little coordination among SAARC countries regarding the harmonization of pharmaceutical regulations and medicines safety. Pakistan, India and Bangladesh have experienced medicine-related tragedies where many patients have died. This study aims to examine current pharmacovigilance activity in the SAARC region to improve pharmacovigilance practices and to make recommendations for building a platform for collaboration to improve the safety monitoring of medicines in the region. The current review utilized secondary data. We reviewed the official websites of all SAARC countries' national regulatory authorities for pharmacovigilance-related information. A data set with eleven pharmacovigilance indicators were gathered and synthesized. Key Findings: All eight SAARC member countries have pharmacovigilance systems with full membership in the WHO Program for International Drug Monitoring. Out of eleven pharmacovigilance indicators, India met ten;Pakistan, Bangladesh and Bhutan nine;Maldives and Afghanistan seven;Nepal and Sri Lanka five. The SAARC countries do not have a harmonized pharmacovigilance system or centralized database. Due to positioning in different WHO regions, it is proposed to create a consortium on medicine safety among SAARC countries like other regional organizations of the world to strengthen the pharmacovigilance systems and harmonize the pharmacovigilance practices among member countries. Summary: To improve the quality of medicines and to strengthen regional medicine safety, the SAARC secretariat should consider forming a technical group of all member countries' regulatory authorities.Copyright © 2022 The Author(s). Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved.

Managing the Pandemic in the South Asian (SAARC) Countries

This paper explores the coronavirus pandemic response from a South Asian perspective. When their case numbers were still relatively low, the South Asian Association for Regional Cooperation (SAARC) countries adopted lockdowns at the same time or before India did. On 24 March 2020, when there were just two confirmed cases, Nepal went into lockdown, and Sri Lanka locked down on 22 March, when there were 78 cases. India locked down the day after Nepal, with all countries imposing some form of restrictions on people's movement. This paper draws its data from the first year of the pandemic that loomed in the SAARC nations. The regional cooperation provided by SAARC has allowed the sharing of resources and a strengthening of the region's self-reliance. Notably, the commitment made by India to ensure its neighbours are supplied with vaccines, many of these donated. The eight-member SAARC states are Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. This paper draws on the knowledge and perceptions of academics and social workers in the SAARC countries. It provides insight into the responses, impacts, vulnerabilities, and challenges faced by the region and in each specific country since the beginning of COVID-19. This paper also offers a discussion on vaccines, PPE, as well as the role of cooperation across the region. The relationship between India and the SAARC countries and its ‘neighbourhood first' policy are also discussed. © 2022 Pulla et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Interplay Between Policy and COVID-19 Outbreaks in South Asia: Longitudinal Trend Analysis of Surveillance Data.

BACKGROUND: COVID-19 transmission rates in South Asia initially were under control when governments implemented health policies aimed at controlling the pandemic such as quarantines, travel bans, and border, business, and school closures. Governments have since relaxed public health restrictions, which resulted in significant outbreaks, shifting the global epicenter of COVID-19 to India. Ongoing systematic public health surveillance of the COVID-19 pandemic is needed to inform disease prevention policy to re-establish control over the pandemic within South Asia. OBJECTIVE: This study aimed to inform public health leaders about the state of the COVID-19 pandemic, how South Asia displays differences within and among countries and other global regions, and where immediate action is needed to control the outbreaks. METHODS: We extracted COVID-19 data spanning 62 days from public health registries and calculated traditional and enhanced surveillance metrics. We use an empirical difference equation to measure the daily number of cases in South Asia as a function of the prior number of cases, the level of testing, and weekly shifts in variables with a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS: Traditional surveillance metrics indicate that South Asian countries have an alarming outbreak, with India leading the region with 310,310 new daily cases in accordance with the 7-day moving average. Enhanced surveillance indicates that while Pakistan and Bangladesh still have a high daily number of new COVID-19 cases (n=4819 and n=3878, respectively), their speed of new infections declined from April 12-25, 2021, from 2.28 to 2.18 and 3.15 to 2.35 daily new infections per 100,000 population, respectively, which suggests that their outbreaks are decreasing and that these countries are headed in the right direction. In contrast, India's speed of new infections per 100,000 population increased by 52% during the same period from 14.79 to 22.49 new cases per day per 100,000 population, which constitutes an increased outbreak. CONCLUSIONS: Relaxation of public health restrictions and the spread of novel variants fueled the second wave of the COVID-19 pandemic in South Asia. Public health surveillance indicates that shifts in policy and the spread of new variants correlate with a drastic expansion in the pandemic, requiring immediate action to mitigate the spread of COVID-19. Surveillance is needed to inform leaders whether policies help control the pandemic.

National perspectives of COVID-19 in the Maldives

The outbreak of COVID-19, a highly infectious respiratory disease from a novel coronavirus that was first detected in Wuhan city, Hubei Province, China, in December 2019, has since caused a severe outbreak worldwide, prompting WHO to declare the COVID-19 as a pandemic on March 11, 2020. While the impact of the COVID-19 pandemic will be global, both the World Bank and Asian Development Bank assess the Maldives as one of the worst-hit in the world given the high exposure of the Maldivian economy to external shocks, which shares relatively similar conditions like other small island states. This chapter includes the measures taken to control and contain the outbreak, including the establishment of NEOC and its transition to HEOC. It also highlights the key legal frameworks governing response to public health emergencies, the socioeconomic impacts, the effects on the education and public health sector, climate change and environmental challenges, the migrant's situation, and a review of the foreign aid received. This chapter concludes with brief suggestions to strengthen the COVID-19 response in the Maldives. © 2022 Elsevier Inc. All rights reserved.

TOURISM AND ECONOMIC GROWTH NEXUS IN MALDIVES: ASYMMETRIC ANALYSIS AND ROLE OF ICT

The relentless spread of the Covid-19 pandemic, which began in the first quarter of 2020, aided by the periodical emergence of new variants, is continuing to inflict unprecedented damages on the global economy. Interruptions in international travel have led to the collapse of the tourism-related service industry, which is the backbone of the economies of many small islands and developing states. This paper focuses on the Maldives, an island nation in the Indian Ocean, which is one of the top ten most tourism-dependent economies. Adopting the Solow production function, the paper examines the tourism and economic growth relationship using nonlinear autoregressive distributed lag (NARDL) methodology. The analysis shows that tourism earnings and economic growth have a significant asymmetric relationship. The result further reveals that the magnitude of the negative impact of the decline of a given size in tourism earnings on growth is of much larger magnitude than that of the positive impact of the same size rise in tourism earnings. The negative impact of tourism is found to be more pronounced in the long run. ICT spread, measured by the rise in mobile subscriptions, is positively associated with growth and has emerged as a significant contingent factor. We suggest policy measures to step up the recovery progress and growth. © 2022, Universiti Malaysia Sarawak. All rights reserved.

Challenges to education during the COVID-19 pandemic: A SIDS perspective with special reference to the situation in the Maldives

In the wake of the COVID-19 pandemic, which emerged in 2019 in China, countries worldwide have been grappling with the numerous challenges required of them to protect their citizens and respond to the consequences of multiple lockdowns on the global economy and their education systems. The devastating socio-economic impact is apparent worldwide, but Small Island Developing States (SIDS) have been identified as some of the most vulnerable contexts. In this paper, we build on the international literature and discourse on SIDS, giving special consideration to the context of the Maldives. We highlight the challenges to providing education in this Indian Ocean nation and the disproportionately negative impact of lockdown conditions on students’ learning. In the light of original field research carried out with school principals, teachers, students, and parents, we identify and discuss how learners and schools coped with a rapid change to online schooling. In doing so, we highlight what has been achieved and how the pandemic has contributed to the widening disparity between urban and rural schools. Our findings point to the importance of SIDS governments having contingency plans in place to manage education in socially just and equitable ways during emergencies. © This work is licensed under the Creative Commons Attribution-NoDerivatives 4.0 International License. To view a copy of this license

Locating Indian Ocean Island States in India's Foreign Policy

The six Indian Ocean island states are located near key waterways, and are emerging as important actors in the geopolitics of the Indian Ocean. For India, outreach towards these island states is emerging as a key element of its Indian Ocean strategy. In fact, India's SAGAR (Security and Growth for All in the Region) Vision was launched in Mauritius in 2015. In the context of China's growing strategic and economic presence in the region, it is imperative for India to deepen its engagements with the smaller yet strategically important island states of the Indian Ocean. This paper locates the Indian Ocean island states in India's foreign policy broadly, and its maritime strategy specifically.

Small island developing states (SIDS) COVID-19 post-pandemic tourism recovery: a system dynamics approach. (Special Issue: COVID-19.)

The economy of Small Island Developing States (SIDS) is highly dependent on tourism and travel sector. Under the impact of COVID-19, these islands have suffered strongly. Possible recovery strategies are tested through exploring the concept of risk perception as an important factor to influence the behaviour intention under the framework of theory of planned behaviour (TPB). A behavioural simulation is built to help evaluate tourism policies. This paper takes Maldives as an example. Four strategies are tested in the model: social distancing, tax reduction strategy, travel bubble strategy and joint strategy. The results show that the most effective way to change tourist behaviour intention is the travel bubble strategy. The results also indicate that the reduction in tourism arrivals may bring opportunities for local ecosystem recovery. This study exemplifies the advantage of using the system dynamics approach when the past pattern is not a good predictor for the future by making predictions based on how the system works.

Migration, Dignity, Fragility, and Pandemics: Overview of the Special Issue

This special issue presents the findings of an international collaborative research project conducted between 2019 and 2021. This study is a follow-up of a previous study conducted between 2016 and 2019. In both studies, we examined the livelihoods of future climate migrants, who may relocate from Pacific atoll countries to developed countries. The Maldives was also included in this study, as it developed a unique strategy to cope with anticipated sea-level rise. They have developed a new city on reclaimed land and el-evated it, intending to move the majority of its population there. In our first research project, we learned of the challenges faced by Pacific Islanders when transitioning to their new lives in a foreign country. This included inter alia unemployment or lack of opportunities for upward mobility, limited access to healthcare and legal services, and discrimination. We thus developed a formal policy and legal framework for the concept of “Migration with Dignity,” built upon the phrase first coined by then-Kiribati President Anote Tong. Our framework represents the opportunity for migrants to live a life equal to or better than the one they left behind. We then applied our concept of the Migration with Dignity framework to the challenges faced by climate migrants in the real world. The global outbreak of COVID-19 occurred during the implementation of our new research project. This made field research almost impossible in both atoll and developed countries and led us to modify our survey methods to include tele-interviews and remote surveys through the Internet. The pandemic also revealed the exacerbated vulnerabilities of the people who mi-grated to developed countries, such as discrimination, poor or no translation of medical documents, and challenging healthcare processes. We decided to address these issues within the framework of our research. We leave it to the readers of this special issue to decide how far we were able to maintain the quality of our research despite the difficulties we faced due to the sudden pandemic. As we felt at the end of our last collaboration, we now know what we need to do in our next endeavor. © Fuji Technology Press Ltd.

Exercises and visits

The two ays of maritime drills witnessed the three navies engaged in a various tactical exercises including naval manoeuvres and surface warfare drills. 6th Indo-France "EX SHAKTI2021" The Sixth Edition of Indo-France joint military exercise "Ex SHAKTI 2021" commenced at the Military School of Draguignan, France with an opening ceremony on 15 November 2021. French Navy's Chevalier Paul calls at Mumbai port To demonstrate the strength of Indo-French naval cooperation in the Indo-Pacific, a French air defence destroyer called at Mumbai naval port after taking part in a large-scale air and naval joint exercise off the coast of Maharashtra. The exercise is meant to enhance synergy and interoperability between Armed Forces of both the Nations in terms of understanding transnational terrorism both on land and at sea, conducting Counter Terrorism & Counter Insurgency Operations and sharing best military practices and experiences. Besides rigorous training, the joint military exercise also included cultural and sports activities to enhance defence cooperation and bilateral relations. INS Kesari, a Landing Ship Tank (Large) had undertaken similar mission in May/June 2020 to provide humanitarian and medical assistance to Maldives, Mauritius, Seychelles, Madagascar and Comoros, including deployment of Medical Assistance Teams of the Indian Navy in multiple locations. Since May 2020, the Indian Navy has deployed ships to 15 Friendly Foreign Countries under SAGAR missions.

Divided by Borders Connected by Blue Line: Prospects and Lessons for Sustainable Ocean Governance in the Indian Ocean Region

In last few decades, oceans are perceived only as everyone's resource but no one's responsibility. After the publication of Gunter Pauli's book The Blue Economy (2010) and declaration of UN's Sustainable Development Goals (SDGs), there is a call for efficient and sustainable use of ocean resources. Blue economy is all about oceanrelated sustainable development model and has a huge potential in income and employment generation. A fundamental change is required in the way the world's marine economy is managed. The Indian subcontinent (India, Pakistan, Bangladesh, Sri Lanka, and Maldives) has a huge coastline, but unlike Small Island Developing States (SIDS), it is hardly able to develop a comprehensive, integrated blue economy policy at regional level due to border and other disputed transboundary issues. All the above-mentioned countries of the Indian subcontinent are part of Indian Ocean Rim region but not part of the Indian Ocean Rim Association (IORA) which can play a potential role in building a comprehensive strategy for sustainable management of the Indian Ocean. The Covid-19 pandemic has affected most of the sectors associated with blue economy However, the pandemic has also delivered unusual environmental benefits through reduced economic activity and consequent curb on ocean emissions and air and water pollution. Therefore, the objective of the paper is to understand the prospects and lessons of blue economy in the post-pandemic world order as a common policy paradigm in the Indian subcontinent region for sustainable ocean governance in the near future.

A review of clinical management practice of COVID-19 in South Asian countries: systematic review

Our world is currently fighting with highly infectious and deadly severe acute respiratory syndrome-coronavirus-2 virus which has no specific remedy yet. No study focused on reviewing applied clinical management and treatment protocol of coronavirus disease-2019 (COVID-19) by health ministry of different nations till date. Therefore, this study focuses to identify and compare clinical management and treatment protocol guidelines for COVID-19 from 8 South Asian countries. This study will assist the healthcare workers and authorities of different nations by sharing the key information from potential guidelines to treat COVID-19 patients. Necessary information has been collected from the clinical management guidelines for COVID-19 in Health Ministry website of India, Bangladesh, Sri Lanka, Pakistan, Afghanistan, Nepal, Bhutan, and Maldives. Though clinical management practices vary from country to country, all of these countries are utilizing high flow oxygen therapy and mechanical ventilation for critical cases. Moreover, some potential drugs have been suggested for treatment by most of the countries but were not recommended yet as all of them are under clinical trials. Hydroxychloroquine has been suggested by most of these countries. All the countries are developing and updating their guidelines for clinical management of COVID-19 patients. It is worth mentioning that the recovery rate of Bangladesh, India, Sri Lanka, Pakistan, Afghanistan, Nepal, Bhutan, and Maldives is 63.52%, 76.24%, 94.88%, 94.47%, 83.65%, 71.5%, 71.14%, and 83.83% respectively. The oxygen therapy and empirical antibiotic for preventing secondary infection have been used commonly in most of these countries as an effective treatment.

Ethical leadership in educational organizations: A cross-cultural study

The goal of this study is to examine how educators from both Eastern and Western cultures define ethical leadership and which characteristics they associate with ethical leaders. This study also explores ethical examples of educators, tries to answer if major events like Covid-19, high-technology, migration have changed their ethical perceptions, and lastly, examines their reactions to unethical conduct. This qualitative study employed a phenomenological research design. Data collection using semi-structured interviews and open-ended surveys was conducted with 51 educators from Eastern and Western countries. The findings indicate that the attributes of ethical leadership, like honesty, respect, fairness, and justice, are endorsed across both cultures. Other attributes, like flexibility, religiosity, and responsibility, were articulated by the educators from the Eastern sample, while rationality, team spirit and ability to listen were highlighted in the Western sample. The participants recounted their experiences of ethical leadership around several themes, some of which are a friendly approach, equality, defending the rights of others, and standing for right. They specified their different responses to unethical acts and mainly believe that ethics are constant throughout history. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Turkish) Bu calismanin amaci, hem Dogu hem de Bati kulturlerinden egitimcilerin etik liderligi nasil tanimladiklarini ve etik liderlerle hangi ozellikleri iliskilendirdiklerini incelemektir. Bu calisma ayni zamanda egitimcilerin etik olarak gordukleri ornekleri arastirmakta, Covid-19, yuksek teknoloji, goc gibi onemli olaylarin onlarin etik algilarini degistirip degistirmedigine iliskin sorulari yanitlamakta ve son olarak katilimcilarin etik olmayan davranislara karsi gosterdikleri tepkileri incelemektedir. Bu nitel calismada fenomenolojik desen kullanilmistir. Dogu ve Bati ulkelerinden 51 ogretmen ve akademisyene acik uclu sorular yoneltilmis ve bir kismiyla yari yapilandirilmis gorusmeler gerceklestirilmistir. Bulgular;durustluk, saygi, adalet ve adalet gibi bazi etik liderlik niteliklerinin her iki kulturde de vurgulandigini gostermektedir. Esneklik, dindarlik, sorumluluk gibi ozellikler Dogu orneklemindeki egitimciler tarafindan ifade edilirken, Bati ornekleminde mantiksallik, takim ruhu ve dinleme becerisi vurgulanmistir. Katilimcilar, etik olarak algiladiklari olaylari dostane yaklasim, esitlik, baskalarinin haklarini savunma ve hakli icin durma gibi cesitli temalar etrafinda aciklamistir. Katilimcilar etik olmayan eylemlere iliskin farkli tepkilerini belirtmis ve genel olarak etigin tarih boyunca degismedigine inanmaktadirlar. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Editorial – Theory building in marketing: rationalizing South Asian perspective

Nationalistic campaigns of governments to promote local trade and business are yet another challenge to the fore. [...]it requires a better understanding of different cultures so that successful marketing programs can be initiated and implemented. [...]the further developed local financial viewpoint results from South Asian nations' endeavors to monitor their COVID-19 caseload and quickly carry out antibody crusades. [...]the marketing applications/practices of the South Asian countries are different from the other regions to suit the current economic outlook of the region. [...]South Asia's rich history, culture and folklore have not been explored up to its true potential.

An Empirical Study on Motivation to School Teachers in the Maldives during the COVID 19 Pandemic

The COVID 19 pandemic has affected all walks of life;as a result over 100 million children are away from school. The mass university closure and a forced transition to online teaching are to minimize disruptions to the academic year. Many inexperienced online teachers are expected to find the rapid shift from in-person to online teaching hard, and it is a "great experiment" that has to be studied. The study looked into the motivations of Maldivian instructors who were compelled to shift to remote online teaching as a result of the COVID-19. Teachers' self-efficacy refers to their capacity to handle responsibilities and problems in the workplace, and it has an impact on academic achievement. During the COVID-19 epidemic, this study intended to offer an in-depth investigation of the influence of intrinsic and extrinsic motivation on self-efficacy in teachers. The author is attempting to adopt more effective strategies to improve teachers' professional identity and job satisfaction in order to increase the efficacy of teachers, ensure the effectiveness of online teaching, and maintain sustainable development during the epidemic by collecting data from Maldivian schools.

Forecasting Covid-19 New Cases in Maldives

In this study, the ANN approach was applied to analyze COVID-19 new cases in Maldives. The employed data covers the period 1 January 2020 – 25 March 2021 and the out-of-sample period ranges over the period 26 March – 31 July 2021. The residuals and forecast evaluation criteria (Error, MSE and MAE) of the applied model indicate that the model is quite stable. The results of the study indicate that daily COVID-19 cases in Maldives are likely to remain high over the out-of-sample period. Amongst other suggested policy directions, there is need for the government of Maldives to ensure adherence to safety guidelines while continuing to create awareness about the COVID-19 pandemic.

Assessing the recovery rate of inbound tourist arrivals amid COVID-19: evidence from the Maldives

The present study examines the impact of COVID-19 on Maldivian tourism, highlighting the loss of tourists and tourism earnings for the period 2020Q1 to 2021Q2 and analyses the recovery rate of inbound tourists' arrivals post border re-opening (i.e., 2020Q3 - 2021Q2). Seasonal Autoregressive Integrated Moving Average (SARIMA) model was employed to generate monthly forecasts for 2020 and 2021. The results indicate an estimated loss of 1.9 million tourists between 2020Q1 and 2021Q2. A massive drop in tourist arrivals caused an estimated loss of USD 3.5 billion in tourism earnings by June 2021. Results further indicate that with an average monthly recovery rate of 3%, inbound arrivals have recovered 34% of forecasted levels and 40% of 2019 levels by June 2021. The measures implemented by the government of Maldives played a vital role in the recovery of inbound tourism. However, the rebound of tourists has not reached the desired levels except for the arrivals from Russia. Therefore, additional strategies must be implemented for the quick revival of the Maldivian tourism industry. This study expands and enriches tourism management knowledge in the face of a massive crisis highlighting important managerial and policy implications for reviving the tourism industry of the Maldives.

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives.

The multisystem inflammatory syndrome in adults (MIS-A) is a novel syndrome observed during COVID-19 outbreaks. This hyper-inflammatory syndrome is seen predominantly in children and adolescents. The case of an adult from the Maldives who had asymptomatic SARS-CoV-2 infection three weeks before presenting to the hospital with fever, rash, and shock is presented. De-identified clinical data were retrospectively collected to summarize the clinical progression and treatment during hospitalization and the six-month follow-up. SARS-CoV-2 infection was confirmed by RT-PCR. Other laboratory findings included anemia (hemoglobin: 9.8 g/dL), leukocytosis (leukocytes: 20,900/µL), neutrophilia (neutrophils: 18,580/µL) and lymphopenia (lymphocytes: 5067/µL), and elevated inflammatory markers, including C-reactive protein (34.8 mg/dL) and ferritin (2716.0 ng/dL). The electrocardiogram had low-voltage complexes, and the echocardiogram showed hypokinesia, ventricular dysfunction, and a pericardial effusion suggestive of myocardial dysfunction compromising hemodynamics and causing circulatory shock. These findings fulfilled the diagnostic criteria of MIS-A. The case was managed in the intensive care unit and required non-invasive positive pressure ventilation, inotropes, and steroids. With the new surges of COVID-19 cases, more cases of MIS-A that require the management of organ failure and long-term follow-up to recovery are anticipated. Clinicians should therefore be vigilant in identifying cases of MIS-A during the pandemic.

Navigating the health system in responding to health workforce challenges of the COVID-19 pandemic: the case of Maldives (short case).

Being a small island and low-middle income country (LMIC) heavily dependent on global markets for sustaining its basic needs and health system, Maldives faced specific challenges during the COVID-19 pandemic. This was reinforced through tensions between the heavily centralized healthcare delivery and a partially decentralized public health system. Using the pillars of pandemic response proposed by the World Health Organisation, this article explores the planning assumptions, resource estimations and strategies adopted to equip the health system with resources for the pandemic response. The resource need estimates based on projections for COVID-19 identified a shortfall of medical professionals to care for patients while maintaining 55% of the workforce for regular healthcare across the atolls. The findings show that while the policy of lockdown bought time to increase hospital beds and devices, the country was unable to increase the healthcare workforce. Furthermore, as the lockdown eased, the exponential increase of cases took Maldives to the global one per capita incidence. Despite this, with cautious planning and use of resources, the country has so far managed to maintain low mortality from COVID-19. The lessons from this experience are paramount in future pandemic response planning, not only for Maldives, but other small island LMICs.

Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis.

INTRODUCTION: The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic. METHOD: We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression. RESULTS: A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7-48.1, I 2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9-39.4, I 2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity, high publication bias confirmed by Egger's test, and varying prevalence rates across sub-groups. CONCLUSION: South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.