(Bloomberg) --

President Donald Trump is stepping up his campaign to oust Venezuela’s Nicolas Maduro with the coronavirus pandemic and plunging oil prices threatening to worsen a humanitarian disaster years in the making.

The Trump administration says its restrictions don’t prohibit humanitarian aid from flowing to Venezuela, the same argument it makes when pressed about sanctions on Iran. As a result, it’s holding firm to its policies even as some world leaders, including UN Secretary-General Antonio Guterres, say it’s time to rethink sanctions to prevent the outbreak from worsening.

U.S. officials argue that any easing would just strengthen Maduro’s seven-year grip on power, since they think he’d divert aid or cash to bolster allies, particularly in the military.

“The problem in trying to help Venezuela is you just don’t have an easy way to get the money to the people without helping the regime,” said Roberto Simon, senior director for policy at the Americas Society/Council of the Americas. “There’s no question the Trump administration sees this as yet another opportunity to weaken the regime.”

There’s also little question that the situation on the ground in Venezuela is grim -- and has been for years. Even before the pandemic, the country’s broken health-care system was losing a battle against traditional scourges such as measles and malaria, basic food and consumer goods were hard to obtain and inflation was the highest in the world. An estimated 5 million Venezuelans have fled the country in recent years.

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The cononavirus’s impact on Venezuela so far isn’t clear. As of Thursday, Venezuela had just 146 confirmed cases, and five deaths. Those numbers understate the situation, just as they are believed to do in countries such as India, Russia, North Korea and Iran.

Human Rights Watch said last month that Venezuela had only 300 diagnostic tests available for a population of around 30 million, and that about 70% of Venezuela’s hospitals didn’t have any tests. World Bank data from 2014, before the worst of the economic crisis in Venezuela was even underway, said the country had 0.8 hospital beds for every 1,000 people, below an average in Latin America at the time of 2.2.

“The mortality rate will be a lot more severe in a country with no ICU capacity, no ventilators and a health system in such utter collapse that I just can’t imagine how they’ll be able to help patients with coronavirus,” said Kathleen Page, an expert on Venezuela’s public health system who teaches at Johns Hopkins University School of Medicine.

While some international agencies like the United Nations and the Red Cross have been granted safe conduct to operate in the country despite a nationwide lockdown that began on March 17, roadblocks set up by the armed forces have stopped the passage of medicine and aid for local efforts, and in some cases prevented them from accessing much needed fuel.

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Some non-profits “have had many obstacles because they don’t have a safe-conduct to move freely or fill up their tanks,” said Rafael Uzcategui, general director of Provea, a human-rights organization based in Caracas. “Communities and hospitals that used to receive food and supplies are not receiving them, and these populations are becoming even more vulnerable.”

Some outside organizations have also said they’ve had a hard time getting work permits to operate in Venezuela. That is at least partly tied to the Maduro regime’s suspicion that aid groups are fronts for political organizations that seek to undermine his credibility.

The UN alluded to these shortcomings after Guterres announced a $2 billion fund-raising effort to help the world’s poorest nations during the pandemic. In the report, the UN said that relief efforts in Venezuela are being held back by “limited capacity due to lack of registration of international NGOs and the ability of World Food Programme to enter the country and to operate under humanitarian principles.”

Roadmap to Elections

All of that make it less likely the U.S. will bend to pressure to ease sanctions. The Trump administration this week unveiled a roadmap for Venezuela to exit the sanctions regime, calling for a unity government not led by Maduro or America’s preferred alternative, National Assembly leader Juan Guaido, that leads to free and fair elections in about a year.

Guaido says now is the time to form a “national emergency government” and request $1.2 billion from multilateral organizations to fight the coronavirus crisis. Maduro’s repeated efforts to secure IMF loans have so far been rejected.

Without a breakthrough, the sanctions noose is tightening. Trump announced Wednesday that he’s deploying more Navy vessels and Air Force plans in the Caribbean to push back on drug cartels who the administration argues provide needed cash to Maduro’s regime.

That followed the Justice Department’s indictment of Maduro and more than a dozen key aides last week for drug trafficking and money laundering -- the first time the U.S. has take such a move since it targeted Panama’s strongman Manuel Noriega in the early 1990s.

‘Tremendous Threat’

That leaves the two nations at a standstill.

“What the regime is facing now is much more grave than they’ve ever faced before, yet Maduro has, against all odds, managed to stay in power during the past year,” said Phil Gunson, a Caracas-based analyst at the International Crisis Group. The latest sanctions will “have a perverse effect, unifying the government even more,” he added.

Experts warn that without significantly more help soon, the health-care system will be unable to cope, posing a threat not just to Venezuelans but also to Brazil and Colombia, with which it shares porous borders.

“Let’s stop politicizing things while mothers, babies, children and the elderly are under tremendous threat,” said Jan Egeland, a former head of humanitarian affairs at the UN who now runs the Norwegian Refugee Council who supports unfreezing Venezuelan financial assets abroad.

Yet even the latest sanctions and the virus outbreak may not be enough to oust Maduro. Even as his policies of “21st Century Socialism” helped destroy Venezuela’s economy and fueled hyperinflation, his regime managed to find novel ways to get hard cash and stay in power, despite millions of Venezuelans fell into grinding poverty. With the military behind him, he can likely withstand the latest viral onslaught.

“This is government that holds itself up because it control all arms, and especially during a pandemic, having a monopoly on violence is indispensable,” said Gunson.

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