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A Testing Task
Africa faces numerous challenges in prevention and control of coronavirus
By Fikrejesus Amahazion  ·2020-03-27

On the basis of “alarming levels of spread and severity, and by the alarming levels of inaction”, on March 11, 2020, Director General of the World Health Organization (WHO) declared the rapidly spreading novel coronavirus disease (COVID-19) a pandemic. So far, hundreds of thousands of cases have been confirmed in countries across the globe, while tens of thousands of people have died from the disease worldwide.

The number of reported cases in Africa, although relatively small, has recently been climbing. According to the WHO and the Johns Hopkins University Coronavirus Resource Center, as of March 26, there were over 2,500 confirmed cases across Africa, with almost all nations on the continent - at least 46 of the 54 countries - reporting cases. The African countries with the highest number of cases are Algeria, Burkina Faso, Egypt, Morocco, Senegal and South Africa. Most confirmed cases on the continent have involved people arriving from Europe and North America, with little community transmission, although this appears to be increasing. Despite the fact that Africa’s handling of the COVID-19 pandemic has received relatively scant global attention, a rapid spread of COVID-19 on the continent could cripple fragile public healthcare systems and leave a devastating toll on societies and economies. Several factors, in particular, could make containing the virus on the continent especially challenging.

Weak healthcare systems

One major concern is that many countries in Africa have weak, poorly equipped healthcare systems, which will create significant challenges in successfully responding to COVID-19. Generally, across much of Africa, healthcare workforce is only a fraction of what is needed; countries face shortage of funds, and there are often large gaps in delivery of services, such as those between rural and urban areas. Healthcare workers also may lack necessary skills and training, or access to basic technologies or equipment, medicine, and medical information systems.

Although many African countries have received crucial support from the WHO, allowing them to quickly establish or improve testing facilities for COVID-19, there is still a troubling shortage of test kits, and the overall capacity to deal with the pandemic remains limited. Frontline workers face a critical shortage of protective equipment, such as masks, gloves, gowns and disinfectants, which heightens the risk of infection (or other issues, such as high levels of stress), increases the possibility of emergence of outbreak clusters and places a greater strain on the healthcare systems. Furthermore, the number of intensive care unit beds and ventilators available across the continent is extremely small, while facilities for isolation are limited, leaving them unable to cope with a potential surge in COVID-19 patients. Unfortunately, many nations that have traditionally extended vital support to African countries during past crises such as Ebola, must now address their own explosive outbreaks of COVID-19, meaning they may be unable to offer the same levels of essential support.

Another important issue is that many states in Africa are weak and extremely fragile. They may be beset by conflict or political instability, and their authority and control may often not extend to all areas within their territorial jurisdictions. This means that many African states may lack the necessary capacity to actively implement or enforce many of the important measures required to manage a potential outbreak, such as delivering reliable information, screening or testing, enforcing lockdowns and restrictions on public movement, and proactive case finding or contact tracing.

Harsh conditions

As a continent, Africa also has a significant population of vulnerable people, including millions of refugees and internally displaced, which can increase challenges for responding to the threat of COVID-19. Refugees and the internally displaced often live in harsh conditions that are highly conducive to the spread of an epidemic, and they may lack adequate access to healthcare, hygiene materials and sanitation facilities. Also, refugees and internally displaced populations, often on the move, may pose challenges for screening, tracing, isolation, and treatment.

Africa’s response to COVID-19 may also be hindered by the fact that the continent has hundreds of millions of people living in poverty. Low-income groups and those living in poverty are more likely to be exposed to the virus and have higher mortality rates. Due to the lack of resources to prepare and protect against the coronavirus, those living in poverty may face a higher risk of contracting and subsequently spreading the virus. Many Africans also live in densely populated areas, crowded homes and informal settlements or slums with little access to safe water or sanitation, and poor sewage infrastructure. In these places, standard recommended steps to control the spread of COVID-19, such as social distancing or hand-washing, may be difficult or simply not possible to follow. Moreover, with a lack of adequate social security nets and with many Africans employed in the precarious informal economy, people may not have the financial ability to avoid work or remain in lockdown.

Chinese support

While this array of factors could make it especially difficult for African countries to successfully respond to COVID-19, there are also some reasons for optimism. For one, the delayed arrival of COVID-19 to the continent has allowed African governments to observe what other countries are doing to successfully combat the new virus. Also, important lessons learnt from the Ebola crisis in 2014 have improved the resilience of Africa’s healthcare systems.

Finally, China, which has made tremendous progress in fighting against COVID-19, leading WHO officials to congratulate it for setting “a new standard for outbreak response,” has also demonstrated its solidarity with Africa by extending vital support to the continent. The Chinese Government is donating millions of medical supplies, including test kits, masks, and preventive suits critically needed to fight the spread of COVID-19 across Africa, as well as providing extensive prevention and control support to various organs of the African Union (AU). Distribution of medical supplies is being conducted through the AU, which is supported by the Chinese Government and Ethiopian Airlines.

The Chinese Government has also been coordinating and encouraging various Chinese enterprises and private institutions to extend support to African countries. Huajian International, a Chinese footwear company, has extended material support to Ethiopia and several other countries, while Jack Ma, the Chinese tech billionaire and co-founder of the Alibaba online shopping platform, has agreed to donate medical supplies, including millions of COVID-19 test kits, masks, face shields, and protective suits, to all African states. On March 22, 2020, after the arrival in Ethiopia of a batch of medical supplies donated by Ma, Abiy Ahmed, Prime Minister of Ethiopia and the 2019 Nobel Peace Prize laureate, took to Twitter to express his appreciation for the donation.

Additionally, Chinese medical teams across the continent have been encouraged to actively participate in the COVID-19 responses within the countries where they work, while Chinese health officials and experts have been sharing valuable COVID-19 response experience via videoconferences with their African counterparts. For years, of course, China has also contributed significantly to development and improvement of healthcare systems in Africa, providing tens of thousands of scholarships and short-term training opportunities to African students, while also extending billions of dollars for healthcare projects, facilities, equipment and programs.

(The author is a scholar and researcher based in East Africa)

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