According to the World Health Organization (WHO), the number of people who have contracted COVID-19 has surpassed 7.6 million, while the death toll is more than 420,000. In Africa, altogether, there are more than 220,000 confirmed cases with 5,900 deaths. The African Union (AU) has provided a platform on which layers of responsibility extend upwards through authorities, national states, RECs and the international community. The AU’s Regional Economic Communities facilitated regional coordination of cross-border responses mostly through intra-Africa information sharing. In this regard, the AU Centre for Disease Control and Prevention of the Department of Social Affairs has been at the forefront in providing updated continent-wide information and coordinating some of the health equipment supplies.
Pragmatic national responses
The strategies currently applied by the Europeans and Americans such as extensive testing, contract tracing, hospitalization, offering financial aid to unemployed citizens, and large stimulus packages was not possible in Africa. Adding to the pre-existing threats such locust plague, flooding and drought, according to the WHO-JRC Epidemic Risk Index, African countries are considered among those most at risk of an epidemic outbreak, underpinned by a fragile health infrastructure. An estimated 60 per cent of the population does not have access to healthcare. Hospitals, clinics and other local healthcare facilities in the region's states could be overwhelmed by patients seeking care if there is a significant spike in infection and need for hospitalization. Member states also have limited testing facilities.
As with many other outbreaks, most African countries have no realistic alternative to COVID-19 prevention programmes because the financial and structural demands of an adequate treatment regime far exceed their capabilities.
So far, how successful has Africa's response been to the impacts of COVID-19? Can a scorecard be drawn now?
We can see three significant features. First, Africa did not heavily rely on the healthcare system and economic stimulus, two measures on which Western countries anchored their responses. Second, African governments relied more on controlling the vector of the virus, its mobility and contact, imposing several very restrictive measures on people’s movements. Third, they introduced aggressive prevention, following the World Health Organizations guidelines such as hand washing, social distancing, isolation and quarantine. Thus, the African governments moved with speed to impose preventive measures at a pace faster than the spread of the virus. These measures offered them the time for preparation and slowed the infection. Some African countries have employed emergency powers and deployed security forces.
Controlling the vector – restriction of human mobility
The primary vector of the coronavirus is human beings. As in many other diseases such as malaria, vector control, including restriction of movement for persons with COVID-19, is the leading way to prevent coronavirus transmission. In response, more than 42 countries have closed their borders and imposed lockdowns and restrictions of movement while 13 others have imposed partial closure. African governments’ response to COVID-19 began with border closures as unilateral decisions. The bans apply to both internal and external mobility. Most measures are based on public health acts and some on disaster emergency laws. In countries such as Kenya, Mali, Nigeria and Senegal the announcements of restrictions increased urban-rural movement. Along border areas between Mali and Burkina Faso, Togo and Benin, many people were stranded, and in some cases the violent return of migrants to Niger, Libya, Algeria and Mali has been reported. The resettlement of migrants from Libya to Niger and Rwanda is also delayed.
The policy dilemma: between hunger and corona
The above mentioned aggressive preventive measures (social distancing, handwashing, isolation, quarantine, and mandatory masking in public) and restrictions pose a policy dilemma with several possible decisions to be made; each with an opportunity cost but not necessarily of equal weight. The speed of transmission of the virus depends on many factors, and one among them is interconnectedness and mobility. With high levels of restrictions in the form of border closures, lockdowns, curfews, travel bans, and social distancing, transmission has been delayed. The impacts of COVID-19 extend beyond public health, affecting closely interlinked public interests, mainly the social, economic, political and even environmental dimensions of societies. Extreme poverty not only undermines immunity but also creates crowded living conditions that make social distancing almost impossible. Lack of access to water and consequently poor hygiene add to Africa’s vulnerability to the spread of the virus. Extreme poverty makes the propagation of the virus easy, and at the same time it is extreme poverty that makes prevention (in the form of social distancing, hospitalization and financial support for livelihoods) very difficult.
In the African informal economy context, these urgent actions severely impact the livelihood of families with disastrous effects on communities, draining their assets and family savings. These measures will likely destroy national economies. The adverse economic impact is a hammer-blow that could see Africa lose all the advances it has made made of late.
Sustainability of measures
Although known as an effective means of flattening the exponential infection curve, social distancing is proving difficult in Africa and cannot be maintained for a long time due to its impact on livelihoods. At the same time, the WHO is now asserting that the virus is here to stay, and we must learn how to live with it, while the discovery of and widespread access to vaccines and drugs may take years. How long should the restrictions continue? Can the health, economic, and political imperatives be balanced? With lockdowns and restrictions being extended in many African countries, people are posing questions (and sometimes demanding answers from authorities) as to when and at what stage these restrictions should be lifted or at least relaxed.
Pragmatic containment strategies: towards a hotspot-based approach?
African countries need to seek balance between saving lives and livelihoods. The best approach to ensure this delicate balance is ensuring that measures are pragmatic, dynamic, flexible and localized. Such pragmatic strategy with a focus on local action encouraging governments to take a whole of society approach in which state and non-state actors, particularly religious leaders, traditional elders, tribal chiefs and the youth, together with private sector interests, are co-opted into active participation in the battle.
The litmus test: containing local community transmission
The propagation of the virus, mainly associated with international travel, is controlled, at least for now. The final scorecard can only be drawn later this year, if and when Africa can control local transmission effectively. Reports of local transmission are just trickling in, and the challenge for African countries increases when local transmission spikes. Prolonged local transmission may mean a lingering impact on health, livelihoods, and social relations that devastate the countries’ economies.