When America Gets CoronaVirus Under Control, Africa Will Need Our Help


We know too
little about the new coronavirus to say how it will progress in Africa, but we
know enough to realize it is likely to pummel the continent.

As of April 6, Johns Hopkins University reported confirmed cases of COVID-19 in 51 of Africa’s 54 countries, with a total of over 9,400 cases. The number is well below most of the world’s regions, but the coronavirus that causes the disease came late to the continent and is just now gathering steam.

Many of
Africa’s countries have weak health care systems that easily could be overwhelmed
by COVID-19 cases. Thirty-three countries in Africa fall into the “least prepared” category of the Global
Health Security Index.

The fact
that Uganda in 2013 had 0.1
ICU beds per 100,000 people
gives a sense of the scale of the problem. For
comparison, Italy, which may have the world’s highest COVID-19 death rate (we probably
never will be sure, as the Chinese government appears to be vastly
underreporting
cases and deaths), has 12.5
ICU beds
per 100,000 people.

Deadly
diseases already strain African health care. Just as an Ebola outbreak in West
Africa in 2014-2015 led to an estimated 10,000 excess deaths
from HIV/AIDS, malaria, and tuberculosis, COVID-19 cases are likely to consume
scarce medical resources, increasing the toll from other diseases.

Violent
instability grips parts of the continent, and terrorist activity has turned
entire swathes of countries—northern Mali, for instance, or northeast
Nigeria—into no-go zones. Militia attacks on health care workers in the
Democratic Republic of the Congo was a primary impediment to containing the
recent Ebola outbreak there.

The
inadequate governments burdening many of Africa’s countries will hamper an
effective response as well. Citizens may be tempted to ignore public health
orders because they distrust the governments issuing them, often for good
reason.

The
spectacle of soldiers and police abusing
civilians
in Kenya
and South Africa
to enforce lockdown measures illustrates the problem.

Many
Africans won’t be able to follow all the recommended mitigation strategies even
if they want to, and their governments will struggle to enforce lockdowns. The
porous borders of African countries allow people to move easily and undetected throughout
the continent.

Sub-Saharan Africa
also has more extremely poor residents—more
than 400 million
in 2015—than any other region. Those living meal to meal
do not have the luxury of sheltering in place for long.

Social distancing will be impossible in many of Africa’s densely packed slums—home to almost half of its urban population—as will frequent hand-washing where water and soap can be in short supply.

Some of the
continent’s many refugees and internally displaced people also are clustered in
densely packed camps with limited medical facilities, which will further complicate
enforcing lockdowns.

The COVID-19
crisis is piggybacking on the oil price war that sent oil prices plummeting, a
double blow to government revenues of some of Africa’s largest and most oil-dependent
economies, such as Nigeria and Angola.

African
governments have taken on additional debt recently as well; the International
Monetary Fund reports
that 16 African countries are in debt distress or at high risk of falling into
distress. Those governments now have fewer funds available—and fewer means to
raise more—to launch the necessary but costly response to COVID-19

Finally,
most of the continent is moving into fall weather. Coronavirus may prefer
the cold, meaning any protection Africa received from its hot weather is now
crumbling.

Not all the
news is bad for Africa. Its inhabitants on average are the world’s youngest—the
median age is below 20 in sub-Saharan Africa—and the virus does not readily
kill the young. Because COVID-19 was comparatively slow to reach the continent,
governments have the advantage of learning from other countries’ experiences,
and some already have launched aggressive lockdowns.

Although this
is a new coronavirus, many African medical professionals have hard-won experience
responding to epidemics such as Ebola that can help inform the battle against
COVID-19.

The U.S. at
some point will have a sufficient handle on this disease that it can focus on
increasing help to other regions. African countries likely still will be in the
midst of their battle with COVID-19 and should be some of the first countries
to draw increased American attention.





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