When COVID-19 comes to Africa

ADDIS ABABA — The COVID-19 coronavirus, which has now spread to more than 100 countries, has pushed the world into “uncharted territory”, according to World Health Organisation Director General Tedros Adhanom. So far, Africa has recorded relatively few infections, but there is no reason to believe this will not change. When it does, the results could be catastrophic.

One need only recall the West African Ebola epidemic of 2014-2016 to comprehend the potential damage. The hardest-hit countries were Guinea, (with 3,814 cases and 2,544 deaths), Liberia (10,678 cases and 4,810 deaths), and Sierra Leone (14,124 cases and 3,956 deaths). Moreover, since August 2018, the Democratic Republic of the Congo has faced its own large-scale Ebola epidemic, with more than 3,444 cases and 2,264 deaths (as of March 10, 2020).

While Ebola has a far higher mortality rate than COVID-19, the latter’s rapid spread shows that it, too, can quickly spin out of control, causing serious social and economic disruptions. The infection rate in China, for example, began to decline only after weeks of consistent bold measures, active community mobilisation, and “draconian” lockdown measures. Whether the virus is truly contained remains to be seen.

For Africa, the race to prepare is on. This means urgently applying the lessons of recent Ebola outbreaks, beginning by recognising that weak national health systems make a bad problem worse. Many have too little money, infrastructure, and expertise. As the researchers Peter Piot and Julia Spencer, together with Liberian doctor Moses J. Soka, put it, “countries must strengthen their core capacities to prevent, detect, and respond to outbreaks, with commensurate domestic and, where needed, international investments”.

But direct investment in health-care infrastructure and services is only the first step. The fight against Ebola was often hampered by its social context, including community dynamics, local beliefs, political instability, economic fragilities, and lack of trust in government and institutions. Efforts to boost the public’s knowledge and confidence are thus critical to the effectiveness of any COVID-19 response strategy.

People need to know, for example, that basic behavioural changes, especially frequent and thorough hand washing, coughing into one’s elbow, and avoiding crowds, can make a big difference. They must recognise that medical masks offer little protection to the general public, and that attempts to hoard them have led to price gouging and shortages for healthcare professionals. And they must understand that a fully vetted vaccine is still a long way off.

Consistent, credible messaging — coordinated among influential community elders, religious leaders, media, and local government officials — is thus vitally important. And health officials must share information about the progress of the virus, and the measures being taken to contain it, in a timely and transparent manner.

But the imperative extends beyond keeping the public informed. As Piot, Spencer, and Soka acknowledge, communities must be “engaged and empowered” as primary partners in preparedness and response activities. This approach will help to advance another priority: adapting measures to local conditions, including cultural norms, community structures, prevalent occupations, mobility, the political environment and the capacity of health systems.

All of this will require decisive leadership. Rather than leave the response to health ministries, African heads of government should establish high-level committees or task forces to streamline decision-making and resource mobilisation, including by facilitating coordination among government bodies. My country, Ethiopia, has already established such a high-level task force, and organised national diagnostic and laboratory facilities, despite having no confirmed cases.

If managed well, the COVID-19 response will result in stronger healthcare systems that are far better equipped to keep populations healthy in normal times, and to respond to inevitable future crises. But, to be successful, African governments will need outside support.

The WHO has provided guidance on how to fight COVID-19. By coordinating with the African Union Commission and regional organisations, it will be better able to mobilise resources from its international partners.

More experienced governments, especially China’s, and better-resourced agencies, such as the United States Centres for Disease Control and Prevention, should also offer advice and support. To facilitate effective decision-making, African health ministries must keep all relevant agencies fully informed about the situation on the ground.

A comprehensive COVID-19 response must also account for the pandemic’s economic consequences. Already, oil prices are plummeting, bad news for Africa’s producers. Moreover, supply-chain disruptions augur declining exports. The damage to the travel and tourism sectors is just beginning to show.

Many African airlines have already suspended flights to China, contrary to the advice of the WHO and the International Air Transport Association. But others have not. Notably, Ethiopian Airlines, Africa’s largest carrier and the biggest in terms of passenger transport between China and Africa, has introduced new health-inspection protocols and preventative procedures, including at departure points, a process that has required close collaboration with the Chinese authorities. Pilots and cabin crew have received training on protecting themselves and their passengers. The company’s top management has established task forces whose work is reviewed daily, and its board reviews the situation weekly.

This aligns with Ethiopian Airlines’ policy during the Ebola epidemic, when it also decided not to suspend flights. But as the COVID-19 situation evolves, the carrier may have to change its approach, to curb potentially incurring large losses. Many companies may face similar decisions in the coming weeks. To safeguard their economies, African governments must act now, working with think tanks and regional organisations to design effective solutions.

There is no telling how long it will take to bring COVID-19 under control, or how many people will be affected. But African governments, in cooperation with communities and international actors, can take steps now to limit the damage — and lay the foundations for a healthier, more resilient future.

Arkebe Oqubay, a senior minister and special adviser to the prime minister of Ethiopia, is a distinguished fellow at the Overseas Development Institute and the author, most recently, of “African Economic Development: Evidence, Theory, Policy” and “The Oxford Handbook of Industrial Hubs and Economic Development”. ©Project Syndicate, 2020. 

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