As the BBC’s Emily Maitlis said in her refreshingly candid monologue last week, ‘the [Coronavirus] is not a great leveller, the consequences of which everyone rich and poor suffer the same.’ Whilst she may have been referring to Britain in her now viral broadcast, the same could be said for areas outside the Occidental spheres. All eyes are now on Africa to see if it will be the next place to be hit by the Coronavirus wave.
Whilst Europe has become the epicentre of the epidemic since the
first case was announced in late January this year, now, over three months on and 250 million people in lockdown later, Africa may be the next to follow in its path. The continent now has over 12,000 cases, with 600 deaths and counting. These statistics suggest the continent is on a similar trajectory to Italy and the UK, and considering how damaging the virus has been for the richer nations of the world, a major outbreak in Africa - both the globe’s poorest and one of the most populous continents- could cause absolute devastation.
Although it initially appeared that the majority of the 54 African countries were going to avoid the coming coronavirus crisis, recent statistics blight these hopes, with both deaths and new cases steadily increasing by the day. After the disease first spread from Europe in February, 52 countries are now infected, leaving all but 2, Lesotho and Comoros, without any reported cases: at the opposite end of the scale, South Africa tops the continent’s number of reported cases of the disease, with over 2,000 now confirmed. However, the country’s health-care system, known as Africa’s best and to which many neighbouring citizens travel to in order to receive treatment, has likely had an impact in keeping their number of deaths under 100. Other nations won’t be so lucky, however.
"This opportunity [to flatten the curve] is no longer there … for some countries," Dr Michel Yao, the leader of WHO’s African emergency response programme stated to the BBC.
"The worry is also now that [countries] cannot adequately manage this phase, they are moving to [in country transmission]. But we are seeing there is some delay in addressing [this]… to mobilise more people, train more people, think about capacity."
A large number of the problems Dr Yao identifies derive from Africa’s poor healthcare system. Most crucial, perhaps, is it’s underfunding: according to the World Health Organisation (WHO), the continent has 24% of the world’s disease, yet benefits from just 1% of global health care resources. Those who can afford high standard treatment go to different countries to receive it - such as South Africa or America -, but with increasing travel restrictions, hospitals in the individual nations are going to be forced to bear the brunt of the populace .
Unlike much of the Western world, Africa also has to tackle a number of other infectious diseases - such as malaria, cholera and HIV.
“Not only does this pose more of a strain on the already substandard health care system,” Tom Achoki, co-founder of Mass Sciences and a lecturer at the University of Pretoria reported, “but it means thousands more people are at risk of severe and lethal cases of the virus, as the widespread rate of other infectious diseases means a far higher quantity will have lowered immune systems.”
“There's a need to train workers on using masks and gowns to protect themselves when treating COVID-19 patients (...) and the data is still collected on paper forms rather than digitally in many African countries.”
Social factors may also contribute to an exacerbation of the epidemic. Social distancing - a measure countries who are now entering the later stages of the virus’ spread are relying upon to prevent a second wave - is going to be incredibly challenging to enforce in the continent, with 61.7% of Sub-Saharan Africa’s urban population living in slums, and large population densities could make contact- tracing even harder. Combine that with the poor prospects of sanitation initiatives, such as the staple-policy of hand-washing, when 1 in 3 African households don’t even have access to clean water, and it doesn’t create an optimistic picture.
Some countries in Africa have been quick to react to the outbreak, however. Nigeria closed schools in it’s capital of Lagos after only 8 reported cases, and drive-through test centres have been created in Johannesburg, with WHO supporting 43 more countries in establishing testing. Other nations are also stepping up with health initiatives: students at Uganda’s Makerere University have created a hands-free washing unit to be used across their campuses, and household water, electricity bills and public transport have been temporarily subsidised in Guinea.
Africa also has experience to draw upon. Unlike the Western world, many Africans have a living memory of the challenges of a widespread pandemic. The Ebola outbreak of 2014 killed over 11,000 people, with Liberia, Sierra Leone and Guinea the worst hit. However, with a coordinated international effort that included contact tracing, public awareness campaigns and travel restrictions, the epidemic had all but come to an end by early 2016.
So what did this outbreak teach them about handling infectious disease? It showed that Africa had the ability to modify it’s response in order to control transmission - such as setting up community care centres to home patients nearer to their local area. But as many countries are figuring out, Coronavirus is a completely unique disease, creating a strain that few healthcare systems are equipped to support. Whilst Africa may have the experience, it does not have the money, resources or time to circumvent this crisis.
There is no way to predict the outcome of the Coronavirus outbreak in Africa, however, and the only realistic response is to wait with baited breath. Like the rest of the world, the continent is funnelling all it’s supplies in order to quell the crisis: alas, that won’t make up for the years of underinvestment that authorities have tried to sweep under the rug. The International Finance Corporation (IFC) estimates that over the next decade, $25-$30 billion in new investment will be needed to meet Africa’s health care demand. In a future where infectious disease outbreaks may become commonplace, it appears that no amount of cash can compensate for a lack of adequate resources, a rapidly increasing population and a diminishing amount of time.
Image - Unsplash.