Roger Mullin, Director of Momentous Change, Honorary Professor (University of Stirling) member of the Scotland Africa Business Association.
On 13 May 2020, the first case of Covid19 was identified in Lesotho, making it the last of Africa’s 54 countries to declare the presence of the virus. Somewhat surprisingly, Lesotho had already gone into lockdown on 29 March and had actually started loosening lockdown on 6 May.
Like the vast majority African countries, it seems to have shaped its response in light of experiences elsewhere such as in Europe, but not wishing to wait for cases to develop before acting.
Africa has a population of approximately 1.3 billion. It is a very young continent, with a median age of 19.7 years compared to 40.5 years in the UK. Some 43.8% of the population is urban compared to 83.2% in the UK. These data may be contributing to the apparent relatively low impact of the virus across Africa thus far. As recently as May 8, Dr Matshidiso Moeti, director of the World Health Organisation (WHO) Africa region claimed,
“While Covid19 likely won’t spread as exponentially in Africa as it has elsewhere in the world, it likely will smoulder in transmission hotspots……Covid19 could become a fixture in our lives for the next several years.”
Unfortunately, the days following this message has seen significant growth in cases. Exponential growth is by no means off the table and many commentators now believe the peak may be four or more weeks away.
Whereas European countries have considerable data from testing, African countries have much less data upon which to base policy. Latest data suggest that across all 54 African countries, only around 1 test per thousand people has been carried out compared with 50 per thousand in the UK. While a debate rages in the UK about the lack of testing, by comparison a truly calamitous situation exists across Africa. Nonetheless, via such testing Africa declared 107,747 cases with 3,257 deaths by 24 May.
In many areas, from number of deaths from the virus to rates of transmission (Ro), the lack of reliable data is a major concern. Attempts are being made by WHO to address matters, but under capacity cannot be expected to be resolved in the short term.
Economic challenges in the wake of the pandemic are likely to be more severe in Africa than in Europe. A major concern is debt. Ethiopia’s Nobel Prize-winning Prime Minister Abiy Ahmed has forced a recognition that 64 countries across the globe have spent more on servicing external debt in 2019 than on health, leaving them completely unprepared for a pandemic. Almost half of those countries are in sub-Saharan Africa. Unsurprisingly voices are therefore being raised calling for debt write offs for the most vulnerable.
However, over the last two decades Africa has increasingly been reliant on lending from China to the tune of approximately $150billion, with Angola, Ethiopia, Kenya and Zambia amongst those most exposed. And China is proving a tough partner. It rarely does debt write off and it is already clear it will be negotiating on a country by country basis.
Furthermore, even before Africa gets near to reaching the pandemic peak, there have been considerable hits due to impacts elsewhere. Collapsing oil prices have severely impacted on Africa’s largest country, Nigeria. There has been a collapse of high value foreign tourism throughout sub-Saharan countries. Added to this, the lockdowns now in force are pushing millions into ever more extremes of poverty.
Further, the World Bank has recently forecast sub Saharan African countries will see remittances from African migrants back home drop by 23.1% in 2020. Nine countries in sub-Sahara Africa received over $1billon in such remittances in 2019, the most prominent being Nigeria ($23.8 billion), Ghana ($3.5 billion) and Kenya ($2.8 billion). In South Sudan, remittances of $1.3 billion accounted for 34% of its GDP. In 7 sub-Saharan countries remittances accounted for over 10% of GDP. As jobs are lost in large numbers throughout the developed world, migrant labour will suffer for the foreseeable future.
With rising demand and rising prices internationally for medical equipment, PPE, tests and the like, it is little wonder many African countries under the burden of extreme financial pressures are finding it difficult to compete for supplies.
However, it would be wrong to suggest that Africa is merely a passive victim of Covid19. There are innumerable stories of communities being innovative actors in the face of the challenges being faced. With an estimated 1500 to 2000 spoken languages across Africa, there are examples of translators volunteering unpaid to translate public health messages, of local businesses making jerrycans available for hand washing, of the fledgling 3D printer community turning efforts towards making PPE equipment, of tailors in informal settlements making face masks and freely distributing them, and of the motorcyclist strapping speakers to his bike and going into traditional communities with public health messages.
At government levels too, there is evidence of taking immediate action guided both by experience elsewhere and WHO messaging. Take the example of Namibia. As I write it has been 45 days since the last of its 16 detected case of Covid19 was identified. Its first two cases were identified on March 14 and the government immediately suspended air travel. Schools were closed and large gatherings prohibited. Three days after the first cases a state of emergency was declared and by 27 March a lockdown was announced. The sale of alcohol and inter-regional travel was forbidden. The key message “Stay at home” became central to the communication strategy.
However, with Namibia, Lesotho, South Africa and others beginning to loosen lockdowns, there is considerable concerns that, if the peak has yet to be reached, such moves may prove premature
Health services vary enormously across Africa, from relatively advanced health systems such as in South Africa, to those that were nearing collapse even before Covid19 arose; South Sudan being a case in point. The dangers faced by hospital workers are very real and varied, from having to work without PPE, to facing physical attack by security forces, most notably in South Sudan.
Hospital capacity is weak throughout most of Africa. For example, Senegal has 0.3 beds per 1,000 people compared to almost 4 per 1000 in Scotland. In other words, Senegal has only 8% of bed capacity compared to Scotland.
The continent is also highly dependent on imports of medical supplies with an estimated 94% coming from countries that have been hit by the pandemic, many of which are now limiting exports to protect domestic supplies. Much of the press in the UK feed the narrative of how bad it is to export while demanding more action to import equipment.
Structural problems and food security
The pandemic therefore magnifies Africa’s structural weaknesses, which make self-isolation and lockdown measures costly and hard to implement. Some 60% of the world’s poorest people live in Africa and the majority of the workforce is in the informal economy.
Let me turn finally to the challenge of food security.
There is already rising poverty in Africa as a consequence of the pandemic. Global economic conditions combined with lockdowns are destroying the incomes of millions. This will inevitably lead to rising instances of famine and death. David Laborde Debucquet of the International Food Policy Research Institute claimed in April of this year that 79 million people in sub-Saharan Africa could be affected by famine, while David Beasley of the World Food Programme told the UN Security Council that in addition to the threat to health posed by the virus, the world faces “multiple famines of biblical proportions within a few short months,” which could result in 300,000 deaths per day.
Already food protests have been breaking out in a number of countries, from South Africa to Zimbabwe where three women leaders of a protest against poverty and hunger have gone missing since 8 May.
Furthermore, sub-Saharan Africa is home to large numbers of refugee camps, which according to UNHCR are housing 26% of the world’s refugees. In many camps there is little access to basics. The Guardian, reporting from the Nabadoon camp in Somalia back in March claimed “few can afford soap and water is rare”. As a mother was quoted as saying, “I am very scared about this deadly virus…..It is like we are waiting for death to come”. Social distancing in such camps is well-nigh impossible. Health care support is inadequate. It is understandable then that Amnesty International has claimed “Lockdowns and movement restrictions have exacerbated dire living conditions in refugee camps around the world, leaving millions of people at risk of starvation and illness.” Few would disagree.
Finally, a range of “natural” phenomena are adding to problems, the most obvious being the current invasion of huge swarms of desert locusts across east Africa. Kenya, Ethiopia and Somalia are particularly hard hit. The region’s growing season is underway and the swarms continue to grow. Swarms of desert locusts can swell to 70 billion insects and can destroy 136,000 tonnes of crops in a single day. Experts predict up to 25 million people could be pushed into hunger. Efforts to control the invasion are taking place, but the lockdown, social distancing and the difficulty of procuring chemicals are added burdens.
We face great challenges at home, but spare a thought too for our African cousins.