Why Sub-Saharan Africa needs a unique response to COVID-19

COVID-19 medicine

(Credit: Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Neema Kaseje, Founder, Surgical Systems Research Group


  • Malnutrition and disease means COVID-19 could be more deadly in Africa than elsewhere in the world.
  • Health systems in Africa have limited capacity to absorb the pandemic.
  • The strategic approach should focus on containment and aggressive preventive measures.

As of 29 March 2020, there have been more than 680,000 confirmed cases of COVID-19 disease in 203 countries around the world.

On 11 March, the World Health Organization characterized COVID-19 a pandemic. Africa was initially spared, however this is changing rapidly. In the last two weeks, the number of affected African countries increased from 9 to 41. As people continue to travel, it is only a matter of time before COVID-19 spreads to the rest of the 54 countries on the continent. As I write this from Monrovia, Liberia – a country whose health system has suffered enormous challenges due to civil wars and the Ebola epidemic in 2014 – I am compelled to highlight that one size does not fit all, and special considerations need to be taken into account as we develop the COVID-19 response for Africa.

Number of countries in Africa with COVID-19 cases.

The continent’s population and health systems make it different from other regions that have experienced COVID-19 to date. Three factors are important at the population level.

First, the continent’s demographic structure is different from other regions in the world. The median age of the 1.3 billion population in Africa is 19.7 years. By contrast, the median age in China is: 38.4 years, and the median age in the European Union is: 43.1 years.

What is the World Economic Forum doing about the coronavirus outbreak?

A new strain of Coronavirus, COVID 19, is spreading around the world, causing deaths and major disruption to the global economy.

Responding to this crisis requires global cooperation among governments, international organizations and the business community, which is at the centre of the World Economic Forum’s mission as the International Organization for Public-Private Cooperation.

The Forum has created the COVID Action Platform, a global platform to convene the business community for collective action, protect people’s livelihoods and facilitate business continuity, and mobilize support for the COVID-19 response. The platform is created with the support of the World Health Organization and is open to all businesses and industry groups, as well as other stakeholders, aiming to integrate and inform joint action.

As an organization, the Forum has a track record of supporting efforts to contain epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched – bringing together experts from government, business, health, academia and civil society to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.

Experiences in Asia and Europe showed that people over 60, and those with significant health problems are most vulnerable to severe cases of COVID-19. Although Africa’s youth may be considered a significant protective factor in the pandemic, how the virus will evolve and manifest itself on the continent remains unknown.

The second factor within the population is the high prevalence of malnutrition, anemia, malaria, HIV/AIDs, and tuberculosis. Liberia, for example, has one of the highest rates of stunting in the world: one in three children under five years old are stunted. In recent weeks, we have witnessed an increase in the incidence of malnutrition. Moreover, the rainy season has come early this year, which means that malaria cases will rise rapidly and peak malaria cases in 2020 may coincide with the ongoing COVID-19 pandemic.

We should therefore anticipate that in Africa a higher incidence of severe forms of COVID-19 will occur in younger patients because of the demographics and associated endemic conditions that affect the immune system. Malnutrition, anemia, malaria, HIV/AIDs, and tuberculosis are likely to increase the severity of COVID-19. Africa may not see the same narrative of “most people who get it will be fine” play out.

Third, social cohesion and social gatherings are of great importance in Africa. For example, weekly attendance of a religious service is highest in Africa with rates as high as 82% in Uganda and Ethiopia. As a result, measures to impose social and physical distancing may prove to be more challenging, as demonstrated by the protests that broke out on 20 March 2020 in Senegal after public gatherings, including gatherings at mosques were banned as cases of COVID-19 rose. Earlier this week, Tanzania came under scrutiny when it was announced that the country will not close places of worship.

Weekly worship attendance highest in sub-Saharan Africa.

There are two major health system factors that will make the COVID-19 response in Africa more challenging. First, the continent is experiencing the double burden of diseases: in addition to dealing with these endemic infectious diseases, health systems in Africa are facing non-communicable diseases, including injury, and cancer. As a result, the health systems are stretched thin to begin with, and there is very little room to absorb the COVID-19 pandemic.

Second, the capacity to provide critical care is the lowest in the world. Severe forms of COVID-19 lead to respiratory failure requiring ventilation support. The ability to treat severe forms of COVID-19 will depend on the availability of ventilators, electricity, and oxygen. A recent analysis of countries with the highest numbers of intensive care beds per capita does not include any country from Africa. In Liberia for example, there are no intensive care units (ICU) with ventilators. Uganda has 0.1 ICU bed/100,000 population. In contrast, the United States has 34.7 beds/100,000 population.

The countries with the most critical care beds per capita.

Lessons learnt in Italy and China are extremely valuable. However, they cannot be extrapolated directly to Africa because of these differences in demographics and health system constraints.

Because health systems in Africa are strained to begin with and have very limited capacity to absorb the pandemic, the overall strategic approach should focus on containment and aggressive preventive measures.

Early and aggressive physical distancing and frequent handwashing will prevail as the most effective and affordable interventions for the continent, with parallel testing, contact tracing, and isolation of cases. For aggressive preventive measures to work, we will need the full support of populations. Full support of populations can only be achieved with community engagement and strong health leadership.

Furthermore, given the youth of the continent, youth leadership and engagement will be critical for prevention and containment activities. And lastly, given the priority given to religious services, religious leaders will need to participate actively in the COVID-19 response. At the health system level, operating rooms and teams could be reorganized and repurposed to build critical care capacity in district hospitals.

The African context is unique. There are population structure differences, high prevalence of endemic diseases and the double burden of disease, with health systems that are stretched thin with minimal critical care capacity.

A robust COVID-19 response for the continent will need to take these factors into account and include community engagement, health leadership, and involvement of youth and religious leaders to drive containment. At the health system level, temporary repurposing and reorganizing of the surgical system will be key to increasing critical care capacity during the response, focusing on what we have as we move forward.

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Climate emergency: City mayors are ‘world’s first responders’, says UN chief

On Grexit: Incompetence just launched the historic Ultimatum that could open “pandora’s box”

Deal on EU funds for common asylum, migration and integration policies up to 2027

4 key steps to support cross-border payments and digital trade growth

Five-year low inflation for Eurozone and now Mario has to finally wake up the Germans

Future EU-UK Partnership: European Commission publishes draft legal text

Human rights breaches in Iran, Egypt and Tanzania

Data show EU Economy in a stubbornly subdued state

Key elements of the EU-China Comprehensive Agreement on Investment

Assembly President launches new initiative to purge plastics and purify oceans

Responsible Artificial Intelligence

Coronavirus: Commission unveils EU vaccines strategy

You can live up to 10 years longer by doing these 5 things

Deepening Europe’s Economic and Monetary Union: Commission takes stock of progress

EU Parliament says ‘no’ to austerity budget

European Youth Forum warns of a Peter Pan generation as a result of financial crisis and response to it

ECB’s €1.14 trillion again unifies Eurozone; Germany approves sovereign debt risks to be pooled

There is no patient safety without healthcare workers’ safety

How Egypt’s economy can continue to thrive during a global pandemic

Rising number of young people excluded from jobs, education and training

Over 85% of European bathing sites rated as excellent for water quality

Back to school: Schoolchildren to receive milk, fruits and vegetables at school thanks to EU programme

Mental health and suicide prevention

Your recycling actually gets recycled, right? Not always, says this report

The three US financial war fleets

A conceptual approach to Violence Against Healthcare in Turkey from SDG’s

Plan for troop pullback ‘now accepted’ by rival forces around key Yemen port, but fighting intensifying elsewhere, Security Council warned

EU makes key TTIP document public as protests get louder

Regional policies slowed down by EU bureaucracy

“We always honor our words, and in that respect we expect our partners to honor their words as well”, China’s State Councillor and Foreign Minister Wang Yi highlights live from Brussels

European Union supports survivors of sexual violence in conflict

Europe slammed by Turkey’s shaky Erdoğan; both playing with immigrants’ agony

Workers want flexibility. After COVID, they just might get it: Poll

How do we upskill a billion people by 2030? Leadership and collaboration will be key

The ASEAN Community sees the light: the genesis of a new powerful economic and political bloc and EU’s big opportunity

Collaboration and connectivity at ITU Telecom World 2019

Coronavirus: EU grants €314 million to innovative companies to combat the virus and support recovery

Global ageing is a challenge – and an opportunity

South Sudan’s women caught up in ‘futile man’s war’ UN gender equality chief

Why growth is now a one way road for Eurozone

UN rights chief denounces Burundi for ‘belligerent and defamatory’ attack on inquiry team

Skills: Five new cross-border collaboration projects selected for Erasmus+ funding to develop excellence in vocational training in Europe

To build a resilient world, we must go circular. Here’s how to do it

This is what great leadership looks like in the digital age

How to rebuild trust and integrity in South Africa

International community agrees on a road map for resolving the tax challenges arising from digitalisation of the economy

Terrorist content online: MEPs agree to start negotiations with EU countries

Code of Practice on Disinformation one year on: online platforms submit self-assessment reports

Air Pollution Control: Does Your Action Matter?

Zuckerberg, a paella, and the mighty EU questionnaires that would stop Whatsapp acquisition by Facebook?

How start-ups will lead India through the Fourth Industrial Revolution

Ukraine: Is there a political force able to undo the division?

Cybersecurity Act: build trust in digital technologies

Is our brave new world about to burst?

Vestager vs. Google: a fight to ensure a competitive innovation framework

Coronavirus in Brazil: mental health in tragedy

This Dutch company has devised an innovative way to deal with food waste

The European Union and Central Asia: New opportunities for a stronger partnership

Here’s why e-mobility must be at the heart of the green recovery

How COVID-19 is making companies act for the long term

More Stings?

Advertising

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s