/ 24 March 2020

Covid-19: Why it is so difficult for Africa to ‘flatten the curve’

Zimbabwe Health Virus Covid19
A medical staff member washes her hands at the Wilkins Infectious Diseases Hospital in Harare on March 11, 2020, as they demonstrate their state of preparedness to treat the Covid-19 coronavirus. (Jekesai Njikizana/AFP)

Covid-19 has now hit more than 40 African countries, with almost 2 000 confirmed cases as of March 23. So far, the coronavirus has been slow to spread across Africa, but there are several factors unique to the continent that could make it difficult to reduce the rate of infections — and make the pandemic more deadly for Africa than for other continents.

A major factor is the near-impossibility of social distancing in many African societies. Most communities harbour a strong social culture and are built around extended family ties. In many cases, children are taken care of by grandparents. Much of the urban population lives in informal settlements where it is impossible to distance yourself from your neighbours. Conflict, poverty and natural disasters have left 18-million people internally displaced or seeking refuge in other countries, many living in camps with little or no water, low sanitation, and non-existent healthcare.

This is complicated further by the porous nature of African borders. Most of the current confirmed cases are from travellers outside the continent. The low volume of international mobility may have temporarily spared Africa, for now. However, once the pandemic does take hold, it will be difficult for most African countries to enforce a lockdown: the frequent and poorly governed movements across borders among kin communities and pastoralists who remain outside the purview of states could make the propagation of the virus transnational.

With nearly broken public-health systems, deprived public-health sectors and a very small number of specialised hospitals, there is little capability for identification, testing, confirmation, isolation and treatment of those people infected. Taking the experience of those countries already affected, the preparations and current intensive-care capacity in Africa pales in comparison to the oncoming infections. South Africa, the most prosperous African country, has declared the pandemic a disaster and it is employing its emergency fund. South Africa has about 5 000 intensive-care unit (ICU) beds. Sudan, for example, is estimated to have just 40 ICU beds in public hospitals.

Beyond the virus

Beyond the effects of the virus itself, Covid-19 is likely to have severe knock-on effects for African health systems, potentially destroying recent gains. And what about the populations that are already reliant on humanitarian aid? With donor countries trying to mobilise all their resources to fight Covid-19 in their own jurisdictions, long-term projects in Africa risk being abandoned (for instance, the United States recently recalled all of its 7 000 Peace Corps volunteers, who were working in 60 countries around the world, including 26 in Africa).

This is all before the economic cost of confronting the pandemic has been accounted for (South Africa, the continent’s second-largest economy, on Monday announced a 21-day lockdown, the economic impact of which will reverberate far beyond its borders); or the political and security costs, because the pandemic makes it more difficult for the continent to address conflict and poor governance.

That last issue is crucial: in many cases, poor governance is the reason why African countries are not prepared for the pandemic. But governance — good governance — is also the only way to make it through this difficult time intact.

Many African states, especially the ones in conflict, are strong in the wrong functions of state. Resources are poured into government security, governing parties and the interests of select individuals or groups. At the same time, these states are weak on the functions of state necessary to ensure human security, such as health, education and trust — precisely the functions necessary during this crisis.

The reality is that markets will not salvage societies during calamities such as this one. States that have human security as their central mission might. But, largely thanks to the misguided prescriptions of dominant powers, some African states have been reduced to “police states”, which are strong only when it comes to securing and maintaining their own power, unconstitutionally. The structural adjustment programmes pushed by global governance institutions such as the International Monetary Fund and the World Bank have led to the end of many social and health services in Africa.

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The roles of African states have been minimised; non-state actors, mainly due to international support, offer many of the services that states are supposed to provide. Several Western initiatives, including the Washington Consensus, arrived to empower civil society organisations to deliver most of the soft security — and, in some cases, hard security — in the name of private security firms. Done at the expense of states, this has resulted in weak and non-viable states, most often unable to carry out core state functions that could have endowed them with the legitimacy that is desperately required in times of crisis. African states became fragile with limited control of the means of violence and their territories, leading to the ungovernable spaces where most population displacement occurs. 

A common continental position

With a shortage of good governance at a national level, the need for good governance on a continental level has never been more important. Fortunately, there is a roadmap to improve governance in Africa during times of crisis. It needs to be implemented urgently. When it comes to humanitarian crises, the 2016 Common African Position on Humanitarian Effectiveness is designed to enable African Union member states and regional economic communities to predict, prevent, respond and adapt to humanitarian challenges. It prioritises the coordination of cross-border responses and the facilitation of intra-Africa and inter-African aid and information sharing.  

More generally, the AU provides a necessary collaborative platform in which layers of responsibility extend upwards through authorities, national states, regional economic communities and the international community. The AU is also important when it comes to diplomatic initiatives aimed at diffusing volatile situations, enhancing intra-regional and international co-operation, and improving member states’ capacity for timely and efficient response to Covid-19.

One concrete initiative could be to establish a transnational body consisting of heads of state and governments to co-ordinate a response to Covid-19, both within states and across borders.

After all, a transnational threat such as the coronavirus can be combated only by effective transnational governance.

Mehari Taddele Maru is part-time Professor at the Migration Policy Centre of the European University Institute. He is a member of the technical committee of the Tana High-Level Security Forum.