Robert Rotberg is the founding director of the Harvard Kennedy School’s Program on Intrastate Conflict, a former senior fellow at the Centre for International Governance Innovation and president emeritus of the World Peace Foundation.
In a devastatingly interconnected world, there is no escaping the spread of COVID-19 into all of Africa, with reverberating consequences for its 1.3 billion inhabitants – and for the rest of us. At the end of March, Africa had fewer than 5,000 cases and a smattering of deaths across almost all its 54 countries. Those are low numbers compared with the rest of the world, but testing is still limited outside of South Africa. The African pandemic is in its very early phases. Experts predict a tsunami of cases in three weeks.
The coronavirus was late in reaching Africa, where there are few human or physical resources to combat the virulence of the virus – precious few medical facilities or trained medical personnel, little equipment, grave shortages of water, hardly any electricity – and too many leaders who may not be taking the disease as seriously as they should. Corruption abounds, too, even in and around hospitals. (Health ministers and officials in Zimbabwe got fancy new cars last week while their hospitals ran out of essential medicines.)
These are parlous times for many millions of people who still suffer the scourge of HIV/AIDS, endure malaria, forlornly try to combat multidrug-resistant tuberculosis, recently conquered Ebola for the second time and are still savaged by schistosomiasis and a host of other parasitical and worm-induced diseases. Lassa, a hemorrhagic disease like Ebola, has even returned to scar and kill across northern Nigeria. More African babies die from pneumonia than any other ailment, and dysentery is rife. Compromised immune systems are everywhere, ready for the new coronavirus to invade.
China, Europe and North America locked themselves down in an attempt to contain the virus. Africa is trying to copy that method in the hope of doing the same. But isolation may lead to unforeseen deaths among the very young and the elderly, from enforced neglect and starvation.
South Africa has more than a third of the confirmed cases on the continent and many of the earliest deaths. Egypt and Nigeria have fewer, but also few tests. South Africa has ordered its 57 million citizens to stay in their homes for at least three weeks. President Cyril Ramaphosa has put strict limits on gatherings and movement and has instructed the army to patrol. Shots were fired last weekend to enforce his curfew. Residents of the country’s overcrowded cities, with cheek-by-jowl slums, have been instructed to leave their homes only to purchase food, seek medical care or collect welfare grants. Mr. Ramaphosa has closed restaurants, liquor stores and pubs. Even walking a dog off one’s own property is prohibited. Apartheid was less restrictive.
Zimbabwe has also told its inhabitants to stay indoors and the copper-producing province of Katanga in the Democratic Republic of the Congo has done the same, shutting its mines. Malawi is on disaster footing, with its 16 million people on full pause.
Kenya has banned the import of second-hand clothes (hitherto a thriving trade, involving millions in that country and in others), forbidden religious gatherings (one of the major vehicles of spread in Africa, as in South Korea), suspended all international flights (as Ethiopia and Uganda have done) and introduced an overnight curfew preventing movement. Like Uganda, it has also shut schools. Rwanda has closed its borders. Sierra Leone has declared a 12-month-long state of emergency. Senegal and Côte d’Ivoire have done the same. But Tanzania’s autocratic President, John Magufuli, in profound denial like a few other global leaders, has refused to close churches, declaring that the virus is the devil and cannot survive within holy surroundings.
Lagos, the largest city in Nigeria and Africa, has closed its markets (which are being fumigated) and its courts. Abuja, the national capital, is imposing a curfew. Meanwhile, prominent Nigerians, including three state governors and an adviser to the President, have tested positive. Côte d’Ivoire, Mauritania, Burkina Faso (hit hard after church leaders brought the coronavirus back from France), Senegal and Sudan are also under lockdown.
Social distancing worked in South Korea to slow the spread of the virus, and China’s severely restrictive containment policies seem to have halted its otherwise exponential proliferation of cases. But about half of Africa is urban, with a heavy proportion of slums where people live in close quarters, sometimes six to 10 people to a room. Social distancing in any meaningful sense is impossible, except in sparsely populated rural areas (but not in its larger villages). Furthermore, social distancing could be fatal for babies and the elderly, who depend on care.
Nor are African leaders finding it easy to persuade their populations to take the new virus seriously. After all, death is more common in Africa than in developed countries such as Canada or Italy. What might work in Canada will not necessarily succeed in much of Africa. The lockdowns may be too late, as well, given the speed and persistence of the coronavirus.
Africa has hardly any ventilators and few masks relative to new needs (despite generous gifts from China). It has few intensive care units or beds in such units. Already patients sleep on the floors of too many African hospitals. More consequential than those deficiencies, Africa lacks physicians and nurses and sometimes has shortages of medical supplies and basic equipment. Across the continent, there are only 0.19 physicians per 1,000 people. The United States, Britain and Canada have about 3 per 1,000. The global average is about 1.2, though 2.28 is the acceptable global norm. There are many more African medical personnel in Toronto than in dozens of African countries. Nurses and doctors have long been on strike in Zimbabwe.
Personal hygiene is also difficult, with as few as 20 per cent of inhabitants in a typical slum having regular access to piped water. And there may be no soap. Washing hands frequently is impossible and showering is a rare privilege.
The coronavirus may devastate African populations and slow the continent’s anticipated surge in population (from 1.3 billion today to 2.6 billion in 20 years). Fortunately, Africa has proportionally fewer elderly inhabitants than other continents. Its median age is about 20, compared with the 40s across the northern hemisphere. If the young are relatively spared, Africa may survive the virus. If heat and humidity moderate its deadliness, that may help. But both are unproven and unlikely hypotheses.
The coronavirus is apt to wreak havoc in Africa. But that conclusion is based both on the probable mortality consequences and the almost certain economic results. Already the poorest continent, with 50 per cent or more of its peoples subsisting on less than US$2 a day, Africa is losing almost all of its tourist income and many of its export markets and is poised to forfeit remittances (5 per cent of GDP overall and up to 23 per cent in some countries). Manufacturing has ceased. Oil prices are already at rock bottom, and Angola, Nigeria and several other countries only exist economically because of their petroleum revenues. Algeria depends on natural gas exports, which are now paused.
In short, Africans will die from the new disease and (with adults succumbing) will be unable to grow enough food to feed themselves or to afford food from abroad. No African country – not even Egypt– has a real social safety net. And only one, tiny Seychelles, has offered to pay workers who have lost their jobs.
African states from Ethiopia to Senegal are asking for international help. What Africa needs now is debt cancellation and promises of budget support. But in a world plunged into recession, if not depression, pledges of assistance are scarce. These are frightening times for the entire world, no less so for the weakest and poorest continent. Will the wealthier world help those who are poor and in need?
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