Examining Africa’s Battle With COVID-19 – Analysis

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The devastation caused by COVID-19 in Africa, is made formidable not only due to weaknesses in healthcare systems, but also the precarity of economies, varying degrees of socio-political turbulence, as well as the inability of technology to buffer the impact of the crisis.

By Sangeet Jain, Meghna Chadha, Kwame Owino and John Mutua*

The COVID-19 pandemic has been widely described as unforeseen, and a “black-swan event”. It is, however, nothing of the kind.[1] Scientists had long warned the world about the eventuality of such a pandemic. It is therefore nothing short of a failure of policy for the international community to have been caught unawares by the magnitude of the COVID-19 outbreak.

For a long while, it seemed that the African continent had been spared the same magnitude of the pandemic that many countries in other regions were suffering. As of June 30, 2020, the continent had reported only 3.9 percent of the total global case count.[2] Since then, however, the crisis has caught up with Africa, and at the time of producing this report, there were 736,288 COVID-19 cases (5% of all cases globally) and 15,418 deaths in the continent. Among all African countries, South Africa (68.4 percent), Egypt (4.3 percent), Algeria (3.1 percent), Nigeria (3.2 percent), and Kenya (2.8 percent) accounted for 82 percent of all COVID-19 cases reported in the continent.[3]

This report provides an account of Africa’s battle against COVID-19, maps a profile of the continent’s vulnerabilities that render it susceptible to systemic collapse, and analyses ways in which it can build resilience in the face of future crises. The report takes a systemic perspective, and provides analyses oriented around four axes—health, economic, socio-political and technological systems; and three key elements—risk, response and resilience.

Even as the report is divided into these elements for purposes of clarity, it is crucial to understand the complex, interconnected nature of these systems. Inevitable trade-offs arise when crises hit, but their effects tend to cascade across systems.[4] The devastation caused by COVID-19 in Africa, for example, is made formidable not only due to weaknesses in healthcare systems but also the precarity of economies, varying degrees of socio-political turbulence, as well as the inability of technology to buffer the impact of the crisis.

An even more critical caveat relates to the scope of this report. The African continent is not a monolith, and capturing the nuances of its response to the COVID-19 pandemic is beyond the scope of a single report. It is therefore our endeavour to provide policy blueprints and recommendations in broad strokes, and map trends rather than magnify peculiarities.

Section I: Risks

The report opens with mapping pre-existing risks and vulnerabilities in Africa that the pandemic has the potential to exploit and exacerbate. Chapter 1 is a broad health and demographic profile of the continent. Prachi Mittal and Oommen C. Kurian analyse the demographic risks: including age distribution and population density, and healthcare risks: including the continent’s non-communicable disease (NCD) burden, access to clean water, food and nutritional insecurities, and its progress in achieving the Sustainable Development Goals. The chapter also analyses the gaps in health capacities in Africa: with a profile on hospital infrastructure and healthcare workers, and provides an assessment of healthcare expenditure.

Chapter 2 profiles the economic vulnerabilities of the continent. The continent’s experience with COVID-19 has been defined so far more by economic upheaval than overwhelmed healthcare systems, due to early lockdowns and the precarious nature of economies in the continent. The coming recession is likely to reverse hard-won development gains for Africa, pushing millions back into extreme poverty. The chapter draws an estimate of the differential impact of the pandemic on various economic indicators. High levels of debt and trade dependence are highlighted as particular weaknesses for African economies, leaving them overexposed to the virus’ impact. Annapurna Mitra and Alisha George draw some insightful conclusions, for instance, that the impact on growth so far has been most striking in relatively well-off countries in Africa, even as the impact on poverty levels is disproportionately worse for poorer countries.

Chapter 3 is an exposition of the political factors that may amplify and complicate response to crises in Africa. While these risks are not exclusive to the continent, the specificities of their manifestation in Africa is discussed. Leo Kemboi and Jackline Kagume argue that instability, corrosive corruption and conflict have rendered some states politically fragile, and they will require assistance to bolster state capacity and combat the pandemic effectively. Weak state capacities, corruption and neopatrimonialism encumber crisis response, as does the lack of political legitimacy and authority. The pandemic is only likely to exacerbate instability unless managed properly.

The world has turned to technology solutions to keep economies afloat as the pandemic struck. However, the shortcomings of Africa’s technology ecosystem have prevented it from leveraging the full range of benefits that innovation has to offer, in providing a buffer against the pandemic’s effects. In Chapter 4, Arjun Jayakumar discusses the nature of three broad technological risks faced by the African continent—i.e., low R&D capacity, a gaping digital divide, and poor technological capabilities.

Section II: Response

The second section of the report presents an analysis of Africa’s response over the first four months of the COVID-19 pandemic, along the four axes of health, economic, political and technological response. In many ways, Africa’s response to the pandemic was both timely and robust. As the first wave of the pandemic sweeps across the continent, an analysis of successful practices as well as erroneous steps which cost the continent over the past months, can help enable a much more informed response.

Chapter 5 presents an analysis of the healthcare response mounted by African countries, by examining indicators such as testing rates, the progression in clinical management of cases, private sector response, as well as the ways in which countries like Nigeria and Sierra Leone have leveraged their experience of tackling the Ebola and HIV epidemics, in managing the current pandemic. Meghna Chadha and Ananya Pushpa Gandhi provide an assessment of Africa’s response, including the importance of addressing stigmas and mental health as crucial elements of the healthcare response, and the need to train professionals accordingly. The chapter also provides insights into Africa’s progress towards developing a vaccine for COVID-19.

The world has responded to the wholesale economic devastation caused by the pandemic by deploying a range of ameliorative fiscal and monetary policies, and Africa is no exception. Noah Wamalwa, John Mutua and Raphael Muya summarise the fiscal, monetary and tax policy measures deployed by 31 African countries to tackle the economic impact of the COVID-19 outbreak in Chapter Six. The chapter also discusses the role of international support extended by the World Bank, IMF, African Development Bank and bilateral partners in addressing deteriorating fiscal positions and debt burdens across the region.

Chapter 7 provides a critique of the politics of pandemic response in Africa. Meghna Chadha discusses the range of measures deployed by countries to ensure compliance, from social distancing to the imposition of lockdowns. The chapter also includes an analysis of the best and worst performers in the region, and explores whether political regimes matter when it comes to crisis response.

The pandemic has catalysed the use of technological solutions across the world. In Chapter 8, Sadhika Sasiprabhu takes a sweeping look at the acceleration of innovation in Africa sparked by the pandemic. Crucially, technological innovation in the field of healthcare and diagnostics has tremendous potential to bolster weak healthcare capacities in the continent. The chapter demonstrates how a number of African countries have also deployed innovations in the field of contact tracing, e-learning, supply of essential commodities and e-commerce and e-money, to ameliorate the pain inflicted by COVID-19-induced lockdowns.

Section III: Resilience

The COVID-19 pandemic has revealed the state of unpreparedness of countries across the world. The upheaval presents an opportunity to recognise the pressing need to build resilience into the complex systems we inhabit, as we navigate the crisis and work to rebuild and recover from the devastation it has wrought.

In Chapter 9, Abhishek Mishra and Alisha George address the question of the moment: how to make Africa’s healthcare systems more robust and resilient to crisis. Their chapter analyses four significant elements of developing health resilience in the continent: household capacity, healthcare workers, training and capacity building, and financing. The chapter also analyses the role of international coordination in bolstering health-system resilience, and in this regard, explores the synergies and potential for cooperation between India and Africa.

Chapter 10 asks what building economic resilience implies for the African continent. Maureen Barasa, Annah-Grace Kemunto and Kwame Owino outline a number of policy priorities for Africa, in its quest to build back better after the COVID-19 pandemic. These include a drive towards structural transformation and economic diversification across the region, the need for social security frameworks to be strengthened and decoupled from formal employment, a green stimulus to help combat the looming climate crisis in time, a push towards investing in human capital and capabilities, resilience across production, banking and financial systems, as well as the dire state of debt unsustainability in the continent. The pandemic’s impact will affect the ability of African countries to work towards these goals, but with the state driving policy agendas proactively, economies can begin moving in a more sustainable direction.

Chapter 11 focuses on the underlying dynamic driving resilience across systems: socio-political resilience. The pandemic will be a stress-test for the strength of communities and political systems. The COVID-19 crisis has revealed that resilience is not only a function of better healthcare and economic systems, but is also fundamentally determined by political will and social cohesion. Sangeet Jain discusses the five critical components of resilience at the nation-state level in the African context: political legitimacy and trust, collaborative governance, leadership, combating corruption, and the need for transparent communication. The chapter also examines the role of global collaboration, knowledge-sharing mechanisms and foreign aid in enabling Africa to weather crises more effectively in the future.

The final chapter of the report, Chapter 12, envisions an agenda for building technological resilience in the African continent. Sangeet Jain and Sadhika Sasiprabhu offer a blueprint for fostering an inclusive, people-centred technological transformation, and the need to incentivise innovation that meets pressing societal needs. The chapter also discusses the key constraints for digitalisation in Africa, such as lagging investment and the digital divide, and advances policy recommendations to help circumvent them.

Read the entire report here.


Endnotes

[1] Bernard Avishai, ‘The pandemic isn’t a black swan but a portent of a more fragile global system’, April 2020.

[2] ‘Outbreak Brief 24: Covid-19 Pandemic’, Africa CDC, 30 June 2020.

[3] ‘Outbreak Brief 27: Covid-19 Pandemic’, Africa CDC, 21 July 2020.

[4] Tackling coronavirus: contributing to a global effort’, OECDJune 2020.

Observer Research Foundation

ORF was established on 5 September 1990 as a private, not for profit, ’think tank’ to influence public policy formulation. The Foundation brought together, for the first time, leading Indian economists and policymakers to present An Agenda for Economic Reforms in India. The idea was to help develop a consensus in favour of economic reforms.

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