February 14, 2020 was the day that the first case of Covid-19 was reported in the Africa Continent, and this was in Egypt, today almost every country in the continent has registered Covid-19 cases with the WHO. With Africans nations embracing the new normal and reportage indicating declining trend in new cases across much of the region, seven countries, including Benin, Eritrea, Eswatini, Liberia, Nigeria, Sierra Leone and South Africa are showing
an increase of more than 20% in cases.
A slight increase in deaths was also reported. South Africa has seen an increase in weekly cases for the second consecutive week. Even with a declining trend across the African region, the high number of cases reported globally still pose a risk for the region. Additionally, three countries have very high rates of community transmission and are of serious concern.
Testing in most of the African countries has seen Multidimensional challenges such as lack of trained manpower and health infrastructure. The Lancet indicates slow testing, with 17 countries reporting less than the recommended ten to 30 tests per case.
The Africa Centre for Disease Control and Prevention has rolled out several initiatives targeting surveillance and testing, medical supplies, vaccine trials, public health, and social measures for saving lives, economies, and livelihood.
The continent has been engulfed with lots of challenges ranging from lack of funds, low healthcare workforce, and its high burden of disease.
The pandemic has further aggravated the challenge adding to the existing double burden of communicable and non-communicable diseases along with poverty, poor health literacy, and weak health systems.
The Johns Hopkins Center for Health Security publication reported African continent is least prepared to respond to health emergencies, treat the sick and protect health care workers, The weak healthcare system and high prevalence of malnutrition, malaria, HIV/AIDS, and tuberculosis are further challenges.
Moreover workers are also facing mental stress, physical exhaustion, and separation from families; therefore, this calls for their safety and mental well-being.
Social and religious gatherings are not uncommon in Africa. Many countries have banned such gatherings and this has received resistance from some people across the region thus affecting physical distancing. Family clustering, poor health literacy, infodemic and poverty may also contribute to a poor response. The lockdowns and stay-at-home strategy have halted business activities making the poor the most vulnerable to the economic consequences, posing further challenges to adhere to precautionary measures. Price hikes for masks and hand sanitizers have also been reported. The presence of porous borders and congested cities and slums are also some of the issues facing some African countries.
The aggressive second wave of the Covid-19 came knocking in the Continent with many more cases by the end of 2020 as compared to the first wave.
Many factors were responsible, including less stringent public health and social measures, COVID-19 variants, and lockdown fatigue. but Improved monitoring of COVID-19 data and local solutions may have kept the continent safe from exposure to third wave.
COVID-19 has caused substantial disruption to health services in African countries. According to a modelling study by the Lancet an increase in deaths of up to 10 percent, 20 percent, and 36 percent due to HIV, tuberculosis (TB), and malaria respectively during the pandemic for low- and middle-income countries was reported in the continent.
With the ravaging Covid-19 Sub-Saharan countries needs to prioritize access to insecticidal nets and antimalarial treatment to prevent malaria epidemics with a study from Kenya conducted indicating that long-lasting TB burdens about 25,000 additional cases due to the lockdown disruptions.
The pandemic has led to disturbance in the provision of HIV services in Sub-Saharan Africa adding to the HIV death burden. Another analysis of HIV treatment indicated that a disruption in treatment caused by COVID-19 could result in an additional 500,000 HIV deaths In Africa.
HIV remains highly prevalent in sub-Saharan Africa with over 25·7 million (uncertainty range 22·2–29·5) people estimated to be living with HIV in the region in 2018. Concern exists that possible disruptions in HIV programmes due to COVID-19 could affect HIV-related mortality and new infections. Negative effects of the COVID-19 epidemic on access to health services have begun to emerge. A survey of people living with HIV run by the Human Sciences Research Council in South Africa via a social media platform found that 13% of people said they did not have access to their chronic medication during lockdown, with some reports in the area as of May, 2020, showing that only 30–50% of patients were collecting their medication.
A recent report by UNDP, analyzing the long-term socio-economic impact of COVID-19 in the African continent conceptualizes across three systems: Human, domestic, and international flow effects. The study states that all these factors are interlinked, with effects on human health such as changing patterns of mortality and morbidity, while simultaneously decreasing economic activity and affecting the international economic system. The long-term impact of COVID-19 will push back the gains and lead to increasing child mortality and poverty by 2025 and 2030. The report calls for increased investment in health infrastructure, children, and youth to minimize the indirect economic and health impacts on future generations.
Women and children have also been disproportionately affected due to the pandemic in the African continent. With COVID-19 pushing 150M people around the world into extreme poverty, many countries like Kenya and Nigeria have been adversely impacted.
The movement restriction due to the pandemic has had implications on food security too for Africa and has led to calls for strengthening food security and safety net policies and programmes.
The closure of schools has seen a direct impact on nutrition and the youth’s ability to earn, thus, leading to loss of human capital.
Antenatal care services have been grossly impacted during the pandemic due to lack of healthcare resources. A report from Kenya, Tanzania, and Uganda shows adverse impact of COVID 19 on antenatal services. This will further add to the high neonatal and maternal mortality rate in the countries, pushing back the target of achieving the SDG of reducing maternal mortality ratio.
Similar to the consequences of the Ebola outbreak, the COVID-19 pandemic has severely impacted mental health in Africa.
Healthcare workers, COVID-19 patients, children, youth, and the elderly suffer from anxiety and depression. The pandemic response should integrate mental health education and counselling along with psychosocial support during and after the pandemic.
Findings from Kenya, Uganda, and South Africa on the indirect heath effects of COVID-19 showed disruptions in essential health services, and the consequent adverse health effects of said disruptions. It suggests to invest in the generation of local data and evidence for both facility and community level to tailor response measures and recovery efforts.
An online survey conducted in East and West Africa finds peer-to-peer communication beneficial in promoting COVID-19 policy compliance. according to the survey, while there is widespread knowledge that physical distancing reduces the spread of the virus, respondents underestimate their peers’ support for policies designed to enforce physical distancing, expect others not to practice physical distancing, and do not maintain physical distance themselves. However, more than half of respondents wrote a message to encourage others to practice physical distancing. Findings from survey experiments suggest that making salient the social and material costs for not keeping physical distance were insufficient to encourage compliance, suggestive of the absence of a social norm of physical distancing at the time.
While the pandemic has negatively affected the health and economy of many countries, it also provides an oppurtunity to reshape healthcare systems.
The WHO regional director for Africa Matshidiso Moeti during a press conference earlier this year supported implementing universal health coverage programmes, emphasizing primary and preventive healthcare as well as digital innovations and better preparedness for epidemics.
The COVID-19 vaccination drive has been off to a slow start since it began on 1 March 2021. The vaccination rollout has been varied across the African continent mainly due to scant supply of vaccines and financial crunch of vaccine shipment through COVAX has further added to Africa’s woes.
“The COVID-19 vaccination drive has been off to a slow start since it began on 1 March 2021. The vaccination rollout has been varied across the African continent mainly due to scant supply of vaccines and financial crunch.”
As of May 10, most African countries had begun vaccination but nine countries have administered less than a quarter the doses received, and 15 countries have given half of the doses received. Reasons for slow rate of vaccination are in-equal distribution of vaccines, lack of healthcare infrastructure, and vaccine hesistancy and skepticism, to name a few. Africa’s vaccine coverage is the lowest at about eight doses as opposed to the 150 doses per 1,000 people being administered globally.
Another constraint on vaccination is from the evidence of increased breakthrough rates of coronavirus variant BNT162b2 on Pfizer-BioNTech vaccinated individuals.
A recent study in The Lancet on impact and effectiveness of BNT162b2 variant of concern on coronavirus cases, hospitalisation, and deaths suggests effectivity of vaccine across age groups in preventing both symptomatic and asymptomatic SARS-CoV-2 infections.
An increase in vaccine coverage have been found to decrease incidence of infection.
COVID-19 has further exposed weaknesses in African economies and heightened healthcare deficiencies. The World Bank Group speculates that Africa requires US $100 billion to tackle COVID-19 impact across sectors.
Africa needs to scale up and adapt safety net programmes and ensure food security to overcome the impact of the pandemic on their livelihoods. A review of the impact of the pandemic on equitable access to essential medicines and vaccines for universal health coverage in Africa calls for a multipronged approach for sustainable healthcare reforms; and minimizing social and economic risk associated with the pandemic.
Investments and reforms in health-and social care and harnessing innovations like e-health is the need of the hour for a robust and sustainable recovery from COVID-19.
In Conclusion, Most African countries have set up measures to respond to the 2019-nCoV pandemic. However, these efforts are not without challenges. It is important for Africa to continue to intensify efforts and address the challenges to effectively respond to the uncertainty the pandemic poses. This also calls for a unique approach to ensure a proactive response. Early isolation, effective knowledge sharing, contact tracing, good reporting and surveillance system, parallel testing, collaborations and cooperation within and outside the continent, sustained community engagement and diseases prevention and control measures, including physical distancing and proper hand and respiratory hygiene should continue to be prioritized in the region.