Grim scramble in Africa to contain Covid-19 outbreak

Some African states are in lockdown, others are slow to respond. All are short of health supplies, writes Claire Keeton

05 April 2020, By Claire Keeton

You can’t go to war with a knife, without the right equipment,” says Kenyan health executive Amit Thakker, referring to Africa ’s shortage of supplies to fight the coronavirus pandemic. In the seven days to Tuesday this week, the number of confirmed Covid-19 cases in Africa more than doubled, from 1,998 to 5,287. In the same period deaths soared from 58 to 172. The 48 countries in Africa affected by Covid-19 wi l l need an estimated 8-million masks, 1-million tests “right now”, 1-million KN95 respirators, 500,000 protective suits, about 5,000 ventilators … and the list goes on, says Thakker, chair of the Africa Healthcare Federation .

Forewarned by the devastation in other regions, African health ministers responded early to Covid-19, meeting on February 22 to strategise against their common enemy, a virus that is slow to show its teeth. And until the threat is pressing and real, the need for social distancing to stay safe may be less compelling than the imperative to make money to survive. About one in three Africans live on less than$2 (about R35) a day, and many need to trade at markets to survive. Religious leaders still call on their congregants to gather to pray. Tanzanian President John Magufuli won’t close churches and has reportedly said that “corona is the devil and it cannot survive in the body of Jesus”. But if the virus fills African morgues to overflowing, it will be too late to contain it in high-density settlements, where clean water and sanitation are often scarce and isolation virtually impossible.

“My neighbourhood, even our house, has not had running water for more than a year now. Not a single drop, ” says Zimbabwean photographer Tafadwa Tarumbwa, from Chitungwiza, 30km south of Harare. “Some people are still gathering water at boreholes and wells. In the streets I’ve seen people carrying buckets of water,” he says. After Zimbabwe declared a 21-day lockdown, “Chi Town ”, as it is colloquially known, looked deserted. “I have not seen kids running around the streets,” Tarumbwa says. “I don’t know how long the large families here can keep themselves indoors.” Political, religious and community leaders are crucial to raise awareness — as they did with Ebola —that Covid-19 is a real danger, says John Nkengasong, director of the Africa Centres for Disease Control and Prevention (Africa CDC).

Volunteers distribute cleaning supplies and advice on protection against the coronavirus in a refugee camp in Mogadishu, Somalia, this week. Picture: Sadak Mohamed/Anadolu Agency via Getty Images

A devastating fight.
“We are at war with this virus and it will be a devastating fight,” he says, warning of the strain it will place on economies and on resources for programmes against other killer diseases, such as malaria. Nearly 70% of the world’s 38 million HIV/Aids infections are in Africa and about a third also have TB infections, which commonly causes lung damage. Two of Africa’s key sources of income — tou rism and the export of raw commodities — have been disrupted by the pandemic. Only three years old, the Africa CDC, under the banner of the African Union, has stepped up to lead the continent-wide response to Covid-19, which ranges from scientific interventions to a rumour-tracking system to counter misinformation . Garlic, lemon and ginger do not, for example, cure Covid-19, though Ethiopian church leaders — in pronouncements that stirred memories of Manto Tshabalala-Msimang — said they did, causing a spike in market prices for the items. ( SA’s former health minister recommended garlic, lemon and olive oil as a cure for HIV/Aids.)

“It is very important that we have an evidence-based approach, that countries have a scientific advisory group informing the decisions of leaders,” says Thakker. Before Rwanda had a single confirmed case, President Paul Kagame had put up portable hand-washing stations at Kigali’s central bus station and posted a video of himself washing his hands. On Wednesday the director-general of the World Health Organisation, Tedros Adhanom Ghebreyesus, said it was critical for African countries to be “well equipped to detect, test, isolate and treat cases, and identify contacts”, even though patient numbers were still relatively low. “It is encouraging this is occurring in many countries, despite limited resources,” he said, urging debt relief for Africa and calling for social welfare to protect the most vulnerable citizens.

Thakker, who is executive chair of Africa Health Business, a health management consultancy based in Nairobi, said private-public health partnerships were mobilising in Kenya to combat the pandemic. Health professionals in Kenya have provided free training to hotel staff in preparing 82 facilities for quarantine and about 1,200 people are working in a Covid-19 call centre. Raising funds is also key; the estimated price tag for supplies needed is $120m said Thakker. The African Covid-19 Response Fund kitty has about $12.5m to date. “The fund really has support from the heads of state. [President] Cyril Ramaphosa is leading this movement , ” says Thakker. “We need an African solution for the African continent.”

Global support of the kind that helped combat Ebola in West and Central Africa is unlikely to be repeated because every region is facing its own Covid-19 challenge. Chinese billionaire Jack Ma’s foundations, in response to an appeal from Ethiopian Prime Minister Abiy Ahmed, is providing health supplies for countries in Africa. Ethiopian Airlines has already delivered most of the gear, including diagnostic tests, masks and protective suits. The continent’s capacity to test for Covid-19 has ramped up over the past two months. At first only SA and Senegal had the capability, but now more than 40 countries do.

No copy-paste solution
The lessons the continent can learn from other regions hard hit by Covid-19 are important but they cannot be a “copy-paste solution”, says Thakker. “Political leaders must spread facts and not fear. We need to have clear communications, daily updates and a road map to prepare people to avoid social chaos . ” One of the possible advantages Africa has is the predominantly youthful makeup of its population, given that the virus appears to be most deadly against the elderly. In Africa, about 3% of the population is over 65, while in Europe the proportion is nearly 20%. For Tarumbwa, one of the notable effects of lockdown in Chi Town is that the dancehall songs and “young ghetto music” favoured by the youth no longer dominate the airwaves. “Now early in the mornings I’ve started to hear ‘grown – up ’ music in the air. The TV remotes and radio dials are now in the hands of the parents,” he says.