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Updated May 11, 2020
Novel Coronavirus Disease 2019 (COVID-19): Impact in Africa
As Congress considers the global impact of COVID-19,
some Members may examine the implications for sub-
Saharan Africa (Africa). Most African health systems
struggle with low capacity, trailing world averages in per
capita numbers of doctors, hospital beds, ventilators, and
oxygen cylinders. Although lessons from past disease
outbreaks (e.g., recent Ebola outbreaks) led some countries
to quickly ramp up disease surveillance and behavior
change campaigns, overall state capacity tends to be low.
Confirmed caseloads in Africa have been relatively low to
date, but may be underreported. The pandemic has
disrupted efforts to prevent and contain other diseases,
including polio, measles, malaria, and HIV/AIDS.
African countries with high rates of health conditions that
affect immune systems such as HIV/AIDS, tuberculosis,
diabetes, and malnutrition may face particular challenges
in curbing COVID-19 morbidity and mortality, despite
youthful populations. Infection control measures such as
physical distancing and frequent handwashing may not be
viable for those without access to clean water and
sanitation, or living in crowded urban settlements, prisons,
or camps and other settings for displaced persons. As of
2019, more than 24 million Africans were displaced due to
conflicts and disasters, and Africa hosted 26% of the
world's refugees, according to U.N. figures.
African economies have been severely affected. Global
prices for key commodity exports (e.g., oil, natural gas, and
certain minerals) have cratered. Job-rich sectors such as
transportation and tourism are largely suspended, and
remittances from African workers abroad have withered.
Informal workers have lost meager incomes due to COVID-
19 control measures, and prices for basic goods have risen.
In April, the International Monetary Fund (IMF) projected
that African economies would contract by 1.6% overall in
2020, the most severe regional recession in decades. The
World Bank estimated that 23 million more Africans could
fall into extreme poverty due to the pandemic.
The World Food Program (WFP) warned in March that
diminished local purchasing power, spikes in global food
prices due to export restrictions and speculation, and trade
disruptions could cause dire hardships in Africa. Food
insecurity was already extensive as of early 2020, including
in conflict-affected areas of the Sahel and East Africa
(which is also facing locust infestations), and in drought-
afflicted parts of Southern Africa.
Starting in March, most African governments imposed
restrictions on international air travel, border crossings,
large gatherings, and, in some cases, domestic travel. Many
closed schools, places of worship, and local markets; some
imposed curfews. (An exception is Burundi, where officials
have allowed large campaign rallies ahead of elections
slated for May 20.) Since late April, some African
governments have begun to loosen restrictions on religious
services and markets; a few have reopened schools.
Most African governments have allocated new budget
resources for their health systems, and many have pledged
tax relief and/or targeted financial or food aid for their
poorest or most vulnerable citizens (e.g., Kenya, Rwanda,
Senegal, South Africa). Some targeted aid efforts have been
supported by U.N. agencies, private firms, local civic
organizations, and diaspora groups. Some countries have
imposed trade restrictions (e.g., a ban on fuel exports from
Angola). Some governments have also cut top officials'
salaries (e.g., Kenya, Malawi, Rwanda, South Africa).
Several countries have pursued innovative pandemic
responses. Senegal is developing a cheap and rapid
COVID-19 test kit, while Rwanda and Ghana have
pioneered the use of drones to deliver medical supplies to
rural areas. Nonetheless, many African governments lack
sufficient domestic resources to import medical equipment,
cushion local economies, and build up food stocks. African
leaders have appealed for international aid and, in some
cases, debt relief in light of the impact of COVID-19.
In responding to the pandemic, some African governments
have invoked emergency powers, including, in a few cases,
the authority to issue legislative decrees (e.g., Senegal,
where parliament endorsed the move). State security forces
have injured or killed civilians while enforcing lockdowns
in some countries (e.g., Kenya, Nigeria, and Uganda).
Control efforts have resulted in restricted media access, and
crackdowns on COVID-19 fake news have raised
concerns from press freedom advocates (e.g., in Ethiopia,
Somalia, and Uganda). Residents have rioted against
lockdowns or the placement of treatment centers in some
countries (e.g., C6te d'Jvoire, Niger, and South Africa).
Health Aid. For more than a decade, about 70% of U.S.
annual bilateral aid for Africa about $5.3 billion in
FY2019 has supported health programs, primarily focused
on HIV/AIDS (see Figure 1). The State Department and
U.S. Agency for International Development (USAID)
administer these funds, and the majority of U.S. global
health assistance generally. Other federal entities such as
the U.S. Centers for Disease Control and Prevention (CDC)
also support related efforts, as well as U.S. emergency
responses to global disease outbreaks and pandemics.
The United States has committed more than $100
billion over the past 20 years to support public health
on the African continent-by far the largest donor
nation. [...] And those investments.., have built the
foundation for Africa to begin to battle this
coronavirus. - Administration telephone press
briefing on COVID-I 9 in Africa, April 22, 2020
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