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1 [1] (August 4, 2021)

handle is hein.crs/goveefy0001 and id is 1 raw text is: $ Conressina Reeac Servic 0 Updated August 4, 2021 Coronavirus Disease 2019 (COVID-19): Impact in Africa Sub-Saharan Africa has confirmed fewer COVID-19 cases and deaths per capita than other regions, but many countries have faced a deadlier third wave of cases since mid-2021. As of July 2021, southern African countries had the highest per-capita caseloads (and had also administered the most tests). Public health experts have expressed acute concerns about the regional surge in both cases and deaths, which they attribute to the spread of the highly transmissible Delta variant and public fatigue with infection control restrictions. Most governments in Africa have struggled to secure vaccines. Total cumulative confirmed cases and deaths remain concentrated in a handful of countries, led by South Africa (Fig. 1). Studies suggest that case data may be underreported in many countries, and experts warn that asymptomatic transmission may have hidden the scope of the spread while allowing for potential virus mutation. Figure 1. Total Confirmed Cases and Deaths in Africa As of 7/22/21 %of Cases % of Deaths (Total cases: 4,492,322) (Total deaths: 109,107) Africa 51.8% Africa 62.%5 Ethiopia 6.2% Ethiopia 4.0% Kenya 4.3% Kenya 3.5% - Zambia 4.2% Zambia 2.9% Nigeria 3.8% Zimbabwe 2.6% Other 29.7% - ther 24.5% Source: CRS graphic based on data from World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. Impact. The pandemic has exacerbated health system constraints in many African countries, infecting over 115,000 health workers and disrupting routine health services such as childhood immunizations. Some infection prevention measures have been difficult in areas with limited access to clean water and sanitation, including crowded urban settlements, prisons, and humanitarian settings. Still, many countries' quick initial responses to the pandemic, youthful populations, and other factors may have averted worse public health scenarios to date. Falling global prices and demand for key natural resource exports (especially oil and certain minerals), disruptions in trade and tourism, reduced remittances from African workers abroad, and local lockdown measures severely affected African economies in 2020. The World Bank estimated in April 2021 that COVID-19 had pushed up to 40 million more Africans into extreme poverty. The World Food Program reports that the pandemic is contributing to a rise in severe food insecurity in parts of Africa. Economic hardships and anger at state-imposed restrictions have fueled recent protests and unrest in several countries (e.g., Senegal and South Africa). Vaccine Distribution and Access Fewer COVID-19 vaccine doses have been administered per capita in sub-Saharan Africa than in other regions (Fig. 2). As of mid-July 2021, about 52 million people in Africa (including North Africa) had received at least one vaccine dose (representing about 1.6% of the world's vaccinated people) and about 20 million (1.5% of Africa's population) were fully vaccinated, according to the World Health Organization (WHO). Among countries with over a million people, Mauritius, Zimbabwe, and Eswatini have reportedly obtained the most doses per capita in sub-Saharan Africa. South Africa has obtained about 6.1 million doses, or about 11 per 100 people. Eritrea has not sought vaccines; in a shift, Tanzania and Burundi began to do so in July 2021. African governments have secured COVID-19 vaccine doses via the multilateral COVAX initiative, direct purchases, and bilateral donations. China has reportedly donated the most doses bilaterally (at least 3.4 million total for 24 sub-Saharan African countries); the United States has donated more doses overall but has channeled them through COVAX. The World Bank and Afreximbank (a regional trade financing institution) have helped finance pooled purchases. As of July 30, COVAX had shipped at least 27.3 million vaccine doses to sub-Saharan African countries. COVAX currently aims to provide 850 million doses to Africa (including North Africa) by April 2022-enough to vaccinate 30% of eligible countries' populations-after India's restrictions on exports of Indian-manufactured vaccines delayed planned deliveries in early 2021. The emergence of new variants, vaccine hesitancy, logistical challenges, receipt of nearly-expired vaccines, and other factors have further constrained vaccination campaigns. Figure 2. Vaccine Doses Administered per 100 People Europe and Eurasia 95.0 East Asia and the Pacific 73.4 Western Hermisphere 6.4 South and Central Asia 243 Near East 22.3 Sub-Saharan Africa 2.6 as of 7/28/21 Source & Notes: CRS graphic based on WHO data. Regions follow State Department definitions. Total number of doses administered, including single- and two-dose regimens. African Government Responses to COVID-19 Public Health Responses. The African Union's Africa Centres for Disease Control and Prevention (Africa CDC, founded in 2015 with U.S. and Chinese support) has helped build African countries' capacity to detect and respond to COVID-19. The Africa CDC also helped launch the nonprofit Africa Medical Supplies Platform and African ittps://crsreports.congress.gov

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