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1 [1] (December 22, 2021)

handle is hein.crs/govehdl0001 and id is 1 raw text is: Congressional Research Servioe Informing the legislative debate since 1914 Updated December 22, 2021 Coronavirus Disease 2019 (COVID-19): Impact in Africa In December 2021, the World Health Organization (WHO) warned of a fourth wave of COVID-19 cases across much of Africa, notably in southern Africa. This followed South Africa's genomic identification and notification to international health authorities of the new Omicron variant, first detected in Botswana. Public fatigue with infection control measures, the Delta variant, and low vaccination rates helped drive earlier waves of cases in many African countries in 2021. Omicron's rapid spread prompted countries around the world (including the United States) to restrict travel from southern Africa, which African leaders decried as punitive and discriminatory. Overall, confirmed cases and deaths in sub-Saharan Africa (hereinafter, Africa) have been lower than in other world regions and concentrated in a few countries, with the majority in South Africa (Figure 1). As access to testing has been low in many countries, some health experts posit that actual caseloads and mortality may be higher. Figure 1. Total Confirmed Cases and Deaths in Africa as of 12/15/21 % of Cases (Total cases: 6,349,628) S Guth Africa 50.5% Ethiopia 5.9% Kenya 4.0% - Nigeria 3.4% Zambia 3.3% Other 32.8% % of Deaths (Total deaths: 151,314) > Lth Africa 59.6% Ethiopia 4.5% Kenya 3.5% Zirbabwe 3.1% arnbia 2.4% Other 26.8% Source: CRS graphic based on WHO COVID-19 Dashboard data. Impact. The pandemic has exacerbated health system challenges in many African countries, infecting health workers and disrupting routine health services, such as childhood immunizations and malaria and tuberculosis treatment. Some infection prevention measures have been difficult to implement in areas such as crowded urban settlements, prisons, and humanitarian settings. Still, many countries' quick initial responses, youthful populations, and other factors may have averted worse scenarios to date. The pandemic's economic impact in Africa has been severe. It initially caused a drop in global demand and prices for African natural resource exports (especially oil and some minerals), disrupted trade and tourism, stemmed remittances from African workers abroad, and prompted local lockdown measures. Some African economies began to rebound in 2021, but the region is recovering more slowly than others due, in part, to African governments' limited stimulus resources. The effects of increased poverty, food insecurity, and school closures (often without virtual options) are likely to endure. Vaccine Distribution and Access African countries have obtained far fewer COVID-19 vaccine doses per capita than other world regions (see Figure 2) due to limited financial resources, delays in donor-pledged deliveries, mass procurement of vaccines by wealthier countries, and supply chain constraints. In addition, India, a major source of vaccine production for developing countries, restricted vaccine exports for much of 2021 to meet domestic demand. Vaccine supplies have increased in recent months, but logistical challenges, shortages of syringes and other commodities, and donations of nearly expired doses have hindered vaccination campaigns. Some African countries also have faced significant vaccine hesitancy. In addition to the humanitarian toll of the virus in Africa, some experts assess that the scale of unmet vaccination needs in the region may facilitate virus mutations. Among African countries with over a million people, Botswana (47%), Lesotho (29%), Rwanda (28%), and South Africa (26%) had fully vaccinated the largest share of their populations as of mid-December, according to WHO data. At the other end of the spectrum, fewer than 1% were fully vaccinated in Burundi, the Democratic Republic of Congo (DRC), and Chad, and fewer than 2% in Africa's largest country, Nigeria. Eritrea has not released data. Figure 2. Global Vaccination Rates by Region At Least One Dose ® Fully Vaccinated Share of population as of 12/15/21 0% 25% 50% 75% 100% Sub-Saharan Afric East Asia & Pat eI _________ Europe & Euraia Ew .s___ Nr East a South & Central asia Western Hemisphe Source: CRS graphic based on WHO COVID-1 9 Dashboard data. Notes: Regions follow State Department definitions (with the addition of the United States to Western Hemisphere). African governments have secured COVID-19 vaccine doses via the multilateral COVAX initiative, direct purchases, and bilateral donations. The United States has donated the largest number of doses to African countries of any government, followed by China. The World Bank and Afreximbank (a regional trade financing institution) have financed pooled purchases by the African Union (AU). In late 2021, amid ongoing challenges with vaccine supply chains, COVAX reduced its COVID-19 vaccine provision target for Africa for 2021 from 600 million doses to 470 million. In November, the AU and COVAX assailed the majority of vaccine donations to Africa to date as having

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