COVID-19 IN AFRICA: Challenges and opportunities 

By Paul Ejime*

By Paul Ejime

THat the COVID-19 pandemic has negatively impacted the world to the extent of defining how humans live, work and play is no longer news. Within several months, the deadly virus has claimed close to 300,000 lives from the more than four million people infected worldwide. By 11 May, 53 countries in Africa accounted for 2,290 of the deaths and 21,821 recoveries from 63,235 cases of the infection. But the more significant concern now is the plague’s end-date, how nations can cut their losses, with an anticipated second-wave, mitigation of devastation; recovery and how to navigate the complicated and unpredictable post-COVID-19 era.

For Africa, the prognosis for these imponderables could not be bleaker from political governance to the socio-economic ecosystems, health infrastructure and medical care improvement, the conduct of businesses and corporate institutions, religious life, family units and inter-personal relationships.

Even before the pandemic, the existential architecture in many African countries had been on life support. The nations’ mostly monolithic commodity, raw material-dependent economies are shackled by foreign debt peonage, corruption, mismanagement and underwhelming growth rates.

Technological development is lagging, and with the so-called brain-drain syndrome, the best of Africa’s skilled personnel in almost all aspects of human endeavour are either in Europe or America. But on the other side of this gloomy picture exacerbated by the pandemic lies immense opportunities. The task is about identifying and utilising the lessons learnt to turn a new page for immediate, short and long-term benefits.

Beginning from the health sector, so much has been said and written about the continent’s weak health systems; the poor healthcare delivery compounded by the highest of the disease burden of all regions. There is also the suffocating unacceptable levels of poverty and hunger and displacements caused by socio-economic and political upheavals. A situation where a small fraction of the population enjoys the best healthcare, including the luxury of medical tourism while the majority of the citizens cannot access simple pain killers in the nondescript settlements called hospitals is no longer tenable.

A situation where, according to the World Health Organisation (WHO), malaria kills some 423,000 people in Africa or 94% of the 450,000 annual deaths worldwide, especially pregnant women and children under-five is unacceptable. Apart from the human costs, malaria drains more than US$12 billion annually from Africa in hospitalisation, drugs and lost person-hours. This is in addition to the continent’s disproportionate fatalities from Neglected Tropical Diseases (NTDs) such as Lassa fever, cholera, typhoid, river blindness, meningitis and trachoma to name but a few. Instead of the huge unjustifiable sums devoted to the salaries and allowances of politicians, the health sector must get more than the minimum 15% of the national budgets. According to the World Bank’s figures for health budget percentage to GDP in Sub-Saharan Africa in 2016, only Sierra Leone with 16% met that mark, Nigeria, Africa’s largest economy, budgeted less than 4% and the figure hovered between 3% and 10% for other countries in the region. Africa is not good with data and statistics. Still, a rough estimate would show that millions of scarce foreign exchange, which would have been saved from medical tourism in the past few months of the global lockdown, should go into improving the health sector.

Ironically but thanks to the coronavirus pandemic, African governments must now realise the urgent need to partner with African skilled labour scattered abroad to improve and strengthen the health systems within the continent. As Africa continues to sleep at the wheel, there is the usual mad rush to develop therapeutic remedies and vaccines for more dramatic diseases such as HIV/AIDS, SARS, Ebola and most seasonal flus. However, not for malaria, which is more lethal in the continent and is as old as its colonial history.  Also, why is Africa, with its abundant human resources in the medical field, now waiting for COVID-19 treatment and vaccine from abroad?

The continent is also short on the development of molecular and diagnostic laboratories, disease surveillance and epidemiology, but even more worrisome is the negative attitude and reactions by Africans towards efforts to produce drugs or remedies by fellow Africans. For instance, Madagascar has come up with a possible treatment, the CVO Organics for COVID-19, Senegal is reported to have produced cheap testing kits and ventilators. The Ewu Monastery in Nigeria’s Edo state and the country’s renowned scientist Prof Maurice Iwu have offered suggestions about a possible cure. But unprofessional criticisms, cynicism and condemnations have trailed these efforts instead of Africa mobilising its medical institutions and scientists within and outside the continent to examine the efficacy or otherwise of these products. That is not the way to go. About 80% of the African population relies on Traditional or Alternative medicine for their medical care, just as 70% of the population are involved in agriculture, albeit mainly at subsistence level. Why can’t the continent harness its rich endowments and resources to end the dependence on imports? There are also opportunities for Africa to develop or improve its e-medicine infrastructure.

On the economic front, instead of effective collaboration, many African countries often choose to go it alone mainly to satisfy the selfish interests of the policy-making politicians at the expense of their countries. No wonder the COVID-19 pandemic has compounded the weakness of the economies of many African countries, particularly the oil-dependent nations and other commodity producers. The prices of the commodities, including cocoa and cotton, among others have crashed at the world market following the global lockdown. The need for diversification of the economies is the usual mantra, but minimal action is taken in terms of implementation. Drastic change is not only urgent, but it is now or never. The continent cannot continue to sell its commodities at give-away prices only to buy the processed by-products at cut-throat rates. Why, for instance, must oil-rich Nigeria continue to refine its crude abroad, or depend on oil revenue for ages? The same argument goes for cocoa, gold, copper and other minerals. DR Congo is rich in gold, but this has enriched its former colonial power Belgium, while Congolese citizens wallow in poverty.

Why is intra-African trade struggling in comparison to the ever-increasing commercial exchanges between African countries and the outside world, even in a world governed by the principles of regional integration?

The situation must change in the post-COVID 19 era so that more African countries can trade more effectively among themselves.

The World Bank’s data shows that the total external debt for sub-Saharan Africa jumped by nearly 150% to US$583 billion in 2018 from US$236 billion ten years earlier. Doubtless, this will hinder the continent’s response to COVID-19 pandemic. It is bad enough to continue to incur external debts, but Africa’s usual practice of calling for debt relief now and then is not only embarrassing but shameful. The COVID-19 pandemic is a wake-up call for the continent to ‘think without the box,’ look more inwardly; produce what it needs and consume what it produces instead of running up unsustainable debts that have not positively impacted the living conditions of its long-suffering 1.3 billion population.

In the running of government affairs, corporations and even small businesses, positive lessons from the pandemic are legions. Governments and businesses must innovate and evolve creative ways for sustainability and survival. So much can be achieved using technological tools for virtual/online applications, including for teleconferencing instead of physical contact meetings. Some jobs might be erased, but hard choices are required for the sake of national and corporate survival and the protection of lives and livelihood.

Also, in the education sector, while most schools in Africa are under lock and key, many institutions of learning outside the continent are running using online learning and teaching applications. The opportunity has presented itself for Africa to leapfrog its technological advancement, to scale-up internet penetration and improve e-learning and teaching, which is also tied to improvement in the electric power supply in the region. Workers do not necessarily have to work from offices. The COVID-19-induced Work From Home (WFH) initiative can be explored to maximise its benefits while at the same time addressing the concerns of workers that are likely to be impacted negatively.

Even in the faith or religious sphere, the restrictions on mass gathering and closing of places of worship might seem insensitive and anti-religion. But on profound reflection, smart faith leaders can see a silver lining in innovative and creative ways of worshipping God, who is everywhere and not necessarily at Olympic-size worship centres. There could be an innovative way to marry e-worshipping with limited mass gathering and physical contacts in the post-COVID-19 era.

Even in the entertainment industry and sports, recalibration of practice and presentation has become inevitable for survival and sustainability.

What about the impact of the COVID-19 pandemic on the family units and inter-personal relationships? Many family members have lost their jobs, but the WFM initiative also has its advantages. Sociologists and social workers have always decried the many anti-social vices associated with the fact that family members do not spend quality time together. Restaurants have replaced the more nutritious home-cooking, while many parents, not necessarily by choice leave home when their children are still in bed and only return when the children are already asleep.

Many spouses have thus welcomed the fact that the lockdown might have contributed to more excellent bonding of families. So, COVID-19 could be a blessing in disguise, but whatever gains are achieved should continue beyond the lockdowns.

One crucial missing element from the COVID-19 pandemic response in Africa is unambiguous messaging and effective communication by governments and their agencies to assist the population. Outbreak or Crisis Communication emphasises the development of suitable strategies, incorporating behaviour change and action plans for implementation.  Equally critical is public sensitisation and enlightenment to get the citizens’ buy-in, ownership and to ensure that they take responsibility with voluntary compliance.

The implementation of effective communication strategies will also help to bridge the yawning confidence gap or mutual mistrust between African governments and the citizens. Without proper or clear messaging, government efforts and COVID-19 response have appeared chaotic and ineffectual. No matter their best intentions, the authorities cannot carry the citizens along if the latter feel alienated. Also very pronounced in many African countries during the pandemic period is the misuse of emergency powers by governments and the attendant violations of human rights. Citizens will most likely support government policies and measures where the reasons for such measures are transparent, effectively communicated and in simple languages.

Like most plagues, COVID-19, whether a pandemic or ‘plandemic,’ as some conspiracy theorists have claimed, will end at some point. But some of its impacts would linger with humanity for some time to come. Physical distancing will surely cease, and this must not be confused with social distancing because a world without social networking will be painful to contemplate. Another COVID-19 pandemic new normal is hand washing. This was very effective during the last Ebola virus pandemic and must be encouraged as part of the post-COVID-19 collective and personal hygiene survival tool. Cleanliness they say is next to Godliness.  This is also essential for good health and to keep away diseases.

Above all, the COVID-19 pandemic has rekindled the positive values of humanity. Amid the tragedies are also success stories involving miraculous recoveries, humanitarian and philanthropic gestures and the heroism of health workers, first responders, and many extraordinary feats. And let’s not forget those still struggling with the infection and families that have lost loved ones without saying their last goodbyes because of the imposed isolation or quarantine. These are all warriors in a war against an invisible enemy and deserve appreciation and commendation for turning adversity into an opportunity for good!