Around the world, the COVID-19 outbreak is putting significant strain on countries’ health-care systems, economies, and social fabric. In the months ahead, African countries will face many of the same issues, as well as some impacts that are unique to the continent.
Health-Care System. Given the low capacity of the health-care systems in most parts of Africa and the prevalence of other serious illnesses, COVID-19 could quickly overwhelm the system. That’s because the disease has symptoms that are similar to those of other common illnesses treated at the primary-care level, spreads easily through a population, and has high rates of complication and mortality for the elderly and for people with co-morbidities. At the same time, it will be difficult to deploy certain major mitigation measures in Africa. Consider social distancing. In African cities—and particularly in tightly packed informal settlements—keeping people apart is no simple thing. And although people are relatively dispersed in rural areas, communicating information about social distancing in order to change behavior there will be challenging. Furthermore, many people in Africa do not have food supplies on hand and rely on daily wages to survive, making it impossible for them to stay home for an extended period.
If health-care systems in the region become overwhelmed, the consequences could be dire. First, deaths among patients with other illnesses could spike, and other types of public health measures could falter. Second, citizens’ distrust could increase, leading patients who need treatment to avoid seeking care. During
the 2014 Ebola crisis, a lack of trust in the health-care system contributed to the spread and lethality of the disease. Third, the capacity of the already weak health-care system could erode further if large numbers of health-care workers fall ill.
Economy. COVID-19 will undoubtedly depress economies in Africa, as it continues to do around the world. An economic slowdown will trigger revenue declines for small businesses and larger companies operating in Africa, including those in the tourism industry. Citizens will face job losses and reduced wages as companies lay off workers, and as workers operating in the informal economy lose income as well. At the same time, foreign direct investment in the continent will likely stall.
The likely impact on the agricultural sector is more complicated. The pandemic could disrupt food supply chains and trade. In particular, misinformation, panic, or unexpected border disruptions could trigger prices shocks—already a risk due to recent desert locust activity. In 2014, during the height of the Ebola outbreak, rice prices increased by more than 30% in the three worst-hit West African countries (Guinea, Liberia, and Sierra Leone). On the other hand, if borders remain open and trade continues to flow reasonably well, countries in Africa could hold up better than economies in other parts of the world because demand for agriculture products across the continent and globally would remain high.
Companies and governments are likely to face shortages of cash and working capital. If African economies slow significantly, tax receipts will drop, limiting government liquidity. That, in turn, could hamper governments’ ability to pay for the workers, infrastructure, and supplies needed for the emergency response and to provide economic stimulus to mitigate a serious economic downturn. Several African countries are already implementing shelter in place or lockdowns, so these liquidity issues could surface quickly.
Society. As COVID-19 cases grow and the health-care system and economy come under intense pressure, several social challenges will emerge. Families may lose incomes and have trouble acquiring food and other basic necessities. Family structures may suffer significant disruption as people are lost to the disease; and community cohesiveness may break down as governments prohibit gatherings, funerals, and other events that reinforce bonds. At the same time, misinformation and conspiracy theories may spread, and unrest and crime may surge as people grow more desperate, intensifying fear in communities.
The disease’s spread could also increase social inequity, in the same way that HIV/AIDS had a major and disproportionate impact on specific vulnerable and marginalized populations. In the case of COVID-19, school closings may disrupt school-based nutrition programs and children’s learning. At the same time, existing socioeconomic inequity will inevitably lead to disparities in people’s access to health care, food, and supplies. And interventions such as shelter in place could exacerbate inequity by reducing wages for workers, especially those in the informal sector.
The novel coronavirus has arrived in Africa—and the outbreak will look different there than in other parts of the world. Consider the demographics. COVID-19 has exacted a heavy toll among older patients in most countries, but Africa has a young population, and younger people who contract the disease seem to fare relatively well. However, Africa will face unique challenges, too. Health-care systems on the continent remain weak and will not be able to handle a widespread outbreak. In addition, many people there have serious health issues—such as HIV, tuberculosis, or acute malnutrition—that make them vulnerable to other illnesses. And social distancing will be difficult to establish in Africa, particularly in poor populations that need daily income to survive. As a result, the death toll in Africa is likely to be concentrated among the malnourished, the sick, and the poor.
