Africa Surpasses One Million Cases as Pandemic Expands to Rural Areas

With 17% of the world’s population, countries in Africa account for only 4% of reported cases and 3% of COVID-related deaths globally. Researchers have not been able to explain what the WHO Regional Director for Africa described as a “slow burn” in early August despite the continent surpassing one million cases. Various hypotheses are being explored, including the continent’s youthful population, the possibility of a certain degree of ‘herd immunity’ from past exposure to other coronaviruses, or a lack of adequate disease surveillance.

Two studies published this month, however, suggest that Africa’s infection rate may be significantly higher than the official figures. The South African Medical Research Council, reviewing mortality trends, recorded over 41,000 “excess deaths” between May 6 and August 25, 2020 compared to last year, indicating a steeper pandemic trajectory. The researchers also reported that 40% of pregnant women as well as people with HIV/AIDS that visited public health facilities in Cape Town had SARS-CoV-2 antibodies. In another study, blood samples of Kenyan blood donors tested between in the first two weeks of May found that 5.6% had antibodies for COVID-19, while almost 10% of donors in Mombasa were positive, significantly higher than Kenya’s official infection rate at the time (2093 cases, 71 deaths).

With almost half of all cases, South Africa remains a particular concern, as the WHO earlier this month dispatched a surge team to support pandemic response efforts in the country. Additional resources have been deployed in other countries as the burden of infections spreads beyond major cities to rural areas, increasing the need for decentralized testing, tracing, isolation, and treatment beyond urban hubs.

The continent’s pandemic response funding gap is expected to exceed US$100 billion annually over the next three years. So far, the World Bank, the IMF and the African Development Bank have disbursed about US$60 billion to countries in Africa. That sum is slightly lower than the estimated $65 billion monthly cost of lockdowns, as the IMF projects economic activity in Sub-Saharan Africa to contract by 3.2% this year alone. Many of these developing economies will need significant capital bases to frontload pandemic preparedness and response capacity, as multilateral development banks and the international community have been urged to take bold, innovative, and expeditious action. Among the proposals is another replenishment round for the World Bank’s International Development Association, as well as new allocations of the IMF’s Special Drawing Rights that currently exceed US$129 billion.