COVID-19 In-depth Analysis

Africa and the implications of a second wave of COVID-19 infections

While Africa has demonstrated a degree of resilience against the COVID-19 pandemic to date, this progress could be affected by a potential second wave of infections. If such a second wave is even worse than the first, which seems to be the pattern in Europe, it will have serious implications for Africa’s health systems, as well as its economy and the growing debt crisis. This situation presents additional challenges for the Africa Centres for Disease Control and Prevention (Africa CDC), which has thus far played a leading role in coordinating prevention measures and promoting a coherent African response.

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Photo: USAID in Africa
Photo: USAID in Africa

The second wave of COVID-19 infections in Europe, which in some countries has seen infection rates worse than the first wave, represents a worrying trend for Africa. Speaking at a press conference on COVID-19 in Ethiopia, director of the African CDC, Dr John Nkengasong, called on African governments to remain cautious and warned of a significant recent increase in COVID-19 infections. This echoes an earlier warning by the World Health Organization (WHO), in early October, for Africa to continue to exercise caution amidst a seemingly downward trend in infection rates over the past few months.

The second wave of COVID-19 infections in Europe, which in some countries has seen infection rates worse than the first wave, represents a worrying trend for Africa

The warnings come at a time when several African states have reopened their borders, relaxed lockdowns and removed restrictions on gatherings. According to the recent Africa CDC Outbreak Brief 43, there was an increase in reported cases during October 2020. This could be indicative of the start of a second wave of cases on the continent. Thus far, the countries that account for approximately 86% of newly reported COVID-19 cases include Morocco (41%), South Africa (12%), Tunisia (10%), Kenya (8%), Algeria (5%) and Ethiopia (4%), which places these states at the forefront of a renewed phase of infections.

The Africa CDC has coordinated several initiatives and has taken measures that may strengthen Africa’s resilience if it has to manage a significant second wave of infections. In an effort to encourage a standardised and evidence-based approach to public health practice to minimise infection, the Africa Joint Continental Strategy for COVID-19 Outbreak has been developed. This provides a platform for cooperation and coordination among member states, and relies on the political will and ability of states to share information in a timely manner.

The development of an Africa Task Force for Coronavirus (AFTCOR) – comprising state public health representatives, non-governmental organisations, research institutions, Africa CDC staff and multilateral organisations – brings together key stakeholders to promote capacity building, provide coordination and identify urgent needs within the member states. The Africa CDC’s multi-actor approach is also used to accelerate testing on the continent, and aims to deploy one million community health workers for testing by the end of 2020, as well as to train 100 000 healthcare workers. Its target to conduct 10 million COVID-19 tests has been supported by the Partnership to Accelerate COVID-19 Testing (PACT): Test, Trace, Treat. This initiative aims to boost the continental capacity to test and reduce COVID-19 transmissions by bringing together health practitioners, community workers and testing supplies. In addition to this, the Africa CDC Consortium for COVID-19 Vaccine Clinical Trials (CONCVACT) has been developed to support high-quality vaccine clinical trials in Africa, as well as to encourage initiatives taken by African manufacturers.

The Africa CDC has also facilitated the establishment of the Africa Medical Supplies Platform (AMSP) to support the procurement and supply of COVID-19-related medical equipment. Its purpose is to provide immediate global and continental access to suppliers and service providers. This may be useful in mitigating risks associated with the problematic personal protective equipment (PPE) tender processes seen in some African states. Lastly, the Africa CDC has developed the Africa against COVID-19 initiative, which focuses on addressing the economic impact of the pandemic on the livelihoods of African people by harnessing digital solutions to ensure the efficient movement of people across borders. This is key to promoting economic activities that can counter the impact that COVID-19 has had on the livelihoods of African people and on regional trade, as well as fuelling Africa’s debt crisis.

The impact of a second-wave of COVID-19 infections on Africa’s debt crisis

The COVID-19 pandemic forced countries around the world to make a choice between lives and livelihoods. Many countries in Africa and around the world chose to enter into lockdowns to protect the capacities of their healthcare systems and to ensure that they were not overwhelmed. However, the lockdowns resulted in many countries in Africa facing economic challenges, especially those that did not have strong economies prior to the COVID-19 pandemic. For example, in 2017, Ghana had a national debt level of 70% of its gross domestic product (GDP) – 30% above what the International Monetary Fund (IMF) deems feasible for developing countries. In Angola, by the end of 2020, it is expected that the country’s debt will be 120% of its GDP, which is an even larger burden during a pandemic than it would be in “normal” times. Angolan donors have pledged to relieve the country of US$6.3 billion in debt over the next five years; however, this is not enough to fully mitigate the challenges that Angola’s economy faces. Zambia is another example of economic strife on the continent, as the state is on the brink of defaulting on its loans – it was unable to pay its US$40 million debt service payment due last month.

More broadly, the IMF has estimated that Africa needs US$410 billion to pay off all foreign debts by 2023. Avenues for income generation to pay off the debt have been hindered as a result of the pandemic. Countries that are rich in minerals and hoped to raise money off their raw materials have been negatively affected by drops in prices and restrictions on the movement of goods. The drop in oil prices in 2020 has resulted in a decrease in revenue and a reduction of projected GDP growth for countries such as Angola, Gabon and Congo-Brazzaville. Gabon’s finance minister, Jean-Marie Ogandaga, explained that “if you suddenly get half your salary, you can’t just continue to pay your debts as if nothing was wrong”.

The IMF and the World Bank have indicated their intention to assist African states to deal with the debt crisis, while the G20 has allowed heavily indebted countries to suspend the repayments of loans until June 2021. However, some countries have taken further loans during the pandemic, only adding to the debt problem on the continent. While a freeze on loan repayments may relieve the burden for the time being, it does not produce sustainable debt relief, nor does it address issues of revenue generation on the continent. In the end, the large amounts of money needed to service debts, coupled with money lost to corruption and increased expenditure to combat COVID-19, has made it difficult for African states to service those most in need. Therefore, a second wave of COVID-19 may only serve to increase social tension and entrench poverty, unemployment and inequality among African societies, as well as between African countries and other parts of the world.

Dr Andrea Prah is a researcher at ACCORD, and Katharine Bebington is an intern at ACCORD.

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