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In this opinion piece, Prof. Agnes Binagwaho, MD, MPEd, Ph.D. The Vice Chancellor of the University for Equity in Global Health in Kigali, Rwanda, and her research associate Kedest Mathewos explain why African countries fared much better than their Western counterparts in the fight against COVID-19.
In 2019, the Global Health Security Index ranked countries based on their preparedness for pandemics. The United States was identified as the most prepared country, while most African countries were considered to be the least able to cope with any new health threats.
To further cement this perspective of Africa’s unpreparedness, Africa as a continent was predicted to have 10 million COVID-19 related deaths.
However, this prediction could not have been more wrong, as African countries contributed only 3.6% of COVID-19 cases and 3.6% of deaths from COVID-19 worldwide as of November 13.
In recent months, scientists, global health professionals and journalists have tried to explain Africa’s unexpected response to the pandemic. However, these explanations often fail to recognize the reasons behind the prompt response of African countries to the pandemic.
Over the last 11 months, we have seen that borders do not prevent the spread of this crisis, whether in the health or economic sector. The pandemic, which originated in Wuhan, China, in December 2019, has spread to more than 217 countries and territories to date. The economic crisis has not escaped any country, and the world economy is expected to contract by 5.3% this year.
In order to provide a concerted response to this global pandemic, African countries took advantage of continental and regional collaboration.
As early as February 4, 10 days before the first case of COVID-19 was detected in Africa, the African Centers for Disease Control and Prevention (CDC) established the Africa Task Force for the New Coronavirus to coordinate the response to the pandemic across the continent. .
On February 22, the CDC of Africa convened an emergency meeting with 55 ministers of health from across the continent to discuss the COVID-19 pandemic and agree on a strategy for the entire continent.
This strategy was based on preventing transmission and mitigating community spread to avoid overloading already stressed health systems across the continent.
This continental leadership has provided guidance to member states and ensured a concerted response to the pandemic.
This continental approach was combined with collaboration at the regional level. A good example is collaboration within the East African Community (EAC). Since the main objective of African countries was to prevent the spread of the virus, the EAC invested in the creation of a regional electronic cargo and driver tracking system to track COVID-19 cases across borders.
Some landlocked countries in this region, such as Rwanda, rely on cross-border truck travel to transport essential goods, such as medicines. Therefore, to prevent cross-border contamination, this system helps these countries to digitally share the COVID-19 test results of truck drivers and consequently to quarantine and treat those who had the infection.
This not only creates the channel for transparent information exchange, but also maximizes the use of the scarce resources required to test asymptomatic essential workers who may have had the virus. It also allows us to take them to treatment earlier, thus increasing the chances of recovery.
Additionally, within the framework of this initiative, truck drivers’ mobile phones are being used as tracking tools to track all places where drivers made a stop and ultimately protect communities. These collaborative systems contribute to a common understanding of the status of the pandemic in the region and provide countries with a tool to efficiently halt the spread of the pandemic.
While many countries in the Western world did not immediately implement the well-known evidence-based interventions, most African countries took this issue seriously to protect their populations.
Border blocks and closures were implemented very soon after the first cases were reported, to support the prevention strategy. Already on March 15, several African countries closed their borders, canceled flights and imposed strict blocking measures to prevent the influx of cases.
South Africa implemented one of the strictest lockdowns in the world on March 27, contributing to the infection rate decline from 42% to 4%. We can also take the example of Rwanda, which implemented a blockade on March 20, just 6 days after the first case was detected, and banned all non-essential travel within the country.
Key to Rwanda’s response was its ability to adapt quickly to changing contextual factors and emerging situations, for example, prolonging the lockdown in regions with a high incidence rate, opening those with lower rates, and closing popular markets. overcrowded and relocating merchants to smaller markets in less populated areas.
In addition to the implementation of lockdowns, most African countries were quick to adopt other evidence-based prevention interventions, such as hand washing, the use of masks and social distancing.
In Rwanda, the government communicated prevention guidelines through social media channels and other traditional media, such as radio, and leveraged community health workers to raise public awareness of the virus and the preventive measures.
Stations for hand washing were provided in public places and due to the closure of schools, student volunteers were used to encourage people to adhere to these guidelines.
This open communication channel and community involvement further increased community trust in the public health system, identified as the highest in the world by a Wellcome Trust study, and contributed to public adherence to the guidelines. prevention and response.
However, simply enforcing regulations is not enough to achieve compliance. In Rwanda, the government put its theoretical understanding of the social determinants of health into practice.
In a country where the informal sector represents 64% of economic production, the blockade caused the interruption of economic activity and made it difficult for people to obtain income to support their families.
Protection of economically vulnerable populations
The government used local leaders to identify vulnerable members of the communities and provided them with food and financial assistance. As of May 19, the government had provided this assistance to 20,000 vulnerable households.
It was also in this solidarity movement that top government leaders had lost their April salaries, a move that was quickly followed by many Rwandans.
Additionally, testing, contact tracing, isolation and quarantine services, as well as treatment, were provided free of charge. We can also see similar examples in other African countries.
For example, the Federal Housing Corporation in Ethiopia announced a 50% reduction in housing rent due to the COVID-19 pandemic. Some countries provided free water and electricity to vulnerable citizens and granted tax breaks.
These support measures for the vulnerable are essential to ensure that those who cannot afford to carry out prevention measures themselves have the capacity to do so.
Lastly, many African countries adopted innovative technology tools to respond to the COVID-19 pandemic.
In Rwanda, the government used robots to measure people’s temperatures in public spaces and hospitals; drones for mass communication, surveillance and drug delivery; and joint tests to maximize human and financial resources.
Additionally, several countries are embracing cashless transactions to avoid unnecessary human contact during the cash exchange.
COVID-19 has accelerated this process in West African countries, with major providers, such as MTN Ghana, MTN Nigeria, Vodafone Ghana, and Sonatel Senegal, reducing mobile money transaction fees, and so did MTN Rwanda. These key private sector innovations are supporting the government’s response to the COVID-19 pandemic.
Various posts have provided various other explanations for the successful response of African countries to COVID-19.
Some were driven by a Western supremacy mentality that purposely undermines Africa’s successes by using guesswork supposedly based on the nature of the virus and the temperature in Africa, as if the climate on the continent is homogeneous.
Too many of these claims have no scientific backing, but are based on correlations that we all know do not prove causation. Of course, we do not deny that there may be other factors, such as demographic makeup, geographic factors, pre-existing antibodies, and others, that could contribute to this low number of cases and deaths. In fact, it is in everyone’s interest to study them.
Yet attributing Africa’s success during the COVID-19 pandemic to chance alone, and ignoring the rapid and concerted response that many African countries adopted very early in the pandemic, contributes to cultivating the negative perception of Africa: the expectation that we must fail in all scenarios.
Such arguments simply serve as a bridge between past and present white supremacist narratives that movements like Black Lives Matter and commemorative events, like Black History Month, actively denounce.
