By Abdul Tejan-Cole
It was only a matter of time before the corona virus disease (Covid-19), arrived in Sub-Saharan Africa. On February 28, Nigeria confirmed that an Italian citizen who works in Lagos and had returned from Milan, Italy, a few days earlier, had tested positive for the virus.
On Monday this week, Senegal confirmed its first case – a French passenger on an Air Senegal flight from Marseilles to Dakar that landed on February 26. On Tuesday, it confirmed a second case, an 80-year-old man from the Sarcelles suburb of Paris who arrived in Dakar on February 29. A Gambian national who had returned from Spain, and manifested symptoms of the virus, tested negative.
Before the virus reached sub-Saharan Africa, Algeria, Tunisia, Egypt and Morocco had all recorded cases mostly from Italian citizens or residents. Globally, according to the World Health Organization (WHO) Situation Rep as of March 3, 2020, a total of 90,870 cases had been confirmed in 73 countries. 80,304 of these cases occurred in China with 2,946 deaths. 10,556 cases and 166 deaths outside of China.
The low rate of infection in Africa has left many puzzled. Many theories have been advanced. These include that Africans have genetic immunity from the virus; the virus does not thrive in Africa’s hot weather and Africans spend more time outdoors and not crammed together.
Based on the currently available evidence, most of these theories are baseless. There is no evidence to suggest that Africans enjoy any immunity or have stronger genes. According to Nanjala Nyabola, a Kenyan writer and activist, “(P)eople forget that Africa gets a fraction of the global intercontinental travel traffic. It's unlikely that we are miraculously immune to Covid-19. More likely that infected people are less likely to visit Africa.” She further opined: “I don't think it's immunity. I think it's a time lag. And sensible countries will use this lag to get ready. My two cents.”
True, Africa must be prepared for a potential onslaught. The risk is real. Already some countries within the continent are taking positive steps. Most countries have cancelled flights to and from China as a precautionary measure. In line with the recommendations of the Africa Center for Disease Control and Prevention, almost all African governments have publicly put in place screening at points of entry, especially airports.
Kenya has established a National Emergency Response Committee chaired by the Cabinet Secretary for Health to coordinate “Kenya’s preparedness, prevention and response to the threat of Coronavirus." In a press release Nigeria’s Red Cross Society announced that “we have placed on alert about one million of our volunteers across the country.” Uganda’s Ministry of Health has reported that more than 100 people that arrived at the international airport at Entebbe were quarantined. Mozambique stopped issuing visas for Chinese nationals.
But a lot more needs to be done. The factors that may contribute to the spread of the virus on the continent need to be fully and urgently addressed. The first and foremost is the slow information dissemination about the virus. In many countries on the continent, illiteracy rates are high. There is a need to produce and disseminate information on how to combat the virus in a way and a manner that the entire population can comprehend. In many African countries, the radio remains the most influential information outlet.
According to UNESCO, radio is uniquely-positioned to bring communities together and foster positive dialogue for change. At the town and village level, loudspeakers and town criers may also be used. Musicians, artists and traditional, community and religious leaders must work with trained health personnel to share correct information. Social media including WhatsApp is increasingly providing Africans with greater access to information and can distribute news faster and to a wider audience than traditional news sources.
In the long run, the best preventive mechanism is to promote water, sanitation and hygiene (WASH) in schools through curriculum and classroom practices and ensure that schools and public institutions offer potable drinking water, hand-washing facilities and clean and safe toilets.
Secondly, our health authorities must be able to combat misinformation proactively. During outbreaks, misinformation and fake news are usually rife. The panic and myths surrounding the coronavirus will probably cause more harm than the virus itself. Too many half-truths and untruths are flying around already. Myths that it was created and deliberately released; Covid-19 will only affect the elderly; spraying alcohol or chlorine all over the body will kill viruses or that it is a death sentence are false. I
n addition, the story that a Nigeria Uber driver who drove the first person to test positive to the Covid-19 escaped from a hospital and demanded N100m or else he would spread the virus. False information is also rapidly spreading about how drinking water every 15 minutes could render the virus impotent. These myths may mislead people and prevent some from taking precautionary measures to avoid infection. Rumors, misinformation and false information cannot be entirely eliminated but proactive and preemptive measures to lessen the risk they pose.
A key way to address misinformation is by promoting greater transparency and honesty. Lack of transparency in China at the initial stages of the outbreak contributed to fear. Instead of acting to contain the spread of the virus, the Wuhan government moved to stop the spread of information. Eight doctors were reprimanded by the local police for spreading “rumors” online.
Thirdly, our health systems remain very weak. Limited health care facilities perhaps have been the most significant catalyst in aiding the spread of viruses. Limited personnel, inadequate facilities and supplies have compounded the problem. The World Health Organization (WHO) declared the coronavirus outbreak a global health emergency - largely because of fears that poorer countries may not be able to cope with an outbreak. WHO chief Tedros Adhanom Ghebreyesus is quoted as saying, "(T)he main reason for this declaration is not what is happening in China but what is happening in other countries. Our greatest concern is the potential for the virus to spread to countries with weaker health systems."
We must begin to take public health much more seriously. They say prevention is better than cure and prevention is the best medicine. As Bitange Ndemo of the University of Nairobi’s School of Business puts it, “(A)s evidenced from Wuhan, the cost of a public health emergency is far greater than any country can handle. We can avoid this if we begin to build better institutions of public health... It must be in our DNA that individual actions have a bearing on our collective will. It is cheaper now to wade off disease by investing in the necessary infrastructure and building the right organisational culture than waiting to react to an epidemic that we have helped create.” A reliable, consistent, high-quality, robust primary health care system is crucial to fight epidemics.
Fourthly, we need to avoid stigmatization and Sinophobia. Some individuals who display the symptoms would stay home and self-medicate and ultimately die rather than submit to tests. This is due to the stigma usually attached to some diseases. Already with the emergence of Covid-19, there has been growing anti-Chinese sentiments. As one author puts it “sneezing and coughing while Chinese” has become the ultimate sin. Africans suffered immense ridicule during the Ebola epidemic. As was shown during the HIV/AIDs pandemic, stigma can be more harmful than the virus itself. It is important to adopt an approach that makes treatment available and accessible in a manner that protects and upholds the rights of individuals is an effective approach to combating the virus. Combating the coronavirus shouldn’t be an excuse for discrimination and the violation of fundamental human rights.
Africa must also prepare for the economic consequences of the epidemic. Sub-Saharan Africa may be the region hardest hit outside of Asia by the spread of the coronavirus. About two million Chinese live and work in Africa. According to Quartz Africa, “(T)here are more Africans in China today than ever before. Over 81,000 Africans went to China to study in 2018. Africans are now the largest group of foreign students in China.” Before the COVID-19 outbreak about eight flights a day operated between China and African nations. Direct airline flights between Africa and China have jumped over 600% in the past decade. This is a clear sign of the extremely strong economic links between Africa and China.
China’s investment in Africa has increased by more than 100-folds. According to the China Investment Global tracker, the value of China’s investment and contracts in sub-Saharan Africa in the three years between 2015 and 2018 totalled $299 billion. China has also increased its demand for natural resources from Africa and its investment in African industries and infrastructure. Any adverse impact on China’s economy will hit Africa very hard. The virus has had a devastating impact on China’s manufacturing sector, this will no doubt result in significant increases in the cost of goods exported to Africa. In some countries, public projects managed and funded by the Chinese are likely to suffer long delays and possible cancellations. According to Uganda’s Daily Monitor, “(T)he coronavirus outbreak has hit Chinese-controlled infrastructure projects in Uganda, threatening to stall upwards of 90 per cent of the country’s major roads construction.”
According to World Health Organization officials, the mortality rate for Covid-19 is 3.4% globally, higher than previous estimates of about 2%. The mortality rate can differ depending on the quality of the health-care system where it is treated. This may seem low to some, but there is no cure or treatment for the diseases, vaccines will not be developed until at least a year from now. We are still struggling with understanding how the virus is transmitted and finding out what the real mortality rate is. It is therefore crucial that as a continent we are not complacent. We must always be prepared. From the Bubonic plague in the 14th century, the cholera and influenza epidemics in the 19th century to the more recent HIV/AIDS, Asian flu, SARS and Ebola, world history is littered with deadly outbreaks. Even if we get off lightly with Covid-19, Africa must be prepared for the next virulent strain which is lurking just around the corner.
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