COVID-19 in Africa: half a year later

In February 2020, the first case of COVID-19 was recorded in Africa. Borders were closed, confirmed cases quarantined, and curfews imposed early, which helped countries to slow down the spread of the virus. A slow rise in cases compared with other parts of the world resulted, highlighting Africa’s weak health systems, fragile infrastructure, inadequate availability of trained personnel, and poor access to medical supplies and equipment. As of Sept 3, the continent had more than 1·2 million symptomatic cases and 30 000 deaths, with a 2·4% case fatality, representing 5% of global infections.

The African Union, the African Centre for Disease Control and Prevention (Africa CDC), and the WHO Regional Office for Africa leading the efforts to control COVID-19 say the continent has come a long way from two referral test centres and untrained health workers to limit human to human transmission, ensuring countries have the capacity to isolate, and provide appropriate treatment to affected people.

In January, South Africa’s National Institute of Communicable Diseases and Senegal’s Institute Pasteur were the only referral laboratories on the continent, responsible for testing samples from other African countries. Now preventive, diagnostic, and treatment measures have been improved, and all African countries can now diagnose COVID-19, with 14 performing over 100 tests per 10000 people.

WHO and its technical partners sourced more than 2·1 million testing kits among other medical supplies and trained around 100 000 health workers. After measuring the countries’ readiness in coordination, surveillance, laboratory capacity, case management, and infection prevention and control, WHO said that Africa’s score rose to 78% from 62% 6 months before.

“We have had what seems to have been a peak and now have the daily number of cases being reported overall at the regional level going down”, says WHO’s Africa regional head, Dr Matshidiso Moeti. The gradual rise in COVID-19 cases has made it difficult to distinguish a specific peak, while transmission patterns vary within and between countries, she says.

Dr John Nkengasong, director of Africa CDC, said in the Sept 3rd weekly media briefing, that they have observed a 14% decrease in new cases in the past 2 weeks in Africa. The largest number of infections, however, are still being recorded in South Africa, Egypt, Morocco, Nigeria, Ethiopia, and Algeria.

Reflecting on the COVID-19 pandemic, Nkengasong said that three lessons have emerged so far for Africa: focus on diagnostics, vaccine development, and drugs. “Africa imports 95% of drugs—this is unsustainable for a continent of 1·3 billion”.