Coronavirus (666) Uncertainty amidst COVID-19 (9) COVID-19 in Sub-Saharan Africa (4)

25 May, 2020

In a recent virtual meeting on Zoom we discussed UHC2030 and the effect that focus on COVID-19 pandemic is having on routine health services especially in Africa. We contributed the following summarised thoughts and views:

Africa is still experiencing “increases in numbers of COVID-19 cases. BUT has it got ‘advantages’, if you might call it that? :

i) Demographics are on its side. Median age under 20 years - less than half that of Italy

ii) Experience of high long standing infectious disease burden e.g. Lassa fever, Ebola, TB, HIV/AIDS, Measles, NTDs, including malaria, typhoid, cholera, etc

iii) The Africa Centre for Disease Control & Prevention is said to be looking into unresolved scientific debate : e.g. Weather on the Coronavirus-SARS-COV-2.

However there must be no room for complacency by African countries, for even these advantages are true, If COVID-19 pandemic overwhelms the advantages, the devastation to the Health, Economic, and Security Sectors of African countries will be unimaginable being that they are had very weak systems before COVID-19 pandemic.

We agree that COVID in Africa can be viewed through 3 lenses: China (the emerging dependence of Africa on China means that there is disruption of supply chains and affecting huge infrastructure investments, etc; Global (already African countries are overburdened by internal and external debts, so the huge fall in Global GDP growth - Recession due to COVID-19 will be crushing); Africa (still plagued by poverty, disease and ignorance before COVID-19 is also struggling to contain rising violent extremist threats, drought and cyclone, steep fall in oil prices and other commodities).

Like most countries in the West, but probably more so, majority of the population are in micro, small and medium enterprises, depending on daily work and earnings to survive, therefore Africa needs more of the types of palliatives that we read and hear about that Western countries have implemented. The effects of Lockdown on over-tasked health systems, over-worked health workers many of whom have been infected, reduced / loss of income for daily paid workers / job losses, means that African countries risk social unrest, if the matter of palliatives is not addressed quickly. The alternative, relaxing or cancelling the lockdown I the escalation of the community transmission of COVID-19 and more deaths and morbidity.

Africa, cannot avoid many of these costs, but must try to avert the worst effects. It must rely on evidence informed practices from countries that have been through the worst to guide African countries own path to overcoming the pandemic. No exact solutions book, but the surest and cost effective route is through Best Science. Not short cuts!

The lack of investment by Africa in research including Health research make us to ask, where is Africa in the Global Race to produce a Cure and produce a Vaccine? What lessons can Africa learn from here, for After COVID-19?


Joseph Ana

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Email: jneana AT