Sub-Saharan Africa
In the early stages of the Covid-19 pandemic, many expressed warnings of the devastating effects that the virus would have on low-income countries. Those with grossly insufficient healthcare systems such as South Sudan, which has “more vice presidents (five) than ventilators (four)” or Yemen, where “49 percent of health facilities are not functioning or only partially functioning,” were of particular concern. Many feared that, coupled with high population density in urban areas and an inability for many to self-quarantine, the virus would rampage through the Global South, leaving in its wake a devastating death toll.
But as the virus raged on, and as high-income countries began scrambling to contain the virus, infection rates in sub-Saharan Africa (SSA) remained staggeringly low. This left scientists and public health experts scratching their heads, searching for explanations to the seeming conundrum. Many fell back on classic – and in many cases justified – indicators, such as incomplete or inaccurate health data. Elsewhere, claims were made that SSA’s outsized young population could be the explanation for low death tolls, or that a supposed heat resistance had kept the virus transmission rates at bay. Others have noted that experience from earlier infectious disease outbreaks, such as Ebola, have prepared both officials and citizens for exactly this scenario.
Despite these low infection rates, however, we do know that the economic and livelihood effects of the pandemic have been immense. On a macro-level, the World Bank estimates that economic growth in SSA is expected to fall to -3.3% in 2020, marking its first recession in 25 years. As a result, prices for food and other essential goods have spiked. In Nigeria, one report found that the price of rice alone jumped by 30% over the span of only four days in March. Compounded by travel restrictions and constrained access to credit, the economic fallout for many has proven no less problematic than the virus itself.
Uncertainty amid increasing reports of cases
Unfortunately, new reports of increased spikes in Covid-19 cases are popping up across the region. In Kenya, a second wave of Covid-19 cases is emerging, a trend that much resembles that which we are seeing in much of the Global North. Furthermore, large urban centers such as Nairobi represent a large proportion of these new cases, perhaps confirming earlier concerns regarding high population density.
Ghana, a country praised for its testing capabilities, battled off a first major wave in mid-August. But now, after months of low daily case counts, the numbers are again rising. In Zimbabwe, reports claim that 100 students at a secondary school had tested positive on Tuesday, November 17, numbers which do not reflect publicly available statistics. These discrepancies raise pertinent questions about inaccuracies of or general delays in reporting within the country.
Similar to Ghana, Rwanda’s initial wave of cases in August was battered down relatively quickly thanks to innovative testing methods. While the country’s numbers have remained relatively low, however, outbreaks are being reported in prisons across the country. New measures have now been put into place to tackle these outbreaks, though the results of the measures are yet to be seen. Similar prison cases have been reported in Malawi and Uganda, though latter is also experiencing an uptick in protests related to the upcoming elections in January, some of which have turned violent as the pandemic disrupts traditional campaigning.
Though case numbers are reportedly decreasing in Ethiopia, the country has just broken into a major civil conflict. The conflict has been accompanied by extensive media censorship, which has cut off many lines of communication both in and out of the continent’s second most populous country. Even more muddled is the pandemic’s effect in Tanzania, which still has not officially reported a single Covid-19 case since May 8. Despite the many hypotheses given for the country’s halt of testing – nearly all of them political – the matter of the fact is that we have little to no credible indication of the situation in Tanzania.
To say it is clear what is happening in SSA would be to misspeak. Between emerging conflicts, inconsistent testing, media censorship, and widespread misinformation, case numbers are sporadic and shrouded in uncertainty. And while small windows into the state of the pandemic are emerging here and there, they generally only raise more questions than answers.
New vaccine looks promising, but not for low-income countries
As the world begins looking forward, much of the narrative has now shifted to what many are hoping will be the Covid-19 silver bullet: the vaccine. With Pfizer’s recent announcement of its Phase 3 vaccine trials that showed a 95% efficacy rate, many are beginning to ask questions about the eventual distribution of the vaccine. In the US, frontline healthcare workers and the elderly are at the front of the line. Similar guidelines have been presented in the European Union (EU). However, the question less posed is how the vaccine will be distributed globally.
A recent study from the Duke Global Health Institute shows that high- and middle-income countries have already purchased 3.8 billion doses from various vaccine candidates, with the option to purchase another 5 billion. Both Canada and the United Kingdom (UK) have already purchased enough to cover their entire populations, while the EU has reportedly ordered roughly 400 million doses for member states. The numbers coming out of the US show that the country has already purchased enough doses to cover 230% of its population. This all stands in stark contrast to the total vaccines purchased by low-income countries: zero.
Canada, UK, and the EU are all signatories of COVAX, a multilateral initiative to ensure equity in Covid-19 vaccine access and distribution. Despite this, the Duke study shows that these countries are “undermining the pact by negotiating ‘side deals’ for large vaccine shipments that will result in a smaller piece of the pie available for equitable global allocation.” Because of this, the report warns that countries relying on COVAX, including most SSA countries, will likely be waiting until 2024 for the vaccine.
Despite multilateral efforts, once again rich countries with strong global economic influence will be the first to benefit – and benefit handsomely. And regardless of the current Covid-19 situation in SSA, if this hoarding of vaccines and flexing of economic power by the world’s richest economies continues, it will be hard to picture a post-pandemic world anytime soon. Harder yet will be to picture a post-pandemic sub-Saharan Africa.