Success v failure: Is there one Africa COVID19 story?

 In analysis, infographic, Social Media

Updated Weekly

Over the past few months, as we have scored through and collated the data from a huge number of sources, to share our weekly updates on what African countries are doing to tackle COVID19, we have noticed that many others writing on the same topic tend to see what is happening in very black and white terms, as if there is a single story. Case studies are shared of current successes – like Mauritius. While elsewhere data is selectively chosen to imply that testing rates on the continent are universally poor.

Yet, our cross-continental, comprehensive data, week after week, has tried to demonstrate that such simplicity is at best misguided, at worst it is misleading. We need to look deeper and comparatively, provide context that people inside and outside of China can recognise. 

So what does the detailed, comparative data reveal this week? 

We have previously discussed the “mixed” results we are seeing – with some countries making progress and others struggling. This week we see this developing even more into a “divided” continent – divided between those countries struggling to contain COVID19 and those countries who have understood what it takes to stop the virus.

But which countries sit in which camps? How are the continents’ largest economies faring? Are the most populated countries facing the steepest challenges? Are the poorest countries being overwhelmed? And is it only isolated islands that seem to be getting to post-COVID19 status, or are there others?

Our infographic below suggests there is no linearity or underlying physical or economic factors that determine success or not. What matters most, and as we have suggested in previous editions, is the actions of governments – democratically elected or otherwise – to encourage their citizens to avoid risky behaviours and create the right conditions for them to do so. 

Take Namibia, Seychelles, Uganda, Eritrea, and Lesotho. What marks out these 5 countries? So far, none of them have seen any COVID19 deaths. Despite the fact that 4 of the 5 countries detected their first cases in mid-to-late March. How? A range of techniques: Eritrea has reportedly focused on community management of tracing and quarantine; Mauritius on very strict lockdown.  These are all worth exploring.

How about what marks out Mauritius, South Africa, Djibouti, Seychelles and Cabo Verde? These are the 5 countries testing the most per capita on the continent. South Africa is 23rd in the world for absolute numbers of tests done so far, while Mauritius is 16th in the world for tests per capita.  Yet Mauritius is the most densely populated country in Africa, while Djibouti is one of the poorest countries in the world, ranking 171 out of 189 countries and territories in the last UNDP Human Development Index.

How about Botswana, Lesotho, Mauritius, Mauritania and Zimbabwe? These 5 countries have so far tested at least 200 people to every detected case in their countries. That’s well above the WHO suggested test:case ratio of 10-30. Yet, these 5 countries were ranked – in order – 121st, 60th, 153rd, 33rd and 10th worst on the 2020 Fragile States Index. Bound together by action, yet literally spanning the entirety of a governance index.

What links the countries that appear to be struggling is just as broad.

Let’s take Algeria, Cameroon, DRC, Sao Tome and Principe, Somalia and Sudan. According to WHO data, in 2014, Algeria was 3rd best on the continent for health expenditure per capita, while DRC ranked 2nd worst.  Yet, these 6 countries are testing the least compared to the number of cases they have. 

Similarly, the countries with the largest numbers of cases are not only the most populous, nor the poorest. The countries with the highest amounts of deaths so far include South Africa and Sudan – at opposite scales of the GDP per capita spectrum. Some of these countries did detect cases earlier than many other African counties (such as Algeria and Egypt), but Sudan, for instance, detected its first case on 15th March. Nigeria on 11th March – the day WHO declared COVID19 a pandemic.

Hence, we see in our data a sort of “bifurcation” – those countries clearly making real progress, those that seem to be in difficulty, and those we still need to watch carefully.

Our recommendation to the governments of this last category – the as yet “undetermined” – is to  continue work to “flatten the curve”, and learn from the successful examples so far – to get new relevant ideas and techniques. The signs are there that many are doing so. Last month 23 African countries were mandating mandatory use of masks. Now 30 are. Over the last month, African countries have more than tripled the total tests completed – from around 785 thousand to now over 2.3 million. If this momentum can be maintained or increased, it will make a huge difference. African countries are also making use of support from others. China’s medical teams have been to 11 countries on the continent so far. We hope more health support from China and traditional donors will be directed to the countries that are struggling the most, urgently. 

However, we also see worrying signs. Suggestions of opening up to international travel could be premature. This week Mauritius had a set back as 2 returning nationals who had tested negative before flying to Mauritius several days later – while in quarantine – tested positive. Similarly, allowing large gatherings may invite potential for “super-spreader” events, which will make tracing and controlling spread very challenging, potentially creating “second waves”. 

Hence, we also recommend continuing to be cautious about opening up – the costs could be overwhelming.

Check out the data below, and let us know your reflections and suggestions for further lines of enquiry.

To find out how Development Reimagined can help you, your organisation or Government during the COVID-19 outbreak please email the team at clients@developmentreimagined.com .

Special thanks go to Rosie Wigmore, Rosie Flowers and Jinyu Chen for their work on the graphic and collecting/analysing the underlying data.

The data was collated from a range of sources including: government websites and media reports, the IMF policy tracker; the US Chamber COVID19 Dashboard; Our World in Data, Africa CDC and Worldometer. Data on Chinese medical teams is drawn from Chinese state media reporting. Our methodology is entirely in-house, based on analysis of social distancing categories and other trends.

If you spot any gaps or have any enquiries, please send your feedback to us at DRteam@developmentreimagined.com, we will aim to respond asap.

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