Success against coronavirus will require national leadership, engaged local responders, and strong cooperation with NGOs
by Charles Holmes and Matthew Boyce and Rebecca Katz February 27, 2020

A looming epidemic of COVID-19 in Africa presents a deadly threat. This is especially the case in densely populated urban areas with limited opportunities for social distancing, poor baseline systems to support hygiene and sanitation, and comparatively few level-one trauma hospitals or health care facilities that can provide respiratory support. Two COVID-19 cases have been diagnosed on the continent, and testing of other potential cases is underway.

Yet, African leaders are not starting from a scratch. African countries have been fighting increasingly successful battles against a number of pandemic infectious diseases over the last several decades, have built enormous human capacity and systems capacity for health care. Substantial improvements in health have been made over the last decade and a half, driven by well over $100 billion in investments from central governments, external donors, and health agencies led by PEPFAR and the Global Fund, but also Gavi, the Vaccine Alliance, the Global Polio Eradication Initiative and others.

‘Because of the robust responses to these diseases, many African countries are starting from a very different baseline than twenty years ago’

Mortality due to HIV/AIDS in eastern and southern Africa has decreased by over 50 percent from its peak in 2004 due to the rapid expansion of treatment programs, and new HIV infections in the region have decreased by 28 percent since 2010. Malaria cases in Africa have decreased by 40 percent from 2000–2015, and many countries in the region are on track to meet aggressive malaria control goals. And since the 1980s, the polio response has led to the virus’ near elimination on the continent and has tangibly strengthened disease outbreak preparedness.