In Africa, lack of coronavirus data raises fears of ‘silent epidemic’
When the new coronavirus hit Tanzania in mid-April, President John Magufuli called for three days of national prayer to seek God’s protection from the scourge. Barely a month later, he claimed victory over the disease and invited tourists to return to his East African nation.
His rush to reopen came despite alarm from the World Health Organisation (WHO) over an almost total lack of information on the spread of the virus in the country of 55million people, which has one of the region’s weakest health care systems.
The shortage of reliable data afflicts many African nations, with some governments reluctant to acknowledge epidemics or to expose their crumbling health systems to outside scrutiny. Other nations simply cannot carry out significant testing because they are so ravaged by poverty and conflict.
Sharing information is vital to tackling the pandemic in Africa — both for planning the response and mobilising donor funding — public health experts say.
As things stand, it is impossible to gauge the full severity of the contagion across Africa.
According to the latest data collated by Reuters, Africa, with a population of 1.3-billion people, had over 493,000 confirmed cases and 11,600 deaths. By comparison, Latin America, with roughly half the population, had 2.9-million cases and 129,900 deaths.
The official numbers make it seem as though the illness has skirted much of Africa, but the real picture is certain to be worse, with WHO special envoy Samba Sow warning on May 25 of a possible “silent epidemic” if testing was not prioritised.
By July 7, 4,200 tests per million people had been carried out across the continent, according to a Reuters analysis of figures from the Africa Centres for Disease Control and Prevention (CDC), a body set up by the AU in 2017.
That compares with averages of 7,650 in Asia and 74,255 in Europe.
Interviews with dozens of health workers, diplomats and local officials revealed not just a scarcity of reliable testing in most countries, but also the lengths some governments have gone to, to prevent news of infection rates from emerging, even if that meant they missed out on donor funding.
“We cannot help a country against its own will,” Michel Yao, head of emergency operations for the WHO in Africa, said. “In some countries, they are having meetings and not inviting us. We are supposed to be the main technical adviser.”
Tanzania confirmed its first case of Covid-19 on March 16. The next day, the government convened a task force to coordinate the response with international partners including the WHO, foreign embassies, donors and aid agencies, multiple sources said.
This body never met again with outsiders, two foreign officials familiar with the situation told Reuters, while government officials failed to show up to dozens of subsequent coronavirus-related meetings.
“It’s very clear the government does not want any information about the state of Covid in the country,” said one aid official who, like many of those interviewed, asked not to be identified for fear of antagonising political leaders.
Tanzania’s health minister
Ummy Mwalimu and government spokesperson did not respond to phone calls or emailed questions raised by this article about their handling of the crisis. The spokesperson, Hassan Abbasi, has previously denied withholding information about the epidemic.
Tanzania’s failure to share information about its outbreak has frustrated its neighbours, who fear that gains won through painful lockdowns in their own countries could be jeopardised as Tanzanians cross porous borders.
The WHO organised a call on April 23 with African health ministers to discuss, among other things, a lack of information sharing, Yao said. He declined to say who was on the call, and Tanzania did not respond to requests for information as to whether its minister participated.
The United Nations agency cannot compel co-operation and must tread carefully.
When WHO officials expressed concern in late April about a lack of measures to contain the virus in Burundi, the tiny East African nation expelled its top representative and three other WHO experts without explanation in May.
Burundi was one of the first African countries to shut its borders in March, which seemed to slow the virus’ spread initially. But the country saw an uptick in suspected cases after rallies were held in the run-up to May 20 general elections, a health care provider said, speaking on condition of anonymity.
While some countries won’t share information, others can’t: Their health systems are too broken to carry out any largescale testing, surveillance or contact tracing.
Some countries, like Cameroon and Nigeria, have decentralised testing, but many others have very little capacity outside their capitals, said Franck Ale, an epidemiologist with the aid group Médecins Sans Frontières (Doctors without Borders).
Democratic Republic of the Congo, a nation of 85-million that was already battling Ebola, was quick to suspend international flights and lock down parts of the capital Kinshasa when the virus hit in midMarch.
However, it took three months before the government was able to process tests outside Kinshasa, said Steve Ahuka, a member of Congo’s Covid-19 response committee, citing a lack of laboratories, equipment and personnel. In many areas, it still takes two weeks to get results, said two doctors.
SA is one of the few to have rolled out mass testing. But it had a backlog of more than 63,000 unprocessed specimens as of June 10, because global suppliers were unable to meet its demand for laboratory kits, the health ministry said.
SA’s national laboratory service declined to disclose the current backlog.
In the absence of comprehensive testing data in other parts of the world, researchers look to different yardsticks to judge the prevalence of the coronavirus, including reviewing the number of deaths that exceed the average for the time of year.
But even that is not possible in most of Africa because data from previous years is lacking.
Only eight countries — Algeria, Cape Verde, Djibouti, Egypt, Mauritius, Namibia, Seychelles and SA — record more than 75% of their deaths, according to the UN. —