Africa’s challenges continue to grow
BY THE beginning of May 2021, more than a year after the first person was diagnosed with Covid-19 in Africa, more than 4.5 million cases were diagnosed with over 122 000 deaths recorded.
This is a small proportion of the global number of cases (153 187 889) and deaths (3 209 109).
According to the ranking of cases on Worldometer, 11 countries on the continent are ranked in the top 100 on the bases of the number of reported cases. These are: South Africa (20), Tunisia (55), Ethiopia (61), Egypt (68), Nigeria (79), Kenya (80), Algeria (86), Ghana (93), Zambia (95), Cameroon (99) and Mozambique (100).
While this ranking only takes into consideration the number of cases reported and not testing capacity or population size, it does provide some idea of the size of the challenge each country faces relative to others.
The Covid impact on Africa must be viewed against other health challenges that people of the continent are burdened with. For example, Africa accounts for about two-thirds of the global total of new HIV infections with an estimated 25.7 million people living with HIV and of the 30 high burden tuberculosis countries in the world, 24 are in Africa.
In 2017 nearly 2.5 million Africans contracted tuberculosis and over 660 000 died from the disease. In terms of child mortality, 1 in 13 children in sub-Saharan Africa dies before their fifth birthday compared to 1 in 185 globally.
Despite differences in the number of Covid cases, its impact on health systems and the extent of lockdowns in African countries during 2020, many countries have reported significant impacts on routine health services.
According to a survey by the Global Fund for HIV, TB and Malaria, countries in Africa reported a 5% decline in antenatal visits in 2020 compared to 2019, a 23% decline in clinic visits by children under 5 years of age and a 28% decline in tuberculosis diagnosis. South Africa, the country with the largest number of Covid cases and death on the continent, has also seen significant disruptions in routine services: HIV testing declined by 22% and tuberculosis testing declined by 26% in 2020 compared to 2019.
Of equal concern is the increase in facility reported maternal and neonatal mortality. Health services were disrupted as a result of lockdowns, lack of transport, facilities stopping services or limiting services, non-availability of health workers who may have been infected, fear and stigma.
Reviews by the Brooking Institute and others suggest that Africa is not on track to meet its SDG goals. Clearly, the Covid-19 pandemic will make this task much more difficult. Added to this is the impact of climate change with the World Meteorological Organisation reporting that 2019 was among the three warmest years on record for the continent and that the warming will have devastating effects on crop production and food security.
With more than 60% of people in Africa involved in the agriculture sector, any impact on this sector will have significant effects on the livelihoods and well-being of Africans.
However, there are opportunities that countries can leverage to accelerate progress. Young populations, increasing urbanisation, use of technology (including mobile telephony) and increasing intra-African trade.
It is said that one should not waste a crisis. The Covid-19 pandemic has heightened the challenges confronting Africa and this crisis must be used to transform how countries on the continent do their business in both the public and private sectors.