As the coronavirus disease (COVID-19) continues to spread, countries in sub-Saharan Africa are still experiencing outbreaks of other infectious diseases; the top causes of outbreaks from 2016 to 2018 were cholera, measles, and viral hemorrhagic diseases, such as Ebola virus disease, yellow fever, dengue fever, Lassa fever, and Rift Valley fever. These outbreaks have occurred alongside humanitarian crises and other public health emergencies in the region.
At the end of 2019, almost all African countries had undertaken a Joint External Evaluation (JEE) of the International Health Regulations (IHR). This process helped countries identify the gaps in their ability to prevent, detect, and respond to public health threats. Many countries had developed competencies in real-time surveillance and immunization, but overall, there was a pressing need for improving the resilience of the health sector in order to ensure effective outbreak response. In response to recommendations from the JEEs, countries were supported to develop multisectoral National Action Plan for Health Security (NAPHS), addressing the gaps identified by the JEE and aligning with the various country sectoral plans.
This state of heightened alert across Africa has helped to prolong the containment phase of COVID-19 in many African countries. At the start of the pandemic in China, WHO’s African regional office and the Africa Centres for Disease Control provided guidance and technical and financial support to prepare countries. In our paper, we observed that Africa is better prepared than ever before because of our stronger national public health institutes, the rapid scale-up of testing capacity, better coordination at the continental level, and the capacity of built-in surveillance and contact tracing which has occurred since the 2013–2016 West African Ebola outbreak.
The first case of COVID-19 was reported in the African region on the 14th of February in Egypt, and in Sub-Saharan Africa on the 27th of February in Nigeria [3, 4]. This was over 1 month after the first case of the disease was reported in China, giving the region lead time to prepare for a large outbreak. As local transmission supersedes imported cases and the doubling time shortens to below 7 days in more than 95% of the affected countries, countries are now bracing for the impact of the pandemic.
Despite widespread misinformation about the immunity of Africans to COVID-19, overall poor health is driving mortality globally. Reports from other continents are showing higher morbidity and mortality in people of African heritage. While the observed disproportionality in adverse outcomes may be due to the impact of health disparities, poorer access to health care, and lower socioeconomic factors, the implication for African countries is clear.
At the end of April 2020, the continent has recorded a cumulative total of 20,652 cases and 861 associated deaths (case fatality ratio 4.2%) have been reported across 45 countries, the highest mortality have been recorded in Algeria 12.6% (425/3382), Liberia 9.7% (12/124), Democratic Republic of the Congo 6.1% (28/459), Mali 5.9% (23/389), Burkina Faso 6.6% (42/632), and Niger 4.2% (29/696).