May 4, 2020
Coronavirus Disease 2019 (COVID-19): Impact in Africa
As Congress considers the global impact of COVID-19,
caseloads (e.g., Burkina Faso, Niger, Kenya, Democratic
some Members may examine the implications for sub-
Republic of Congo). Several have imposed curfews.
Saharan Africa (“Africa”). Most African health systems
Many African heads of state have invoked emergency
struggle with low capacity, trailing world averages in per
powers, including, in a few cases, the authority to issue
capita numbers of doctors, ventilators, oxygen cylinders,
legislative decrees (e.g., Senegal, where parliament
and hospital beds. Although lessons from past pandemics
endorsed the move). State security forces have injured or
(e.g., recent Ebola outbreaks) led some countries to quickly
killed civilians while enforcing lockdowns in some
ramp up disease surveillance and behavior change
campaigns, overall state capacity tends to be low.
countries (e.g., Kenya, Nigeria, and Uganda). Control
efforts have resulted in restricted media access, and some
Countries with high rates of health conditions that can
crackdowns on COVID-19 “fake news” have raised
compromise immune systems —such as HIV/AIDS,
concerns from press freedom advocates (e.g., Ethiopia,
tuberculosis, diabetes, and malnutrition—may face
Somalia, Uganda). Residents have reacted violently to
particular challenges in curbing COVID-19 morbidity and
lockdowns or the placement of treatment centers in some
mortality, notwithstanding Africa’s youthful populations.
countries (e.g., Niger, Côte d’Ivoire, South Africa). Such
Measures such as physical distancing and frequent
dynamics may deepen the challenge of ensuring compliance
handwashing may not be viable for those without access to
with health measures, and could spur future unrest.
clean water and sanitation, or living in crowded conditions
Most African governments have allocated new budget
such as informal urban settlements, prisons, or camps and
resources for their health systems. Senegal is developing an
other settings for displaced persons. As of 2019, more than
innovative cheap and rapid COVID-19 test kit. Many
24 million Africans were displaced by conflicts and
governments have pledged tax relief and/or targeted
disasters, and Africa hosted 26% of the world’s refugees,
financial or food aid for their poorest or most vulnerable
according to U.N. figures. Efforts to counter other diseases,
citizens (e.g., Kenya, Rwanda, Senegal, South Africa),
including polio and measles vaccinations and anti-malaria
campaigns, have been disrupted due to COVID-19 control.
some of which are supported by U.N. agencies, local firms
and civic organizations, and diaspora groups. Some
The pandemic is severely affecting African economies.
countries have imposed trade restrictions in response to the
Global prices for key commodity exports (e.g., oil, natural
pandemic (e.g., a ban on fuel exports from Angola).
gas, and certain minerals) have cratered. Job-rich sectors
Governments have also cut top officials’ salaries (e.g., in
such as transportation and tourism are largely suspended.
Kenya, Malawi, Rwanda, South Africa).
Informal workers have lost already meager incomes due to
Nonetheless, many African governments lack sufficient
COVID-19 control measures. Global trade and supply chain
domestic resources to import medical equipment, cushion
disruptions have led to rising prices for basic goods. In
local economies, and build up food stocks. Prior to the
April, the International Monetary Fund (IMF) projected that
COVID-19 crisis, many African governments were already
African economies would contract by 1.6% overall in 2020,
reliant on donor aid for budget support and/or funding for
the most severe regional recession in decades. The World
infrastructure, health, and education projects. African
Bank has estimated that 23 million more Africans may fall
leaders have appealed for international aid and debt relief to
into extreme poverty due to the pandemic.
support health and economic responses to COVID-19.
The World Food Program (WFP) warned in March that
Selected U.S. and Global Responses
diminished local purchasing power, spikes in global food
Health Aid. For more than a decade, about 70% of U.S.
prices due to export restrictions and speculation, and supply
annual bilateral aid for Africa—about $5.3 billion in
chain disruptions could cause dire hardships in Africa. Food
FY2019—has supported health programs, primarily focused
insecurity was already extensive as of early 2020, including
on HIV/AIDS (Fig. 1, below). The State Department and
in conflict-affected areas of the Sahel and East Africa
U.S. Agency for International Development (USAID)
(which is also facing locust infestations), and in drought-
afflicted parts of Southern Africa.
administer these funds, and the majority of U.S. global
health assistance generally. Other federal entities such as
African Government Responses
the U.S. Centers for Disease Control and Prevention (CDC)
African governments have imposed a range of restrictions
also support related efforts, as well as U.S. emergency
on population movements and activities. Most have banned
responses to global disease outbreaks and pandemics.
large gatherings and closed schools, places of worship,
and/or local markets. Nearly all countries have restricted
“The United States has committed more than $100
international travel and border crossings. Some have
bil ion over the past 20 years to support public health
restricted internal travel and/or access to areas with large
on the African continent—by far the largest donor
nation. […] And those investments… have built the
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Coronavirus Disease 2019 (COVID-19): Impact in Africa
foundation for Africa to begin to battle this
may be limited by longstanding U.S. policy concerns and
coronavirus.” – Administration telephone press
legislative restrictions. U.S. bilateral aid for certain African
briefing on COVID-19 in Africa, April 22, 2020
countries is also subject to legislative restrictions due to
As of May 1, the State Department and USAID had
concerns about human rights conditions and other issues.
announced about $239 million in health, humanitarian, and
Figure 1. U.S. Bilateral Aid to Africa by Sector
governance aid to support COVID-19 response in Africa,
Funds Appropriated to State Department and USAID, FY2019
including public health information campaigns, lab
capacity, disease surveillance, water and sanitation, and
infection control in healthcare settings. This is on top of
funds for global activities or other federal entities.
The World Health Organization (WHO) has facilitated
deliveries of medical and personal protective equipment
(PPE), and has sought to coordinate aid and guide response
efforts. In April, the WFP, WHO, and African Union (AU)
established an air logistics hub in Ethiopia to fly equipment,
supplies, and trained personnel across Africa, and to help
medically evacuate responders. The WHO is also working
with the Africa Centres for Disease Control and Prevention
(Africa CDC), an AU agency established with U.S. and
Chinese assistance, to build countries’ healthcare, disease
surveillance, and lab capacities. (The Trump Administration
suspended U.S. funding for the WHO in mid-April.)
The government of China, along with Chinese firms and the
prominent Chinese tycoon and philanthropist Jack Ma, have
provided test kits, PPE, ventilators, technical assistance,
personnel, and training to multiple African countries. The
European Union (EU) pledged in April to reallocate $2.2
billion in existing aid to support COVID-19 response in
Africa, alongside a similar bilateral pledge from France.

Economic Aid. As of May 1, the State Department and
Source: CRS graphic, based on public budget documents and
USAID had allocated limited bilateral aid specifically to
sectoral al ocations provided to CRS by USAID in February 2020.
address economic effects of COVID-19 in Africa ($2.7
Note: Does not include funds administered on a global basis.
million for Ethiopia). In April, the IMF approved
emergency loans for 18 African countries, with few
The pandemic could have a lasting impact on regional
conditions attached, along with debt service relief for 19
governance and stability. Control measures may strengthen
African countries. The Group of 20 (G-20) suspended debt
authoritarian governments and erode checks and balances in
payments for the world’s poorest countries, many in Africa.
democratic ones, by constraining civil society and
The extent to which China’s loans are included is uncertain.
opposition activities and disrupting parliamentary and
Issues for Congress
justice system functions. Elections may be delayed, as in
Ethiopia, or marred by low turnout due to fears of infection.
COVID-19 poses challenges for bipartisan congressional
Economic hardships and food price spikes could spark new
policy objectives in Africa. These include improving health,
unrest or conflicts in a region where state-society relations
addressing humanitarian needs, encouraging free trade,
were already fraught. The advanced age of some African
bolstering food security, promoting democracy, and
countering China’s influence
leaders may place them at particular risk from COVID-19,
. The pandemic appears likely
raising the prospect of succession crises.
to complicate U.S. aid delivery and project implementation,
military cooperation, commercial access and trade, and
U.S.-China rivalry in Africa has been a focus for the Trump
oversight. Ultimately, COVID-19 may alter policymakers’
Administration and some Members of Congress. China’s
priorities, and it could reshape Africa’s development and
current emphasis on health aid appears intended to deepen
security landscape. Congress may consider whether to
its already extensive ties with the region. The Trump
modify U.S. aid in response—for example, reorienting food
Administration’s assertion that the WHO (headed by an
security and economic growth programs in a global context
Ethiopian national) aided China’s COVID-19 “cover-up”
of reduced trade, or adjusting security assistance to bolster
has spurred sharp pushback from many African leaders.
African militaries’ medical capacity or urban crowd control.
Pro-China narratives may be undermined, however, by the
poor treatment of some Africans living in China during the
U.S. economic relief for African countries suffering from
pandemic, the reported poor quality of some donated
the impact of COVID-19 may be channeled primarily
equipment, and jockeying over debt relief. Other countries
through international financial institutions (IFIs) such as the
seeking influence, military ties, and commercial access in
IMF, World Bank, and African Development Bank (AfDB),
Africa (e.g., France, Russia, Turkey, India, Gulf states) are
for which Congress appropriates substantial funding. U.S.
likewise confronting COVID-19 challenges of their own.
support for debt relief (whether multilateral or bilateral) or
credit for certain countries, such as Zimbabwe and Sudan,
Alexis Arieff, Coordinator, Specialist in African Affairs
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Coronavirus Disease 2019 (COVID-19): Impact in Africa

Tomas F. Husted, Analyst in African Affairs
Lauren Ploch Blanchard, Specialist in African Affairs
IF11532
Nicolas Cook, Specialist in African Affairs


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https://crsreports.congress.gov | IF11532 · VERSION 1 · NEW

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