Updated May 11, 2020
Novel Coronavirus Disease 2019 (COVID-19): Impact in Africa
As Congress considers the global impact of COVID-19,
governments have begun to loosen restrictions on religious
some Members may examine the implications for sub-
services and markets; a few have reopened schools.
Saharan Africa (“Africa”). Most African health systems
Most African governments have allocated new budget
struggle with low capacity, trailing world averages in per
resources for their health systems, and many have pledged
capita numbers of doctors, hospital beds, ventilators, and
tax relief and/or targeted financial or food aid for their
oxygen cylinders. Although lessons from past disease
poorest or most vulnerable citizens (e.g., Kenya, Rwanda,
outbreaks (e.g., recent Ebola outbreaks) led some countries
Senegal, South Africa). Some targeted aid efforts have been
to quickly ramp up disease surveillance and behavior
supported by U.N. agencies, private firms, local civic
change campaigns, overall state capacity tends to be low.
organizations, and diaspora groups. Some countries have
Confirmed caseloads in Africa have been relatively low to
imposed trade restrictions (e.g., a ban on fuel exports from
date, but may be underreported. The pandemic has
Angola). Some governments have also cut top officials’
disrupted efforts to prevent and contain other diseases,
salaries (e.g., Kenya, Malawi, Rwanda, South Africa).
including polio, measles, malaria, and HIV/AIDS.
Several countries have pursued innovative pandemic
African countries with high rates of health conditions that
responses. Senegal is developing a cheap and rapid
affect immune systems—such as HIV/AIDS, tuberculosis,
COVID-19 test kit, while Rwanda and Ghana have
diabetes, and malnutrition—may face particular challenges
pioneered the use of drones to deliver medical supplies to
in curbing COVID-19 morbidity and mortality, despite
rural areas. Nonetheless, many African governments lack
youthful populations. Infection control measures such as
sufficient domestic resources to import medical equipment,
physical distancing and frequent handwashing may not be
cushion local economies, and build up food stocks. African
viable for those without access to clean water and
leaders have appealed for international aid and, in some
sanitation, or living in crowded urban settlements, prisons,
cases, debt relief in light of the impact of COVID-19.
or camps and other settings for displaced persons. As of
2019, more than 24 million Africans were displaced due to
In responding to the pandemic, some African governments
conflicts and disasters, and Africa hosted 26% of the
have invoked emergency powers, including, in a few cases,
world’s refugees, according to U.N. figures.
the authority to issue legislative decrees (e.g., Senegal,
where parliament endorsed the move). State security forces
African economies have been severely affected. Global
have injured or killed civilians while enforcing lockdowns
prices for key commodity exports (e.g., oil, natural gas, and
in some countries (e.g., Kenya, Nigeria, and Uganda).
certain minerals) have cratered. Job-rich sectors such as
Control efforts have resulted in restricted media access, and
transportation and tourism are largely suspended, and
crackdowns on COVID-19 “fake news” have raised
remittances from African workers abroad have withered.
concerns from press freedom advocates (e.g., in Ethiopia,
Informal workers have lost meager incomes due to COVID-
Somalia, and Uganda). Residents have rioted against
19 control measures, and prices for basic goods have risen.
lockdowns or the placement of treatment centers in some
In April, the International Monetary Fund (IMF) projected
countries (e.g., Côte d’Ivoire, Niger, and South Africa).
that African economies would contract by 1.6% overall in
2020, the most severe regional recession in decades. The
Selected U.S. and Global Responses
World Bank estimated that 23 million more Africans could
Health Aid. For more than a decade, about 70% of U.S.
fall into extreme poverty due to the pandemic.
annual bilateral aid for Africa—about $5.3 billion in
FY2019—has supported health programs, primarily focused
The World Food Program (WFP) warned in March that
on HIV/AIDS (Fig. 1, below). The State Department and
diminished local purchasing power, spikes in global food
U.S. Agency for International Development (USAID)
prices due to export restrictions and speculation, and trade
administer these funds, and the majority of U.S. global
disruptions could cause dire hardships in Africa. Food
health assistance generally. Other federal entities such as
insecurity was already extensive as of early 2020, including
the U.S. Centers for Disease Control and Prevention (CDC)
in conflict-affected areas of the Sahel and East Africa
also support related efforts, as well as U.S. emergency
(which is also facing locust infestations), and in drought-
responses to global disease outbreaks and pandemics.
afflicted parts of Southern Africa.
African Government Responses
“The United States has committed more than $100
Starting in March, most African governments imposed
billion over the past 20 years to support public health
restrictions on international air travel, border crossings,
on the African continent—by far the largest donor
large gatherings, and, in some cases, domestic travel. Many
nation. […] And those investments… have built the
closed schools, places of worship, and local markets; some
foundation for Africa to begin to battle this
imposed curfews. (An exception is Burundi, where officials
coronavirus.” – Administration telephone press
have allowed large campaign rallies ahead of elections
briefing on COVID-19 in Africa, April 22, 2020
slated for May 20.) Since late April, some African
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Novel Coronavirus Disease 2019 (COVID-19): Impact in Africa
As of May 1, the State Department and USAID had
Figure 1. U.S. Bilateral Aid to Africa by Sector
announced about $239 million in health, humanitarian, and
Funds Appropriated to State Department and USAID, FY2019
governance aid to support COVID-19 response in Africa,
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 managed by other 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. The WFP, WHO, and African Union (AU) have
established regional air logistics hubs 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.
Source: CRS graphic, based on public budget documents and
Economic Aid. As of May 1, the State Department and
sectoral al ocations provided to CRS by USAID in February 2020.
USAID had allocated limited bilateral aid to address
Note: Does not include funds administered on a global basis.
economic effects of COVID-19 in Africa ($2.7 million for
Control measures may strengthen the region’s authoritarian
Ethiopia). As of May 11, the IMF had approved emergency
regimes and erode domestic checks and balances in more
loans—with few conditions attached—for 25 African
democratic ones, for example by constraining civil society
countries, and debt service relief for 19 African countries.
and opposition activities and disrupting parliamentary and
The Group of 20 (G-20) suspended debt payments for the
world’s poorest countries,
justice system functions. Elections may be delayed, as in
many in Africa. The extent to
Ethiopia, or marred by low turnout due to fears of infection.
which China’s loans are included is uncertain. Some
At the same time, some governments may be weakened.
African governments are also in talks with private creditors.
Insurgent and terrorist groups may seize new opportunities
Issues for Congress
(although the full impact on their strength remains to be
COVID-19 poses challenges for bipartisan congressional
seen), and economic hardships could spark new unrest or
policy objectives in Africa. These include improving health,
conflicts. Some African leaders may be at particular risk
addressing humanitarian needs, encouraging free trade,
from COVID-19 due to their age or health conditions.
bolstering food security, promoting democracy, and
countering China’s
U.S.-China rivalry in Africa has been a focus for the Trump
influence. The pandemic appears likely
Administration and some Members of Congress. China’s
to complicate U.S. aid delivery and project implementation,
current emphasis on health aid appears intended to deepen
military cooperation, commercial access and trade, and
its already extensive ties with the region. The Trump
oversight. Ultimately, COVID-19 may alter policymakers’
Administration’s assertion that the WHO (headed by an
priorities, and it could reshape Africa’s development and
Ethiopian national) aided China’s COVID-19 “cover-up”
security landscape. Congress may consider whether to
has spurred sharp pushback from many African leaders.
modify U.S. aid—for example, reorienting food security
The poor treatment of some Africans living in China during
and economic growth programs in a global context of
the pandemic, the reported poor quality of some donated
reduced trade, or adjusting security assistance to bolster
equipment, and uncertainty over debt relief may undermine
African militaries’ medical capacity or urban crowd control.
pro-China narratives in Africa, however. Other countries
U.S. economic relief for African countries suffering from
seeking influence, military ties, and commercial access in
the impact of COVID-19 may be channeled primarily
Africa (e.g., France, Russia, Turkey, India, Gulf states) are
through international financial institutions such as the IMF,
likewise confronting COVID-19 challenges of their own.
World Bank, and African Development Bank, for which
Congress appropriates substantial funding. U.S. support for
Alexis Arieff, Coordinator, Specialist in African Affairs
debt relief or credit for certain countries, such as Zimbabwe
Lauren Ploch Blanchard, Specialist in African Affairs
and Sudan, may be limited by longstanding U.S. policy
Nicolas Cook, Specialist in African Affairs
concerns and legislative restrictions. U.S. bilateral aid for
Tomas F. Husted, Analyst in African Affairs
certain African countries is also subject to legislative
restrictions due to human rights concerns and other issues.
IF11532
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Novel Coronavirus Disease 2019 (COVID-19): Impact in Africa


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https://crsreports.congress.gov | IF11532 · VERSION 2 · UPDATED

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