Coronavirus Disease 2019 (COVID-19): Impact in Africa




Updated March 5, 2021
Coronavirus Disease 2019 (COVID-19): Impact in Africa
Sub-Saharan Africa (“Africa”) has confirmed far fewer
rebound to 3% growth in 2021. The World Bank and World
COVID-19 cases and deaths per capita than many other
Food Program (WFP) predict dire implications for already
regions to date, but a second, deadlier wave of cases has hit
widespread poverty and food insecurity in the region.
many African countries since late 2020. Confirmed cases
African Government Responses
remain concentrated in a handful of countries, led by South
Public Health Responses. Despite capacity challenges,
Africa (Fig. 1). South Africa also has conducted the most
many African governments quickly ramped up disease
COVID-19 tests in absolute terms, and in late 2020
surveillance, case isolation, contact tracing, and behavior
discovered a new, more virulent variant of the virus that has
change campaigns in early 2020, drawing on lessons from
spread worldwide. Africa’s estimated case fatality rate
managing past outbreaks of other infectious diseases (e.g.,
surpassed the global average in early 2021, possibly due, in
Ebola and tuberculosis). By mid-March 2020, most had
part, to the emergence of new virus variants.
restricted air travel, border crossings, large gatherings,
Figure 1. Total Confirmed Cases and Deaths in Africa
nonessential businesses, and, in some cases, domestic
transit. Some imposed curfews. Starting in late April, many
African countries began to loosen constraints on religious
services, markets, transportation, and education. Some (e.g.,
South Africa and Rwanda) later re-imposed restrictions
amid case spikes; others continued to lift restrictions while
urging continued protective measures such as masks.
Several countries have pursued innovative responses to the
pandemic. For example, Senegalese institutions have
worked with a British firm and private foundations to
develop and produce an inexpensive rapid COVID-19 test
kit. Rwanda and Ghana are using drones to deliver medical
supplies to rural areas, and Rwanda has used robots to take

patient vital signs in clinics. South African cell phone firms
Source: CRS graphic, based on analysis by Research Assistant Sarah
have supported the creation of a telemedicine system.
Collins of data from WHO Coronavirus Disease (COVID-19) Dashboard.
Some experts attributed Africa’s relatively low confirmed
The African Union’s Africa Centres for Disease Control
and Prevention (Africa CDC, founded in 2015 with U.S.
caseloads in 2020 to the early implementation of robust
and Chinese support) has helped build local capacity to
containment measures, along with the region’s youthful
detect and respond to COVID-19 by training lab, medical,
populations and other factors. Poor transportation
and immigration personnel, and by providing test materials
infrastructure, limiting international and domestic travel,
and personal protective equipment. In mid-2020, Africa
may also have slowed transmission in the region. Cases also
CDC launched the non-profit Africa Medical Supplies
are likely underreported due to testing capacity constraints
Platform to support pooled purchases of medical supplies
and some countries’ refusal to track or share data.
and COVID-19 vaccines. This effort aims to reduce costs,
The pandemic has further weakened Africa’s already fragile
ease procurement, and overcome global trade and supply
health systems, sickening thousands of local health workers
disruptions. Several African countries began administering
and disrupting efforts to respond to other diseases and
vaccines in early 2021, though South Africa’s rollout was
public health challenges. Preventive measures, such as
complicated by the new variant.
social distancing and frequent handwashing, are
Economic Responses. Many African governments have
challenging in areas with limited access to clean water and
reallocated budget resources and instituted economic
sanitation, including in crowded urban settlements, prisons,
stimulus measures. Some have provided aid for their most
and camps for displaced persons and refugees. (Africa hosts
vulnerable citizens—supported, in some cases, by U.N.
over a quarter of the world’s refugees, per U.N. data.)
agencies, private firms, local civic groups, and diaspora
The pandemic’s regional economic impact has been severe,
members. Most African governments, however, lack
due to a drop in global demand for key natural resource
sufficient domestic resources to import medical supplies,
exports (e.g., fossil fuels and certain minerals), the
cushion local economies, and build up food stocks
disruption of global trade and tourism, and the impact of
sufficiently. Many African leaders have appealed for new
local lockdown measures. Remittances from African
donor aid and/or debt relief in the context of the pandemic.
workers abroad have also declined. In late 2020, the
Governance Implications. Several African heads of state
International Monetary Fund (IMF) predicted that as a
have invoked emergency executive powers to respond to
region, Africa would see a 3% economic contraction that
COVID-19, with varying degrees of legislative approval.
year, the biggest recession in decades, with a limited
Some have imposed restrictions on political and civil
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Coronavirus Disease 2019 (COVID-19): Impact in Africa
society activity, and state security forces enforcing
member and key creditor in Africa—have cited debt
lockdown measures in some countries have been accused of
suspension agreements with at least a dozen African
human rights abuses. A few countries (notably Ethiopia)
countries. Some African governments are also in talks with
have postponed elections, citing COVID-19; fear of
private creditors, although this can raise the risk of a
infection may have inhibited electoral turnout in others
sovereign credit downgrade.
(such as Guinea and Mali in early 2020). Officials in some
The European Union (EU) pledged in 2020 to reallocate
countries have been accused of corruption and misuse of
$2.2 billion in existing aid to support COVID-19 response
public health funds (e.g., in Democratic Republic of Congo,
in Africa, with some EU member states making similar
Kenya, and Zimbabwe). The risk of gender-based violence
bilateral pledges. The government of China, Chinese firms,
also has reportedly risen amid lockdowns.
and politically connected Chinese philanthropists have
Selected U.S. and Global Responses
provided medical supplies, technical assistance, personnel,
U.S. Assistance. To date, the State Department and U.S.
and training, and have pledged to aid with vaccination.
Agency for International Development (USAID) have
Russia agreed in February 2021 to provide 300 million
publicly announced over $488 million in COVID-19-
doses of its Sputnik V vaccine via the African Union.
focused health, humanitarian, and economic aid for African
Outlook and Issues for Congress
countries, along with ventilator donations for multiple
The pandemic has adversely affected longstanding U.S.
African countries. The Department of Defense and U.S.
policy goals in Africa, including improving health and food
Centers for Disease Control and Prevention (CDC) also
security, encouraging trade and investment, and promoting
have provided support. Most preexisting U.S. bilateral aid
democracy. COVID-19 also has complicated U.S. aid
for Africa has funded health programs, focused primarily
implementation, military cooperation, commercial access,
on HIV/AIDS (Fig. 2).
and oversight. China and Russia, meanwhile, appear to
Figure 2. U.S. Bilateral Aid to Africa by Sector
view COVID-19 as an opportunity to bolster their influence
Funds Appropriated to State Department and USAID, FY2019
and image in Africa vis-à-vis Western countries.
African governments have struggled to access critical
supplies to fight COVID-19. Regional leaders have called
for greater equity in global access to vaccines and
therapeutics, and for increased financial assistance. To date,
U.S. economic aid in response to the pandemic has been
largely channeled through international financial
institutions such as the IMF, though several countries have
received U.S. bilateral economic aid tied to COVID-19.
U.S. aid and support for multilateral financial assistance for
certain African countries are subject to legal restrictions due
to human rights, human trafficking, or other concerns.
The pandemic is also influencing political stability and
governance in some African countries, affecting electoral
processes as well as freedoms of assembly and expression.
Rising economic hardships may fuel unrest, including in
countries already facing protests, insurgencies, and/or
Islamist militant threats. Governments undergoing volatile
political transitions (e.g., Sudan and Ethiopia) have come
under increased strain. COVID-19 also has sickened and
killed some African senior officials and opposition figures.

President Trump’s criticisms of the WHO—headed by a
Source: CRS graphic, based on public budget documents and
former Ethiopian official—for alleged bias toward China
sectoral allocations provided by USAID in February 2020.
spurred pushback from many African leaders. The Biden
Note: Does not include funds administered on a global basis.
Administration has restored U.S. participation in the WHO,
and has pledged support for COVAX, a multilateral
Other Global Responses. The World Health Organization
initiative co-led by the WHO that seeks to promote
(WHO) has sought to help coordinate and assist COVID-19
equitable global access to COVID-19 vaccines. Some
response efforts in Africa. The WHO, WFP, and African
countries in Africa began receiving vaccines via COVAX in
Union have established air logistics hubs to fly equipment,
early 2021. The impact of U.S. actions on the course of the
supplies, and personnel across Africa. The WHO has also
pandemic in Africa, and on African perceptions of the
worked with Africa CDC to build African countries’ health
United States, remains to be seen.
care, disease surveillance, and lab capacities.
As of January 2021, the IMF had approved nearly $17
Alexis Arieff, Coordinator, Specialist in African Affairs
billion in COVID-19-related financial assistance for 38
Lauren Ploch Blanchard, Specialist in African Affairs
African countries, alongside roughly $408 million in debt
Nicolas Cook, Specialist in African Affairs
service relief through mid-April 2021. The Group of 20 (G-
Tomas F. Husted, Analyst in African Affairs
20) has suspended debt payments for the world’s poorest
IF11532
countries, many in Africa. Officials in China—a G20
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Coronavirus Disease 2019 (COVID-19): Impact in Africa


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