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




Updated August 20, 2020
Coronavirus Disease 2019 (COVID-19): Impact in Africa
As of August 2020, confirmed COVID-19 cases and deaths
to the pandemic (+6-9%). The World Food Program (WFP)
per capita in Sub-Saharan Africa (“Africa”) continued to
has warned of a “hunger pandemic” in Africa, where food
lag other regions. Cases also remained concentrated in a
insecurity was already widespread.
handful of countries, led by South Africa (Figure 1)—
African Government Responses
which has conducted the most COVID-19 tests by far—
Public Health Responses. Despite capacity challenges,
although cases were rising quickly in many locations. In
many African governments quickly ramped up disease
general, World Health Organization (WHO) scientists have
surveillance, case isolation, contact tracing, and behavior
predicted that COVID-19 may spread more slowly in Africa
change measures in early 2020, drawing on lessons from
than in some regions due to social and environmental
managing other infectious disease outbreaks (e.g., Ebola
factors, including poor transportation infrastructure. At the
and tuberculosis). In March 2020, most countries imposed
same time, cases are likely underreported, as testing has
restrictions on air travel, border crossings, large gatherings,
been hampered by capacity constraints and the refusal of a
nonessential businesses, and, in some cases, domestic
few governments to track or publish data. Low death rates
transit. Some imposed curfews. Starting in late April, many
may be attributable to Africa’s young populations, although
African governments began to loosen constraints on
the full effects of COVID-19 comorbidity with conditions
religious services, markets, transportation, and the
such as HIV/AIDS and malnutrition remain to be seen.
education sector. Some countries have since re-imposed
Figure 1. Total Confirmed Cases and Deaths in Africa
some restrictions in response to spikes in cases (e.g., South
as of August 17, 2020
Africa), while others have continued to reopen gradually.
Several countries have pursued innovative responses to the
pandemic. For example, Senegalese institutions have
collaborated 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. South African cell phone firms have
supported the creation of a telemedicine system.
The African Union’s Africa Centers for Disease Control
and Prevention (Africa CDC, founded in 2015 with U.S.
and Chinese support) has helped build local capacity to
detect and respond to COVID-19 by training lab, medical,

and immigration personnel, and by providing test materials,
Source: CRS graphic, based on analysis by Research Assistant Sarah
medical equipment, and other health commodities (e.g.,
Collins of data from WHO Coronavirus Disease (COVID-19) Dashboard. personal protective equipment or PPE). In June, the Africa
CDC launched the non-profit Africa Medical Supplies
The pandemic has further weakened Africa’s already fragile
Platform to support pooled purchases of medical and
health systems, sickening thousands of local health workers
sanitary materials, with the aim to reduce costs, ease
and disrupting efforts to prevent and contain other diseases
procurement, and overcome trade and supply disruptions.
such as HIV/AIDS, tuberculosis, malaria, measles, and
polio. Preventive measures such as distancing and frequent
Economic Responses. Most African governments have
handwashing may not be viable for those without access to
reallocated budget resources, instituted economic stimulus
clean water and sanitation, or in crowded urban areas,
measures (e.g., tax relief or loan guarantees), and initiated
prisons, or camps for displaced persons and refugees. As of
targeted aid for their most vulnerable citizens. U.N.
late 2019, more than 24 million Africans were displaced
agencies, private firms, local civic organizations, and
due to conflicts and natural disasters, and Africa hosted
diaspora groups have supported some efforts. Many central
26% of the world’s refugees, according to U.N. figures.
banks have acted to increase liquidity. Overall, however,
most African governments lack sufficient domestic
The regional economic impact of the pandemic has been
resources to import medical equipment, cushion local
severe, due to a drop in global demand for key African
economies, and build up food stocks. A number of African
natural resource exports (such as oil, natural gas, and
leaders have appealed for new donor aid and/or debt relief
certain minerals), the disruption of global trade and tourism,
to support pandemic response and economic recovery.
and the impact of local lockdown measures. Remittances
from African workers abroad have also withered. The
Governance Implications. Several heads of state have
International Monetary Fund (IMF) and others expect the
invoked emergency executive powers to respond to
region to register its sharpest economic contraction in
COVID-19. Security forces have injured or killed civilians
decades. The World Bank estimated in June that 26 to 39
in some countries while enforcing lockdowns or responding
million more Africans could fall into extreme poverty due
to protests spurred by pandemic-related hardships (e.g., in
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Coronavirus Disease 2019 (COVID-19): Impact in Africa
Kenya, Nigeria, South Africa, and Uganda). Control efforts
which China’s loans are included remains uncertain. Some
have resulted in restricted media access, and crackdowns on
African governments are also in talks with private creditors.
COVID-19-related “false news” have raised concerns from
The government of China, along with Chinese firms and the
press freedom advocates (e.g., in Ethiopia, Somalia, and
prominent Chinese tycoon and philanthropist Jack Ma, have
Uganda). Officials in some countries have been accused of
provided medical and PPE supplies, technical assistance,
corruption and misuse of public health funds (e.g., in
personnel, and training to multiple African countries. The
Democratic Republic of Congo, Kenya, and Zimbabwe).
European Union (EU) pledged in April to reallocate $2.2
Selected U.S. and Global Responses
billion in existing aid to support COVID-19 response in
U.S. Assistance. As of July 29, 2020, the State Department
Africa, alongside a similar bilateral pledge from France.
and U.S. Agency for International Development (USAID)
Outlook and Issues for Congress
had announced over $464 million in health, humanitarian,
COVID-19 has adversely affected bipartisan U.S. policy
and economic assistance to support African responses to
goals in Africa, such as improving health and food security,
COVID-19. The Department of Defense and U.S. Centers
encouraging trade and investment, promoting democracy,
for Disease Control and Prevention (CDC) have also
and countering China’s influence. The pandemic has also
provided support. Most U.S. bilateral aid for Africa
complicated U.S. aid implementation, military cooperation,
supports health programs, focused on HIV/AIDS (Figure
commercial access, and oversight. Ultimately, the pandemic
2).
may reshape Africa’s development and security landscape
Figure 2. U.S. Bilateral Aid to Africa by Sector
and could alter U.S. policy priorities and aid.
Funds Appropriated to State Department and USAID, FY2019
African governments have struggled to access critical
supplies to fight COVID-19 amid global competition, and
leaders have raised concerns about future access to vaccines
and therapeutics. Aid groups and African officials also have
questioned the potential impact of the U.S. withdrawal from
the WHO on the agency’s public health work in Africa,
including routine vaccine campaigns and emergency
responses to other disease outbreaks. African leaders have
also called for 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,
for which Congress appropriates U.S. funds. U.S. support
for multilateral debt relief or credit for certain countries
(e.g., Zimbabwe and Sudan) has been limited by
longstanding U.S. policy and legislative restrictions.
The pandemic could affect regional political stability and
governance trends. Many countries have imposed new
restrictions on civil liberties and/or disrupted parliamentary
and judicial functions. Elections may be delayed—as in
Ethiopia—or marred by low turnout. An inability to contain
COVID-19 and/or respond effectively to its economic
shocks may further undermine the popular legitimacy of
governments already facing protests, insurgencies, and/or

Source: CRS graphic, based on public budget documents and
Islamist militant threats. Governments undergoing seismic
sectoral al ocations provided by USAID in February 2020.
political transitions (e.g., in Sudan and Ethiopia) have come
under increased strain. Some observers suspect that
Note: Does not include funds administered on a global basis.
Burundi’s president became the world’s first head-of-state
Other Global Responses. The WHO has sought to
fatality from COVID-19 when he died in June 2020—
coordinate aid and guide COVID-19 response efforts in
although “cardiac arrest” was the official cause.
Africa. The WHO, WFP, and African Union have
Meanwhile, several foreign governments seeking to
established air logistics hubs to fly equipment, supplies, and
increase their influence in Africa, including China, appear
personnel across Africa, and to help medically evacuate
to view COVID-19 as an opportunity to do so. The Trump
responders. The WHO is also working with the Africa CDC
Administration’s assertion that the WHO (headed by a
to build African countries’ health care, disease surveillance,
former Ethiopian official) aided China’s COVID-19 “cover-
and lab capacities. (The Trump Administration suspended
up” spurred a sharp pushback from African leaders. At the
U.S. funding for the WHO in April 2020 and pledged in
same time, the poor treatment of some Africans living in
May to withdraw from the organization.)
China during the pandemic, the reportedly poor quality of
As of August 2020, the IMF had approved pandemic-
some Chinese donated equipment, and uncertainty over
related emergency loans for 33 African countries and
debt relief may undermine pro-China narratives in Africa.
separate debt service relief for 22 African countries. The
Group of 20 (G-20) has suspended debt payments for the
Alexis Arieff, Coordinator, Specialist in African Affairs
world’s poorest countries, many in Africa. The extent to
Lauren Ploch Blanchard, Specialist in African Affairs
Nicolas Cook, Specialist in African Affairs
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Coronavirus Disease 2019 (COVID-19): Impact in Africa
Tomas F. Husted, Analyst in African Affairs
IF11532
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Coronavirus Disease 2019 (COVID-19): Impact in Africa


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