How Africa Defied the Odds with Fewer COVID-19 Deaths

When the COVID-19 pandemic was declared a global emergency in March 2020, the international community braced for a catastrophic impact on Africa. The continent’s underfunded health systems, limited infrastructure, and high poverty levels led many to predict that Africa would suffer the worst outcomes. Alarmist predictions suggested millions of lives would be lost, and the healthcare systems in several African nations would collapse under the strain. However, five years after the pandemic began, Africa has proved these forecasts wrong. Despite the challenges, Africa’s recorded death toll remains astonishingly low, standing at just over 175,500 deaths, which constitutes only about 2.5% of the global death toll of 7 million, according to the World Health Organization (WHO).

Early Warnings and Dire Predictions

In the early stages of the pandemic, global health experts predicted that Africa would be the hardest-hit region due to its limited resources and health infrastructure. For example, the United Nations Economic Commission for Africa projected that up to 3.3 million people could die in the region as a direct result of the pandemic. The situation seemed particularly dire because many African countries faced challenges such as overcrowded urban slums, inadequate healthcare facilities, and fragile health systems that struggled even in the face of basic infectious diseases like malaria and tuberculosis.

Yet, as the pandemic unfolded, Africa defied these grim forecasts. While the global death toll from COVID-19 surged, Africa’s death rates remained comparatively low, and this phenomenon has sparked a great deal of interest and debate among researchers and public health experts.

Africa’s Resilience: Lessons from Past Epidemics

One key factor contributing to Africa’s unexpected resilience in the face of COVID-19 is its experience with other devastating outbreaks, such as Ebola, MERS, and HIV/AIDS. African countries have faced serious public health threats in the past, and their responses to those crises helped build capacity and knowledge that would later be invaluable during the COVID-19 pandemic. Health experts point to Africa’s ability to manage previous outbreaks as a critical reason behind the continent’s successful handling of COVID-19.

Oyewale Tomori, who chaired Nigeria’s advisory committee on COVID response, emphasized that African scientists and public health officials already had vast experience in tackling infectious diseases. This expertise, developed over decades of dealing with anthrax in Kenya, Ebola in Nigeria, and Marburg and Mpox in Rwanda, proved to be an asset in the fight against COVID-19. Even though Africa received significant international support, the continent’s ability to effectively control disease outbreaks and engage in practices such as border surveillance, contact tracing, and patient isolation were vital to keeping the COVID-19 death toll lower than anticipated.

The Role of Data and Testing Capacity

While testing capacity in Africa was initially limited, efforts to rapidly scale up diagnostic capabilities proved crucial. The Africa Centres for Disease Control and Prevention (CDC), led by Mosoka Fallah, took proactive steps to prepare the continent for the impending threat of COVID-19. Before Africa identified its first case in February 2020, the Africa CDC convened health ministers from across the continent to develop a coordinated strategy to tackle the pandemic.

At the time, there were only two labs in Africa capable of testing for the virus. However, the Africa CDC opted to train scientists locally, particularly in countries like South Africa and Senegal, rather than relying on international laboratories. This decision allowed the continent to build its own diagnostic capacity and reduce its dependence on external entities. The Africa CDC also partnered with Ethiopian Airlines and the World Food Programme to facilitate the transportation of medical supplies and testing kits across the continent when international flights were grounded.

By leveraging local resources, including the support of philanthropic organizations like the Jack Ma Foundation, and fostering partnerships within Africa, the continent managed to strengthen its testing and diagnostic capabilities. African nations like Ghana even began producing their own personal protective equipment (PPE) to address shortages in clinics.

Strict Lockdowns and Demographic Advantage

Another critical factor that helped limit the spread of COVID-19 in Africa was the continent’s strict containment measures. Many African countries, including South Africa and Kenya, imposed some of the world’s most stringent lockdowns early on. In South Africa, for instance, the government deployed police and soldiers to ensure compliance with social distancing regulations and restrictions on gatherings, including alcohol consumption and the sale of cigarettes.

These measures, although controversial at times due to instances of police brutality, were effective in reducing the spread of the virus, particularly in the early stages of the pandemic. In Kenya, health authorities restricted funeral attendance to no more than 15 people, and burial ceremonies were carried out swiftly to minimize exposure.

Africa also benefited from its relatively youthful population. With more than 70% of sub-Saharan Africa’s population under the age of 30, the continent’s demographic profile was advantageous in fighting COVID-19. Younger people tend to experience milder symptoms and have stronger immune systems compared to older individuals, which resulted in fewer hospitalizations and fatalities. Research found that two-thirds of Africa’s population experienced asymptomatic or mild cases of the virus, further reducing the number of severe infections and deaths.

Community Outreach and Public Awareness

In addition to government measures, community outreach played a significant role in controlling the spread of the virus. In rural areas, local populations were generally well-informed about the virus, and many actively reported suspected cases to health authorities. This strong sense of community cooperation helped identify and isolate cases more quickly than in regions where public awareness and contact tracing systems were less robust.

Moses Orinda, head of health programs for Catholic Relief Services in Kenya during the pandemic, explained that Africa’s strong community outreach networks and public awareness campaigns were key in preventing widespread transmission. Despite the lack of widespread testing, many villages actively engaged with health authorities to report cases and prevent outbreaks from spreading further.

Underreporting and Data Gaps

While Africa’s relatively low death toll has been widely praised, experts caution that the true impact of COVID-19 in Africa may not be fully understood. A lack of widespread testing and challenges in data collection have contributed to gaps in accurate reporting. For example, the WHO has acknowledged that African countries conducted fewer tests compared to nations in Europe and the United States, which may have resulted in an underreporting of cases and deaths. A 2022 World Bank study also found that Kenya, in particular, underreported its COVID-19 death toll.

Despite these challenges, African health experts believe that the continent’s response to the pandemic was far better than initially expected. The relatively low death toll compared to the grim predictions made in 2020 highlights the resilience, adaptability, and innovative approaches adopted by African countries in managing the crisis.

The Road Ahead: Strengthening Health Systems

Although Africa’s experience with COVID-19 has been more favorable than initially anticipated, there is still much work to be done. Mosoka Fallah pointed out that the pandemic highlighted critical gaps in Africa’s health systems, particularly in rural areas. While some countries responded effectively, there is a pressing need to strengthen healthcare infrastructure, including primary health care centers and diagnostic capabilities, to ensure that future disease outbreaks can be detected and controlled at the community level.

“We need to be able to build stronger, accessible primary health care centers that have drugs, water, and diagnostics, so that our people can get treatment in their villages without burdening hospitals in cities,” Fallah emphasized. By investing in healthcare infrastructure, Africa can better prepare for future health crises and continue to defy the odds in the face of global challenges.

Africa’s experience with COVID-19 serves as a powerful reminder of the importance of local expertise, community cooperation, and innovative problem-solving. The continent’s ability to weather the storm and keep death rates low is a testament to the resilience of its people and the adaptability of its health systems. While challenges remain, Africa’s success in combating COVID-19 provides valuable lessons for other regions of the world facing similar crises. By continuing to invest in healthcare infrastructure, fostering community engagement, and harnessing local knowledge, Africa can ensure a more robust response to future health threats.