Covid-19 spread risk in the African continent

Source: Jeune Afrique. Graphic data processing by IFI Advisory

On 14 February 2020, the Egyptian health authorities officially confirmed a Covid-19 case in Egypt, the first in the country and in the entire African continent. The patient, a Chinese citizen travelling to Egypt, was identified upon entering the country during the health screenings currently in force at all Egyptian international airports.

Since the beginning of the Covid-19 health emergency, there have been numerous suspected cases in Africa (so far, in South Africa, Angola, Botswana, Burkina Faso, Ivory Coast, Cameroon, Ethiopia, Gabon, Ghana, Guinea, Equatorial Guinea, Kenya, Madagascar, Mauritius, Namibia, eSwatini, Democratic Republic of the Congo, Uganda, Nigeria, Sudan and South Sudan). Although most of the suspected cases reported to the World Health Organization (WHO) have not been confirmed, about ten people are still quarantined and will have to undergo further screening.

Source: Africa CDC

In general, it is no coincidence that the first African case has been identified in Egypt: first, Egypt has higher health standards than the other countries of the continent, thus allowing for faster identification of any cases of infection; second, Egypt is one of the main regional hubs for connections to and from China, which exposes the country to greater risk than other states in the continent.

However, the presence of a better health and public health emergency management system than the average in African countries also suggests that Egypt will be equipped to contain the spread of the virus. The French National Institute for Health and Medical Research has recently prepared a paper on behalf of the French government on how ready the African continent is to deal with a possible Covid-19 outbreak: the paper identifies Egypt as the country facing the highest risk of importing the virus, but, at the same time, the one relying on the highest health standards to respond to the emergency.

Research on how the disease is going to spread in the African continent is based on two factors: the ability of countries to respond to health crises (assessed mainly against the SPAR – State Parties self-Assessment Annual Reporting, which states send to the WHO) and the Infectious Disease Vulnerability Index – IDVI. Based on the said assessment systems, the best prepared countries for a Covid-19 outbreak would be South Africa, Egypt, Tunisia and Morocco, followed by Botswana. Somalia, South Sudan, Mauritania, Chad and Central African Republic are, instead, the least prepared ones. Generally speaking, response capabilities in the event of a Covid-19 outbreak are particularly low in the continent. This is likely to expose Africa to a high risk of spreading Covid-19.

More in detail, some OMS-led international studies have classified 13 countries as ‘at greater risk’, also on the basis of direct flight connections and the number of Chinese passengers travelling through African airports (the assessment, therefore, does not take other entry points into account), namely Algeria, Angola, Ivory Coast, Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Mauritius, South Africa, Tanzania, Uganda and Zambia. However, this assessment may change according to the development of the spread of Covid-19 in Chinese provinces.

In order to respond to mounting concern, politic and health institutions have set a continental task force (‘Task Force Africa’), composed by epidemic experts constantly in contact with WHO and coordinated by 5 countries (Senegal, Kenya, Morocco, Nigeria and South Africa). National and international health institutions are focussing efforts on enhancing diagnostic capability in the African Union (AU) member states: currently, approximately 16 out 54 countries are equipped to test coronavirus: about 90% of African countries are expected to complete the process by the end of the month.

The spread of Covid-19 virus poses a severe threat for Africa, as it exacerbates a critical situation in the continent, linked with weaknesses of public healthcare (broadly precarious and inefficient, with poor capabilities to diagnose and respond to epidemics), the spread of infectious diseases (especially malaria, tuberculosis or HIV-infections), food and hygiene insecurity (according to UN Agency data of 2016, nearly 28% of the African population is under food insecurity risk). Concern is also related to a significative number of people at risk of contagion due to the high demographic pressure of the continent.

The possibility of a spread of uncontrolled outbreaks might hinder the continent’s socio-economic development, further reducing its growth prospects. On the other hand, from an international perspective, an uncontrolled spread of the virus in Africa would also extend globally.

The said issues, therefore, make it necessary for companies running business in Africa to take specific mitigation measures, so as to ensure regulatory compliance, protection of people and asset integrity. This cannot be done without a preliminary analysis carefully carried out in order to find out legal obligations, organisational and procedural gaps, potential operational risks (which vary depending on the sector of activity and areas of operations), and, consequently, measures to implement.