The COVID-19 pandemic in the African continent

Abstract

In December 2019, a new coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and associated disease, coronavirus disease 2019 (COVID-19), was identified in China. This virus spread quickly and in March, 2020, it was declared a pandemic. Scientists predicted the worst scenario to occur in Africa since it was the least developed of the continents in terms of human development index, lagged behind others in achievement of the United Nations sustainable development goals (SDGs), has inadequate resources for provision of social services, and has many fragile states. In addition, there were relatively few research reporting findings on COVID-19 in Africa. On the contrary, the more developed countries reported higher disease incidences and mortality rates. However, for Africa, the earlier predictions and modelling into COVID-19 incidence and mortality did not fit into the reality. Therefore, the main objective of this forum is to bring together infectious diseases and public health experts to give an overview of COVID-19 in Africa and share their thoughts and opinions on why Africa behaved the way it did. Furthermore, the experts highlight what needs to be done to support Africa to consolidate the status quo and overcome the negative effects of COVID-19 so as to accelerate attainment of the SDGs.

Keywords: Africa; COVID; Coronavirus; Coverage; Epidemiology; Essential health services; Health; Immunity; Infectious disease; Pandemic; Vaccination.

Fig. 1

Dr. Godfrey Bwire (MBChB, MPH, PhD) is a medical doctor, researcher, and policymaker. Godfrey is the current head of the division of public health emergency preparedness and response of the Republic of Uganda Ministry of Health. In addition, Godfrey is a research fellow in the department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda. Godfrey’s research interests are on infectious diseases, public health, and cholera. Bwire et al. identified a new Vibrio cholerae transmission event from South Asia to East Africa, PMID: 29864113. Godfrey has an excellent peer-review record and has great interest in advancing research through, international collaborations, peer reviews, publications, and editorial work

Fig. 2

Shows the top and least COVID-19 affected countries in Africa after excluding the island states (which had very few cases) except Comoros. This analysis is based on COVID-19 data reported to the World Health Organization for the period 2020–2021. A The top most COVID-19 affected countries presented in the descending order. B Least affected countries in the ascending order after excluding the island states

Fig. 3

The barriers to COVID-19 introduction into Africa and reporting of cases and deaths to the World Health Organization. It is possible that the transmission / protective barriers to SARS-CoV-2 introductions and the health system barriers (low COVID-19 testing and low reporting of cases and deaths) could have complemented each other to result in low COVID-19 incidence and mortality for Africa during the period 2020–2021

Fig. 4

Alex Riolexus Ario is the Director of Uganda National Institute of Public Health. A Public Health Specialist with extensive knowledge in epidemiology, health policy, health systems, and quality improvement models. He has worked in various capacities in Ministry of Health and served as a member in numerous TWGs, Steering Committees, and Boards; Board Member, Africa CDC’s Journal of Public Health in Africa; Member, Africa Mortality Surveillance Taskforce, Advisory Committee, Koffi Annan Global Health Leadership Program and Africa COVID-19 Surveillance Taskforce; Deputy Chair, East Africa Mortality Surveillance Taskforce and Uganda COVID-19 Inter-Agency Technical Taskforce; Chair East-Africa Regional Technical Advisory Committee and IANPHI, Africa Network

Fig. 5

Eyu Patricia, BBLT, MPH, is a field epidemiologist with 4 years of experience in public health and epidemiology. She has worked in both private and public institutions and supported the Ministry of Health under various positions. Most recently, Patricia supported the Uganda COVID-19 response in case investigation, strengthening the surveillance structures at the districts, alert reporting, and developing surveillance tools. She has publications in food poisoning and other disease outbreak investigations. Patricia is currently a field epidemiology trainer in the Field Epidemiology Training Program-Intermediate level and part of the mentorship team in the Advanced FETP

Fig. 6

Felix Ocom is the Deputy Manager of the National Public Health Emergency Operations Centre, Ministry of Health, Uganda, and a member of COVID-19 Incident Management Team. Felix is a national trainer for the Uganda National Rapid Response Teams for public health emergencies, and Integrated Disease Surveillance and Response. He participates in the development, implementation, and evaluation of national public health emergency preparedness and response strategies, in line with International Health Regulations (2005). Felix has worked with the WHO (2016–2020) as a consultant epidemiologist, US CDC (2008–2012) as a public health specialist (HIV Biomedical Prevention), and in various positions in the public health sector in the Government of Uganda. Felix’s interests include public health emergency management and building resilient systems for public health emergency preparedness and response at community levels

Fig. 7

Dr. Wamala Joseph Francis is the Country Preparedness Officer in the WHO Country Office for South Sudan, Juba. He holds a Medical Degree and a Master’s in Public Health from Makerere University, Kampala, Uganda and a Ph.D. in Public Health Epidemiology from Walden University, Minnesota, USA. His professional career and research work focuses on public health surveillance and epidemiology of epidemic and pandemic prone diseases in the developing and humanitarian contexts. Dr Wamala has over 20 years of work with national Ministries of Heath, one-health stakeholders, and other actors critical for strengthening emergency preparedness, response readiness, and public health security

Fig. 8

Dr. Kwadwo Asamoah Kusi is a Senior Research Fellow in Immunology at Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana. He holds BSc and MPhil degrees in Biochemistry from University of Ghana and a PhD in Medicine from Leiden University Medical Centre, The Netherlands. His research focuses on identifying protective immune response targets in Plasmodium and on multi-allele vaccine formulation strategies to counter the strain-dependent effects of antigen polymorphism on immune responses. Dr. Kusi is lead immunologist on ongoing clinical trials at NMIMR. He was recipient of the Ghana National Youth Achievers Gold Award for Science in 2012

Fig. 9

Kondwani Charles Jambo is a Group Leader at the Malawi-Liverpool-Wellcome Programme and a Senior Lecturer at the Liverpool School of Tropical Medicine. He is an immunologist, with an interest in natural and vaccine-induced immunity at the individual and population level. His research aims at addressing public health problems relevant to low-income settings. His research has provided critical insights on the extent of SARS-CoV-2 population exposure and immunity in Malawi. He has provided expert advice towards formulation and revision of the national COVID-19 vaccination policy. Dr Jambo is a recipient of the Wellcome Intermediate Fellowship and the MRC African Research Leader award

Fig. 10

Dr Latif Ndeketa is Principal Research Associate at the Malawi-Liverpool-Wellcome Trust Clinical Research Programme (MLW). At MLW, he is the Deputy Group head of the Infectious Disease Epidemiology Group and co-leads the Vaccines Theme. Latif contributes to the accelerated reduction of morbidity and mortality of vaccine preventable diseases in low-income settings through novel surveillance methods for vaccine programs. He leads clinical research studies, provides scientific advice to relevant government and private institutions, and is an active member of several national technical advisory committees. He is a Medical Doctor with a Masters in Vaccinology and Drug Development, and a Masters in Epidemiology

Fig. 11

Dr. Rhoda Wanyenze, MBChB, MPH, PhD, is Dean of the School of Public Health and a Professor in the Department of Disease Control and Environmental Health at Makerere University. Dr. Wanyenze has vast experience in public health research, capacity building, and program management, especially in infectious diseases, sexual and reproductive health, and health systems. She has led a wide network of research partnerships with academic institutions and ministries of health in Africa and is Principal Investigator for a study evaluating the Covid-19 response in five countries in Africa. She has served on Boards of several organizations in Uganda and globally

Fig. 12

Ambrose has medical degree in human medicine, a master’s degree in epidemiology and a PhD in biomedical sciences. Between 1996 and 2011, Ambrose held senior management, leadership and scientific positions at the Uganda Ministry of Health, the Institute of Tropical Medicine, Antwerp and the Medicines for Malaria Venture (MMV). He has been field coordinator for multi-country malaria clinical trials and a senior fellow of the European and Developing Countries Clinical Trials Partnership (EDCTP). Between 2011 and early, 2016, he was regional scientific director for East Africa of the Worldwide Antimalarial Resistance Network (WWARN) and later senior clinical research fellow with the University of Oxford-KEMRI Wellcome Trust Programme. Since 2016, Ambrose has been regional advisor for health security and International Health Regulations, spearheading the efforts to build and sustain capacities to better prevent, detect and respond to infectious disease epidemics, pandemics and other public health threats before they spread