COVID-19: A race against time to avert disaster in West Africa

The days when COVID-19 was but a distant threat to West Africa are over. It is now clear that the virus is here to stay: with the exception of South Africa, the region is the hardest hit in sub-Saharan Africa. Burkina Faso, Guinea, Ghana, the Ivory Coast, Nigeria and Senegal are at the top of the list. Luckily, the infection curve is not exponential, even if community transmission of the virus is gaining ground.

West African leaders are acutely aware that prevention is the only way to avert a disaster. They have responded quickly and aggressively, knowing full well that they could pay a high price, like they did with the Ebola outbreak, if they fail to act decisively.

At the start of the COVID-19 pandemic, there was only one laboratory in the region that was equipped to diagnose the virus. Healthcare systems in West Africa, which have long been underfunded and overburdened, would quickly be overwhelmed if the situation were to escalate. 

The dilemma of social distancing

To curtail the spread of COVID-19, curfews, restriction of movement within countries and closure of borders, schools, markets or religious sites are now the norm in many West African states. Nigeria has gone a step further, imposing (and extending as per 13 April) a total lockdown in Lagos and Abuja. In Senegal, President Macky Sall does not exclude this possibility, given the imminent danger of an exponential rise of community transmissions in cities like Dakar.

However, enforcing a complete lockdown in the region is impossible. Millions of people live in densely populated urban settlements often with communal access to water and sanitation facilities; not everybody has a fridge and continuous access to electricity to store food; and, more importantly, an overwhelming majority of the population works in the informal sector and cannot survive without their daily wage.

A strict quarantine and its consequences on people’s livelihoods would have devastating effects on food security, schooling levels, the fight against preventable diseases and a variety of other development indicators across the region. This would increase other causes of mortality, probably affecting the population in proportions much higher than COVID-19 would.

Full lockdown policies must be backed by a solid social security net that can effectively prevent the most vulnerable from slipping into severe poverty or malnutrition. In West African countries, alternatives to a full lockdown have to be considered. The following is a non-exhaustive list of possibilities:

  • Improving access to clean water, hand-washing and sanitation, or other policies to decrease the viral load.
  • Following the Asian model by imposing a universal mask-wearing requirement in public spaces – a cheap but effective measure to slow down the infection rate. Senegal has made mask-wearing compulsory as of 19 April. 
  • Focusing on mass testing and tracing COVID-19 infection routes. 
  • Implementing targeted social isolation of at-risk groups – more carefully protecting them would relieve pressure from intensive care units.
  •  Limiting the amount of people allowed on public transport (both official and unofficial), while supporting the entities who run the service to ensure the availability of more vehicles.
  • Reorganizing public markets instead of closing them down in order to reduce infection risks and improve hygiene conditions. Many trading spaces have an informal organisation system to assign stalls, intervene in disputes, etc. Authorities should work in collaboration with these structures instead of unilaterally.

Of course, none of these suggestions would be effective without widespread awareness campaigns to encourage behaviours that slow the spread of COVID-19. Providing the population with accurate information about the disease is also key. To enhance the success of these efforts, community and religious leaders must be involved in the process.

This is especially important since security forces and authorities in some countries have come under fire for the use of force and brutality to enforce lockdown restrictions. A great dose of pedagogy – not violence – is essential for the population to adhere to the fight against COVID-19, particularly if the situation affects their livelihood.

Economies on a cliff edge

The economic crisis will be of a similar scale to the public health disaster. According to the World Bank, West Africa’s growth “is expected to weaken substantially” due to a fall in external demand and domestic production disruptions. The COVID-19 recession is a chance to rethink the region’s international trade model – massively exporting raw materials and importing manufactured goods in return. Supply problems, price increases and higher unemployment rates are among the likely consequences.

West African countries have been pouring money into funds to support businesses and social security grants. Burkina Faso has announced a 394 billion CFA emergency plan; Senegal will release 69 billion CFA for food distribution and has created the “Force COVID-19” fund, endowed with 1000 billion CFA; Ghana will release 1 billion cedis and Nigeria has promised conditional cash transfers to the country’s most vulnerable and a 500 billion naira corona-fund. Water and electricity bills will also be taken care of by many of these states.

However, these measures are very difficult to implement as they often fail to reach the most vulnerable. For instance, it is a widespread worry in Senegal and Nigeria that the resources to back businesses and vulnerable households will be granted to government supporters or those in circles close to it.

An opportunity for West African integration

At regional level, it is the West African Health Organisation (WAHO), a specialised institution part of the Economic Community of West African States (ECOWAS), which has taken the lead in responding to COVID-19. Medical supplies such as diagnostic test kits, personal protective equipment for health staff and prescription tablets have been urgently distributed to member states, and online training of healthcare personnel was arranged.

These interventions complemnent the ECOWAS assistance plan (humanitarian assistance and support for economic recovery). This initiative is promising news; it now must be translated into action.

Firstly, supporting public healthcare systems; pooling human, scientific, technical and academic resources and sharing good practices is essential. West Africa’s already shaky economies will suffer enormously if each state fights on its own. Financial support from the ECOWAS to tackle the crisis – also the economic one – is needed to avoid a human disaster.

Finally, the WAHO should establish guidelines and recommendations in line with the aforementioned suggestions for the sake of coordination. The disproportionate use of force by some member states to enforce the lockdown must be firmly condemned; turning a blind eye equates to normalising violence.

The virus knows no borders. The response of the ECOWAS to the crisis should show the unity of a choir, rather than the dissonance of an unruly cacophony. Supranational organisations have traditionally been perceived as ineffective in the region – this is an opportunity for the ECOWAS to prove that it is united and that is has practical relevance to people’s lives. It is not too late to avoid a disaster, but time is ticking and citizens are watching.

(Main image: A beverage seller is seen walking around a street in Dakar, Senegal on 21 April 2020. Senegal has imposed mandatory wearing of face maks in all public and private workplaces, markets, bazaars and public transportation vehicles to curtail the spread of COVID-19. – Alaattin Dogru/Anadolu Agency via Getty Images)

The opinions expressed in this article are those of the author(s) and do not necessarily reflect the views of SAIIA or CIGI.

22 April 2020
Contributor
Subject
Diseases, Epidemics