As the number of confirmed COVID-19 cases increases around the world—with new clusters recently emerging in Italy, Iran and South Korea—the World Health Organization (WHO) warns that its “biggest worry” is to make sure that the disease does not spread in countries with weaker health systems that have historically struggled to contain infectious disease outbreaks in the past, many of which are in Africa.
The WHO has prioritized response and detection measures in 13 African countries because of their direct links with or high volume of travel to and from China. Organizations like the WHO and the Bill & Melinda Gates Foundation are now trying to strengthen public health systems across Africa in preparation for a COVID-19 outbreak. “The threats posed by COVID-19 [have] cast a spotlight on the shortcomings in health systems in the African Region,” Dr. Matshidiso Moeti, WHO Regional Director for Africa, said in a statement on Feb. 22, noting that there are “critical gaps in readiness for countries across the continent.” That’s especially true for COVID-19, because it’s a “respiratory disease and the systems in Africa, historically, have not been as well developed for that,” said Dr. Mike Ryan, executive director of the World Health Organization’s health emergencies program, at a press conference Feb. 24.
Even countries with strong health systems have struggled to respond to the COVID-19 outbreak. The healthcare infrastructure in Wuhan, China, where the outbreak began, “which is much more capable than most places in Africa, was overwhelmed for weeks,” says Scott Dowell, deputy director in the Global Health Division of the Gates Foundation who is leading the organization’s COVID-19 response. Authorities in Wuhan built two hospitals in less than two weeks and more than 30,000 health workers from across China were sent to the city at the epicenter of the outbreak. “There’s virtually no place in Africa that can manage that kind of surge,” Dowell says.
The 2019 global health security index, a project from the Nuclear Threat Initiative and the Johns Hopkins Center for Health Security, categorized 195 countries across the globe as either “least,” “more,” or “most” prepared when it comes to their ability to prevent, detect and respond to disease outbreaks. Over 30 African nations were scored “least prepared.” (Other countries in that category include Yemen, Syria and Venezuela).
Outside of mainland China, there have been upwards of 2,700 cases of COVID-19 identified and at least 45 related deaths across more than 35 countries, as of writing. Two weeks ago, Egypt reported the first “confirmed” COVID-19 case on the African continent. Subsequent testing suggests the individual may not have the disease but they are still being monitored for a 14-day observation period that is supposed to end on Feb. 27. A second COVID-19 case was reported on the continent on Feb. 25 in Algeria, which is one of the 13 African countries the WHO has identified as a top priority. But experts say it’s very possible there are many more cases in African countries beyond these two.