The pandemic is moderate now but could spiral out of control in Africa

As the Covid-19 pandemic spreads worldwide, causing sickness and death as well as social, trade and travel disruption, Africa's heads of states are anxiously watching and scratching their heads. This is the first time that African countries will have to contain a pandemic, treat its victims and feed the poor and the unemployed while on quarantine and as independent states.

Will they rise above self-interest and prioritise the health and welfare of their citizens, invest in their healthcare system, reform their bureaucratic public sector supply system and close the life-threatening poverty gaps to both mitigate the impending spread of Covid-19 and, by extension, drive down the risk of future pandemics. Or will they wreak havoc?

This is the pivotal unknown in this pandemic. I am praying Africa's leaders rise above their selfish interests.

A pandemic, according to WHO, is the worldwide spread of a new disease — and Africa is no stranger to this.

Take my beloved Democratic Republic of Congo, for instance. Since 1976, we have experienced over ten bouts of Ebola – the quintessential zoonotic killer. The most recent and by far the country's largest-ever outbreak only ended few days after Valentine's Day on 17 February 2020 after nearly two years of rampage

In South Africa, which is home to Africa's best-developed healthcare system, around 7.7 million people living with HIV — the world's largest population of people living with HIV.

Elsewhere in the continent, the epidemics of cholera, malaria, obesity, tuberculosis or chronic hunger still rages.

However, compared with the new Covid-19, which is easily spread through coughing, sneezing or contact with contaminated hands and surfaces, the pathogens behind outbreaks such as Ebola appear quite moderate.

From its origin in Wuhan, a sprawling metropolis in central China where the global coronavirus outbreak began, Covid-19 has now infected over 537,000 people in 176 countries and has killed over 24,000 - and many more are unfortunately expected to die in the coming weeks and months.

That is a staggering number that should frighten us all, particularly given that Europe, North America, the Middle East and China, unlike much of the countries in Africa, have the money, healthcare and manpower to rapidly contain a pandemic, treat its victims and support the broader population while on quarantine.

In much of Africa, healthcare systems are weak. The few healthcare facilities that exist often lack the most basic equipment. More than 98 percent of drugs consumed in Africa are produced abroad, which makes it hard to access the right medicine, at an affordable price.

Most health facilities are often understaffed with poorly trained, overworked and underpaid healthcare personnel. This is why diseases that have a 90 percent cure rate in India have a 90 percent death rate in Somalia or Malawi.

While existing Covid-19 cases in Africa remain moderate in number comparatively, but what is clear is this could dramatically spiral out of control.

The pandemic in Italy, which has one of the world's best healthcare systems with a GDP equal to that of Africa's 54 countries combined, went from 2 cases in Rome on 31 January to over 80,000 confirmed at the time of writing with 8,215 deaths – the highest number of confirmed deaths in the world.

That prospect, while hardly certain, brings into focus Africa's urban areas, which are perhaps most at risk and where 40 percent of the continent's 1.2 billion people live — and this is an underappreciated part of this pandemic.

But what makes Africa different is that so many are poor and living with underlying health and social issues. You have the three big killer diseases on the continent; malaria, tuberculosis and HIV/AIDS coupled with problems stemming from poverty, climate change, unemployment, political violence and corruption.

How many could be stricken or require medical care over the next 14 days or 14 weeks or 14 months – adding even more pressure on the few healthcare facilities that sustain many communities – is anyone's guess.

A pandemic, history has shown us over and over, is never an isolated crisis. Pandemics are always monsters with multiple heads, and the coronavirus is no different.

We are anxiously watching and scratching our heads as it continues to rage across Europe while simultaneously morphing into an economic crisis.

If it continues to worsen, which is what the WHO says is happening, it could become a political crisis. In places like South Sudan, CAR, Somalia, Libya, Nigeria, Chad and Congo, where insecurity and armed conflicts are already raging, very little stands between the best and worst-case scenarios.

A joint effort will be required to fight the pandemic on the continent.

It takes little imagination to envision the impact this could have should Africa's leaders let Covid-19 spread with the same sweeping inexorability as it has done in Wuhan or Italy.