The way to a pragmatic containment strategy for Covid-19 in Africa

The Covid-19 virus has now hit almost every country in Africa, and altogether there are more than 36,847confirmed cases with 1589 deaths.

The predicted level of infection from current models is almost too ghastly to contemplate, but they may turn out to be correct. The United Nations Economic Commission for Africa (UNECA) recently warned that in a best-case scenario, Africa might face 300,000 Covid-19 deaths in 2020. 

The African Union Bureau of Assembly rightly considers that the pandemic "could explode in an even more catastrophic way than has been seen thus far in Africa." 

Dark storm clouds hang over the African people, and our broader societies and states. 

At the same time, with lockdowns and restrictions being extended in many African countries, people are posing questions (and sometimes demanding answers from authorities) as to when and at what stage should these restrictions be lifted or at least relaxed. 

Between hunger and corona

Lockdowns pose a policy dilemma with several possible equations; each with an opportunity cost but not necessarily of equal weight. Preventing the spread of the virus and saving lives demands urgent measures like social distancing, lockdowns, travel bans and states of emergency. 

In the context of the informal economy in Africa, these actions severely impact the livelihood of families with disastrous effects on communities, draining their assets and family savings. These measures will likely destroy national economies. 

The adverse economic impact is a hammer-blow that could see Africa lose all the advances it has made it has made in recent times.

The known effective means of flattening the exponential infection curve, social distancing, is proving difficult in Africa and cannot be maintained for a long time due to its destruction on livelihoods.

Mitigating these impacts on the poor and the economy would require significant public expenditure on social protection nets and huge investments in the public sector, especially the health sector plus a stimulus for overall economic recovery. 

Failing to provide continuous stimulus may render the economy irreparably damaged. Without economic activity, and state coffers overstretched, treasuries will lack replenishment in the absence of standard revenue generation. 

All these tacitly infer policy alternatives that create policy dilemmas. These policy dilemmas throw a spotlight on the quality of leadership and governance. 

The fact is that poverty is a vector spreader of Covid-19. Extreme poverty not only undermines immunity but also creates crowded living conditions that make physical/social distancing near impossible. Lack of access to water and consequent poor hygiene adds to Africa's vulnerability for the spread of the virus. 

Extreme poverty makes the propagation of the virus easy, and at the same time, it is extreme poverty that makes the prevention (in the form of social distancing, hospitalisation and financial support for livelihoods) very difficult. 

But what should Africa's policy choice to contain the spread and impact of Covid-19 be?

Pragmatic containment strategy 

The strategies currently applied by the Europeans and Americans such as extensive testing, ICU hospitalisation, offering welfare to citizens, and large stimulus packages aren't possible in Africa. 

As with many other outbreaks, most African countries have no realistic alternative to Covid-19 prevention programmes because the financial and structural demands of an adequate treatment regime far exceed capacity. 

Prevention, however, primarily demands social distancing, which is unlikely without stricter community measures than those now in place. Hence flattening the curve will take time and many lives. 

African countries need to balance the saving of lives and livelihoods. The best approach for a delicate balance is to ensure that measures are pragmatic, dynamic, flexible and localised. 

A localised and pragmatic containment strategy needs to aim at saving lives by taking urgent measures to contain local transmission, lower infection and death rate. Such a strategy may reduce levels of illness and hospitalisation. 

At the same time, it needs dynamic and flexible sets of measures that allowing quick adjustment based on local realities, local expertise and proximity to hotspots, borders, markets and churches and mosques.

The mitigation of the adverse impacts of the pandemic on the livelihoods of the poor and local economy need to be another facet of the containment strategy. This may contribute to the maintenance of social stability, including religious practices that may oppose a ban on collective prayers. 

Localisation actions, global implications 

For the continent to flatten the curve of the Covid-19 spread, Africa has only one option: aggressive prevention. 

Aggressive prevention is ultimately implemented at the local level, even more at the neighbourhood and household level. This makes families and local communities the battleground for the fight against Covid-19. 

Fostering local solidarity can deliver a quicker means of mitigating not only the disastrous impact of self-isolation on livelihoods but also helps in the control of outbreaks of disease through tracing and isolation. 

Hence, harnessing community assets becomes a necessity. Furthermore, localisation encourages collaborative working mechanisms, use of local expertise, and ensures better accountability through the proximity of officials to the communities enhancing the legitimacy of actions. 

Proximity and local expertise would help tailor all interventions to its local context. Furthermore, localisation enhances ownership which encourages the initiation of programmes by local entities. But localisation needs to empower local authorities to implement and take ownership of their responsibilities, as well as to mobilise traditional and modern civil society organisations such as faith-based institutions, community leaders, and the private sector.

African states need to focus on mobilising community assets and the active participation of formal and informal structures and communities including traditional leaders and chiefs, religious heads and customary support systems. 

Such mobilisation needs to be conducted with strict protocols from health officers. The localisation of a response through concrete, actionable plans and a suitable implementation mechanism becomes vital for its success. 

Localisation also assists with cross-border cooperation and taps into community assets that could help build the resilience of border communities in the implementation of a cross-border response to Covid-19. 

A pragmatic strategy with a focus on local action will also encourage governments to take a holistic approach in which state and non-state actors, particularly religious leaders, traditional elders, tribal chiefs and the youth, together with private sector interests, are co-opted into active participation in the battle.

Africa's fight against the virus needs a pragmatic strategy that ensures localisation of flexible measures, and the mobilisation of an entire society, through mass communication.