Mick Hartley

We've been so busy navel-gazing over the coronavirus pandemic here in Europe and the US – was the lax Swedish approach right or wrong? – is Trump to blame for those high US figures? – that we've forgotten about Africa. Ian Birrell has been paying attention, though, and his conclusion is grim. We can argue about the rights and wrongs of lockdown in the west, but by now the answer for Africa is clear: lockdown has been a disaster…

As Covid-19 began to sweep across the planet earlier this year, the warnings about the disease’s impact on Africa were terrifying. The World Health Organisation predicted ten million cases within six months, raising the horrifying prospect of fragile health systems becoming overwhelmed with corpses piled up in hospital corridors. Other UN experts said there could be 1.2bn cases and 3.3m deaths without emergency interventions, while more optimistic modelling from the influential experts at Imperial College, London, anticipated 300,000 deaths.

Little wonder countries on the continent rushed to follow the lead of rich nations such as Italy and Spain that were visibly struggling to cope with pandemic. Many closed borders, shut businesses and locked down citizens. Among the firmest responses was Uganda’s, where public transport was suspended, schools shut down, shops closed, curfews imposed and big gatherings banned. Kampala has conducted more than 350,000 tests, according to official data. After doom-laden warnings of 68,000 fatalities from the virus if there were failure to act, there have been 44 confirmed coronavirus deaths in this east African nation of 43m.

Such actions won praise from global health bodies. Yet were blunt lockdowns really the right approach in Africa? A growing body of doctors, economists and scientists fear these measures will have disastrous consequences. These experts warn of financial carnage, spiralling epidemics of other diseases, the intensification of gender and wealth inequalities and the battle against poverty being set back by decades. They point to Africa’s youth, with a median age of 18 years compared with 41 years in Europe, and few people in the highest-risk older categories — which may help explain why a continent of 1.3bn people has seen fewer confirmed virus deaths than the UK. Almost one in five Britons is aged 65 or over; in Africa, it is fewer than one in 50. Yet the impact of shutting down countries will be far worse than in wealthier developed nations.

David Bell, a malaria specialist who has worked with both Bill Gates and the WHO, is among those concerned that we may be witnessing catastrophe unfolding on the continent. “It seems global health authorities did not think through the collateral damage, yet we knew by March the age-related fatality levels of this virus. If you looked at Italy or China, it was old people who were dying. In developing nations, many people live day to day, so even short disruption can be devastating to lives, while there are already large epidemics of malaria, tuberculosis and HiV that will only get worse if you reduce access and healthcare for a few months.”

In contrast to Uganda's strict approach, Malawi – for a variety of reasons – failed to impose a lockdown. 

Predictive modelling warned that inaction would lead to 16 million infections, 483,000 hospitalisations and 50,000 fatalities in this southern African nation of 19m people — yet there have been just 176 confirmed deaths to date.

Worth reading in full. Birrell's conclusion:

This discussion over lockdown in Africa is a microcosm of the wider global debate over how to balance the handling of a deadly new disease with wider health, commercial and social issues. But it is multiplied many times over since coronavirus fatality rates are so much lower than in developed nations while the impact so much more profound. “Lockdowns are the wrong policy not just for Africa, but for almost all low income countries,” said Charles Robertson, global chief economist at Renaissance Capital and author of a book on Africa’s renaissance. I fear he is right. The more you look at the data, the harder it is to avoid the conclusions that the instant panicked response on the continent was a mistake — and one that may have the most hideous long-term consequences.