The scale of the disaster confronting Africa in the coronavirus crisis, with the least robust health care systems in the world and a venal bourgeoisie incapable of responding to the surge of cases, is becoming ever clearer.
Nearly 10,000 cases of COVID-19 have been confirmed on the African continent—a huge underestimate given the lack of testing kits—and 376 people have died. At least 148 health care workers have tested positive and four have succumbed to the virus.
Tedros Adhanom Ghebreyesus, secretary general of the World Health Organization (WHO) said, “The best advice for Africa is to prepare for the worst and prepare today”—advice African governments have ignored.
The Global Health Security (GHS) Index, which assesses countries’ abilities and preparedness to respond to biological threats and novel flu epidemics or pandemics, exposes African governments’ lack of preparation for the pandemic, which was both foreseeable and foreseen.
Its 2019 report stated, “National health security is fundamentally weak around the world. No country is fully prepared for epidemics or pandemics, and every country has important gaps to address.”
It found, “Only 19 percent of countries receive top marks for detection and reporting” of biological threats, with only “5 percent of countries scoring in the highest tier for their ability to rapidly respond to and mitigate the spread of an epidemic.”
The average overall GHS Index score among all 195 countries assessed was 40.2 out of 100. The majority of countries ranked as “least prepared” are in Africa, with Somalia (16.6) and Equatorial Guinea (16.2) listed at the bottom. Only South Africa comes in with a relatively high number—34.
A recent Bloomberg article, “Trapped by Coronavirus, Nigeria’s Elite Faces Squalid Hospitals,” notes that the Nigerian elite, who have long been accustomed to flying to the UK, France or India for medical treatment, will now have to face the consequences of their own policies.
Francis Faduyile, head of the Nigerian Medical Association, said, “The health system is not strong enough. Over the years, it’s been denied normal funding and things are not where they’re supposed to be. If the burden of the coronavirus is added, it may be too heavy; it may actually cause a total collapse.” He said, “It’s going to be a lesson for those who think they can neglect the health system.”
What the article describes is horrific. And Nigeria is by no means the worst case as the GHS index shows. According to its health ministry, Nigeria has 75,000 doctors, 180,709 nurses and 25,000 pharmacists for a population of 200 million. But half of all registered doctors have emigrated to the advanced Western countries. Nigeria has 0.5 hospital beds per 1,000 people, far below WHO thresholds, and only five laboratories are able to test for the coronavirus.
Health spending accounted for about 5 percent of the government’s budget over the last decade, falling far short of the African Union’s recommended minimum of 15 percent. It has largely focused on recurrent spending, with little or no capital investment. Only N427.3 billion ($1.096 billion) of the federal budget (4.5 percent) went to health, which amounts to just N2,000 (US$5.50) for each of Nigeria’s 200 million population.
The Financial Times noted that African governments spend an average of $12 per capita a year on health compared with $4,000 in the UK. In Nigeria, there are just 169 ventilators for 200 million people. Nigeria has one of the highest mortality rates of children under five in the world, with one in ten children dying before the age of five. It provides health care coverage to only 3 percent of its population through the National Health Insurance Scheme (NHIS).
Life expectancy, at 52 years, is below the African average. HIV, tuberculosis and malaria are among the leading causes of death, together accounting for around 20 percent of all deaths. Some 40 percent of the population lack access to clean drinking water while only 30 percent have adequate sanitation.
This terrible situation is not due to a lack of resources. According to Oxfam, “The combined wealth of Nigeria’s five richest men—$29.9 billion—could end extreme poverty at a national level, yet 5 million face hunger. More than 112 million people are living in poverty in Nigeria, yet the country’s richest man would have to spend $1 million a day for 42 years to exhaust his fortune. … The amount of money that the richest Nigerian man can earn annually from his wealth is sufficient to lift 2 million people out of poverty for one year.”
The worldwide economic slowdown has led to plummeting demand and prices for Africa’s natural resources, including oil and gas, a collapse in tourism and travel and remittances from the African diaspora, while border closures and flight bans have curtailed the export of key agricultural produce.
Ahunna Eziakonwa, the UN Development Program regional director for Africa, warned that the economy faces a “complete collapse” unless the spread of COVID-19 is controlled. Up to 50 percent of all projected job growth will be lost. “We will see a complete collapse of economies and livelihoods. Livelihoods will be wiped out in a way we have never seen before.”
Governments throughout the continent are using the pandemic and the attendant lockdowns as the pretext for military dictatorship to deal with mounting opposition in the working class.
The Japan Times reported that in Nigeria a soldier enforcing the lockdown killed Joseph Pessu, a resident of the oil city of Warri in the southern state of Delta. In Kenya, security forces enforcing the lockdown killed a 13-year-old boy on his balcony. Yusuf Moyo, the boy’s father, said, “Where is our safety if not in our own homes?” Four others have been killed.
In South Africa, the police and the army have used whips, rubber bullets and tear gas to disperse people in Hillbrow, an inner-city Johannesburg neighbourhood. In Zimbabwe, the army and police forced thousands of homeless people from the streets and transported them to open fields, empty school grounds and stadiums where makeshift shelters are being set up to enforce social distancing.
Kristalina Georgieva, managing director of the IMF, estimates that emerging countries may need as much as $2.5 trillion in support. The possibility for widespread unrest will only grow as food shortages hit ailing African economies. Vera Songwe, executive secretary of the Economic Commission for Africa, “If we need an example of what the lack of multilateralism looks like, we’re seeing it today. If one of us has the virus, all of us have it.”
An international and coordinated response to stop the spread of the virus on the African continent must be mounted. Measures must be taken to provide the necessary medical equipment and staff to halt the pandemic—without which the coronavirus will spread, killing millions. A socialist leadership in the African working class must be built, pulling behind it the impoverished peasantry and in unity with the workers in imperialist centres for an uncompromising struggle against the banks, corporations and world imperialism.