21 May 2020 Volume :8 Issue :16

COVID-19 Responses in Africa: Implications for Peace, Security, and Public Health

COVID-19 Responses in Africa: Implications for Peace, Security, and Public Health
A stock image of a man wearing a face mask as Africa and the world battle the COVID-19 pandemic.

- By Johannes John-Langba and Vivian Nasaka John-Langba

During a nation-wide address on April 13, 2020, President Muhammadu Buhari of Nigeria warned Nigerians about the danger posed by the COVID-19 pandemic. In his words, “This is not a joke; it is a matter of life and death.” To underline the seriousness of the situationhe announced the extension of regional lockdown measures by an additional 14 days within the Federal Capital Territory of Abuja (FCT), Lagos, and Ogun States in a bid to contain the spread of the new coronavirus.1

In December 2019, China identified and notified the global public health community about the emergence of a novel coronavirus among patients at health facilities in the Hubei province of the country. This novel coronavirus was identified as the coronavirus SARS-CoV-2 and its attendant illness as coronavirus disease 2019 (COVID-19).2 Within weeks, the virus had spread rapidly across Wuhan, the Chinese city where it was initially identified, and to other parts of Asia, Europe, and the United States in epidemic proportions. The World Health Organization (WHO) later declared this a pandemic on March 11, 2020 as the new coronavirus continued to spread across the globe with devastating outcomes for lives, livelihoods, and economies.3

As of April 20, 2020, over 2.4 million people have been infected globally and 168,500 have died from COVID-19.4 Although the worst affected countries remain outside the African continent, both in terms of infections and fatalities, the number of infections and deaths continue to rise in Africa. The likelihood of health systems on the continent becoming overwhelmed as the virus spreads is high, given the weak and fragile state of public health systems in most African countries.5 The most recent Covid-19 statistics provided by the Africa Centre for Disease Control and Prevention (Africa CDC) indicate that out of the 55 African countries, 52 have reported coronavirus infections amounting to 22,513 cases and 1,126 deaths, with the Union of the Comoros, Lesotho, and Western Sahara as the only African countries that have not reported COVID-19 cases.6

Given the challenges that many African countries face with weak health systems, the implications of the COVID-19 pandemic on public health, peace, and security on the continent are dire. The linkages between public health, societal wellbeing, politics, and the performance of the national health systems are well documented in Africa, particularly in post-conflict countries as well as those experiencing protracted conflicts.7 While the United Nations (UN) Security Council has not yet formally determined the Covid-19 pandemic a threat to international peace and security, as it did in the case of the 2014 Ebola Virus Disease (EVD) epidemic in West Africa,8 the African Union (AU) has expressed concerns about the likelihood of the Covid-19 pandemic impacting negatively on the continent’s stability.9 At its 910th meeting held on February 13, 2020, the African Union’s Peace and Security Council noted that the COVID-19 outbreak is a public health emergency that “could constitute a threat to peace and security on the Continent.”10

Public health responses to the Covid-19 pandemic in Africa have varied from one country to another, but reflect a general trend towards declaring states of emergency followed by restrictions of movement (mostly lockdown and shelter-in-place restrictive measures), except in instances where access to essential supplies such as food or medicine are required. In addition, most African countries have adopted other WHO recommended mitigation strategies including quarantine, social distancing, self-isolation, and improved water, sanitation, and hygiene (WASH) practices. Others include mass coronavirus testing and contact-tracing at the community level. Although these strategies for mitigating the spread of COVID-19 have proven effective in “plateauing the curve” in China and South Korea,11 they have been accompanied by limited or no measures to address the unintended consequences of the mitigation strategies given the realities of unacceptably high unemployment, inequality, and economic informality in most African countries. It is not surprising that concerns have been raised by the AU and various UN agencies about the implications of the aforementioned COVID-19 response strategies on peace, security, and public health in African countries. The implementation of mitigation and containment strategies have resulted not only to the perpetuation of existing poverty and inequalities, but also heightened security-related problems.12

Across Africa, incidences of violence perpetrated by security forces deployed to enforce curfews and confinement measures are being reported.13 Deaths and injuries resulting directly from actions by State security personnel have been reported in a number of African countries including Nigeria, Zimbabwe, Kenya, and South Africa.14 The UN has also reported that violence against women – in particular domestic violence – has intensified in countries where lockdown or stay-at-home orders have been implemented.15 This notwithstanding, evidence from the 2014 EVD outbreak in West Africa indicates that public health emergencies can exacerbate the multiple forms of violence that women and girls already face.16

Lessons from the West African EVD response also indicate that the outbreak contributed to the loss in traction for immunisation programmes against tuberculosis, measles, and yellow fever.17 While data is currently limited on the impact of the COVID-19 pandemic on maternal and child-health service provision, the WHO and UNICEF have raised concerns about the suspension of immunisation interventions18 as several countries including Nigeria have halted vaccination programs,19 which will certainly have an impact on the prevention of outbreaks of common childhood diseases such as polio, measles, rubella, and acute respiratory illnesses with implications for public health, peace, and security. The Democratic Republic of Congo (DRC) stands out as a country that is on the precipice of disaster. It has been battling three epidemics; EVD, measles, and cholera, and is now faced with the additional challenge of dealing with Covid-19 with a fragile health system due to on-going armed-conflicts in parts of the country.20

Other conflict-affected or post-conflict African countries, including Burkina Faso, Mali, Niger, Nigeria, Cameroon, Libya, Somalia, and South Sudan, have all reported cases of COVID-19. Should these governments redeploy their troops to deal with public health crises as a result of the coronavirus, disruptions are likely to occur with respect to counterterrorism activities and contribution of troops to peacekeeping missions. Another concern is the possibility of troop deployment becoming another channel for transmitting Covid-19 within countries and across borders. This factor lends itself to the need for a regional African approach to address the pandemic. The Africa Centre for Disease Control and Prevention (Africa CDC) is well positioned to provide technical tools and measures that can be adapted to ensure that the contextual dynamics in individual African countries are taken into account in all COVID-19 mitigation responses to address its adverse effects on populations already facing severe socio-economic inequalities. It is also important that measures for ending the COVID-19 pandemic in Africa include measures that ensure equitable and sustainable access to good quality healthcare facilities and treatment. Finally, COVID-19 response measures must also incorporate social policies that transform the socio-economic conditions of the people taking into account the precarious peace and security situation in Africa.

1. Libby George, “Nigeria to Extend Coronavirus Lockdowns for 14 More Days: President Buhari,” Reuters, April 13, 2020, https://www.reuters.com/article/us-health-coronavirus-nigeria/nigeria-to-extend-coronavirus-lockdowns-for-14-more-days-president-buhari-idUSKCN21V1US.

2. WHO, “WHO Timeline – COVID-19,” accessed April 24, 2020, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen.

3. WHO, “Coronavirus,” accessed April 20, 2020 https://www.who.int/health-topics/coronavirus#tab=tab_1.

4. Johns Hopkins University, “COVID-19: Dashboard by the Center of Systems Science and Engineering,” https://coronavirus.jhu.edu/map.html.

5. Mario J. Azevedo, “The State of Health System(s) in Africa: Challenges and Opportunities,” in Historical Perspectives on the State of Health and Health Systems in Africa, Volume II. African Histories and Modernities(Palgrave Macmillan: Cham, 2017), 1-73. https://doi.org/10.1007/978-3-319-32564-4_1.

6. Africa CDC, “COVID-19: Latest Updates on the COVID-19 crisis from the Africa CDC,” accessed April 20, 2020, https://africacdc.org/covid-19/.

7. Johannes John-Langba, “National Health Systems and Unmet Need for Antiretroviral Medication and HIV-related Healthcare in African Countries Emerging from Conflict,” International Peacekeeping20, (2013): 427-438. doi:10.1080/13533312.2013.846134.

8. “Resolution 2177 (2014): Adopted by the Security Council at its 7268th meeting, on 18 September 2014,” United Nations Security Council, accessed April 10 2020, http://www.securitycouncilreport.org/atf/cf/%7B65BFCF9B-6D27-4E9C-8CD3-CF6E4FF96FF9%7D/S_RES_2177.pdf.

9. African Union, “The 910thMeeting of the AU Peace and Security Council (PSC) on Ebola and Coronavirus Outbreak- (Africa CDC), 19 February 2020,” accessed April 10, 2020, http://www.peaceau.org/en/article/the-910th-meeting-of-the-au-peace-and-security-council-psc-on-ebola-and-coronavirus-outbreak-africa-cdc; “COVID-19,” African Union, accessed April 19, 2020, https://au.int/en/covid19.

10. African Union, “Press Statement: 910thMeeting, 13 February 2020 Addis Ababa, Ethiopia PSC/PR/BR (CMX),” accessed 10 April 2020, https://www.peaceau.org/uploads/psc.-910.press-statement.ebola-coronavirus.13.02.2020.pdf.

11. Biao Tang et al, “Lessons drawn from China and South Korea for Managing COVID-19 Epidemic: Insights from a Comparative Modeling Study [Submitted],” Bulletin of the World Health Organization, (April 2020). http://dx.doi.org/10.2471/BLT.20.257238.

12. UN WOMEN, “COVID-19 and Ending Violence against Women and Girls,” accessed 11 April, 2020, https://www.unwomen.org/-/media/headquarters/attachments/sections/library/publications/2020/issue-brief-covid-19-and-ending-violence-against-women-and-girls-en.pdf?la=en&vs=5006.

13. News Wires, “Security forces use violent tactics to enforce Africa’s coronavirus shutdowns,” France24, April 1, 2020, https://www.france24.com/en/20200401-security-forces-use-violent-tactics-to-enforce-africa-s-coronavirus-shutdowns.

14. Ibid.

15. UN WOMEN, “COVID-19 and Ending Violence against Women and Girls,” accessed 11 April, 2020, https://www.unwomen.org/-/media/headquarters/attachments/sections/library/publications/2020/issue-brief-covid-19-and-ending-violence-against-women-and-girls-en.pdf?la=en&vs=5006.

16. UNICEF Helpdesk, “GBV in Emergencies: Emergency Responses to Public Health Outbreaks (September 2018),” 2, accessed April 11, 2020, http://www.sddirect.org.uk/media/1617/health-responses-and-gbv-short-query-v2.pdf

17. Peter Beech, “The COVID-19 Pandemic could have Huge Knock-on Effects on Women’s Health, says the UN,” World Economic Forum, April 2, 2020,” https://www.weforum.org/agenda/2020/04/covid-19-coronavirus-pandemic-hit-women-harder-than-men/.

18. UNICEF, “More than 117 million children at risk of missing out on measles vaccines, as COVID-19 Surges: Statement by the Measles & Rubella Initiative: American Red Cross, U.S. CDC, UNICEF, UN Foundation and WHO, April 13 2020,” accessed April 13, 2020, https://www.unicef.org/press-releases/more-117-million-children-risk-missing-out-measles-vaccines-covid-19-surges.

19. Sarah Newey and Anne Gulland, “Measles and Polio May Come ‘Roaring Back’ as Global Vaccination Programmes Shut Down: Experts Warn of a Resurgence of Childhood Diseases as Essential Services are Disrupted by the Coronavirus Pandemic,” The Telegraph, March 31, 2020, https://www.telegraph.co.uk/global-health/science-and-disease/measles-polio-may-come-roaring-back-global-vaccination-programmes/.

20. UNICEF, “Children in the Democratic Republic of the Congo at Risk from Killer Measles, Cholera Epidemics: COVID-19 Latest Challenge Facing Battered Health Services: Press Release, March 31 2020,” accessed April 11, 2020, https://www.unicef.org/press-releases/children-democratic-republic-congo-risk-killer-measles-cholera-epidemics.

Johannes John-Langba, PhD, MPH, is an Associate Professor of Social Work and the academic leader of Research and Higher Degrees in the School of Applied Human Sciences at the University of KwaZulu-Natal (UKZN) in Durban, South Africa. A recipient of the SSRC’s Africa Peacebuilding Network (APN) Individual Research Grant (IRG) in 2015, his current research focuses on mental health, migration and health, health systems strengthening, sexual violence and exploitation, social policy and development, and the intersections of public health, peace, and security.

Vivian Nasaka John-Langba, LLM, is an independent human rights consultant and a doctoral candidate in Public Law in the Faculty of Law at the University of Cape Town (UCT), South Africa. She previously worked as a research advisor at the South African Human Rights Commission (SAHRC) in Johannesburg, South Africa. Her research interests include refugee rights, statelessness, the African human rights system, and gender, health, and human rights.

This article was first published by the Social Science Research Council (SSRC), an independent, international nonprofit that mobilises necessary knowledge for the public good by supporting scholars worldwide, generating new research across disciplines, and linking researchers with policymakers and citizens.

Click here to view the original article: https://kujenga-amani.ssrc.org/2020/04/30/covid-19-responses-in-africa-implications-for-peace-security-and-public-health/

Photograph: Chadolfski / Shutterstock.com

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