The document summarizes Africa's response to the COVID-19 pandemic in 3 main points: 1) Africa saw a relatively lower number of COVID-19 cases and deaths compared to other regions, due in part to early intervention and containment measures taken by African governments. 2) While lockdowns and restrictions helped curb the spread of the virus, they also negatively impacted economies and exacerbated issues like food insecurity, gender inequality, and access to healthcare for other diseases. 3) Moving forward, the document recommends strategies like increasing local manufacturing and supply chains, strengthening public health systems, expanding social protections, and pursuing digital transformation to build resilience against future crises.

2. StoÏc Africa: Story of a resilient continent
during COVID-19 outbreak
By
Kaouthar Lbiati
June 11th 2020

3. Disclaimer
• The opinions expressed in this presentation are solely those of the
presenter and not necessarily those of any of the companies /
Institutions that the presenter is affiliated with.

4. Outline
1. Africa’s response to COVID-19 pandemic
2. Impact of COVID-19-Disease-Related Policies in Africa
3. Strategies to build resilience beyond the pandemic

5. Total number of COVID-19 cases & fatalities in Africa is
relatively lower compared to Asia, Europe & the Americas
 0.02 deaths per 10,000 of the population in Africa,
compared with 2.2 in Europe 2
1- Data June 9th by John Hopkins University
2- WHO, Africa Centre for Disease Control, and European Centre for Disease Control)
as of June 9th
196,368 cases1 of Covid-19
5,364 deaths1 from the disease
86,111 recoveries 1
Egypt
South-Africa
Fatality rate = (Death / Cases)
Mortality rate = (Death / Population)

6. Africa’s response to COVID-19
pandemic

7. The Swift African Response To COVID-19 Pandemic
• EARLY INTERVENTION
• Isolation, contact tracing & testing
• Virus Containment (w/o complete eradication)
• RESILIENCY OF GOVERNMENT & POPULATIONS
• (22) sub-Saharan African countries: cash transfer programs,
• (13) Afro-countries: in-kind transfers (e.g., food vouchers or
food distribution, school feeding)
• Social-distancing, shielding, hygiene measures
• INDUSTRIAL RESILIENCY
• Repurposing local production towards medical supplies
(masks, ventilators, tests)
• INNOVATION & TECHNOLOGY
Smoother recession WITH
macroeconomic measures
Safe healthcare capacity WITH
protective measures

8. Limited performance of African manufacturing at
scale & limited participation in Global R&D efforts
• Constrained domestic capacity and supply
 Various shortages of diagnostic equipment and medical supplies
 Heterogeneous capabilities across the continent to develop and manufacture health
commodities at scale
• Limited African involvement in the global R&D COVID-19 response
 (3) clinical trials underway for vaccines; (2) in Egypt and (1) in South Africa
 Readiness to introduce and drive the rapid uptake of new vaccines ?

9. African Union’s Center For Disease Control (AU-
CDC) Continent-Wide Strategy Has been Critical
• Founded by the African Union in 2016 as a result of the Ebola epidemics
• Goals
1. Prevent severe illness AND death from COVID-19 infection,
2. Minimize social disruption and economic consequences of COVID-19 outbreaks
• Modalities
1. Coordinate* the efforts of Member States, African Union agencies, World Health
Organization (WHO), and other partners (WAHO, AU-NEPAD)
2. Promote evidence-based public health practice for Surveillance, Prevention,
Diagnosis, Treatment, and Control of COVID-19
3. Direct regional efforts in the research (genomics at scale)
* ensure synergy and minimize duplication, WAHO, AU-NEPAD Genomics are important for surveillance (strain mutation, spread of disease) & to inform the development of vaccines

10. Some countries leveraged preparedness plans from
ebola epidemic to fight COVID-19
• ETHIOPIA 1 completed a door-to-door survey of, Addis Ababa, in (3) weeks,
• Symptoms documentation and travel history for its (5) million residents,
• Testing at risk group or symptomatic
• LIBERIA 2 leveraged Community Health Systems (CHS) for COVID-19 response
• CHS Workers assisting in disease surveillance and community education on sanitization practices (+ facilities set up
in areas with limited/no access to running water)
• GHANA’s COVID-19 response has been granted WHO’s recognition
• Risk and vulnerability assessment carried out during Ebola outbreak ensured the country had stable essential
supplies for COVID-19 outbreak 3
• DEMOCRATIC REPUBLIC OF CONGO (DRC)4
• May 31st 2020 : NEW outbreak of Ebola in Mbandaka (northwest Équateur Province) + COVID 19
• June 2nd : 4 cases of infection (ebola), 4 deaths (ebola)
1- https://www-newyorker-com.cdn.ampproject.org/c/s/www.newyorker.com/news/news-desk/what-african-nations-are-teaching-the-west-about-fighting-the-coronavirus/amp
2- McKinsey report 2020
3- USAID Global Health Supply Chain Technical Report – Best Practices in Supply Chain Preparedness for Public Health Emergencies , Ghana Ministry of Health: “National Preparedness and Response Plan for the Prevention and Control of Ebola
Viral Disease,” (2014); Ohene et al. “Assessment of the response to cholera outbreaks in two districts in Ghana,” Journal of Infectious Diseases of Poverty (2016)
4- https://africacdc.org/news-item/government-of-democratic-republic-of-congo-declares-11th-ebola-virus-disease-outbreak/

11. Some countries leveraged preparedness plans
post-ebola epidemic to fight COVID-19
• Genomics capabilities
• NIGERIA1 March 2020  1st genome sequence of SARS-CoV-2 from Africa
• MOROCCO2 “First Complete Genome Sequence of a 2019 Novel Coronavirus
(SARS-CoV-2) Strain Causing a COVID-19 Case in Morocco »
• Virology: National biosafety level 3 & 4 laboratories1
• NIGERIA, KENYA & SOUTH AFRICA own national biosafety level 3 laboratories
• GABON & SOUTH AFRICA have biosafety level 4 laboratories.
1- https://theconversation-com.cdn.ampproject.org/c/s/theconversation.com/amp/how-africa-has-developed-its-scientific-research-capabilities-135345
2- http://www.lram-fgr.ma/actualites-tp/sequencage-du-genome-complet-du-sars-cov-2-et-isolement-en-culture-cellulaire-au-lram/
*Genomics are important for surveillance (strain mutation, spread of disease) & to inform the development of appropriate vaccines for the region
** biosafety laboratories work with viruses & other infectious pathogens

12. Testing Strategies : Local mitigation against shortage & to
increase volume (up to 10m) & cut cost (down to 1$)
 GHANA
• Covid-19 test kit , results in 15-20 minutes. Awaiting approval from the Ghana FDA
• Innovative approaches such as "pooled testing“
 SENEGAL test kit. cost < $ 1. Distribution: June 2020
 UGANDA test strip for Covid-19 , works in minutes, cost $ 1
 KENYA to manufacture a simple cotton swab coronavirus test
 MOROCCO diagnostic test RT-PCR. Currently seeking Market Authorization
 SOUTH AFRICA qPCR kit cheaper than imported. Results in 65 min. Available in June
 AU-CDC’s & AFENET Partnership to Accelerate COVID-19 Testing (PACT)
• 10 millions COVID-19 tests (April - August 2020) : Ongoing Production in Kenya, Morocco, Senegal , South-Africa
• 10,000 community healthcare workers (CHW)
• 80 surveillance responders to support contact tracing
MAsCIR: Moroccan foundation for Advanced science, innovation and research, RT-PCR determine whether antibodies are present, indicating the individual has been infected, AFENET African Field Epidemiology Network

13. Rwanda’s (5) Robots namely; Akazuba, Urumuri, Ngabo,
Ikirezi and Mwiza
 Screen 50 to 150 people per minute, administer temperature checks
 Deliver food and medication to patient rooms,
 Detect abnormalities (Data analytics) while keeping medical records of Covid-
19 patients
https://nairobinews.nation.co.ke/news/rwanda-now-employs-the-use-robots-in-the-fight-against-covid-19
"Technology was the silver lining of this pandemic. For us,
digital tech played a critical role in facilitating continuity of our
regular lives… but also in sectors like education and trade,
where there were largely traditional practices and were largely
affected by the pandemic.“ —Paula Ingabire, Minister of
Information Communication Technology and Innovation of
Rwanda

14. South-Africa’s Chatbot: Digital Educational Services
• Johannesburg-based non-profit organization
• The WhatsApp bot uses Turn.io’s machine
learning technology
• delivers automated responses for free with
information on coronavirus
• South Africa 2.6 million users
• Mar. 20th 2020: Praekelt.org became WHO
Health Alert
• 10 million users - three days after launch
• Languages: English, Arabic, Spanish ( & 20 other
languages)

15. Impact of COVID-19- Disease-
Related Policies in Africa
Were there any unintended consequences?

16. Africa: Half of the countries have implemented partial or
nationwide lockdowns. Almost all have restricted certain
activities or movement
Africa’s 2020
annual GDP
GROWTH
(-3.5%)
from 3.9%
to 0.4%
According to
ECA
calculations,
Cost of (1mo) of
foreclosure
across Africa
=
$ 65 billion per
month

17. (14) African countries adopted school closure policy, but,
are children a vector of the covid-19 disease?
Source: World economic forum
Policy Impact & Gender
Bias
W/O schools or child care
options.
• Women to reduce hours
or close their business
• Less income
• More domestic violence
(correlation with policy?)

18. Existing comorbidities could worsen the severity of COVID-19
– Impact on TB & Malaria services during lockdown
 Data* modelling for TB (2020 – 2025) 1
• Up to 6.3 million more people are predicted to develop TB
• 1.4 million more people are expected to die as cases go undiagnosed &
untreated during lockdown
Set back to global efforts to end TB by five (5) to eight (8) years
 The number of malaria deaths could double in 2020 as a result of COVID-19 (WHO) 2
1-https://amp-theguardian-com.cdn.ampproject.org/c/s/amp.theguardian.com/global-development/2020/may/06/millions-develop-tuberculosis-tb-covid-19-lockdown
TB research was commissioned by the Stop TB Partnership in collaboration with Imperial College London, Avenir Health and Johns Hopkins University (US)
2- “WHO urges countries to move quickly to save lives from malaria in sub-Saharan Africa,” World Health Organization press release, April 23, 2020, who.int.

19. Impact of testing strategies : Is the burden of disease underestimated?
“Where public-health practices like contact tracing and isolation are robust, the ratio % of positive tests among all tests done is more telling than the raw number of tests
being done” 1- Cowling et al (13th March, nytimes.com)
Testing strategy Exponential growth in cases of infection in (10) African countries

20. Strategies to build
resilience beyond
the pandemic

21. Stairway to Heaven strategies
Local Manufacturing
Substitution of imported
essential medicines with local
production leads to:
 Affordability (~ -20% mark-up)
 Export markets
Global supply-chain
realignments
Over (5) years,
 substitution of 5 to 10%
of imported intermediate
goods with regional
production
 Africa’s manufacturing
output (+ $10–20 B)
Public Health
Emergency Planning & Response Playbook
 Surveillance networks data & information systems (IT) - based
 Well-defined trigger mechanisms
 Emergency Supply Chain (ESC)
R&D
 Increase budget
 Priority growth roadmap
per region
Regulations
 Regional trade (CFTA)
 Harmonized trade policies
 Standardized cross-border
regulations (rapid custom
clearance)
 Regionally pooled
procurement mechanisms
(economies of scale)
Transport & Logistics
 Infrastructure
 Logistics Management
& Information Systems
(LMIS)
Digital Strategies
Systems’ strengthening
 end-to-end strategy based
on Gaps analysis in current
digital systems
 4G & 5G
Healthcare Budget
Reallocation
 Design Health systems’
Financing mechanisms
for maximum impact
OOP: out of pocket. CFTA; Continental Free Trade Area. By spring 2018, 44 states had formally joined CFTA. working on removing tariff and nontariff barriers to trade
Universal Health
Coverage Acceleration
 Essential care +/- mini OOP
 Informal sector included
Healthcare
Industry

22. Highway to Hell mitigation strategies
• HUNGER is the other threat hanging over Africa
• Sub-Saharan Africa food importations $ 35 billion/year
• Logistical challenges within supply chains1
• Disruption 1 in food supply & informal workers’ food security
• Relative POVERTY2 for informal workers (lost income)
• +21% in upper-middle-income countries, (MIC)
• +56% in lower- and low-income countries (LIC)
• GENDER BIAS: Women more vulnerable than males
• More exposed to informality in LMIC
LMIC: low- and lower-middle income countries . 1- ILO: COVID-19 and the impact on agriculture and food security, ILO Sectoral Brief (Geneva, 17 April 2020), 2- ILO Monitor, op. cit., note 2
Subsidies to
farmers & in-Kind
programmes
Rapid transition
from informal (68%)
to formal Sector
Social Policies
 Childcare benefits
 social assistance
programmes
Mitigation strategies

23. Thank you very much for your kind attention!