Rutgers Expert Explores Impact of COVID-19 in Sub-Saharan Africa

The COVID-19 global pandemic has reached many African countries already suffering from malnutrition and disease, under-resourced health systems and limited economic funding.

Richard Marlink, director of Rutgers Global Health Institute and a leader in the global response to HIV/AIDS, understands what it means to address health problems in sub-Saharan African countries, home to more than 1 billion people. He discusses the impact of COVID-19 in the African region and what can be done to help these countries fight the worldwide pandemic. 

Are health systems in sub-Saharan Africa prepared to handle COVID-19?

With regard to medical intensive care for people with severe respiratory infections, the answer is no. Even before COVID-19 was a factor, there weren’t nearly enough intensive care beds or ventilators or health care workers trained to manage intensive care needs. Now that the pandemic is hitting the region, I expect hospitals in sub-Saharan Africa to reach their capacity at a terrifying speed, especially in comparison with developed countries.

How will the region’s high prevalence of HIV/AIDS and other diseases affect COVID-19 infection rates and outcomes?

There is no data yet on how HIV/AIDS or tuberculosis, both prevalent diseases in the region, will affect COVID-19 infection rates or outcomes. We are hoping that in the case of HIV, people who are on effective anti-HIV treatment will have COVID-19 infection rates and outcomes that are similar to those without HIV. 

Additionally, other preexisting conditions that can lead to worse outcomes for those with COVID-19 include hypertension, chronic lung diseases, diabetes and cancer – diseases that are not well addressed in most African health care settings. All of this, in addition to the lack of intensive care capabilities, means that morbidity and mortality rates for COVID-19 in sub-Saharan Africa will be nothing short of devastating. Around the globe and certainly in sub-Saharan African settings too, many people living with HIV or those exposed to TB are still without effective treatments.

Does the region have the testing capability needed for the COVID-19 pandemic?

Rapid DNA testing is more widespread in sub-Saharan Africa since the responses to AIDS and tuberculosis there, both in terms of expanded expertise and laboratory infrastructure. 

An African task force for COVID-19 preparedness and response has also been established, and I know of former colleagues in Senegal who are working on an inexpensive, rapid COVID-19 test right now. However, even with this network of laboratories, most African countries will not be able to afford the scale-up of diagnostic testing that is needed urgently. Just like the rest of the world, African countries will need to scale up testing quickly. The strength of this response will be stronger in some African countries than in others.

What kinds of economic impacts will this pandemic have in sub-Saharan Africa?

A global economic downturn will affect sub-Saharan African countries in the worst way. Just like in the United States, there is already a significant impact on travel and other industries. Local businesses have been forced to shut down and individuals who find themselves without paychecks for a substantial length of time will be negatively impacted. 

Additionally, trading partners and donor countries like the United States, China and several European countries will not be in the position to conduct business as usual. Economic recovery will be slower in developing countries, and I expect very tough times ahead for many African countries. 

How can countries help given the increase in confirmed cases and severe shortages of resources in Western countries like the U.S.?

If this pandemic is not defeated globally, we will not be able to get rid of this viral threat. As the COVID-19 crisis has shown, infectious diseases have no borders. The U.S., along with other G20 countries, can and should create a global, coordinated response to this pandemic instead of the ad hoc, country-by-country response the world has now. 

We must stop underfunding the World Health Organization and other mechanisms and research institutions that help in responding to global emergencies. In the short term, we can help with the fight of this global pandemic by expanding access to telehealth, telemedicine and other telementoring efforts in the African region as access to the internet and mobile phones have increased. 

Over the long term, we should resolve to help sub-Saharan African countries and other developing countries build quality health care services and expand the health care workforce. Unless we take the health of Africa seriously, a global response to this or any future pandemic will be impossible.