COVID in Africa: How the pandemic hit different and what we learned from it

September 6, 2022
Written by Olivia Giovetti
Photo by Ed Ram

Case numbers for COVID were lower in Africa than other continents, and the cases themselves were less severe. That’s a win. But it’s not the whole story.

COVID in Africa: Fast Facts

  • Reporting on 47 out of 55 countries and territories, the WHO estimates just 8.7 million total cases of COVID in Africa since 2020. 75% of those cases were recorded in just three countries. 
  • COVID fatalities have also been much lower in Africa than other continents (fewer than 200,000)
  • Three reasons that Africa may have been spared the worst of the pandemic is that its population is younger, its climates are warmer, and many countries are used to dealing with public health crises
  • However, the ripple effects of lockdowns and border closures have hit hard, pushing 55 million Africans below the poverty line
  • Other crises were also sidelined in order to curb the spread of the virus, leaving many emergencies underfunded
  • Pandemic-related inflation has also contributed to rising hunger rates in many countries
  • Inequities are leaving many countries undervaccinated

Komrabia Turay is an okada driver from Kambia Town, Sierra Leone. (Photo: Gavin Douglas/ Concern Worldwide)

No margin for error

If you want to see who keeps Sierra Leone moving, look for the okada riders, motorcyclists who offer inexpensive and speedy transportation around the country. On a good day, an okada driver will get more fares than they can handle. In 2020, however, this became a liability. So much close physical contact left drivers as one of Sierra Leone’s most at-risk groups for COVID-19. The alternative, which tens of thousands of drivers realized during the country’s pandemic-related lockdowns, was not much better. 

“Bike riding gives us a small [amount of] money to make a living,” says Komrabia Turay, an okada rider in Kambia Town, about two hours north of Freetown. His margins are slim. He earns roughly the equivalent of $3.50 per day, and more than half of that goes into the weekly rental fee for his bike ($13). No cash, no bike — and no room for error. This was especially hard for Komrabia, whose clientele before 2020 was largely business travelers from neighboring countries like Guinea. “It is challenging, because the dollar has gone up, so traders don’t come here as much.”  

Komrabia’s story offers a snapshot of how COVID-19 impacted many countries throughout Africa. While health has been a concern for the last two-and-a-half years, case numbers have been much lower here in comparison to other continents. That’s a win. But it’s not the whole story. 

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How did Africa beat the pandemic?

An overview of COVID-19 case numbers in Africa as of August, 2022

An overview of COVID-19 case numbers in Africa as of August, 2022 (Data via Johns Hopkins University)

With a population of over 1 billion, the number of coronavirus diagnoses across Africa has been small compared to other continents. Reporting on 47 of the continent’s 55 countries and territories, the World Health Organization estimates just 8.7 million cases in total, with nearly 75% of these cases recorded in just three countries: South Africa (4 million), Morocco (1.2 million), and Tunisia (1.1 million). Fatalities have also been much lower than other regions, with the WHO reporting a relatively low 173,079 since 2020. That’s less than 2% of the total number of cases worldwide. 

There are several reasons that Africa has, overall, had lower infection and fatality rates for COVID-19. Here are three key points:

1. In terms of age, Africa is a “young” continent

As of 2020, the median age in Africa was 19 years old — meaning that half of the continent’s population was older, and half were younger. Compare that with a median age of 32 years for Asia, 38 years for North America, and 43 years for Europe. In 2020, Dr. Matshidiso Moeti, the head of WHO Africa, told UNICEF that just 3% of the total population in Africa was 65 year or older. 

As we’ve seen, younger people have statistically fared better with the coronavirus as they are less likely to have comorbidities or some of the risks faced by older people. Many ministries of health have reported that the cases that were recorded in regions and countries were also milder as a result. Elders in Africa also are less likely to live together in retirement or senior care homes which, as Dr. Moeti added, made another key difference: “One of the big drivers in Western countries is that the elderly people were living in specialized homes and these became places where the transmission was very intense.” 

2. The average climate in Africa is not conducive for COVID-19

As one study from the University of Maryland revealed, the high temperatures and humidity found across the continent (combined with the fact that one-third of Africa sits below the Equator, inverting the seasons), meant that the initial wave of COVID-19 was less successful compared to other cities in other climates. Looking at data from March of 2020, the researchers concluded that lower temperatures and high humidity correlated with cities that had significant outbreaks of the coronavirus.

3. For many, the pandemic wasn’t a unique situation

On a global level, the scope of the coronavirus pandemic has felt unprecedented for many of us, especially in the United States. However, in many countries in Africa, the response to such an outbreak is a familiar routine. For residents of countries like Guinea, Liberia, and Sierra Leone, the 2014-16 West African Ebola epidemic was not only more deadly, but also still fresh in the minds of many. The learnings from that outbreak, the largest of its kind in history, could be readily applied to COVID-19. And, because the virus reached Africa later than Asia, Europe, and North America, governments and citizens had more time to put their action plans into place.

When a pandemic is more than a health crisis 

The success of halting the virus’s spread and intensity, however, is not the full story. Millions of Africans are worse off than they were at the beginning of 2020. In this case, the impact of COVID-19 across Africa has largely been an impact of secondary and tertiary effects.

1. The pandemic pushed 55 million Africans below the poverty line

Let’s go back to our okada driver, Komrabia Turay. With many Sierra Leoneans still recovering from the long-term effects of the Ebola epidemic, the country went into lockdown early — just a few days after its first case of the coronavirus was confirmed on March 31, 2020. That was costly for people like Komrabia, who not only couldn’t work from home, but also relied on other people’s mobility in order to earn a living. 

“Lockdown was not easy for me, it affected my livelihood,” said Abdullai Kamara, a 19-year-old high-school student (also from Kambia) who earns his tuition by selling mobile phone top-ups. “I was locked in the house for three days; it was difficult to find something to eat.” Many Africans also rely on migrant labor to support their families, traveling abroad for informal gig work for a certain amount of time and sending the funds home.

Abdullai Kamara (19) is a mobile phone top-up seller and a high school student. (Photo: Gavin Douglas / Concern Worldwide)

In what the African Development Bank (AFDB) described as “the worst recession in more than half a century,” 2020’s lockdowns carried a ripple effect at the national and continental level. The overall GDP for the continent shrank by 2.1%, and fiscal deficits were estimated to be at an all-time high: 8.4% of the GDP. The AFDB also estimated that debts increased by 10 to 15 percentage points.

These numbers trickled down to the most vulnerable Africans, creating inflation, low supplies, and high demand for basic staples like flour. In 2021, the AFDB predicted that 38.7 million more people on the continent could slide into extreme poverty due to the pandemic — bringing the total poverty rate up to 34.4% of the continent’s population. That turned out to be an optimistic projection: The UN Economic Commission for Africa recently reported that pandemic-related disruptions “reversed more than two decades of progress in poverty reduction on the continent,” pushing an estimated 55 million Africans into extreme poverty. And that was just for 2020. 

2. Other health issues were sidelined

Many national healthcare systems in Africa lacked the resources to accommodate a global pandemic response. As a result, funds earmarked for other high priority health initiatives were quickly diverted to cover a COVID response. While the situation could have been much worse had the pandemic hit with full force, this also meant that many of the more pressing health concerns were overlooked. This underscored the massive health inequities between high- and low-/middle-income countries. 

3. COVID increased hunger in some of the world’s hungriest countries

COVID-19 is also linked with rising hunger rates, thanks to border closures restricting trade, market closures keeping people at home with limited supplies, and — perhaps most important — inflation costs. A 2021 World Bank survey from Sudan reported that 47% of families were worried over their food security, and many had already begun to eat less food or fewer meals to conserve resources. For 20% of families surveyed in May of last year, they were already unable to afford bread, grains, and dairy due to pandemic-related inflation. Likewise, in the Democratic Republic of Congo, the disruption of food systems meant that the cost of a food basket in 2021 had increased by 15% compared to 2020. 

In Freetown, Sierra Leone, Mbalu Moussa and her business partner, Esther Samba, recalled the double-hit of food waste and lost income due to related market closures. The two have sold fish in the city’s Moyamba Market for over a decade, but the days of lockdown meant that they had to wait for two days to get to their supplier. “Our fish got spoiled waiting at the checkpoint,” Mbalu said. She and Esther took out loans to recover from this time, but were glad to see that vaccinations led to business picking up. 

Mbalu Moussa (center) and her business partner, Esher Samba (right) at their fish stall in Freetown’s Moyamba Market. (Photo: Gavin Douglas / Concern Worldwide)

4. Border closures cut off the flow of critical supplies and aid, especially to hard-to-reach areas

Border closures both local and international made it hard for supplies to reach those who needed them most, both in response to the pandemic (oxygen, PPE) as well as other necessities (food aid, clean water). Many of the most vulnerable communities are already hard to reach due to bad roads, conflict, and other infrastructure issues. These delays exacerbated what was already a fragile situation. 

In the case of climate-related disasters — which included devastating floods in Burundi and South Sudan, fires in Sierra Leone, and the Mount Nyiragongo eruption in the Democratic Republic of Congo — this also delayed response teams from arriving on the scene. 

5. Underfunded crises have lost even more financial support

In the 2021-22 fiscal year, prompted by the economic impacts of the pandemic, the United Kingdom’s Foreign, Commonwealth & Development Office cut its foreign assistance budget by 30%. For countries like Somalia, which has been experiencing a decades-long cycle of crisis, this has had a devastating impact, cutting the reach and even number of both humanitarian aid projects and longer-term development programs. 

Members of a village resilience committee in Somalia prepare to take sand bags to river to build a protective embankment against flooding, while observing social distancing measures in June, 2020. Floods hit the country during COVID-19 lockdowns. (Photo: Khalid Aswad)

When vaccine inequity meets medical misinformation

The new challenge across the continent now is getting vaccines to low-income countries—and getting people vaccinated. As we saw with the myths and fears surrounding Ebola, the lack of trust that many Africans have in their respective governments is reflected in how people view initiatives like vaccine drives. This is understandable given the political climates many have grown up in. Still, it’s a hurdle to clear for curbing the spread of the virus. 

This was how Komrabia initially felt when the Sierra Leonean government began rolling out vaccinations last year. One of the best ways of fighting misinformation, however, is hearing counter-arguments from people you trust. After Komrabia saw that some of his friends had gotten the jab and were fine, he realized that this was not only essential for his health, but for his family: As the breadwinner for a wife and three children, including two daughters in school, he knew they would have nothing to fall back on. What’s more, some locations in Kambia couldn’t be accessed by unvaccinated okada drivers in an effort to slow down the spread. “I did not go to school, so that is why I am passionate about my daughters going to school,” Komrabia added. He now proudly holds up his vaccine passport. 

But even this is a lucky story, even in 2022. Vaccine inequity has meant that many countries without the financial resources to source more doses of approved COVID-19 vaccinations are left waiting, unable to even cover their most essential frontline workers and vulnerable populations. As of this writing, Sierra Leone has only vaccinated 24% of its population — well below the global average of 62.5%. 

Maseray Bangura is vaccinated against COVID-19 in Khunthai Town, Kambia, Sierra Leone by Concern’s mobile vaccination team. At the beginning, she had reservations about taking the vaccine but once she spoke with Concern staff, she was convinced it was safe. (Photo: Gavin Douglas/Concern Worldwide)

COVID in Africa: Concern’s response

In 2020, Concern began to respond to the COVID-19 pandemic and its related impacts in all 24 countries where we work. In some cases, the virus itself was a footnote to much larger issues still at hand, with many situations unrelated to the pandemic becoming exacerbated by its ripple effects. Read on below for reports from each of the countries in Africa where we work. 

COVID-19 in Burkina Faso

Concern began working in Burkina Faso in January 2021. Pandemic-related restrictions became one facet of the country’s humanitarian crisis and, coupled with a deteriorating security situation, made access to the communities most in need more difficult than initially anticipated. 

One of our key areas of focus in our first 12 months was to help strengthen the healthcare systems of the areas where we operate. We’ve provided preemptive support to health centers and staff in areas that saw a high influx of internally-displaced people (IDPs) and where health services were not operating at maximum capacity. This support worked as an ounce of prevention versus a pound of cure, reducing the risk of local health systems from being overwhelmed due to both COVID-19 and seasonal spikes of other illnesses. We’ve also designed cash-for-work activities that reduce environmental risk factors (such as clearing drainage canals) and prioritized WASH activities such as building latrines and shower blocks to promote hygiene at acceptable standards to reduce the risk of transmission. 

COVID-19 in Burundi

COVID-19 cases in Burundi had a modest spike in the first weeks of 2022, but confirmed cases remain low compared to other countries in the region. Part of this was due to tight border closures implemented by the government in an effort to prevent population movements. While this was medically necessary, it also carried consequences: The normal flow of supplies and goods that come in from neighboring countries (including the DRC and Rwanda) has been disrupted and limited for the last two years.

The border closures have also reduced remittances — vital cash flows from family members living and working abroad, economic migration, and cross-border trade of perishable goods like fruits and vegetables. All of this has had the hardest effect on the livelihoods and food security of the most vulnerable, rural families. Burundi reopened its border posts with Tanzania in the first half of 2021, though travel to and from the DRC and Rwanda remained limited until this year. Spikes in cases have also meant that these reopenings are subject to change as needed. 

Concern has been working with the Emergency Department in Burundi’s Ministry of Health in response to the pandemic, and is a member of a pillar strategy group for risk communication and community engagement. Our humanitarian aid response in the country was adapted to fit the needs of the pandemic in its early weeks, including awareness sessions and cash transfers to offset the economic losses of lockdown. Participants in these programs reported an 80% satisfaction rate despite some delays in the delivery of assistance and pivots due to a rapidly-evolving situation. 

A Concern Care Group Volunteer demonstrating how to cough while protecting others from COVID transmission in Kirundo, Burundi. (Photo: Maud Biton / Concern Worldwide)

COVID-19 in the Central African Republic

The pandemic hit the Central African Republic (CAR) eight years into a protracted crisis, further exacerbating already high vulnerabilities of a population facing violence, hunger, and political instability. In implementing a UNICEF-funded project to support healthcare facilities in the Ouham and Ombela Mpoko prefectures, Concern had initially set out to work with 25 health centers and 280 community healthcare workers. However, an eroded security situation coupled with an increase in fighting during 2021 prevented us from reaching half of the facilities initially identified. This is one example of how the pandemic has further complicated complex humanitarian emergencies around the world. Since 2021, Concern has been working with state partners to support COVID-19 vaccination campaigns, as well as vaccinations against polio and the measles. 

COVID-19 in Chad

The COVID-19 pandemic has continued to affect Chadian people’s lives, not only as a deadly virus but also through its ripple effects. Chief among these are social and economic shocks, as well as the pandemic’s effect on a general climate of uncertainty within the country due to a tense political situation, which has included the death of President Idriss Déby, a subsequent military transition, and elections in 2021 as well as 2022. In 2021, the World Bank reported that the pandemic contributed to increasing Chad’s poverty index by 5.5 percentage points, deepening an already fraught situation. The country ended the year with a new wave of cases that began with a 62% increase in diagnoses in October. At the end of July, commercial flights into Chad resumed, however land borders remained closed in an effort to halt the spread of the virus.  

Concern worked on several initiatives to prevent and limit the transmission of COVID-19 in several areas of Chad. In the Lac province (which includes Chad’s portion of Lake Chad), an ECHO-funded project allowed us to reach nearly 48,000 people in seven areas with key information on COVID detection and prevention. In many of these areas, we also provided health facilities with PPE, including 700 masks and 14,000 bars of soap. In Bagasola’s district hospital, we also built an isolation room for patients waiting on their test results for the coronavirus. We offered the same sensitization and training sessions among Chad’s IDP communities — reaching over 45,000 — and improving sanitation facilities that served a total of 21,000 internally-displaced Chadians in order to halt the spread. We also provided hygiene kits to 5,000 families located across three IDP sites. 

A Concern medical staff member checks the health of a child

A Concern medical staff member checks the health of one out of 145 children who had turned up to a mobile health clinic in Chad. The most common ailments seen are skin conditions, malaria and malnutrition. (Photo: Gavin Douglas / Concern Worldwide)

COVID-19 in the Democratic Republic of Congo

The secondary impacts of COVID-19 have made the DRC’s protracted humanitarian crisis that much more complex. These ripple effects, combined with ongoing conflict, the effects of climate change, and the world’s highest number of people dealing with hunger, have created a high level of humanitarian need. Unfortunately, this has been met with a decline in funding — at the end of 2021, humanitarian response in the DRC for 2022 was only at 37% funding. 

COVID came to the DRC in 2020 as only the latest in a series of health crises, including a cholera outbreak and the world’s second-largest Ebola epidemic on record. Taken together, however, these issues exacerbated the country’s structural issues, especially those faced by the large amount of the population living below the poverty line who lack access to basic health and social services. Only 31% of Congolese have access to quality water sources; 12% lack access to basic sanitation facilities and 56% lack access to satisfactory toilets. These not only increase the risk of transmission, but also have increased hunger rates in the DRC. In 2021, 4.4 million Congolese — 3.4 million of whom are children under the age of five — suffered from acute malnutrition

Inflation due to COVID-related lockdowns and border closures has also increased the cost of a food basket by 15% compared to 2020, which led to Concern increasing emergency food distributions in the most vulnerable areas, as well as implementing more agricultural recovery activities, setting up Village Savings and Loans Associations (VSLAs), and providing monthly cash grants for up to 10 months. 

Lwanzo, a health worker from Lukanga, DRC dresses to set an example of what to wear to isolate an infectious disease patient. (Photo: Esdras Tsongo/Concern Worldwide)

COVID-19 in Ethiopia

Like many countries in Africa, Ethiopia has experienced the pandemic as one of several issues of high concern, including insecurity, hunger, inflation, and droughts. Relief efforts for many of these issues were delayed in 2020 and 2021 due to movement restrictions. More pressing now for Ethiopia is that the country is currently one of several facing famine-like conditions due to the Horn of Africa crisis, brought on by multiple failed rainy seasons in a row. We’ve seen these risks increase through the first half of 2022 and are increasing our response in the area. 

COVID-19 in Kenya

Through 2020 and 2021, Kenya faced a series of lockdowns, curfews, and adjustments to school calendars. In fact, nighttime curfews were only lifted towards the end of 2021, following spikes in COVID cases in March and August of that year, meaning that businesses have only recently started coming back to full operations. The epicenter of the pandemic in the country was its capital city of Nairobi, where overcrowded conditions and underfunded development projects allowed the virus to flourish. Vaccine inequity has also hampered initiatives to control the pandemic — at the end of 2021, only 3.3% of Kenya’s adult population had received a vaccine. In August 2022, that figure is still a relatively low 17.3%. 

In the country’s rural areas especially, COVID-19 undid progress on community healthcare, with clinics and health facilities perceived as coronavirus hotspots and the government redirecting resources earmarked for critical health services to fight the pandemic. Education was also interrupted, with schools in the country closed between March and December of 2020, with the country’s Ministry of Education adjusting schedules in 2021 to make up for the lost time. 

Generally, however, the impact of COVID-19 in Kenya — particularly on its lowest-income residents — has been more focused on deepening levels of poverty and hunger, especially in Marsabit and Tana River Counties. Combined with the Horn of Africa drought and the 2020-21 locust invasions, this impact has led an additional 2.4 million people declared food insecure, and over 600,000 children diagnosed with acute malnutrition in 2021. 

As part of its COVID response in Kenya, Concern worked with the Kenya Institute of Curriculum Development to help support parents, caregivers, and students in the return to the classroom. Schools participating in this project saw enrollment rates between 90% and 95%, well above the national average. COVID-related WASH interventions — focusing on clean water access in the arid and semi-arid counties of Turkana and Marsabit and hygiene-specific outreach in Nairobi — helped reduce cases of diarrhea and other water-borne diseases significantly. Cash transfers funded by Irish Aid were also distributed to over 400 families. Overall, our COVID-specific response in 2021 reached over 9,400 people — 6,200 of whom were female.

COVID-19 in Liberia

Between 2014 and 2016, Liberia was one of the epicenters of the world’s largest Ebola epidemic. Many Liberians remembered the lockdowns and movement restrictions of that outbreak when these were mandated again in 2020. While regulations eased up in 2021, the country experienced a minor peak in cases that summer which quickly overwhelmed the health system. Monrovia’s Star Base Hospital had capacity for just 50 ICU cases of the virus, and it quickly ran out of oxygen during the crisis. Other hospitals turned COVID-19 patients away due to the volume of cases. This remains a risk for the country given the spread of new variants. 

Concern Liberia quickly integrated COVID-19 prevention measures into all of its programs in 2020. In 2021, we worked with the International Rescue Committee to support the country’s COVID-19 vaccination deployment plan, with our work focusing on the hardest-to-reach communities and most vulnerable people. We provided training and operational support to vaccinators and social mobilizers in four of the country’s 15 counties (Grand Bassa, Rivercress, Sinoe, and Grand Gedeh) and extended our coverage to an additional three counties (Maryland, Rivergee, and Grand Kru). Our vaccination efforts included full vaccinations for over 49,000 people, including 2,600 frontline health workers. 

COVID-19 in Malawi

COVID-19 was declared a national disaster in Malawi on March 20, 2020, although the country had not registered any cases at that time (the first three cases in Malawi were recorded on April 2, 2020). Waves of infection throughout that year led the government to undertake a number of response and preparation activities at the national level, including border and school closures. In 2021, Malawi saw consistent peaks and valleys with COVID-19 case numbers, with spikes in January (the most severe wave of infections), June, and December. 

Concern’s intervention began in 2020 in supporting the national health system in facing the challenges of the pandemic, a response we increased during the severe third wave at the beginning of 2021. Initially, we distributed nearly 7,500 face masks, 300 bottles of liquid soap, and 370 bottles of hand sanitizer across four districts. We also ran radio phone-in programs across community stations, in partnership with government departments like the District Health Office, to educate communities on preventative measures and share information on vaccinations (including dispelling myths and fears surrounding it). Because of COVID-19’s impact on women and girls, we also focused on information and awareness around gender-based violence and the psychosocial toll of lockdowns. We also supported five healthcare facilities in their ongoing response with training and supplies, and have been working with local leaders, government branches, and fellow NGOs to deliver the vaccine to more people.  

Concern employee Judith Cent distributing soap to the Health Surveillance Assistants (HSAs) and Community Health Volunteers (CHVs) to distribute among the community. (Photo: Concern Worldwide)

COVID-19 in Niger

The bigger health concern for Niger in 2021 was an epidemic outbreak of cholera, which began in the second half of the year and infected 5,500 (killing 159). Comparatively, it managed to control the number of COVID cases (7,007 between 2020 and 2021) and fatalities (259 related deaths across the same two-year period) between 2020 and 2021, avoiding the large waves of contamination experienced in other countries. 

Despite this good news, the measures taken by the government to contain the spread of the virus — including gathering and travel restrictions — have had an impact on livelihoods and food security, with inflation rates jumping up 2.6%. 

Production of MISOLA® enriched flour in Niger. The nutrient-fortified flour is a food supplement used to treat malnutrition and undernutrition, which is on the rise in the country. The women who work on production wear masks as added protection against transmitting COVID-19 and other illnesses. (Photo: Ollivier Girard/Concern Worldwide)

COVID-19 in Rwanda

In recent years, poverty rates in Rwanda dropped dramatically: from 60% in 2000 to 38% in 2016. However, undernourishment still affects nearly one-third of the population, and the landlocked country’s social and economic development was also severely impacted by border closures (including those with neighboring Uganda, Tanzania, Burundi, and the DRC). Early action helped to keep the national health system responding to the influx of cases (which, as of this writing, are ove 132,000). Economically, though, Rwandans have suffered and the World Bank estimates more than half a million people have fallen back under the poverty line. 

Despite neighboring two countries with protracted conflict and violence, Rwanda’s security situation has remained stable throughout the pandemic, which is another accomplishment for the country. It’s also approved six vaccines for use, with 68% of its population fully vaccinated as of August, 2022. 

2020: A group of Graduation participants in Rwanda received tools to prepare for the agricultural season, as well as face masks and guidance on how to properly wear them. (Photo: Gaspard Uwumukiza / Concern Worldwide)

COVID-19 in Sierra Leone

Like Liberia, Sierra Leone was one of the epicenters of the 2014-16 Ebola epidemic. Fortunately, the coronavirus spared many here, with cases remaining low — the highest seven-day average for confirmed cases was under 100. Likewise, the national health system was not overwhelmed, and, while some restrictions continued from 2020 into 2021, people could attend school and move freely from district to district. 

However, COVID had a harsh impact on Sierra Leoneans as a driver of high inflation against the background of a weak economy, and a roadblock to the country’s dependence on imports (particularly food). The country’s hunger levels have been rising due to a weak food system and an average 28% increase in global food prices as the result of pandemic-linked inflation. Concern Sierra Leone has responded to this, as well as the country’s overall COVID-19 response, supporting the Ministry of Health and Sanitation’s vaccine rollout to healthcare workers and vulnerable people at risk of being otherwise excluded. 

COVID-19 in Somalia

One of the biggest challenges of COVID in Somalia was not the disease itself, but its effects in a country over 6,500 miles away. The United Kingdom’s Foreign, Commonwealth & Development Office cut its foreign assistance budget by 30% for the 2021-22 fiscal year in response to the economic impacts of the pandemic, which has had an outsized effect on Somalia’s most vulnerable communities as certain activities and programs were placed on hold (including many aimed at improving the livelihoods of participants). This shrinkage of donor funds also led to a shortage of medical supplies in the country last year.

Concern Somalia has worked at addressing the wide-ranging impact of the pandemic in the country. In one district last year, we provided outpatient services while keeping social distancing measures in place, for nearly 77,000 people — including 577 children who received their (non-covid) necessary immunizations. We also treated malnutrition cases in 8,600 children with a 97% cure rate. Our health and nutrition projects also offset the stigmatization that the second and third waves of COVID created for healthcare workers and patients. 

In 2022, however, the pandemic is still linked to delays in delivering life-saving humanitarian assistance where it’s needed most. This is especially worrisome as Somalia (along with Ethiopia and Kenya) is caught in the Horn of Africa drought, with millions of people facing famine-like conditions. 

COVID-19 in South Sudan

For the people of South Sudan, the cumulative effects of the country’s protracted humanitarian crisis — including years of conflict, the climate crisis and related events, and an economic tailspin — were only worsened by COVID-19. This is especially true for the 1.6 million South Sudanese who are internally displaced, many of whom rely on clinics and healthcare centers for nutrition support for themselves and their children. Concern adapted to this by teaching parents and caregivers how to screen their children at home for malnutrition, limiting the number of people who sought out in-person healthcare. WASH interventions were also integrated with health and nutrition services to help build awareness of COVID-19 prevention and related hygiene measures, reaching nearly 20,000 people with these services in just one region. Surveys showed a general increase in critical knowledge from 78% in 2020 to 86% in 2021. 

COVID-19 in Sudan

Through 2020 and 2021, Sudan was hit with COVID-19 while also undergoing political shifts that began in 2019 and taking in an influx of refugees from neighboring Ethiopia beginning in 2020. A World Bank survey from 2021 revealed additional instability and uncertainty caused by the pandemic, lockdowns, and related inflation: 47% of families surveyed reported worrying over food security and modified their eating habits to account for an anticipated shortage. By May of 2021, just over a year into the pandemic, over 20% of families surveyed could no longer afford to buy bread, grains, or dairy due to inflation.

One of Concern’s main focuses in Sudan during the pandemic has been addressing the challenges related to lockdowns and displacement, especially in terms of getting refugees to officially-approved camps and then ensuring they have the essential food, water, and non-food items once they arrive.