As of March 29, there were more than 3,200 confirmed cases of COVID-19 across 40 African countries. The regional director of the WHO Regional Office for Africa, Matshidiso Moeti, warned that the new coronavirus disease will spread rapidly throughout the continent if immediate steps are not taken to contain it. While COVID-19 poses a daunting threat to the developed world, this will likely pale in comparison to its impact on Africa, where many healthcare systems are more fragile. Philanthropy will be needed to meet mounting challenges there. To do so, it should learn from the strategies adopted during the recent Ebola crisis.
The impact of this global emergency is already being felt by the international humanitarian aid sector, which includes U.N. organizations like UNICEF and UNOCHA and nongovernmental organizations like the International Rescue Committee and CARE International. While philanthropists like Michael Bloomberg, Bill Gates, and Mark Zuckerberg have pledged to fund aid for lower-income countries, numerous organizations have posted emergency appeals for contributions and have struggled with donors who—understandably—focus on their own countries when they prioritize their giving.
As COVID-19 makes headway into Africa, these donor priorities need to change. While European and North American countries already have the capital resources to care for their populations, the populations in the greatest need are elsewhere—in sub-Saharan Africa, in internationally displaced person camps in the Middle East, and in countries like Venezuela, whose public service sector has collapsed. International aid organizations are oftentimes the only ones that can reach such populations, and should be at the top of our priorities.
Fortunately, the international humanitarian aid community has never been more prepared to address an epidemic in the Global South. Given this community’s experience with the 2013-16 Western African Ebola epidemic, it is well-positioned to respond to the new threat of COVID-19 Like COVID-19, Ebola has a long incubation period and infectious carriers can remain asymptomatic for up to 21 days. And like COVID-19, Ebola requires a coordinated response between all public health agencies—state and non-state—in order to track and halt the infection’s spread.
In the African context, this effort often proves challenging. For one, Africa’s precarious medical care infrastructure and limited state capacities leave few resources available for addressing a spike in medical emergencies, let alone for taking preventative measures. Second, the abundance of refugees and internally displaced persons in the Chad Basin area make the region fertile ground for epidemics. Public health emergencies and the economic crises they often cause lead many people to flee in search of safer ground, oftentimes across international borders. A large-scale migration of potential carriers of an infectious disease is nothing short of disastrous, and can easily outweigh any local public health efforts to stop an epidemic. Especially in sub-Saharan Africa, addressing an epidemic requires a coordinated international effort.
The Ebola epidemic taught international humanitarian organizations to work much more closely with one another and with host governments than they were used to previously. Like the COVID-19 epidemic, the cooperation of the entire population of several countries was required in order to stop the spread. Organizations like International Rescue Committee and Doctors Without Borders helped coordinate aid across borders—in particular in Guinea, Sierra Leone and Liberia—and worked closely with local health systems in order to contain the outbreak. Their activities ranged from instructing locals about safe burial practices that reduce Ebola transmission, distributing hygiene products, providing outpatient treatments, and helping surveil the epidemic’s progress—the type of aid that will be needed when COVID-19 hits, as well. At present, in part because of this previous outbreak, numerous humanitarian aid agencies are already deployed on the ground and are poised to address the new coronavirus.
One of the most important lessons from the Ebola epidemic was that the additional stress on local healthcare facilities came at the expense of treatment for patients suffering from other diseases—in particular, chronic ones like HIV. The CDC estimates that more than 10,000 lives were lost during the epidemic to other diseases like HIV, tuberculosis and malaria. As hospitals overflowed with Ebola patients and healthcare workers succumbed themselves to the disease, little funding or working hands were available to treat those diseases. Philanthropists wanting to make an effective intervention during COVID-19 should turn to one of the most commonly neglected aspects of epidemic interventions: continuing healthcare for all medical conditions and supporting the local healthcare systems in affected countries. Not only will this strategy help patients in need during the pandemic, it will also help the country sustain its independent healthcare sector in the long run.
To be sure, philanthropists have much to do in the U.S., and many populations here need their help—undocumented migrants and others who lack access to medical care, for one. However, unlike the U.S., many African countries have minimal medical care infrastructure, and there is an immediate need for international intervention before COVID-19 strikes. Humanitarian fundraising has an illustrious history: Photos and news from Nigeria during the 1967-70 Biafran War moved donors to organize the largest emergency airlift since the Berlin Airlift of 1948-49; the 1985 Live Aid campaign to aid those affected by the Ethiopian Famine raised $127 million with one concert. Organizing again for humanitarian aid for low-income countries should be the next item on the agenda in our response to COVID-19.
Shai M. Dromi is a lecturer on sociology at Harvard University. He is the author of “Above the Fray: The Red Cross and the Making of the Humanitarian NGO Sector.”