Blo mb Bu rch 16, 202026
●In a red-roofed building at the edge of the University
of Abuja Teaching Hospital campus, the walls are
freshly painted, a crew is laying pipes for refurbished
bathrooms, and others are hauling in furniture. The
single-story concrete structure, meant for trauma vic-
tims at the largest health-care facility in the Nigerian
capital, is being rapidly repurposed to quarantine
patients diagnosed with the coronavirus, putting it
on the front lines of Nigeria’s—and Africa’s—efforts
to contain the illness. “We are moving, we are going
to get there,” Yunusa Thairu, the leader of the hospi-
tal’s coronavirus response team, tells staff crowded
into an auditorium next door. “Let’s be confident.
This is not a death sentence.”
Across Africa, officials are bracing for a rapid
spread of the pathogen. The worry is an outbreak
could devastate the region, which accounts for 16%
of the global population but just 1% of health-care
spending. There’s little money for ventilators and
other life-support equipment needed for severe
cases of Covid-19, and any sustained fight against
the coronavirus would steer resources away from
malaria and HIV, which kill hundreds of thousands
every year. If Italy, with 41 doctors per 10,000 peo-
ple, is struggling to contain the disease, virus track-
ers fear what would happen if it were to sweep across
Africa, where there are just two doctors per 10,000.
“It will be worse in an African setting,” says Nathalie
MacDermott, an infectious disease specialist at King’s
College London.
Nigeria is where the virus first made landfall
in sub-Saharan Africa, on Feb. 27, when an Italian
businessman tested positive in Lagos, the coun-
try’s sprawling, congested commercial capital. It
has appeared in at least 10 other African nations,
sparking a flurry of responses. On March 2, Senegal
reported a French national had been infected. A few
days later, Egypt said it had 48 cases, most linked to
a Nile River cruise ship. Kenya has set up isolation
facilities in Nairobi, activated an emergency opera-
tions center, and secured extra protective gear. “Alot still needs to be done,” says Isaac Ngere, a mem-
ber of Kenya’s national coronavirus task force. “Our
schools are crowded. Our living areas are crowded.
Our public transport is crowded. That’s a good envi-
ronment for the disease to spread.”
The International Monetary Fund on March 4
pledged to make $10 billion available at zero interest
to help poor countries, especially in Africa, tackle
the virus. The World Health Organization has sup-
plied testing equipment and training throughout
the continent while focusing on 13 countries with
strong links to China, the region’s top trading part-
ner. Muhammad Ali Pate, a former Nigerian health
minister now with the World Bank, fears the virus
could devastate “the crevices of society” where
health systems are weak. “If you look at a map, you
will see areas where cases have not been detected,”
Pate says. “That may reflect that the virus isn’t there.
But it may be telling us something else: that they may
not have the capability to test.”● Does Ebola offer
any lessons?
Health authorities fret that efforts to fight the
coronavirus will indirectly contribute to an increase
in deaths from illnesses such as malaria, which kills
about 400,000 Africans a year. The 2014-16 Ebola
epidemic, which left more than 11,000 dead, high-
lights the risk of overwhelming health-care systems.
Across West Africa, the Ebola crisis disrupted treat-
ment of malaria, HIV, and tuberculosis: Many clinics
shut down, and patients with other ailments avoided
doctors for fear of contracting Ebola. “More people
died from a lack of general health services than from
Ebola,” says Jimmy Whitworth, a professor of public
health at the London School of Hygiene & Tropical
Medicine. “We must make sure we don’t neglect those
services while we fight the coronavirus.”w will frica
cope with an
outbreak?
● Doctors per 10,000
people in Africa2