[Paper] Race and Death or Hunger? COVID-19 and Its Impact on African Populations

Summary

Background

The impact of the coronavirus outbreak, which originated in Wuhan, China, on global health and the economy has been devastating and continues to this day. In Africa, the disease-causing virus COVID-19 has led to unprecedented levels of caseloads and deaths in African countries. This narrative review aims to establish the scale of the health and economic crisis triggered by the pandemic in Africa, including its impact on the informal economic sector, domestic GDP, and its political aspects.

Method

Evidence documents issued from January 8, 2020, to August 8, 2020, were obtained from databases such as Google Scholar, PubMed, Scopus, and Web of Science. Additionally, published and unpublished abstracts were searched from suitable websites, government documents, organizational reports, newspaper commentaries, and reports issued by global, regional, and local disease control and prevention centers.

Results

The COVID-19 pandemic has led to four crises in Africa:

1. Health Crisis: As of August 8, 2020, there have been 1,039,000 (12%) confirmed deaths among frontline healthcare workers, with over 22,966 (2.4%) deaths overall. The highest number of deaths was in Southern Africa with 11,024 (48%), followed by Northern Africa with 6,989 (29.2%).
2. Social Crisis: Human rights violations, killings of civilians by security forces, and an increase in crime have led to social inequalities, household breakdowns, instances of social unrest, and worsening general poverty.
3. Economic Crisis: This is symbolized by a decrease in GDP and massive unemployment.
4. Political Crisis: This includes the implementation of inappropriate measures for Africa, discrimination against refugees and immigrants, evacuation of nationals to their home countries, distrust in political leaders, postponement of national elections, and an increase in conflicts and unrest.

Conclusion

During the COVID-19 outbreak, lockdowns serve as a racial measure against death and hunger in developing regions such as Africa, whereas they are a preventive mechanism in affluent countries. Policymakers must apply new, region-specific preventive and management strategies to address this growing disaster.

Keywords: Africa, coronavirus disease, economic impact, GDP, political crisis, social impact

Background

The rapid and global spread of coronavirus disease (COVID-19) has triggered the largest public health and economic crisis the world has faced in over a century. It affects individuals of all races, genders, and religious groups, regardless of their economic status. The widespread transmission of this virus globally, driven by the ease of movement through labor, tourism, trade, and international travel, has led to the movement of people from Wuhan, China, to other previously unaffected regions. The dramatic increase in the prevalence, incidence, and mortality associated with the COVID-19 outbreak has placed significant limitations on social freedoms, travel freedom, social cohesion, and global community productivity.

On January 3, 2020, the World Health Organization (WHO) declared the situation a global emergency in response to the spread of the disease both within and outside China, marking it as the first pandemic. The WHO expressed major concerns about the need to protect countries with limited resources, fragile health systems, and insufficient preparedness for the health crisis they were facing. To support preliminary preparedness and response activities, the WHO allocated $1.8 million from the Contingency Fund for Emergencies (CFE), considering the potential impact on human health, the effectiveness of current preparedness and response measures, and the auxiliary impact. In early February 2020, recognizing the increase in cases in developed countries and the inability of medical systems to handle the large number of critically ill patients, African countries such as Kenya, South Africa, Rwanda, and Uganda began implementing preventive measures, including lockdowns, flight bans, closures of schools and universities, border closures, bans on public transportation, and curfews.

The COVID-19 outbreak has disrupted networks among African populations, particularly affecting meetings, tourism, travel, trade, and physical contact. This disruption is due to the restrictions placed on national territories and borders to limit the spread of the disease. African communities have been compelled to use advanced technologies such as the internet, webinars, smartphones, and other electronic systems to stay connected. Despite the lockdowns in many countries, the prevalence and spread of COVID-19 continue to increase exponentially, with over 19.8 million cases and more than 729,891 deaths reported as of August 8, 2020. Numbers in other countries soon surpassed those initially recorded in China, including the United States, Brazil, India, Russia, South Africa, and Mexico. Although the outbreak in China had reached a mature stage, many developed countries, including Italy, France, Germany, Spain, the United States, and the United Kingdom, had reached their peaks through domestic transmission after initial spread through infectious migrants. The global impact of this disease has been overwhelming, leading to widespread morbidity, mortality, social collapse, and economic loss. In Africa, the expansion of the outbreak is in the growth phase, with significant concerns about future high infection rates due to poverty and socio-economic factors in countries such as Egypt, Algeria, South Africa, Morocco, Ghana, and Nigeria. Unlike wealthy countries such as those in Europe, African cultures value collectivism and communal living, which contrasts with enforced lockdowns, curfews, social distancing, and isolation, leading to increased infection rates, morbidity, and mortality. Religious events, large social gatherings, traditional funerals, and weddings involving large gatherings are standard cultural practices in Africa. These, combined with a lack of sufficient knowledge and information about the disease and inadequate implementation of actual information, contribute to the spread of the coronavirus. In contrast, evidence from countries like China, South Korea, Japan, and Turkey confirms that self-care and social isolation significantly reduce the spread of infection. If temporary cultural reforms are not implemented in Africa, the number of cases and deaths due to outbreaks may exceed the global total.

In contrast to the situation in wealthy Western countries, many Africans' lives are based on consuming sufficient food daily to survive. It is impossible to confine African communities at home for an extended period, as people need to access fields and find ways to obtain food. For example, in Ethiopia, Kenya, Nigeria, and South Africa, many individuals violate lockdown measures by moving extensively in public places such as towns and markets, despite restrictions, in search of daily food. While lockdowns are intended as measures to contain the COVID-19 outbreak and prevent infections in wealthy countries, they represent a life-or-death competition for survival among many Africans, who face the choice of being confined at home and dying from hunger or violating lockdown regulations to work and obtain food, risking death from disease. Regardless of the choices citizens make, they face a struggle against death, hunger, and the virus. In Africa, the public's understanding of the morbidity and mortality caused by the disease remains inadequate, and implementing preventive mechanisms to curb its spread is particularly challenging in most countries. This significant obstacle is further exacerbated by social practices, the influence of traditional greetings, poor sanitation (e.g., washing hands with soap when clean water is unavailable), material sharing such as door handles, toilets, television remotes, cell phones, and computer keyboards, and a general lack of vigilance and egoistic tendencies, which are expected to double the risk of coronavirus infection in Africa. Evidence from China shows that prohibiting material sharing, implementing lockdowns, and establishing social distancing significantly reduced transmission. This is because the majority of Africans live below the poverty line, with millions engaged in informal work. Even if they stay at home, the overcrowded and unsanitary living conditions in Africa make physical distancing and sanitation nearly impossible, leaving these workers and their families continuously exposed to the virus. Furthermore, most Africans lack access to running water, which not only limits handwashing opportunities but also endangers women and those they come into contact with.

Community-based self-care and management approaches are encouraged to combat the coronavirus pandemic due to their extensive impact on global morbidity and mortality, the resulting financial implications, and their significance for public prevention. Effective measures against COVID-19 require collaboration between government organizations, non-governmental organizations, private institutions, healthcare facilities, schools, universities, and religious centers. If implemented properly, such collaborations could enable healthcare systems to effectively address the impacts on high-risk individuals and groups as part of global prevention strategies.

Moreover, evidence from Africa indicates that travelers, large gatherings, handwashing, physical contact with others, and sharing materials handled by hands are associated with higher disease prevalence, as these activities increase the chances of coming into contact with the virus. The transmission of coronavirus continues to increase, with prevalence spreading across Africa regardless of healthcare system and economic levels. This necessitates further research and analysis of the health, social, economic, and political impacts, highlighting public health requirements and estimating the necessary funding and measures for appropriate preventive actions. Therefore, it is essential to conduct comprehensive analyses, previously unreported, to assess the impact of COVID-19 outbreaks on health and economic growth in resource-limited countries like Africa. Current evidence primarily focuses on confirmed cases, recoveries, and deaths, with little information on social, economic, and political impacts. This narrative review aims to establish the impact of COVID-19 on case numbers, recoveries, deaths, the effects of the health crisis on formal and informal economic sectors, GDP changes before, during, and after the pandemic in Africa, and the political and other outcomes of preventive measures such as lockdowns.

Method

Sources

An electronic search was conducted for relevant reports published between January 8, 2020, and August 8, 2020, from databases including Google Scholar, PubMed Central, Scopus, and Web of Science. Additionally, abstracts from both published and unpublished sources, as well as reference lists and tables of contents from relevant journals such as The Lancet, New England Journal of Medicine, and Nature, were searched. Searches also included documents related to Africa from global and regional government sources, WHO global and regional reports, updates from Regional and Local Disease Control Centers (RLCDC), and articles from The Guardian (UK) and The Washington Post (USA).

Survey Search Terms

Search terms used included: 'Infectious Diseases,' 'Coronavirus,' 'COVID-19 Pandemic,' 'COVID-19 Impact,' 'COVID-19 Economic Impact,' 'Severe Acute Respiratory Syndrome (SARS),' 'Impact of COVID-19,' 'Economic Impact of COVID-19,' 'COVID-19 Health Impact,' 'COVID-19 Social Impact,' 'COVID-19 Case Reports,' 'COVID-19 Death Reports,' 'Social Distancing,' and 'Lockdown'.

Selection Criteria

Two reviewers independently evaluated all titles and abstracts of the identified studies, applying the following four selection criteria to determine (1) whether further investigation was needed:

1. Does the report include African countries?
2. Is it published in English?
3. Is the content relevant to the purpose of the study?
4. Was it published between January and July 2020?

For studies meeting the selection criteria, full-text versions of journal articles or other primary materials were obtained, and consensus was reached after discussion for any unclear studies. From the final selection of primary materials, we (J.G. and M.K.) independently extracted data into a standard data form. We contacted authors of studies with missing data via email and obtained data where possible.

GDP Estimates

GDP forecasts for pre-pandemic, current, and post-COVID-19 in Africa were calculated based on data from the continent's World Economic Outlook database. Initial results from the search of primary materials identified 136 studies using the Mendeley Desktop reference management tool to identify duplicates and manage data. After excluding duplicates, checking the eligibility of full-text articles, applying exclusion criteria, and screening, 32 papers met the selection criteria.

Figure 1: Process of Selecting Data from Literature and Conducting a Narrative Review

Health Crisis in Africa

Since the first case of COVID-19 was confirmed in northern Egypt on February 15, 2020, the pandemic and its associated morbidity and mortality have dramatically increased across Africa's five regions (North Africa, Central Africa, East Africa, West Africa, Southern Africa). The virus reached the continent just three months after being initially reported by WHO in China, and within a month of arriving in northern Italy, which was considered the epicenter of the disease at that time. Despite this, the number of cases in Africa was expected to be lower.

As of August 8, 2020, a total of 9.2 million COVID-19 tests had been conducted in Africa, confirming over 1 million infections, with 707,877 recoveries and 22,966 deaths recorded.

Southern Africa conducted the most tests with 4 million (43% of all tests conducted), while Central Africa conducted the fewest with 327,007 (4%). The highest number of cases was in Southern Africa with over 565,003 cases (56%), followed by North Africa with 171,251 cases (17%), and West Africa with 136,952 cases (13.6%). The highest number of deaths was in Southern Africa with 11,424 (48%), followed by North Africa with 7,030 (29.3%). The countries with the highest number of reported cases were South Africa (553,188), Egypt (95,314), Nigeria (46,140), Ghana (40,533), and Algeria (34,693). The six countries with the highest number of virus-related deaths were South Africa (10,210), Egypt (4,992), Algeria (1,293), Nigeria (942), Sudan (773), and Morocco (480).

Strong Resilience of African Countries and Societies in the Face of the COVID-19 Pandemic

According to current data, COVID-19 has had a greater impact on 'developed' countries compared to poorer countries on the continent. Additionally, urban areas have had a higher disease burden than rural areas. A review of data from the Johns Hopkins University Coronavirus Resource Center, as shown in Table 2, indicates that the mortality rates in African countries ranged from 0.5% in Ghana to 8.1% in Chad, whereas in the UK it was 15.0%, in Italy 14.1%, and in Brazil 3.3%. The relatively low mortality rate of COVID-19 cases in Africa is likely due to the youthfulness of the African population, although it may also be attributed to inefficiencies in social and healthcare data collection systems [41].

Impact of COVID-19 on Africa's Informal Economy and GDP Crisis

In Sub-Saharan Africa, 80-90% of economic activity comes from the informal sector, which accounts for 40% of GDP [42, 43]. The outbreak of the COVID-19 pandemic has had a severe impact on this economic sector. Informal workers and businesses [42] involved in activities such as accommodation and food services, manufacturing, wholesale, and retail, including over 500 million farmers producing for urban markets, have been significantly affected. Logistical challenges within the supply chain, especially domestic movement restrictions across borders, have led to disruptions in food supply and threatened the food security of informal workers. Additionally, informal product markets play a crucial role in ensuring food security in many countries as sources of food and as places where small-scale farmers sell their products. Their closure is likely to lead to increased food insecurity and poverty [44].

Table 1: COVID-19 Testing, Confirmed Cases, Deaths, and Active Cases in Africa

Table 2: COVID-19 Mortality Rates, Comparison Among Several Countries

An overwhelming majority of workers in the informal economy are experiencing increased exposure to occupational health and safety risks due to the lack of adequate protection and the increased likelihood of suffering from illness, accidents, or death. COVID-19 exacerbates these risks. If they fall ill, most workers, including migrants, are not guaranteed access to medical care and lack income protection through benefits for illness or work-related accidents [45]. Without medical care, the virus could spread more widely and lead to fatal outcomes. Even if they can access healthcare, many will bear out-of-pocket costs, incur debt, or be forced to sell productive assets, leading to deeper poverty [45,46].

Table 3 compares the projected changes in Gross Domestic Product (GDP) of various African countries before, during, and after the pandemic. Table 3 indicates that Africa's overall GDP is projected to decrease from 2.4% before the outbreak to between 2.4% and 5.1% at its peak, and then increase to 4.1% afterwards. The GDP changes for Sub-Saharan Africa and lower-middle-income countries are reported as −1.6%, −3%, and 1.6%, with forecasts of increases of 4.2%, 4.9%, and 4.9% respectively after the pandemic [35,47].

Table 4 shows the impacts of the COVID-19 pandemic on health, society, economy, and politics in Africa. The health impacts are overwhelming, with the continent's resource-poor health systems, underlying conditions such as lower respiratory infections, HIV/AIDS, diarrheal diseases, malaria, and tuberculosis contributing to early mortality. This was exacerbated by over 3 million early deaths in 2016 [47,48]. In many wealthy countries, comorbidities complicate health outcomes for COVID-19 patients, and in large populations experiencing malnutrition and underlying conditions, there is an increased risk of death from the virus, although the extent of this impact is unclear. Additionally, inadequate health service infrastructure in the African continent may result in many infected individuals not receiving necessary care in facilities with appropriate equipment [24].

Table 3: GDP Forecasts for Various African Regions and Countries Before, During, and Post COVID-19 Outbreak [35, 47]

The outbreak of the pandemic has had a significant impact on the social lives of Africans, limiting the sharing of resources, disrupting family life, and undermining social cohesion due to social distancing and enforced isolation. Most educational institutions in Africa have been closed. Traditional African life, which is cohesive and based on mutual dependence, makes social distancing and isolation particularly challenging. Restrictions imposed by governments not only exacerbate existing inequalities but also lead to increased victimization of women, with a rise in rape incidents [49]. The most economically disadvantaged and vulnerable, such as people with disabilities and the elderly, are particularly affected [50]. Furthermore, the closure of agricultural markets has restricted access to food sources, causing hunger among vulnerable communities that are already below the poverty line (Table 4). In some African countries, such as Ethiopia, Kenya, South Africa, and Uganda, human rights violations, killings of civilians by security forces, and an increase in traditional crimes have been reported [28]. As a result, social unrest has emerged, leading to further impoverishment of communities [51].

Table 4: Impact of COVID-19 on Health, Social, Economic, and Political Aspects in Africa

Here is the English translation:

"Many African countries were already economically precarious due to corruption, unstable regimes, and weak political leadership [39, 47]. Despite this, some countries, such as Djibouti, Ethiopia, Guinea, Côte d'Ivoire, Senegal, and Tanzania, have shown remarkable economic growth over the past six months [39, 52]. In many countries, high formal unemployment rates force people to rely on small-scale farming and informal transactions for their livelihoods. In countries where the economy has stagnated, thousands of jobs have been lost, and the population without reliable sources of income has increased [40, 52]. At the national level, some of the economic impacts of COVID-19 measures include the shutdown of informal economic sectors such as street vendors and small informal shops, known as spaza shops [43]. As a result, per capita income and domestic product trade have decreased, the value of supply chains has diminished, and there is increased pressure on fiscal policies and debt, all of which could lead to financial recessions or downturns [39, 40, 52].

Table 4 shows that notable political impacts of COVID-19 include increased discrimination against refugees and migrants, border closures, restrictions on the movement of goods and services, the collapse of formerly close relationships between African countries, and the evacuation of citizens to their home countries, all of which have led to a lack of trust in leadership [53]. Additionally, due to a lack of running water, measures such as handwashing may not be suitable for Africa [53]. Furthermore, delays in national elections have led to fatal disputes, mistrust, and conflicts between parties and ruling governments in some African countries, such as Ethiopia [54].

Discussion

This narrative review aimed to establish the number of COVID-19 cases, recoveries, and deaths, the impact on the informal economic sector, and predictions for changes in Gross Domestic Product (GDP) in Africa before, during, and after the pandemic. It also sought to clarify the health, social, economic, and political crises caused by the COVID-19 outbreak in Africa and the impact of lockdown measures imposed to prevent the spread of the virus among the African population.

Situation in Africa Before COVID-19

Prior to COVID-19, the healthcare situation in the African continent focused on infectious diseases such as HIV/AIDS, malaria, tuberculosis, and cholera, as well as health issues related to maternal and child mortality. Non-communicable diseases (NCDs) typically received less attention. Social factors in Africa before COVID-19 were diverse and varied. For instance, communities across the continent frequently moved from one region to another for legal purposes such as visits, tours, trade, education, meetings, training, or illegal migration through human trafficking. Regular public gatherings included those around churches, mosques, beaches, campfires, and events such as nightclubs, music and film concerts, mass marketing, social work, weddings, and funerals.

However, the COVID-19 pandemic prompted African governments to implement strategies to protect citizens' lives, health, economy, and rights, resulting in changes to these activities.

The economic context before COVID-19, especially in Africa, was unique with respect to the informal sector and the formal economy. For example, the informal sector consisted of economic activities that avoided costs and were excluded from legal and administrative regulations that applied to property relations, commercial licenses, labor contracts, illegal activities, financial credit, and public economic systems. While labor laws protected the formal economy, COVID-19 exposed the vulnerabilities of the informal sector, as evidenced by the lack of contracts and income protection.

Lastly, the political situation in Africa before COVID-19 (with 22 countries preparing for national elections) posed issues. Elections could either support the legitimacy of leaders or lead to fear and panic associated with events perceived as 'death' situations, potentially holding leaders accountable by replacing them. Given the ongoing pandemic, there is uncertainty about whether countries will proceed with elections according to their schedules. Specifically, some autocratic leaders may use the pandemic as a concern to extend their tenure by postponing elections to a later date or indefinitely.

Incidence, Mortality, and Recovery Rates

Although the pandemic originated in China, the COVID-19 outbreak in Africa has led to very high infection and mortality rates among the African population, which is already vulnerable to infectious and chronic diseases. As of the time of writing this narrative review, the infection and mortality rates related to the virus were highest in North Africa, followed by West and Southern Africa. Model studies in Africa support our findings that, as of June 30, 2020, approximately 16.3 million people in Africa had been infected with COVID-19, with North Africa being the least affected and East Africa being the most affected region. On June 30, the projected number of cases was about 2.9 million in Southern Africa, 2.8 million in West Africa, and 1.2 million in Central Africa. The variability in case load and mortality rates may be attributed to the lower levels of socioeconomic development. In the early stages of the pandemic, transmission is likely to be less and slower in regions with higher levels of socioeconomic development.

Health Crisis

Our narrative review results depict a larger health crisis of the COVID-19 outbreak in Africa. This crisis is exacerbated by the already existing resource-limited healthcare systems and early mortality due to HIV/AIDS, lower respiratory infections, diarrheal diseases, malaria, and tuberculosis, which led to over 3 million deaths in Africa by 2016. In many advanced countries, comorbidities complicate the health outcomes of COVID-19 patients, but the impact on larger populations in states of malnutrition, which are at higher risk of death from the virus, remains unclear. Additionally, due to limited healthcare infrastructure, many infected individuals are unlikely to receive care at facilities equipped with proper resources.

Social Crisis

The social crisis brought to the people of Africa by COVID-19 includes significant harm from constraints such as false news, racism, and discrimination, which hinder the initial control and management of the pandemic. This may be due to the integrative and dependency-based lifestyle in Africa, making social distancing and isolation particularly challenging. The results of this study indicate that the impact of COVID-19 is particularly high among vulnerable groups such as women, the elderly, and individuals with disabilities, with higher mortality rates observed among those with comorbidities. Commentary on minority groups in Israel supports our findings that during the COVID-19 outbreak in Africa, the elderly, disabled individuals, and those with comorbidities have been marginalized in various situations. The findings also align with literature indicating that hypertension, diabetes, cardiovascular diseases, kidney diseases, and respiratory conditions are the most prevalent comorbidities, which may contribute to the lower resistance observed in individuals with comorbidities and the elderly compared to younger individuals and those without comorbidities.

The results of this review show that the closure of food markets and limited access to food sources have led many households to be unable to obtain food or afford food at reasonable prices, resulting in hunger. Evidence suggests that the COVID-19 outbreak could significantly increase poverty among vulnerable households, including a decrease in access to food. This may also be attributed to income loss during the lockdown period. Researchers have corroborated the findings of this review, revealing different understandings and perceptions of the COVID-19 pandemic within African societies, with West African countries showing better knowledge of the virus, likely due to lessons learned from the Ebola outbreak.

Economic Crisis

In many African countries, the formal unemployment rate is high, per capita income is low, and people rely on small-scale agriculture and informal transactions for their livelihood, lacking reliable sources of income. Researchers indicate that many African countries are already economically compromised due to corruption, mismanagement, and a lack of political leadership. At the same time, countries like Ethiopia, Côte d'Ivoire, Djibouti, Senegal, Guinea, and Tanzania have shown significant economic growth over the past 50 years.

Despite the economic growth in some countries, the COVID-19 outbreak has had a significant impact on the already strained African economy. Researchers have supported our findings by showing that some characteristics of the economic impact of COVID-19 prevention measures include a decrease in GDP, a decline in supply chain value, and increased pressure on fiscal policies and debt. The results of this review indicate that economic growth in Africa during the COVID-19 pandemic era (2020) decreased from 2.4% in 2019 to between −2.4% and −5.1%[39]. The pandemic is likely contributing to this forecast due to decreased production and increased costs caused by lockdowns. The United Nations Economic Commission for Africa's situation report forecasts that the economic growth rate for the African region in 2020 will be less than −3.3%[79]. This decrease is considered to result from a reduced share of the African region's extensive export markets in the global economy.

Supporting our findings, research in Kenya predicts a decrease in five GDP-contributing sectors—agriculture, tourism, construction, infrastructure development, and manufacturing—following COVID-19[80]. Additionally, the results of this review reflect the variation in GDP changes between pre- and post-pandemic Africa, with an observed increase in GDP decline (−3%) in middle-income countries, followed by a decline in Sub-Saharan Africa’s overall GDP (−1.6%) during the COVID-19 pandemic[39, 40, 52]. This disparity may result from the varying levels of lockdown implementation by country and differences in socio-economic and trade partnerships between Africa and regions such as Europe, China, and the Americas[60, 61]. According to World Bank Group surveys, the majority of African countries experienced a reduction in GDP from 2.4% pre-COVID-19 to a decrease during the pandemic[52, 81]. The decrease in GDP is likely the result of reduced imports and exports, job losses due to lockdowns in export production, and increased debt to address the pandemic[82].

Political Crisis

The political impact of COVID-19 has been overwhelmingly significant due to the already fragile and vulnerable government structures, in addition to its effects on health, society, and the economy[77]. As a result, connections between African countries have deteriorated, borders have been closed, citizens have sought refuge in their home countries, mistrust has arisen among leaders, and behaviors unsuitable for Africa have become apparent[51, 83]. In this regard, the political decisions taken by African leaders at the onset of the COVID-19 pandemic were likely motivated by fears of their fragile health systems, poor healthcare facilities, and economic stagnation[84]. Despite the constraints faced by public health emergency systems in African countries, the actions taken by African leaders to address the outbreak were not only swift but also highly praised. They declared public health emergencies, banned unrelated public movements, and implemented lockdowns to minimize the potential spread of diseases in their respective countries[85].

The differences in health outcomes, social impacts, and economic losses between developed and developing countries, including both the West and Africa, align with the variations in economic, health systems, and lifestyles. This discrepancy may be attributed to the lack of social support, a significantly higher number of people living below the poverty line, and the fact that more people in Africa are self-employed or not employed in the formal sector.

Significance

Most of the healthcare facilities and resources in African countries are under severe stress. If the spread of the pandemic persists as predicted, the secondary effects of the COVID-19 pandemic will quickly escalate into an economic emergency, leading the world into a recession and severely impacting the most impoverished African countries with limited resources.

Furthermore, while many African countries are implementing COVID-19 management strategies and approaches such as "quarantine, social distancing, self-isolation, water usage, hygiene facilities, and handwashing habits" as outlined by the WHO, these approaches, which have been deemed effective and successful in Asian countries like China and South Korea, remain challenging and often unfeasible in Africa. This is due to inequality, significant job losses, disparities, and informal economic practices. Additionally, the persistence of criminal activities, corruption, and governance failures in African countries constitutes an obstacle to peace, security, and safety, exacerbating existing issues of poverty, hunger, and inequality.

Conclusion

The COVID-19 pandemic has impacted the organization of our healthcare systems, our production, processing, exchange of goods and services, as well as our consumption practices, culture, and our relationship with life and death, and will likely continue to have long-term effects. The studies evaluated in this review contribute to understanding these changes and their impacts. It is up to policymakers and other stakeholders to consider these findings in the prevention and response to new outbreaks.

To effectively address the health, social, economic, and political impacts of the COVID-19 pandemic, a unified, proactive, and organized public health emergency response among leaders, governments, and non-governmental organizations is necessary. The success of preparedness and response to public health emergencies fundamentally relies on the superiority and quantity of accessible information during the outbreak. Rapid communication and the distribution of accurate information are crucial to prevent and manage the impacts of the COVID-19 pandemic on health, society, economy, and politics, ensuring that these issues are neither a matter of racial death nor hunger for the people of Africa.

Therefore, African countries need culturally relevant, indigenous pandemic management strategies to respond to pandemics that could affect their economies, citizens' health, and lives in the coming years.

Abbreviation

BREC: Biomedical Research Ethics Committee
CFE: Emergency Response Fund
COVID-19: Coronavirus Disease 2019
GDP: Gross Domestic Product
LIAC: Low-Income African Countries
MIAC: Middle-Income African Countries
OE: Oil Exporting Countries
RLCDC: Regional and Local Disease Control and Prevention Centers
SSA: Sub-Saharan Africa
UKZN: University of KwaZulu-Natal
WHO: World Health Organization

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