Can Africa Keep Coronavirus Under Control?

By Bunmi Makinwa

The map that is emerging of the global situation of coronavirus disease, better named as COVID-19, is strange and surprising.

Coronavirus Map: Distribution of COVID-19 Cases Worldwide, as of March 17, 2020. Credit: WHO

Take a map of the world with an all-white background and put black spots to mark the places where COVID-19 cases are high or significant. Africa stands out as the only continent that remains mostly white. The other continents have a large number of people who have COVID-19. Many of the countries with a high number of cases also have a correspondingly substantial number of deaths from the disease whilst African countries have recorded very few deaths.

What is strange about Africa? Why is COVID-19 unusually bypassing Africa?

Epidemiology is the study of incidence, distribution, and possible control of diseases and other factors relating to health. It uses a lot of data and statistical information to reflect its conclusions or findings. It gives an account of fundamental factors that influence course of diseases.

As in similar studies of humans, nature and society, when no coherent explanation is possible to explain a phenomenon, epidemiology infers, extrapolates and uses conjectures.

In understanding why Africa is spared to date of many cases of COVID-19, there are a lot of inferences and suggestions, but very little coherent or solid explanation. It is understandable. COVID-19 is a new and rapidly evolving disease. The scientific knowledge is growing but It is too early to draw conclusions.

Compared to the rest of the world, cases of COVID-19 are low in Africa. As at this time of writing, Egypt leads with 196 and also has the highest number of deaths at 6. South Africa is a distant second with 85 cases, followed by Algeria with 61 cases, Morocco has 38 cases and Senegal has 27 cases, in that order. Morocco has recorded 6 deaths and Sudan has one. All other African countries with COVID-19 cases are in single units.

Image result for covid-19 africa

South African Development Community unites to tackle COVID-19. Credit: WHO

The current situation on COVID-19 does not say a lot about where things maybe tomorrow or in the near future. Whilst China was dealing with the first major epidemic and a high number of cases, most countries that became almost overwhelmed with the disease did not foresee the trend. Within weeks, Italy has a raging epidemic with 31,000 plus cases and over 2,000 deaths, and Iran has more than 16,000 cases with almost one thousand deaths. Spain, Germany, France and the USA are battling with rising numbers.

There is, therefore, no valid reason to celebrate or be lackadaisical about the current situation in Africa. Rather, it is as good a time as any to adopt an active and serious preparedness stance. African countries should anticipate any eventuality. There are already lessons to learn from other parts of the world.

African countries cannot be over-prepared, because its best preparedness situation in medical and health services will be not anywhere as strong as the services in China, Iran, South Korea, Italy, France or the United Kingdom – which health care and management capabilities were overwhelmed fast by the epidemic. According to WHO, healthcare and services in Africa, especially in sub-Saharan Africa, are the weakest in the world.

“Keep it out and be prepared”. This is my shorthand of a combined strategic imperative that should drive Africa’s readiness on Coronavirus or COVID-19 given the facts and data available regarding the disease.

From reports and personal observation, African countries have set up testing facilities at airports to monitor travelers and identify possible infected persons. This is excellent. It is doubtful that the same kinds of facilities are available at land borders which are often too numerous to count, and very porous.

COVID-19 is said to have an incubation period of between 14 and 21 days based on current knowledge. It means that an infected person with no symptoms yet may pass through the temperature recording tests at airports and manifest the disease later on. It has probably been the case with several international travelers who have been identified with the disease days after their arrival in countries.

It is also assumed that COVID-19 or a variant of it is not indigenous to African countries. If it exists already, it is most likely to be passive or not as virulent as the type that is ravaging other parts of the world. The assumptions are reasonable until facts prove otherwise. If the assumption proves wrong with time, there will arise a need to respond to emergencies.

For the above reasons and others, the efforts to “keep it out”, may not be as successful as it is touted to be. Therefore, the second part of the strategy, “be prepared,” becomes even more important.

Image result for senegal coronavirus test

Senegal partners with UK lab to develop a hand-held coronavirus test kit. Credit: CNN.

Most African countries have Centre for Disease Control (CDC), or National Institutes of Public Health and similar bodies that are a repository of knowledge and skills in control and preparedness for communicable and non-communicable diseases. They have capabilities to test, confirm COVID-19, treat and manage cases locally, including the capability for contact tracing, isolation and follow-through medical services.

However, medical and care services are most beneficial and effective when disease burden is limited. The fact that most people in the continent do not have reasonable access to health care facilities is a grave complication when epidemics strike.

The maxim, prevention is the cheapest cure, cannot be more appropriate at this time. In order to “be prepared”, African countries should adopt a preventive approach premised on behaviour change, a well-developed public health and change management field.

COVID-19 is a communicable, infectious disease. Unfortunately, merely reviewing measures taken by African countries to date reveal that less than 10 countries out of 54 have taken the preliminary steps of behavior modification and change that can enable people to “be prepared” to overcome the disease. Measures such as limiting the gathering of groups, enforcing reduced movement for social activities, and continuous enlightenment and education with rehearsals for practical understanding are very important.

It is difficult to ask people not to socialize, greet, congregate to celebrate, meet up with family and friends, as they normally do. It is challenging to ask people to wash hands with soap for at least 20 seconds every so often; not to touch mouth, nose and eyes; and to avoid handling public facilities. People just like to do what they normally do. It is human. The social and cultural practices of African peoples have proved tough and resistant to behavior changes that place individuals above groups and community. We have seen it in HIV and AIDS programmes, and in combatting Ebola.

Now with COVID-19, people must be ready and comfortable over time with the disruption of normal life and daily routines. It is difficult to stay home for days, weeks and maybe months, but people must be geared to practice and adopt the new behavior.

Official announcements setting stringent requirements to reorganize life in new ways, cancel public gatherings and events relating to education, work, leisure, and social life, are in order. People must be prodded towards changing their lifestyle.

Behavior modification and change are what it means to “be prepared” for COVID-19 in Africa. It is known that behavior change takes several steps from awareness to understanding, through acceptance, adoption, and ultimately the sustainability of new behavior. It also takes several supporting factors, including policy, politics, faith, social and economic contexts to effect a change of behavior in institutions, societies and amongst people.

The time to begin implementing a behavior change movement to contain COVID-19 in Africa was yesterday. There is no justifiable reason for any country to be taken by surprise having seen how the disease has evolved dramatically in several countries.

If, as time goes on, Africa remains unaffected by the ravages of COVID-19, nothing would have been lost by being prepared for the worst-case scenario. Indeed, it would be a much better situation than saying “had we known” after the unexpected havoc that the epidemic can wreak on a fragile continent.

Bunmi Makinwa was the first head of behavior change communication of UNAIDS at the global level from Geneva. He is the CEO of AUNIQUEI Communication for Leadership.

Facts and Lessons on Coronavirus

By Bunmi Makinwa

Image result for coronavirus

It is highly unlikely that you will be infected by Coronavirus, code-named COVID-19, according to prominent facts from the ongoing epidemic of the virus. This is not what you would think given the hysteria, myths and information that spread every day on the disease.

Coronaviruses are a large family of viruses that may cause a range of illnesses in humans or animals. Among the most well-known coronaviruses are Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Swine Flu. The most-recently discovered coronavirus causes coronavirus disease and has been code-named COVID-19 by the World Health Organisation (WHO). It is known so far to have originated from an animal.

Prevention and avoidance of infection is easy and possible through simple actions that each individual can take, and which organizations, companies and communities can facilitate.

The chances of recovery from the disease are also very high compared to other recent viral epidemics. Facts and data on COVID-19 reinforce the positive conclusions stated above. Yet the spread of COVID-19 is real and new facts are likely to surface as the epidemic becomes scientifically more familiar.

The caricature of Chinese people as being carriers of COVID-19 is incorrect. Though the first known cases of the disease and the largest number of infections and deaths were in Wuhan in Ubei province of China, COVID-19 has appeared in at least 64 countries, three of them are in Africa – Algeria, Egypt and Nigeria.

Egypt was the first African country to report a Coronavirus case, a Chinese person who has since tested negative and has been discharged from quarantine. Algeria has two suspected cases and one of them was confirmed for infection. The two cases were Italians. Nigeria has reported a case and the Italian who travelled to Lagos on February 25 had his case confirmed on February 27. He has been quarantined at a facility in Lagos.

According to the government of Lagos State, the patient’s symptoms have subsided. It means that his potential to infect others has decreased. If the trend continues, he will be released as he will no more pose any danger to others.

Image result for coronavirus countries infected

It is likely that more Africans will be infected by COVID-19 as time goes on, especially Africans who live in or visit places that have a high number of cases of the disease. For example, two South Africans were detected to have the disease on board the cruise ship, The Diamond Princess, in Japan. The Diamond Princess has recorded 705 cases of COVID-19 and 6 deaths to date. It carried 3,711 people and was sailing from Singapore to Japan when the first case was discovered.

Unfortunately, infected people may carry the virus for many days before they show symptoms, and they can infect others. Infection takes place through droplets when infected persons sneeze or cough. Fomites, object or substance that is capable of transmitting infectious organisms from one individual to another, also may carry the virus through to others. Metals and metallic objects are said to be efficient fomites for COVID-19.

Estimates by credible organizations are that infected people have 98 per cent recovery rate from the disease. The two per cent of patients who die from it are predominantly vulnerable

persons such as older people above the age of 50 and most of them have pre-existing conditions, such as diabetes, cardiovascular disease, hypertension, chronic respiratory disease or cancer. It means that young people have a very high capability to recover from infection based on what is known to date about the virus.

In a larger context, whereas SARS has 9.6 per cent and MERS has 34 per cent mortality rates, COVID-19 has about 2 per cent mortality rate.

How does one avoid COVID-19? Remember the following simple measures.

Image result for coronavirus infographic

Wash and rinse hands thoroughly with soap and water for at least 30 seconds. Do it frequently and encourage others to do the same. The hands are the major carriers of viruses and washing hands with soap and water properly kill most viruses. In the absence of water and soap, sanitizers are also effective but not as well as soap and water. Water alone if it is all that is available is useful but very weak as a cleaner for viruses.

Avoid touching the nose, mouth, eyes with hands. The hands pick up viruses and transmit them easily through these parts of the body.

Stay a good distance, about one metre or three feet, away from anyone who sneezes or coughs. The droplets from their sneeze or cough cannot reach you at this distance. Anyone who sneezes or coughs should cover their noses and mouths to avoid spreading droplets to others.

Fomites, such as clothes, utensils, and furniture, also transmit viruses. In public places especially, use fomites sparingly and clean hands frequently when public objects are used.

Stay at home if you feel ill and seek medical care as soon as possible if the illness persists.

It is important to be informed and to obtain new information on the new virus. However, avoid misinformation and myths. For example, the WHO recommends the use of face masks for those who are taking care of patients with COVID-19 or for those who may have a cough, cold, or sneezing. Wearing masks is not a substitute for regular hand cleaning.

There is a lot of wrong information about the current epidemic given the power of social media that turns just about anyone into specialists. Each country has credible sources of information and there are various international organizations that competently provide information. Top of the list is the World Health Organization, Center for Disease Control, National Public Health agencies, and well-established, reputable media organizations.

Bunmi Makinwa is the CEO of AUNIQUEI Communication for Leadership.

Kofi Annan’s Unmet Wishes

By Bunmi Makinwa

Image result for Kofi Annan

Kofi Annan, who passed away on August 18, 2018, at the age of 80, can be situated within the select group of aspirational Africans of his time. Within their generation, the group was imbued with huge dosages of hope, logic and grit. They had numerous wishes but only few were met.

His generation started life when Africans who had opportunities saw no limit to what they could achieve. They hungered after acquisition of education, combined with hard work, and they would use both to conquer the world. They would move Africa, poor and lagging behind, ahead of the world.

Annan was one of the most successful representations of his generation.

In 1957, 19 years old Annan graduated from high school as Ghana his country became independent. He earned degrees from universities in Ghana, USA and Switzerland.

Image result for Kofi Annan young

A handout photo made available by the United Nations shows Kofi Annan (L), Secretary-General of the United Nations, with fellow students, during his younger years, as an MIT Sloan Fellow, studying copper industry, in Zambia, 1971

By the time Annan was 40 years old in 1978, almost all African countries were ruled by Africans. The colonial era was past. Putting an end to apartheid was a political and emotional ambition of Africans under the umbrella of the Organisation of African Unity (OAU), founded in 1963. Development, peace and stability were seen as beacons in the horizon.

Annan was fluent in English and French. His first wife, Ms. Titi Alakija, was from Nigeria. After his divorce, he married Ms. Nane Lagergren from Sweden. Annan was culturally assimilated into many parts of the world.

In 1962, he started work with the World Health Organisation as administrative officer. Within the various organs of the United Nations, he rose to become Under-Secretary General for Peacekeeping in 1992, a senior political role in an inter-governmental institution where one’s emoluments allow a comfortable and cushioned life, though not a wealthy one.

By the time he became United Nations Secretary General (UNSG) in 1997, Annan had probably fulfilled his hopes and wishes. He was at the peak of an illustrious career, and a political peer of heads of state and government.

His continent had matured politically, but it remained seriously under-developed. Africa was ravaged by conflicts and hobbled by extremely poor execution of otherwise laudable policies. Under-development was becoming chronic, and it went hand in hand with diseases and attendant epidemics such as HIV and AIDS. Unemployment, poverty, high mortality of infants and mothers, droughts, corruption and poor access to infrastructure were common.

Annan was a high-flying African; he had international recognition and acclaim, but the successes were diminished by the sad state of the continent. Africa, despite its immense potentials, remained the least developed region of the world, a basket case of world’s political and development agenda. The situation must have affected the number one global diplomat sorely.

Image result for nelson mandela premio nobel

In 2004, six years into his tenure as UN SG, Annan, speaking at a summit of the African Union, created in 2001 as successor to the Organisation of African Unity (OAU), called on African leaders to refrain from changing the law once in office to extend their mandates. The audience comprised presidents and representatives of countries that were guilty of such mandate extension, and others that were scheming for it. They included Gnassingbe Eyadema, Robert Mugabe, Teodoro Obiang Nguema, Omar Al-Bashir, Muammar Gaddafi, Jose Dos Santos, Paul Biya, Paul Kagame, Yoweri Museveni and Meles Zenawi.

It was an unusual speech for the audience. As this writer looked around in the hall at the United Nations Economic Commission (UNECA) where the summit was held, the tension was high. Some presidents looked away from the podium where Annan stood. Some others shifted in their seats, obviously unhappy, uncomfortable.

Annan told the summit that national constitutions were meant to protect society, not to advance “the short-term goals of the ruler”. He said the days of one-person or one-party governments that hung onto power were over. “There is no truer wisdom, and no clearer mark of statesmanship, than knowing when to pass the torch to a new generation. And no government should manipulate or amend the constitution to hold on to office beyond prescribed term limits that they accept when they took office.”

Annan prescriptions were clear and direct. Every country in Africa must have free and fair elections, a credible opposition, an independent judiciary, a free and independent press, and civilian control over the military.

Looking his usual unflappable self, it was clear that the medium size-framed diplomat had decided to use his office to take the moral high ground. He was the voice of the people. He would not merely please presidents nor be cowed by the fact that there in the hall were the leaders of the organization that he coordinated.

At many public forums, Annan continued to be the champion of term limits for political leaders, the spokesperson of good governance, and a shining light calling for much-needed progress in Africa.

At the World Economic Forum in South Africa he maintained the pressure on African leaders who clung onto power. He pointed out that there was a “leadership deficit” in Africa and little was being done to create jobs and lift millions out of poverty.

A highly respected moral authority and voice, he spoke to African leaders as nobody else dared to do. Unlike some past African leaders who would berate their peers for bad deeds for which they themselves were equally guilty whilst in office, Annan’s integrity and impeccable standing made his position unassailable. He was strong though he had no army to fight with, nor did he have money to give as incentives.


The Kofi Annan Foundati
on, which he created after he left office as Secretary General, pursues the same agenda of service as leadership. Annan spent his life and used his moral authority to advance themes of good governance and democratic ideals directly with African leaders.

UN Secretary-General Kofi Annan shakes hands with South African President Nelson Mandela in a meeting on the sidelines of the 12th Non-Aligned Movement (NAM). September 2, 1998.
AFP/Getty Images

At the Nelson Mandela Annual Lecture in 2007, Annan cited Mandela and several other past presidents as examples of former leaders who have shown that “the center stage is not the only place from which you can make a contribution”. 

In 2017 at the 5th Tana High-Level Forum on Security in Africa, Kofi Annan said that elections were being conducted by leaders in ways to keep themselves in office. Such elections contributed to conflicts in the continent.

In similar vein, in August 2017, delivering a lecture at his former high school, he decried how African leaders subverted their people by organizing elections that “lack integrity”. “We need true democratic leaders who understand that they are at the service of the citizens… Leadership is service. Leaders must understand that they hold power in trust of the people… Unfortunately, Africa has had too few of enlightened people of this kind.

Annan was a Nobel laureate whose accomplishments put him shoulders and head above his peers anywhere in the world. Another African Nobel laureate, Wole Soyinka, born in 1934 in the same era, once said that he belonged to a “wasted generation” as his country’s political leadership has fallen short of expectations. Like Soyinka’s, Annan’s life remained incomplete because his wishes for a stable, peaceful and developed Africa remained unmet. Whence comes another honorable, strong voice to challenge the selfish and inept leadership by many African leaders?

Bunmi Makinwa is the CEO of AUNIQUEI Communication for Leadership. Formerly, he was Africa Regional Director of United Nations Population Fund (UNFPA).

MOHAMMAD ALI: THE LAST OF THE CAMELOT GIANTS. A TRIBUTE.

BY PROFESSOR A. BOLAJI AKINYEMI

Nigerian Minister of External Affairs, 1985-87

My generation by which I mean the generation which came into political and social consciousness in the 1960s was lucky in the sense that we had many real heroes, men and women from whom we drew inspiration, who made us feel that the best was within reach and that God’s mission on earth was achievable by doing good. They did not come any greater than John F. Kennedy, Robert Kennedy, Martin Luther King, Jr., Malcolm X, Kwame Nkrumah, Patrick Lumumba, Nelson Mandela, Kaduna Nzeogwu, Francis Fajuyi and yes, Mohammed Ali (the Greatest boxer of all times.). It was also the age of independence for African states, an age that liberated not just territories but the can-do spirit of the whole world.

It reminded us of the can-do and elevating atmosphere prevalent in the court of King Arthur and his knights of the roundtable. That Court was known as Camelot.

But it was also an unfortunate generation because we watched helplessly as each one of our heroes was assassinated, overthrown, and incaserated. It was a generation that watched as dreams were aborted. We watched as the dreams of independence turned into the nightmare of massacres, genocide, civil wars and kleptocracy.

Now, the last of the Camelot Titans, Mohammad Ali is gone, just gone.

I met Ali only once in Lagos during the Shagari period. The United States under Jimmy Carter was trying to organize a boycott of the Moscow Olympic games then due to be held in Moscow. Mohammed Ali was sent by the Carter Administration to lobby African States to join in the boycott. I was still at the Institute of International Affairs as the Director-General and Professor Isaya Audu was the Foreign Minister. I turned up in Professor Audu’s office on appointment only to be told to wait a while as an unexpected visitor had shown up. Soon, the door opened and I leapt up as Ali floated out in a boxing posture as he exited the Foreign Minister’s office. Then we shook hands. Professor Audu said jokingly that Ali should seek to persuade me about the Moscow boycott. That Ali went on diplomatic missions on behalf of the United States showed that even though he was against the Vietnam War and was against racism in the United States, he was not against the United States. He had a presence and a charm that masked the gritty determination of his beliefs. Ali showed a more profound and nuanced opposition to racism in the United States than most of the leaders of the anti-discrimination movements. The singular act of changing his name from Cassius Clay Jr. to Mohammad Ali sent a more powerful message as a symbolic message than a thousand marches. Ali was probably, actually definitely, not aware of the linkage between Islam and Arab slave trade in Africa. A later awareness of this in his later years might account for his switch from Sunni Islam to Sufism (another variant of Islam). Ali was a master of the grand gesture, gestures timed for maximum effect. Without a university education, not to talk of any specialization in psychology, he used psychology to devastating effect against his opponents before they even climbed into the ring.

Ali, the master performer, elevated boxing from the basement of the poor to the sitting room of royalty and billionaires. Boxing will miss him; sports will miss him; humanity will miss him.

He survived in spite of the fact that he did not play safe. He took on the American system when in 1964, he changed his name from Cassius Clay to Mohammad Ali after joining the Nation of Islam otherwise called the Nation of Islam and when he refused to fight in the Vietnam War. Those who took on the system especially in 60s and 70s usually paid with their lives as one hero after another got hunted down by the invisible forces that form the underbelly of rapacious and vicious system. Mohammad Ali survived.

The death of our heroes, speaking for my generation, did not kill our dreams.  Those who kill often do not realize that dreams cannot be killed. They sow seeds that germinate over time and hopefully serve to inspire another generation.

You said you were the Greatest. So say we all. Your death brings to mind the immortal words of John Donne in his poem “For whom the bell tolls” when he wrote “No man is an island, entire of itself; every man is a piece of the continent, a part of the main…any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bells tolls, it tolls for thee”

Good night Mohammad Ali

Professor A. Bolaji Akinyemi

June 5, 2016

 

AMERICAN HUNGER

As an ambitious, searching young man, Cassius Clay invented himself, and became 
the most original and magnetic athlete of the century—Muhammad Ali.