Coronavirus disease (COVID-19), an infectious disease that erupted on the global scene in late December 2019, has been one of the greatest global crises in decades. To date, tens of millions of cases have been confirmed in countries across the globe, more than one million people have died, and the livelihoods of billions have been greatly affected.
While COVID-19 has been a truly global problem, respecting no boundaries, the situation in Africa has positively surprised many experts and observers, with infection and death rates in many African countries much lower than initially feared. Fortunately, the case-fatality ratio (CFR) for COVID-19 in Africa is lower than the global CFR, suggesting disease outcomes have been less severe among African populations (Partnership for Evidence-Based Response to COVID-19). Of course, while Africa as a continent has broadly been successful since the first reported case in mid-February 2020, different countries within the region have reported COVID-19 epidemics of vastly different intensities and responded to the disease with varying levels of success. One country that has had a particularly successful COVID-19 response is Eritrea.
In my previous article, "COVID- 19: Eritrea's Success and Challenges (Part I)," featured in the last edition of Eritrea Profile (Saturday 31 October), I reviewed several of the important factors underlying Eritrea's success so far in combating COVID- 19. In this article, I will discuss some general challenges and other things to keep in mind moving forward.
To begin, as recent developments around the world can clearly testify, COVID-19 is stubbornly defiant and it will not simply vanish or go away. Numerous countries are once again experiencing mounting cases, forcing them to implement restrictions, order curfews, and prepare to go back into extended national lockdowns. Notably, even countries that had successfully dealt with the first wave of COVID-19 are now seeing their number of cases rise exponentially during a second wave. In Africa, the WHO has also noted that the slower spread of the infection in the region means that the pandemic could continue to spread for some time, with occasional outbreaks.
Within this context, despite its general success thus far, Eritrea must remain vigilant, alert, and keep its guard up. There is no room for complacency or relaxation. While Eritrea has cautiously eased many of its restrictions and the national lockdown, there should be recognition that the COVID-19 pandemic is not over yet and many risks remain. We must also be attentive to the risks of widespread "lockdown fatigue" - generally understood as a state of exhaustion (physical, psychological, emotional) caused by the long-term effects of COVID-19 and extended restrictions or lockdowns. Not only is it a problem in its own right, it may contribute to noncompliance with or resistance to guidelines and policies, which can make containing the virus more difficult.
As with other parts of the world, COVID-19 has presented Eritrea with significant economic challenges. The 2020 pandemic has fuelled a global recession expected to be the deepest since World War II. For Africa, the pandemic has put years of hard-won economic progress at risk. Economic activity in the region is expected to contract by 3.3 percent in 2020, meaning that Sub-Saharan Africa would suffer its first recession in a quarter-century.
For Eritrea, the positive economic outlook and predictions for this year will likely not materialize and growth will slow. The response to COVID- 19, involving restrictions and lockdown, came at a considerable loss for businesses, traders, and those working in the informal sector (e.g. casual labor and petty trade). While various measures, such as cash transfers and food distribution, the waiving and deferral of bills and fees, and a national support fund, have been put in place to extend support to vulnerable individuals and families, many households have been financially stretched. It is also well to note that according to a recent report by the World Bank, Africa's "road to recovery will be long and steep."
With measures to prevent the spread of COVID-19 disrupting childhood and mass immunization around the globe, millions are now at risk of other diseases, such as polio, measles, typhoid, yellow fever, cholera, rotavirus, HPV, meningitis, and rubella. In Eritrea, COVID-19 threatens to turn back years of significant progress. Recall that despite its relatively modest resources, Eritrea is one of the few countries that entered the United Nations Sustainable Development Goals period having achieved most of the Millennium Development Goals targets on health.
Hugely to its credit, however, the country has sought to maintain essential routine immunization, prevent the reemergence of preventable diseases, and keep its population healthy. As explained in late August by Tedros Yhdego, Head of the Vaccination Program at the Ministry of Health (MoH), "[COVID-19] is a deadly virus and for sure everyone should be careful. Nonetheless, we continued to give vaccinations in many regions in the nation by following the MoH guideline to protect everyone. We have been able to achieve so much with the relentless help that the people and government have given us. We are trying to give vaccinations thoroughly and carefully. But with the COVID- 19 pandemic, there are challenges such as transporting vaccines by airplanes as most of the airports are closed. But luckily we have been able to get sufficient vaccines that we might need for the year."
As well, during the lockdown, Eritrea's MoH, in collaboration with international organizations, such as UNICEF, extended the provision of therapeutic and preventative programs to address severe acute malnutrition among children under five, and to support pregnant and lactating women. Moving forward, health authorities must continue to strike the difficult and delicate balance between sustaining lockdown measures that reduce the risk of COVID-19 and maintaining safe immunization and other health programs that will prevent other devastating outbreaks in the months and years to come.
Notably, the COVID-19 pandemic is not the only crisis that Eritrea is combating. Over the past several months, communities across the Horn of Africa have been confronted with huge swarms of hungry locusts. Just days ago, the Food and Agriculture Organization (FAO), an agency of the United Nations, reported that "the situation remains very critical as more swarms form and a new generation of breeding has now started in Ethiopia and Somalia." There is significant potential for the large locust swarms to expand and spread, which is a worry for Eritrea. The swarms of "the world's most devastating pest", regarded as the worst in the region for many decades, have waged a heavy toll on communities, farms, livelihoods, and food security throughout the greater Horn of Africa.
Finally, it is rather unfortunate - although not surprising - that the world remains largely blind to African, Eritrean in particular, success. With limited resources, the country has managed to contain COVID-19 through decisive leadership and swift, aggressive action, strong planning and coordination, committed health workers, and engaged communities. It merits more positive recognition and credit. As explained in September by Karen Attiah, Global Opinions editor for the Washington Post, "This should have been a moment for media outlets to challenge corrosive narratives about Africa and the idea that Africans are not capable of effective policy-making. We could be learning from the experiences that Africans and their governments have had with pandemics and viral diseases, including Ebola and AIDS. Instead, the media has largely ignored the policy successes out of Africa. In doing so, Western media is reinforcing colonial narratives of Black inferiority and the inability of Black nations to govern themselves at all, much less govern better than resource-rich White nations."