COVID-19 in Africa, the other French challenge

The way in which COVID-19 is affecting developed countries bodes ill for what is to come on the African continent. A continent that, in regions like the Great Lakes, has just said goodbye after years of fighting another virus, Ebola. How international bodies and countries with greater capacity support those with more fragile health systems will be key to ensuring that the death toll from this pandemic does not soar there. 

In the case of a large part of Africa, France has the possibility, and also the duty, to lead support in the fight against COVID-19. Within the framework of bilateral agreements, France maintains a significant presence - around 3,700 troops - in some West African countries such as Senegal, the Ivory Coast and Gabon, in addition to those deployed in Djibouti, independently of other missions such as Operation Barkhane. Through this permanent presence, but also with the capabilities of other European or international missions and operations, it is possible to contribute to the tasks of containment, disinfection and, if necessary, training in these specific areas for the countries in which they are deployed, in addition to the logistical and health support that they can provide. The influence of France as a former metropolis also coincides with many of the countries with the weakest public health systems, such as those in the West and Central African region. 

So far, official figures in Africa barely exceed 11,000 confirmed cases, most of them concentrated in Morocco, Algeria, Egypt and South Africa, which are precisely the countries that have developed the best health systems. This raises the question of whether less health capacity means worse detection and, therefore, that the situation in some countries is, at present, more serious than the official figures show. 

Countries in West Africa such as Burkina Faso, Côte d'Ivoire and Ghana, and others in Central Africa such as Cameroon, already have several hundred confirmed cases, according to data from the African Union's Centre for Disease Control and Prevention (Africa CDC). In fact, the Africa Center for Strategic Studies (ACSS), in a study published on April 3, noted multiple factors that could affect the development of the pandemic on the continent. The study indicated that the countries that would be most affected, in the first phase, would be those with the greatest exposure to tourism - Morocco, South Africa and Egypt - and that, in later phases, the rest of the factors would come into play, so attention should be paid to other countries with regard to the prevention and containment of the COVID-19.

Among the possibilities that the military presence of international or European missions can offer, the European ones are the most limited in terms of number of troops, not in terms of capabilities or preparation of their personnel. With regard to EUTM type missions, training tasks are in fact already suspended, and some countries are even considering withdrawing their contingents. The United Nations missions, which are much more numerous, both on the continent and in terms of troops and number of contributors, could perhaps adapt their mandate to include support in controlling the spread of the epidemic, making their health and logistical means available to the countries where the missions are located (within the available capacities). 

This could be added to the above-mentioned French forces, whose largest contingents are in Côte d'Ivoire and Djibouti. It is necessary to wait for the development of the next weeks to see if there are political and military advances for the possible use of these human and material means, which have the advantage of being already on the ground.

In the economic and health field, France is also announcing measures to support the African continent in the fight against the pandemic. On Wednesday, Foreign Minister Jean-Yves Le Drian announced at the National Assembly's Foreign Affairs Committee the mobilisation of between 1.2 and 1.5 billion euros to provide financial support to Africa and other vulnerable regions, of which around 75% will be in the form of loans and the rest in the form of donations. 

The recipients of this economic aid will be the 19 countries - 18 African plus Haiti - that French diplomacy considers a priority: Benin, Burkina Faso, Burundi, Central African Republic, Chad, Comoros, Democratic Republic of Congo, Djibouti, Ethiopia, Gambia, Guinea, Liberia, Madagascar, Mali, Mauritania, Niger, Senegal and Togo. Going from the macro to the micro, the French Development Agency (AFD) together with the National Institute of Health and Medical Research (Irsem) are also implementing a project called Aphro-Cov which has been allocated 1.5 million euros. Through this mechanism, they seek to strengthen capacities for the treatment of infectious diseases, improve the early warning system and follow up on suspected cases. Aphro-Cov will be implemented in five countries in French-speaking Africa: Burkina Faso, Côte d'Ivoire, Gabon, Mali and Senegal. However, as in every crisis, there must be not only facts and results, but also good communication.

On April 1, two French scientists gave way to controversy when, in a very ill-advised way, they proposed to test some of the treatments and vaccines under development on the African continent. The almost unanimous criticism of such unfortunate words came from the misinformation that favors the immediacy and anonymity of social networks. The debate, although it had France and its relationship with the former colonies as its main target, soon spread to all developed - and western - countries, to large pharmaceutical companies and to all kinds of conspiracy theories that the COVID-19 crisis is stimulating so much. This type of error must be avoided with an adequate narrative.

As can be seen from the table above, none of the treatments being tested on patients with COVID-19 are performed in any African country. The same is true for potential vaccines, with the most advanced testing being done in China, the United States, the United Kingdom, the Netherlands and Australia. Along with the data on this new virus, the researcher Fred Eboko, who is closely linked to public policies related to the health field and, in particular, to the African continent, provided a much broader view of the relationship between vaccine and drug testing and Africa. 

In an article in Le Monde, the researcher defended the fact that there is currently no link between the continent and the preference for conducting clinical trials there, since this is an area in which Africa tends to be rather marginalised. He even adds that being so relegated to clinical trials is even detrimental to African health, which must deepen the establishment of protocols, including ethical ones, to carry them out, and this can only happen by also being an interested party in the development of the trials. The COVID-19 pandemic will leave many lessons to be learned in very different areas: from health to labour, including issues related to logistics, but also leadership and communication, the latter being essential lessons for all crises.