Dealing with health pandemics in Africa through regional cooperation: the case of COVID-19

Some facts on the ground

With the COVID-19 Pandemic having now reached every African country, mitigating the crisis from both the public health and socioeconomic perspectives has become extremely urgent.  The crisis continues to complicate and increase the challenges of achieving aspiration 1 and goal 1 of Africa’s Agenda 2063 on having “a high standard of living, quality of life and well-being for all.;” as well as SDG 3 on achieving Health and Well-Being.  Based on estimates made by the ECA in 2020, Africa’s GDP growth has been revised down from 3.2 percent growth to a range of -2.6 to 1.8 percent growth.

As of 10 June 2020, confirmed COVID cases in Africa have surpassed 200,000 and over 5,000 deaths have been recorded.  With over 40 percent of total cases having been detected in the last 14 days and a rising trajectory, the pandemic has not yet reached its peak, despite various lockdown measures implemented throughout the continent.  Concerns regarding healthcare infrastructure are particularly significant in Africa.  Among the issues that exacerbate the challenges to effectively deal with the public health crisis are: low levels of health spending on the continent (5.6 percent of GDP[1] compared to a world average of 9.9 percent); limited hospital bed capacity (1.8 beds per 1,000 people[2]), low access to household handwashing facilities (34 percent[3] for those with soap and water); and a heavy dependency on imports for pharmaceutical products (USD 3.6 billion net imports of pharmaceutical products in 2018[4]).  The far-reaching impacts of this crisis and the disease’s high degree of transmission underlines the importance of regional cooperation and integration of healthcare systems.

Importance of Regional Cooperation and Coordination to Address the Pandemic

Previous pandemics and outbreaks such as SARS and Ebola have demonstrated that there is need for better institutionalised and cooperative structures that can provide accountability, timely information and coordinated crisis management strategies.  The areas of particular need for these structures include: (i) human resources for health, (ii) supply chain management, (iii) financing and resource mobilization, (iv) data and ICT infrastructure and solutions, and (iv) partner engagement, coordination, and communications.  Especially in a pandemic with a new disease with high levels of transmission and lethality, the importance of coordination and cooperation cannot be understated – to understand the disease, to craft effective policies at mitigating the public health crisis, and eventually to disseminate a vaccine or cure.

The establishment of the Africa Centre for Disease Control (CDC) by the African Union is a huge step for the continent in providing a continent-wide platform to coordinate infectious disease management.  During this crisis, the Africa CDC has rolled out a new program, the Partnership to Accelerate COVID-19 Testing in Africa (PACT) to increase testing by supporting African governments with support to test 10 million people over the next four months.  The PACT program will also deploy 1 million community health workers to aid contract tracing and seek to train an additional 100,000 healthcare professionals in the continent.  Additionally, during this crisis, the Africa CDC has also served as a central institution in coordinating statistics and sharing knowledge of the SARS-CoV-2 virus throughout this pandemic.

Even with the Africa CDC, there is a still a case to be made for greater coordination and cooperation on regional levels. As COVID-19 cases are not spread equally across subregions, with North and Southern Africa accounting for over 50 percent of all confirmed COVID-19 cases, regional approaches are necessary to respond accordingly to varying levels of outbreak severity. 


The Regional Economic Communities (RECs) serve a key role in managing this pandemic.  Some RECs’ COVID-19 responses are outlined below:


COVID-19 Responses


  • The West African Health Organization (WAHO) coordinates the region’s COVID-19 response
  • WAHO developed Operational Guides and provided online training to healthcare workers in how to manage the disease
  • ECOWAS has supported Member States with PPE and necessary commodities during the crisis


  • The EAC Regional Contingency Plan for Epidemics (2018-2023) is the primary instrument for coordination of health emergencies in the region
  • EAC is also building its testing capacity, with procurement of mobile laboratories and testing kits and materials
  • Improving surveillance and reporting at border checkpoints to build has also been a priority


  • SADC reconstituted the Technical Committee for Coordinating and Monitoring the Implementation of the SADC Protocol on Health, made up of senior public health officials from SADC Member States
  • SADC has asked Member States to utilize the Medical Stores Department to leverage economies of scale through pooled procurement of PPE and pharmaceutical products


  • CEMAC devoted a US$ 152 million program to fund public projects fighting the COVID-19 Pandemic
  • Member States are also working together to collectively call for debt standstills


  • To continue trade of key goods across borders, COMESA has adopted guidelines to inform Member States on the movement of goods and services during the pandemic
  • This includes ensuring the transit routes and trade infrastructure (ports, border checkpoints) remain operational during the crisis

Source: ECA, compiled from REC websites and news run

First Virtual Meeting of Imperatives for Accelerated Health Integration in Africa

In responding to the COVID-19 Pandemic, ECA has also established a forum for RECs and ECA to come together to share knowledge.  The first virtual meeting was held on 13 May 2020 and it explored the potential for greater healthcare integration in the continent, with representatives from AMU, ECCAS, ECOWAS, COMESA, IGAD, SADC, and SACU present.  The meeting highlighted the need to expand the scope of healthcare cooperation and integration in the continent and commended the success like the Africa CDC, the African Medicines Agency, and the African Medicines Regulatory Harmonization Program Initiative. This channel of communication between ECA and the RECs would continue, as a medium to further accelerate regional integration, particularly in healthcare in Africa.

Key Policies Moving Forward

Moving forward, Member States should look to further cooperate on matters of public health, not only to mitigate crises as they occur, but also to build up healthcare infrastructure that is able to cope with future epidemics.  Enhanced information sharing on continental and regional levels continues to be among the most important tools in managing public health crises to better formulate effective data-driven policies to manage crises.  In addition to sharing information, sharing expertise through the training of frontline workers and coordination of border security policies and measures will also help limit disease transmission between countries and enable goods and services to continue flowing, particularly for economies dependent on imports for food and fuels, as well as landlocked countries.  Leveraging the AfCFTA’s framework and the AfCFTA-anchored Pharmaceutical Initiative for pooled procurement and incentivizing local manufacturing will also allow the continent to capitalize on larger size of the African market and to reduce dependency on imports for key goods.  Mobilizing domestic resources on a regional scale can also help provide aid to further manage the outbreak, as success in managing a disease in one country greatly benefits neighbors.

Epidemics know no boundaries and the increasing levels of connection between countries have made outbreaks more global, as evidenced by COVID-19’s global reach.  Cooperation and coordination to align policy responses and mitigation measures is crucial in addressing these public health crises to ensure that subsequent waves do not occur.  A silver lining is that pandemic can serve as a key opportunity in accelerating health integration in Africa to further progress towards Agenda 2063’s “well-being for all”.

[1] Based on data from the World Bank Database

[2] Moore, 2016. “Identifying future disease hot spots”, available at

[3] Based on WASH data from WHO/UNICEF, 2017

[4] Based on data from UNCTADStat