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African trading brokers in China buy knock‐off or copy goods and move them through customs via bribery to African ports; this trade, although illegal, brings desired global products to Africa. This paper, based on interviews with African trading brokers, examines how the internet and Covid‐19 have affected their trade. African customers can now find out the accurate prices of goods; computerized customs regimes make bribery difficult; and Covid‐19 has raised shipping costs. While the informal economic arrangements of these trading brokers will probably continue despite policymakers' efforts to eradicate them, China may no longer be the source of their goods. [ABSTRACT FROM AUTHOR]

This paper addresses bioethics in the context of the coronavirus disease 2019 (COVID‐19) pandemic. The Introduction (Section 1) highlights that at the field's inception, infectiousness was not front and center. Instead, infectious disease was widely perceived as having been conquered. This made it possible for bioethicists to center values such as individual autonomy, informed consent, and a statist conception of justice. Section 2 urges shifting to values more fitting for the moment the world is in. To find these, it directs attention to the Global South, and in particular, Africa, and to the values of ubuntu, solidarity, dignity, kinship, and humility. The paper concludes (in Section 3) that 21st‐century challenges facing bioethics are increasingly global, and calls on bioethicists themselves to be more globally inclusive in their approaches. [ABSTRACT FROM AUTHOR]

Objectives: The contribution of African authors to the biomedical literature is small. We evaluated the African and non‐African scientific production published in the international literature on the COVID‐19 in Africa during the first year of the epidemic (2020). Methods: Papers on COVID‐19 in Africa were extracted from the Medline (PubMed) database for bibliometric analysis including the proportions of three leading and last authors by study type, study country, authors' and laboratories/institutions' countries of affiliation and journal ranking. Results: A total of 160 articles fulfilling the inclusion criteria were analysed. The majority (91.3%) was produced by half (53.7%) of African countries, with important regional disparities, and generally without sources of funding mentioned. The majority (>85.0) of authors in lead positions (first, second, third and last authors) were Africans. Only a small number (8.7%) of studies on COVID‐19 in Africa were carried out by laboratories not on the African continent (mainly Europe, USA and China) and generally received funding. The last and first authors were more frequently of non‐African origin in journals with an Impact Factor ranking ≥1, and more frequently of African origin in journals with a lower ranking (< 1). The first and last non‐African authors tended to report their studies in high ranking ≥1 journals. Conclusions: Our study demonstrates that the emergence of promising African research capable of publishing in indexed but low‐impact factor medical journals and reveals the persistence of a North‐South asymmetry in international cooperation in biomedical research with Africa. [ABSTRACT FROM AUTHOR]

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The paper studies the effects of the coronavirus disease 2019 (COVID‐19) pandemic on African economies and household welfare using a top‐down sequential macro‐micro simulation approach. The pandemic is modeled as a supply shock that disrupts economic activities of African countries and then affects households' consumption behavior, the level of their welfare, and businesses' investment decisions. The macroeconomic dynamic general equilibrium model is calibrated to account for informality, a key feature of African economies. We find that COVID‐19 could diminish employment in the formal and informal sectors and contract consumption of non‐savers and, especially, savers. These contractions would lead to an economic recession in Africa and widen both fiscal and current account deficits. Extreme poverty is expected to increase further in Africa, in particular if the welfare of the poorest households grows at lower rates. We also use the macroeconomic model to analyze the effects of different fiscal policy responses to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Bats are the natural reservoir host for many pathogenic and non‐pathogenic viruses, potentially spilling over to humans and domestic animals directly or via an intermediate host. The ongoing COVID‐19 pandemic is the continuation of virus spillover events that have taken place over the last few decades, particularly in Asia and Africa. Therefore, these bat‐associated epidemics provide a significant number of hints, including respiratory cellular tropism, more intense susceptibility to these cell types, and overall likely to become a pandemic for the next spillover. In this systematic review, we analysed data to insight, through bat‐originated spillover in Asia and Africa. We used STATA/IC‐13 software for descriptive statistics and meta‐analysis. The random effect of meta‐analysis showed that the pooled estimates of case fatality rates of bat‐originated viral zoonotic diseases were higher in Africa (61.06%, 95%CI: 50.26 to 71.85, l2% = 97.3, p < 0.001). Moreover, estimates of case fatality rates were higher in Ebola (61.06%; 95%CI: 50.26 to 71.85, l2% = 97.3, p < 0.001) followed by Nipah (55.19%; 95%CI: 39.29 to 71.09, l2% = 94.2, p < 0.001), MERS (18.49%; 95%CI: 8.19 to 28.76, l2% = 95.4, p < 0.001) and SARS (10.86%; 95%CI: 6.02 to 15.71, l2% = 85.7, p < 0.001) with the overall case fatality rates of 29.86 (95%CI: 29.97 to 48.58, l2% = 99.0, p < 0.001). Bat‐originated viruses have caused several outbreaks of deadly diseases, including Nipah, Ebola, SARS and MERS in Asia and Africa in a sequential fashion. Nipah virus emerged first in Malaysia, but later, periodic outbreaks were noticed in Bangladesh and India. Similarly, the Ebola virus was detected in the African continent with neurological disorders in humans, like Nipah, seen in the Asian region. Two important coronaviruses, MERS and SARS, were introduced, both with the potential to infect respiratory passages. This paper explores the dimension of spillover events within and/or between bat–human and the epidemiological risk factors, which may lead to another pandemic occurring. Further, these processes enhance the bat‐originated virus, which utilises an intermediate host to jump into human species. [ABSTRACT FROM AUTHOR]

This paper examines the determinants of the spread of coronavirus disease 2019 (COVID‐19) in Africa, based on the framework of social determinants of health. Applying Poisson Pseudo Maximum Likelihood (PPML) and quantile regressions to panel data and country‐specific socioeconomic background data from 53 African countries, the study finds that enhancing capacity for early testing helps for timeous uncovering of cases, early isolation and contact tracing for effective control of the spread. Other factors such as managing of international movements through reduction of international exposure and ensuring better sanitation and hygiene were found to be relevant in diminishing COVID‐19 spread, whereas alcohol consumption and population density heighten the spread. The work also highlights that stringent measures will be counter‐productive unless they are coupled with measures to create and preserve livelihoods, together with humanitarian relief assistance to the poorest segments of the population. The results are robust to alternative techniques. As policy recommendations, we implore African governments to the promotion of sustainable livelihoods and social safety nets as measures to accompany stringent lockdowns; and good sanitation programmes to become a lifestyle of citizens. Careful attention should be paid to the socioeconomic trade‐off in respect of international travel restrictions given the high dependence of most African economies on tourism. [ABSTRACT FROM AUTHOR]

Food supply chains are extremely important for food access and livelihoods across Africa, but their role is often overlooked and underappreciated. Under normal conditions, the gap between myth and reality can result in the design of policies and programs with limited or negative impacts on food security and welfare. The shock of COVID‐19 has heightened this disconnect, with potentially dire consequences for food security. This paper demonstrates the importance of recognizing and accounting for the essential role of food supply chains when designing policy and interventions, particularly in response to COVID‐19, and provides recommendations for action based on current realities. [ABSTRACT FROM AUTHOR]

Agricultural value chains worldwide provide essential support to livelihoods, ecosystem services, and the growing bioeconomy. The coronavirus disease 2019 (COVID‐19) pandemic slowed down or reversed decades of agricultural growth and exposed the vulnerabilities of farmers and the food insecure in Africa, thus reiterating the need to build resilience, agility, and adaptability for a sustainable agriculture. Existing social, political, environmental, and economic challenges demonstrate that a path to faster sustainable growth is increased productivity through improved input quality, of which technical inputs are a part. This work presents a perspective calling for African innovative competence in technological and methodological applications and solutions as part of the most critical area of a holistic organization for social progress. It finds that while performances of previous agricultural transformation efforts offer insights for future directions, novel pathways fitting to the diversity of situations and contexts on the continent are needed. These may include vertical agriculture in land‐constrained regions to grow high‐value products, ocean or sea farming in coastal regions, development of multiple‐harvesting crops, and self‐replicating plants. Developing standards that integrate current scientific methodologies and technologies with indigenous knowledge for agricultural growth and disaster management will bring the complementary benefits of both worlds into optimal development. [ABSTRACT FROM AUTHOR]

This article examines the impact of the COVID‐19 pandemic on ride‐hailing drivers in Africa. It argues that, although ride‐hailing offers paid work to some African workers, the commodified and informalized nature of this work results in poor job quality, the effects of which were greatly amplified during the pandemic. Drawing on a mixed methods approach involving in‐depth interviews with ride‐hailing drivers in Nairobi and digital ethnography, it also provides accounts of drivers' hustles to demonstrate strategies of resilience, reworking and resistance among informal workers. The article concludes by highlighting the need for adequate regulatory frameworks and on‐the‐ground solidarity networks to ensure decent working conditions, and to push back against precarity in the gig economy. [ABSTRACT FROM AUTHOR]

Public Health Genomics (PHG) is a relatively new field. The wide application of genomic technologies played a pivotal role in elucidating the full genomic sequence of the SARS‐CoV‐2 virus. This breakthrough proved to be the starting point in the manufacture of diagnostic kits and the subsequent making of vaccines. Beyond the COVID‐19 pandemic, many African countries can take advantage of the various investments in genomic technologies to introduce and intensify the use of genomics for public health gain. Public Health Genomics effectively monitors, prevents, and manages non‐communicable and infectious diseases. However, there are several challenges to implementing PHG in Africa. In this perspective article, we discuss the utilization of PHG during the COVID‐19 pandemic, the lessons learned from using PHG to manage and contain the COVID‐19 pandemic, as well as potential challenges Africa may face when putting PHG into practice compared to challenges of other regions. We also discuss our recommendations for overcoming these challenges. [ABSTRACT FROM AUTHOR]

Africa experienced the third wave of the coronavirus disease in 2019, which caused an 18% rise in cases in most parts of the continent. As of January 2022, the region had an estimated 10.4 million cumulative cases and more than 233,000 deaths, which add up to the burden on the fragile healthcare system, which continues to face a shortage of staff and resources. In addition, the progression of the pandemic further threatens the supply of healthcare workers in Africa due to the increased risk of infection and death, where more than 10,000 healthcare workers in 40 countries have been infected with the virus. This is amid low vaccination coverage, with only 27% of healthcare workers in Africa being fully vaccinated against the disease. Despite the delayed start and slow progression of the pandemic in Africa, there are increasing concerns over the challenges on the African healthcare workers such as economic insecurity and stressful working conditions, which are associated with limited access to personal protective equipment and other vital resources such as ventilators. In addition, the pandemic further predisposes African healthcare workers to social stigma, burnout, insomnia, depression, and fear of safety in their families. The aim of this study is to highlight the challenges faced by African healthcare workers, provide recommendations for change, and emphasize the need to prioritize their physical and mental well‐being. [ABSTRACT FROM AUTHOR]

Introduction: The potential disruption in antiretroviral therapy (ART) services in Africa at the start of the COVID‐19 pandemic raised concern for increased morbidity and mortality among people living with HIV (PLHIV). We describe HIV treatment trends before and during the pandemic and interventions implemented to mitigate COVID‐19 impact among countries supported by the US Centers for Disease Control and Prevention (CDC) through the President's Emergency Plan for AIDS Relief (PEPFAR). Methods: We analysed quantitative and qualitative data reported by 10,387 PEPFAR‐CDC‐supported ART sites in 19 African countries between October 2019 and March 2021. Trends in PLHIV on ART, new ART initiations and treatment interruptions were assessed. Viral load coverage (testing of eligible PLHIV) and viral suppression were calculated at select time points. Qualitative data were analysed to summarize facility‐ and community‐based interventions implemented to mitigate COVID‐19. Results: The total number of PLHIV on ART increased quarterly from October 2019 (n = 7,540,592) to March 2021 (n = 8,513,572). The adult population (≥15 years) on ART increased by 14.0% (7,005,959–7,983,793), while the paediatric population (<15 years) on ART declined by 2.6% (333,178–324,441). However, the number of new ART initiations dropped between March 2020 and June 2020 by 23.4% for adults and 26.1% for children, with more rapid recovery in adults than children from September 2020 onwards. Viral load coverage increased slightly from April 2020 to March 2021 (75–78%) and viral load suppression increased from October 2019 to March 2021 (91–94%) among adults and children combined. The most reported interventions included multi‐month dispensing (MMD) of ART, community service delivery expansion, and technology and virtual platforms use for client engagement and site‐level monitoring. MMD of ≥3 months increased from 52% in October 2019 to 78% of PLHIV ≥ age 15 on ART in March 2021. Conclusions: With an overall increase in the number of people on ART, HIV programmes proved to be resilient, mitigating the impact of COVID‐19. However, the decline in the number of children on ART warrants urgent investigation and interventions to prevent further losses experienced during the COVID‐19 pandemic and future public health emergencies. [ABSTRACT FROM AUTHOR]

This article challenges the role of COVID‐19 crisis narratives in shaping social policy choices in Africa. The COVID‐19 pandemic has focused attention on Africa's vast informal economies, both as a symbol of the continent's intense vulnerability to the ravages of the pandemic, and as a puzzle in the face of the uneven and limited effects of COVID‐19 across the continent. Indeed, an examination of statistical and documentary evidence reveals an inverse relationship between COVID‐19 fatalities and the size of African informal economies, and a perverse relationship between best‐practice COVID social protection responses and levels of COVID‐19 mortality. Scrutinizing the evidence behind African COVID‐19 crisis narratives raises questions about the ability of donor‐led digitized social protection paradigms to address social needs in highly informalized, low‐resource environments. This article highlights the role of crisis narratives as an exercise of power geared to remastering, homogenizing and reimagining African informal economies in ways that facilitate particular types of development intervention, sidelining alternative, more socially grounded policy perspectives. Through a closer examination of historical and contemporary realities in Africa's vast and varied informal economies, the article highlights the need to decolonize social policy by privileging local needs and policy perspectives over global policy agendas in the interest of transformative rather than palliative policy responses. [ABSTRACT FROM AUTHOR]

Across Africa, the deployment of digital solutions such as track and trace apps and vaccine passports to tackle COVID‐19 largely failed in their public health objectives. Yet, in the process, these material interventions revealed and unleashed new potentialities of governance throughout the continent. This article examines these developments and their significance through historical and theoretical lenses. Since colonialism, African states have been built partially through responses to public health emergencies. Such emergencies have enabled authorities to experiment with and enact logics of control, extraction and legitimation. By interrogating the relationship between epidemics, power and technological artefacts, this article argues that COVID‐19 constituted an exceptional event that both unmasked pre‐existing logics of governance but also enabled experiments with novel techniques through digital technology. Digital techno‐opportunist interventions did little to curb the spread of COVID‐19, but such interventions nevertheless have ramifications and implications that extend beyond this moment. While the political outcomes of the rupture caused by COVID‐19 are not yet fully known, and are subject to resistance and reimagination from below, the political opportunity of 'crisis' reveals distinctly new ways in which states and corporations are combining to pursue logics of control, extraction and legitimation across Africa in a digital age. [ABSTRACT FROM AUTHOR]

Introduction: COVID‐19 stretched healthcare systems to their limits, particularly in settings with a pre‐existing high burden of infectious diseases, including HIV and tuberculosis (TB). We studied the impact of COVID‐19 on TB services at antiretroviral therapy (ART) clinics in low‐ and middle‐income countries. Methods: We surveyed ART clinics providing TB services in the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium in Africa and the Asia‐Pacific until July 2021 (TB diagnoses until the end of 2021). We collected site‐level data using standardized questionnaires. Results: Of 46 participating ART clinics, 32 (70%) were in Africa and 14 (30%) in the Asia‐Pacific; 52% provided tertiary care. Most clinics (85%) reported disrupted routine HIV care services during the pandemic, both in Africa (84%) and the Asia‐Pacific (86%). The most frequently reported impacts were on staff (52%) and resource shortages (37%; protective clothing, face masks and disinfectants). Restrictions in TB health services were observed in 12 clinics (26%), mainly reduced access to TB diagnosis and postponed follow‐up visits (6/12, 50% each), and restrictions in TB laboratory services (22%). Restrictions of TB services were addressed by dispensing TB drugs for longer periods than usual (7/12, 58%), providing telehealth services (3/12, 25%) and with changes in directly observed therapy (DOT) (e.g. virtual DOT, 3/12). The number of TB diagnoses at participating clinics decreased by 21% in 2020 compared to 2019; the decline was more pronounced in tertiary than primary/secondary clinics (24% vs. 12%) and in sites from the Asia‐Pacific compared to Africa (46% vs. 14%). In 2021, TB diagnoses continued to decline in Africa (–8%) but not in the Asia‐Pacific (+62%) compared to 2020. During the pandemic, new infection control measures were introduced or intensified at the clinics, including wearing face masks, hand sanitation and patient triage. Conclusions: The COVID‐19 pandemic led to staff shortages, reduced access to TB care and delays in follow‐up visits for people with TB across IeDEA sites in Africa and the Asia‐Pacific. Increased efforts are needed to restore and secure ongoing access to essential TB services in these contexts. [ABSTRACT FROM AUTHOR]

This study examines the potential effect of COVID‐19 on agricultural financing by drawing lessons from past global crises and their link to agricultural financing. With significant impact in multiple sectors, COVID‐19 has caused significant liquidity shortage in the banking and financial institutions sectors that led to widespread business failure. Analysis at the macro, sectoral, and farmer levels confirms the decline in the financing allotted to the agricultural sector in Africa, which could exacerbate the existing structural gap in agricultural financing. Many policy responses and stimulus packages designed to address the negative effects of the crisis are found not to be enough. At the farmer level, findings indicate that many farmers are finding it more difficult to access credit than before the COVID‐19 crisis. For individual governments, a better understanding of the magnitude of the agricultural sector financing and investment needs to propose appropriate complementary responses is lacking. We suggest that, in the face of such a crisis, while in the short term the agricultural sector needs emergency funding, in the medium and long term, greater financial support is required, including long‐term resources at concessional rates, guarantee funds, and more suitable insurance products combined with social safety nets. [ABSTRACT FROM AUTHOR]

Viral infections have been on the rise for the past decades. The impact of the viruses worsened amidst the pandemic burdening the already overwhelmed health care system in African countries. This article sheds light on how the coronavirus together with the already existing viral infections, some of which re‐emerged, impacted the continent. The strategies in place such as immunization, education, will have to be strengthened in all African countries to reduce the burden. Furthermore, governments can further collaborate with other countries in creating guidelines to reduce co‐infection of the diseases. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) in Africa and Africa Center Disease Control (Africa CDC) urge the international community and different countries in Africa to ensure sustainable and concrete action to ensure equal and easy access to the COVID‐19 vaccines, as different countries in Africa are still struggling to develop a safe and effective strategy to ensure equal vaccine distribution, if available. Africa CDC has called on the international community to come together to help Africa with COVID‐19 vaccines to make equal the vaccine distribution among African countries as many cannot afford the vaccine costs due to the level of poverty and other negative factors. The African Union has endorsed the need for Africa to develop a framework to actively engage in easy accessibility to COVID‐19 vaccines, which will allow different countries in Africa to take easy steps that will strengthen the local vaccine distribution system, building workforce skills and knowledge, and enrich outreach services in Africa. The article discusses the need for equal access in the distribution of COVID‐19 vaccines in Africa, the challenges, and the necessary recommendations that can help to mitigate these challenges. Highlights: The need for equal access in the distribution of COVID–19 vaccines in AfricaThe challenges, and the necessary recommendations that can help to mitigate these challenges. [ABSTRACT FROM AUTHOR]

Covid‐19 generated a crisis in capitalism, but not of capitalism. Capitalism reproduces itself in crisis and in ways that have significant but uneven impacts on the conditions and struggles of agrarian classes of labour. This article explores preliminary studies of how Covid‐19 has affected agrarian social formations in Africa, Asia and Latin America and the farmers, petty commodity producers, labourers and agribusinesses who populate them. It considers some of the implications for wage‐labour, agriculture, accumulation and social reproduction including care work. And it briefly considers Covid‐19's political impacts—in terms of the role of the state and possibilities for challenging capitalism, its violence and its ecological crisis. [ABSTRACT FROM AUTHOR]

The debate around the COVID‐19 response in Africa has mostly focused on effects and implications of public health measures, in light of the socio‐economic peculiarities of the continent. However, there has been limited exploration of the impact of differences in epidemiology of key comorbidities, and related healthcare factors, on the course and parameters of the pandemic. We summarise what is known about (a) the pathophysiological processes underlying the interaction of coinfections and comorbidities in shaping prognosis of COVID‐19 patients, (b) the epidemiology of key coinfections and comorbidities, and the state of related healthcare infrastructure that might shape the course of the pandemic, and (c) implications of (a) and (b) for pandemic management and post‐pandemic priorities. There is a critical need to generate empirical data on clinical profiles and the predictors of morbidity and mortality from COVID‐19. Improved protocols for acute febrile illness and access to diagnostic facilities, not just for SARS‐CoV‐2 but also other viral infections, are of urgent importance. The role of malaria, HIV/TB and chronic malnutrition on pandemic dynamics should be further investigated. Although chronic non‐communicable diseases account for a relatively lighter burden, they have a significant effect on COVID‐19 prognosis, and the fragility of care delivery systems implies that adjustments to clinical procedures and re‐organisation of care delivery that have been useful in other regions are unlikely to be feasible. Africa is a large region with local variations in factors that can shape pandemic dynamics. A one‐size‐fits‐all response is not optimal, but there are broad lessons relating to differences in epidemiology and healthcare delivery factors, that should be considered as part of a regional COVID‐19 response framework. [ABSTRACT FROM AUTHOR]

Global powerhouses with tried and tested health systems have struggled to contain the COVID‐19 pandemic. One is left to wonder what will be left of Africa, the second most populous continent after Asia, which is torn by civil wars, hunger, and diseases like AIDS and TB and, in recent years, the Ebola Virus Disease (EVD). The majority of countries' health systems, already dependent on donor aid, are ill‐equipped and under‐resourced to deal with the raging pandemic. There is a lack of isolation and intensive care infrastructure, ventilators, and financial resources to bankroll the fight against COVID‐19 pandemic. However, there is some cause for optimism, for example, in West Africa where infrastructure like diagnostic testing facilities, intensive care units, surveillance, and systems for reporting emergencies used during the EVD outbreak of 2013–2016 can be leveraged to fight the COVID‐19 pandemic. Further, a number of African countries have responded swiftly by activating the necessary political and financial tools to combat the pandemic. Technical support from continental bodies like the Africa Centers for Disease Control and global development partners has improved the capacity of the continent to handle the pandemic. In this article, the authors unpack, review, and share a perspective on Africa's capacity to contain and control the COVID‐19 pandemic and review the current response. Highlights: There is a steady increase in the number of Covid‐19 cases in AfricaHere, authors review Africa's capacity and response to the pandemic.While measures affected by developed countries may be admirable, Africa has to modify within individual countries' capacities to best mitigate the effects of the pandemic. [ABSTRACT FROM AUTHOR]

Sustaining routine childhood immunisations during COVID-19 in Africa The former models a low-impact scenario, where herd immunity will protect unvaccinated children to some degree, excluding measles, and catch-up immunisation campaigns post-COVID-19 outbreak will allow some children to be vaccinated eventually. To reduce the transmission of COVID-19 by contact, 17 African countries have suspended routine childhood immunisation or are currently of an unknown status. [Extracted from the article]