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Africa can be "left behind" after other advanced continents recover from the coronavirus disease 2019 (COVID-19) pandemic as reflected by the global pandemic of HIV/AIDS. In this paper, we summarize potentially adaptable, effective and innovative strategies from China, Italy, and the U.S. The purpose is to help African countries with weaker healthcare systems better respond to the COVID-19 pandemic. China, being the first to report COVID-19 infection swiftly swung into anti-epidemic actions by the use of innovative risk communication and epidemic containment strategies. Italy and U.S., the next rapidly hit countries after China, however, experienced sustained infections and deaths due to delayed and ineffective response. Many African countries responded poorly to the COVID-19 pandemic as evidenced by the limited capacity for public health surveillance, poor leadership, low education and socioeconomic status, among others. Experience from China, Italy and U.S. suggests that a better response to the COVID-19 pandemic in Africa needs a strong public health leadership, proactive strategies, innovative risk communication about the pandemic, massive tests and isolation, and scaling-up community engagement. Lastly, African countries must collaborate with other countries to facilitate real-time information and experience exchange with other countries to avoid being left behind., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 People's Medical Publishing House Co. Ltd. Publishing service by Elsevier B.V. on behalf of KeAi Communications Co. Ltd.)