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With a considerably high level of poverty, high population density and relatively fragile health systems, most African countries have a predominance of factors that could contribute to the rapid spread of the COVID-19 pandemic Despite these challenges, the continent has shown capacity in its response to the pandemic This may be related to the continent's experience in responding to several infectious disease outbreaks such as Ebola disease, Lassa fever and cholera Since the beginning of the COVID-19 pandemic, several local innovations have been developed and implemented These innovations take into consideration unique circumstances in countries such as multiple government levels, belief in traditional medicine, limited access to medical supplies and others This paper describes the various strategies developed in African countries across leadership and coordination, surveillance, laboratory capacity, case management, infection, prevention and control, risk communications, points of entry, research, logistics and supply chain, partnership, food security and education We highlight the impact of these strategies on the response so far, and lessons that other regions across the world can learn from Africa's response to COVID-19 Finally, we recommend the urgent need for increased investment in African health and social institutions to enable the development of African-owned and led strategies in response to disease outbreaks © Author(s) (or their employer(s)) 2021 No commercial re-use See rights and permissions Published by BMJ