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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

At the onset of the COVID-19 pandemic, the WHO recommended the prioritisation of risk communication and community engagement as part of response activities in countries. This was related to the increasing spread of misinformation and its associated risks, as well as the need to promote non-pharmaceutical interventions (NPIs) in the absence of an approved vaccine for disease prevention. The Nigeria Centre for Disease Control, the national public health institute with the mandate to prevent and detect infectious disease outbreaks, constituted a multidisciplinary Emergency Operations Centre (EOC), which included NCDC staff and partners to respond to the COVID-19 outbreak. Risk communication, which also comprised crisis communication, was a pillar in the EOC. As the number of cases in Nigeria increased, the increasing spread of misinformation and poor compliance to NPIs inspired the development of the #TakeResponsibility campaign, to encourage individual and collective behavioural change and to foster a shared ownership of the COVID-19 outbreak response. Mass media, social media platforms and community engagement measures were used as part of the campaign. This contributed to the spread of messages using diverse platforms and voices, collaboration with community leaders to contextualise communication materials and empowerment of communication officers at local levels through training, for increased impact. Despite the challenges faced in implementing the campaign, lessons such as the use of data and a participatory approach in developing communications campaigns for disease outbreaks were documented. This paper describes how a unique communication campaign was developed to support the response to the COVID-19 pandemic.