Coronavirus hampers Africa's fight against malaria, TB

African countries have imposed tough measures against COVID-19. But it may come at the cost of other untreated diseases such as malaria and AIDS.

As early as February - when the coronavirus outbreak was still almost exclusively restricted to China –experts were raising the alarm: Once the virus arrived in Africa, the continent's poor healthcare system meant certain catastrophe.

So far, however, the official figures in Africa do not equal such a disastrous scenario – probably also because many African governments reacted swiftly and appropriately to the potential threat.

According to the World Health Organization (WHO), more than 100,000 people in Africa have tested positive for the coronavirus. Even though the number of cases is likely to be higher due to low testing capabilities, it's already evident that the outbreak in Africa is less deadly compared to other regions such as Europe.

So far, 3,100 deaths in Africa have been linked to COVID-19. In comparison, when 100,000 cases were reported in Europe, 4,900 deaths were linked to the virus.

Initial analysis suggests that the relatively low death rate in Africa may have something to do with the continent having so many young people, who have a lower risk of developing a severe form of illness from the virus. More than 60% of all Africans are under the age of 25.

Routine vaccinations for children interrupted

It's crucial, however, to keep an eye on the potential "collateral damage" as a result of the fight against coronavirus, says Anne Jung, a global health consultant at Medico International, a German-based aid organization.

Jung points out that the strict lockdowns implemented in many African countries have interrupted routine vaccinations for children. She's worried the measures introduced by authorities to curb the spread of the novel coronavirus may indirectly lead to an increase in other infectious diseases such as measles, especially in children.

The most recent figures from WHO appear to confirm Jung's fears: Globally, 117 million children in 24 countries – the majority of them African – have not received their measles vaccinations as a result of the coronavirus pandemic.

Gavi, a global vaccine alliance based in Geneva and Washington, estimates that 13.5 million people have not received important vaccinations due to the suspension of vaccination campaigns. This in turn could lead to a resurgence of infectious diseases, such as measles or polio.

COVID-19 weakens fight against AIDS and tuberculosis

Like much of the world, many African countries have also restructured their health systems to be better prepared for the COVID-19 outbreak. But while this seems like a reasonable plan, it also means that in many places, numerous routine healthcare programs have been affected.

According to Jung from  Medico International, there were already difficulties in the fight against tuberculosis, for example. The disease is just as contagious as COVID-10 and is often fatal.

"Because of coronavirus, the masks which are needed to help treat tuberculosis patients are now missing everywhere in Africa," says Jung.

Read more: Do coronavirus lockdowns in Africa make sense?

The Stop TB Partnership, a Swiss-based NGO, warns that COVID 19-related health care disruptions in sub-Saharan Africa could result in 6.3 million additional tuberculosis cases and an additional 1.4 million deaths between 2020 and 2025. 

In addition, people living with AIDS are particularly susceptible to becoming infected with tuberculosis –around a third of Africans living with AIDS have the TB.

According to a study by WHO and UNAIDS, treatment of AIDS patients is also currently restricted.  Because the supply of antiretroviral drugs can no longer be guaranteed in many places, this and next year more than 500,000 additional people could die from AIDS. 

Will malaria cases double?

"Coronavirus or not, malaria is and remains by far the biggest cause of death in Africa, and it affects children particularly," Javier Macias, a Spanish doctor based in Angola, told DW.

He warns that up to twice as many people could die from malaria this year in Africa if the fight against the infectious disease is further hampered by the coronavirus pandemic.

"Here in Angola, we already have problems with the malaria medication and mosquito nets not being able to reach those affected," says Macias. "This is because the health system is focusing primarily on combating COVID-19."

He mentions a specific case in Huambo, Angola's second-largest city: A street vendor presenting with acute malaria symptoms went to hospital but was sent home with a note saying the hospital was only "taking only the most urgent cases that have to do with COVID-19."

At the end of April, WHO also warned of an impending increase in deaths from malaria: According to their estimates, 769,000 malaria-related deaths in sub-Saharan Africa should be expected in 2020 in the worst-case scenario – twice as many as 2018.

In comparison, WHO currently forecasts Africa will see between 83,000 and 190,000 deaths directly linked to COVID-19 in 2020 – but this is only if the virus is left to spread uncontrollably with no countermeasures in place.

The threat of hunger looms

The collateral damage as a result of the coronavirus outbreak shouldn't won't just impact the fight against other diseases.

"Coronavirus can also kill through hunger," says Reimund Reubelt from the NGO Sign of Hope.

"Large parts of Africa have been plagued by hunger for decades," he told DW. "Currently up to 250 million people are affected. And now there is a virus exacerbating the poor food situation."

Many people face the possibility of not being able to afford food, with prices rising due to the coronavirus crisis. Because of the lockdown, day laborers have lost their jobs and no longer have any income. Curfews have made securing supplies difficult.

Read more: How East Africa is fighting locusts amid coronavirus

"It's not just the virus itself, but the effects of the countermeasures are also placing an enormous burden on people," says Reubelt. "Combined with hunger, coronavirus could become a deadly scourge in Africa." 

Thomas Beckmann from German NGO Diakonie Katastrophenhilfe has similar concerns.

"The anti-coronavirus measures that many African countries have taken have increased hunger significantly," he told DW. "Fields can no longer be cultivated due to border restrictions."

The situation in East Africa, which is currently also dealing with massive swarms of locusts, is particularly troubling, says Beckmann.

"The food situation was already threatened by this plague and now coronavirus is coming – another crisis."