24 Apr North Africa Confronts Covid-19
David Seddon looks in detail at the reported impact of Covid-19 in North Africa. The region has currently experienced some of the largest numbers of reported cases and the greatest number of deaths on the continent. Seddon also asks how we can understand the response of international and national financial institutions to the outbreak on the continent.
By David Seddon
Recent contributions to the roape.net discussion of the coronavirus epidemic in Africa have drawn attention to the pattern of the spread of the disease, the responses by governments and the opportunities this crisis might offer for a widespread and effective refusal to return to ‘business as usual’, and even for a radical transformation of contemporary capitalist economy and society, but with particular reference to sub-Saharan Africa.
The rapidly spreading epidemic is expected to push Africa into recession in 2020 for the first time in 25 years. ‘The Covid-19 pandemic is testing the limits of societies and economies across the world, and African countries are likely to be hit particularly hard,’ according to the World Bank’s Africa’s Pulse report. Real gross domestic product growth is projected to fall sharply, particularly in the region’s three largest economies – Nigeria, Angola, and South Africa. Oil exporting-countries will be hard-hit as oil and gas prices reach rock bottom.
At the beginning of April, Africa already had some 11,000 confirmed cases of the coronavirus (covid-19), with 562 deaths and 1,149 recoveries, according to government statements and WHO data. Although the epidemic was late to start in Africa as compared with many other parts of the world, it now has a foothold in almost every African country and looks set to spread rapidly. On 20 April, the total number of confirmed cases of Covid-19 across the continent was 22,625, with 1,136 deaths and 5,724 recoveries. Africa is clearly at an early stage of the pandemic; but the eventual impact is likely to be huge.
The coronavirus has led to the suspension of international passenger travel in many countries on the continent and hit sectors such as tourism hard. Most African governments have announced lockdowns or curfews in response to the virus, which was slow to reach many African countries but is now growing exponentially, according to the WHO.
The Bank considers that the measures adopted by governments and local populations in response to the epidemic have the potential to precipitate a food security crisis on the continent, with agricultural production forecast to contract some 3 % and up to 7% in the event of trade blockages. ‘Food imports would decline substantially (between 13% and 25%) due to a combination of higher transaction costs and reduced domestic demand,’ according to the World Bank.
The World Bank and International Monetary Fund are proposing to provide emergency funds both to combat the virus and also to mitigate the impact of sweeping shutdowns aimed at curbing its spread. They have also called on China, the United States and other bilateral creditors to suspend debt payments by the poorest countries so they can use the money to halt the spread of the disease and mitigate its financial impact.
In the meanwhile, the Bank has recommended that African policymakers focus on saving lives and protecting livelihoods by spending money to strengthen health systems and taking quick actions to minimise disruptions in food supply chains. It has also recommended social protection programmes, including cash transfers, food distribution and fee waivers, to support citizens, especially those working in the informal sector.
This blogpost is concerned with the countries of North Africa, which at the present time (23 April) have experienced some of the largest numbers of reported cases and the largest number of deaths on the continent. In North Africa, as elsewhere in Africa, the epidemic has been relatively slow to materialise, and governments there have had the advantage of a time-lag in the spread of the virus. The pattern of the epidemic initially depended greatly on the degree of integration into the global political economy and the scale of the movement of goods, and even more of persons, between continents.
On 8 April 2020, when this note was first drafted, Egypt had recorded 1,322 cases of persons infected with the virus and 85 deaths; some 260 persons had recovered. Ten days later, the total number of cases was 3,000; by 23 April the number had reached 3,659 – the largest number in any single African country, including South Africa (3,635), with 276 deaths. In Morocco, the number of registered cases on 8 April was 1,141 with 83 deaths, and 83 people recovered. Ten days later the total number of cases was 2,670, with 137 deaths; by 23 April, the total had reached 3,446, with 149 deaths and 417 recoveries, making it the country with the third most cases in Africa.
In Algeria, the figure for cases of infection on 8 April was 1,423, the highest of all the north African countries at that point, with 173 deaths and 90 recovered; by 23 April, the number of cases had reached 2,910, the fourth highest in Africa. Its death toll, at 402, was the largest of any African country. Tunisia, with a much smaller population, had recorded 596 cases by 8 April, with 22 recorded deaths and five people who had recovered; by 23 April the total number of cases had reached 909, with only 38 deaths. Libya, with a population of only 7 million, had registered only 19 cases so far, by 8 April, with one death and one person recovered; it now has 59 cases but still only one reported death.
Algeria was clearly the most seriously affected of all the north African countries at the beginning of April, but it seemed likely even then that Egypt would rapidly overtake Algeria in the number of cases; and by 19 April it had done so, by a large measure. But still Algeria has suffered more deaths than any other country in Africa, Egypt included. The reasons for this are not yet clear. Libya, which remains embroiled in conflict and chaos, and is almost entirely without functioning public health services, is also likely to see a dramatic increase from its present low base.
Algeria confirmed its first case of Covid-19 on 25 February – an Italian man who had arrived a week earlier; three days later, he was deported on a special flight back to Italy, where he was subject to quarantine. On the morning of 2 March, Algeria confirmed two new cases. By 4 March, the total number of cases had reached 12. The government acted relatively swiftly. Recognising that the threat came essentially from abroad, within two weeks (by 19 March), all international flights to and from Algeria were suspended. All land borders were closed, and ferry services were suspended.
Inside the country, a partial lockdown from dusk to dawn in those wilayas (provinces) most likely to be affected was ordered; across the country, schools, nurseries, universities and mosques have closed; sporting events have been cancelled and many public amenities and public spaces have been shut to the public. On 5 April, the lockdown was extended both in time (with a curfew from 15:00 to 07:00) and in space (all wilaiyas).
On 8 April, given that Algeria did not have the means to carry out mass testing by biological laboratory analysis, the Minister of Health, Abderrahmane Benbouzid, instructed the heads of the country’s health establishments – both public and private – to use thoracic (chest) scanners as a means of screening. Several scientists and health policy analysts have reported the effectiveness of this technique compared to that of biological analysis. It was recognised by the authorities as well as the health professionals that detecting the disease at an early stage and then isolating the infected patient was crucial in the fight against the virus.
It is too early to draw any conclusions as to what sections of the population are being or will be most affected by the epidemic in Algeria, but there must be concern that, as in other countries, people living in areas that are crowded, where physical distancing is difficult if not impossible, are most likely to be infected; this means that the poor and unemployed living in slums and shanty towns in and around the major cities are most at risk.
As to the response ‘from below’, Algerian protestors have called off their weekly anti-government demonstrations for the first time in more than a year to reduce the spread of the virus. For the moment, it would seem, and only for the moment, Algeria is experiencing the calm before the storm. In the meanwhile, however, there are signs that the regime is battening down the hatches, as the presidency postpones the distribution of copies of proposed constitutional amendments to prominent individuals, politicians and NGOs.
Given the size of its population, it is likely that Egypt will suffer the greatest number of cases of infection, and most deaths. Also, despite the centralisation of government – and the fact that Egypt is today more a dictatorship than a democracy – the response has been less prompt than it might have been. All flights from China to Egypt were banned from 26 January onwards; but this was not enough to prevent the first case in the country, on 14 February. Ironically, this involved a Chinese national. The Egyptian authorities notified the WHO and the patient was placed in quarantine.
Incoming flights continued to arrive from abroad. An increasing number of cases was reported in the second half of February, including cases from the United States, Canada, Taiwan and Tunisia. The two Tunisians identified as positive were among 1,000 football supporters who had visited Egypt from Tunis from 27 February to 1 March. All of these were quarantined.
On 28 February, the Egyptian cabinet officially denied rumours that there had been a cover up of the real number of cases. Egypt Watch had reported that Egypt already had at least 20 lab-confirmed cases. Those testing positive for the virus were being held, it was claimed, in military hospitals, inaccessible to the Egyptian Ministry of Health and not recorded in the official health statistics reported to WHO. Confirmed cases allegedly absent from official statistics included a family in Tanta Military Hospital and four people in Qasr El Eyni Hospital.
On 9 March, after the first reported death (a German tourist), the WHO reported that there were now 56 confirmed cases in Egypt, while the Egyptian Minister of Tourism said they had discovered three additional cases, all of whom were hotel workers. On 12 March, the Ministry of Health announced the second death from the virus and that the total number of cases stood at 80. The next day, it was announced that one person had recovered and that 13 more had tested positive, bringing the total cases to 93.
In the meanwhile, a Tunisian returning from Egypt had tested positive for the virus and Tunisia now officially added Egypt to a list of outbreak areas, closing its borders and imposing a quarantine to anyone coming from that country. In the meanwhile, both Qatar and Kuwait had refused to allow anyone coming from Egypt into the country. All international flights into Egypt were now also suspended. At this point, President El-Sisi instructed the government to allocate EGP100 billion to finance a ‘comprehensive plan’ to stop the spread of the virus.
He instructed the governor of the Central Bank of Egypt (CBE), Tarek Amer, to take ‘all necessary measures’ to maintain economic and monetary stability, and to supply the necessary resources to support the social protection system, taking into consideration the neediest groups. He also discussed with Prime Minister, Mostafa Madbouly, the measures to be taken by the government to cope with the economic repercussions, especially the financial needs of different state bodies to deal with the ongoing developments.
The CBE announced a number of measures to support the national economy, including raising daily transaction limits on credit cards as well as cancelling fees and commissions applied at points of sale and on withdrawals from ATMs for six months. It also instructed banks to postpone credit dues for individual debts, including real estate loans and loans for consumer purposes for six months with no fines or deposits in case of late payment.
On 18 March, police detained four activists after they protested in front of the cabinet headquarters calling for the release of political prisoners to protect them from the spread of coronavirus. The next day, the Ministry of Health announced a new death and 46 new cases, bringing the total number of infected to 256 cases (three times as many as the week before), including 7 deaths and 28 now recovering.
All restaurants, cafes, nightclubs and public places were now closed throughout the country from seven in the evening until six in the morning, at least until the end of the month. The decision excluded places that sold food, as well as pharmacies and home delivery services. The decision to close all airports and suspend all domestic flights came into effect from 19 March, to last until 31 March at least.
By 20 March, the total of cases was 285 cases, including 39 who had recovered and had been discharged from hospital, and 8 deaths. The next day, prayers in all of Egypt’s mosques were suspended for an initial period of two weeks. The Coptic Orthodox Church also announced the closure of all churches and the suspension of ritual services, masses, etc.
The same day it was reported that the president had chaired a high-level meeting to discuss the overall performance of the Egyptian economy and the CBE’s monetary policy in light of the recent international developments concerning the novel coronavirus. The governor of the CBE also provided an update on the decisions and initiatives taken by the bank to contain the impacts of the fast-spreading virus and to stimulate the economy, including financing small-sized projects and supporting a number of sectors such as industry and services.
It was reported also that the president had specifically directed the government to support the neediest in the country and those with irregular employment. On 22 March, it was announced that the total number of cases registered had now reached 327 cases, including 56 who had recovered, and 14 of whom had died. The infection had reached 24 out of the 27 Egyptian governorates.
By 4 April, the total number of cases had exceeded 1000, and, as previously reported, the reported total of cases on 8 April was 1,322 cases of persons infected with the virus and 85 deaths. Some 260 persons had recovered. On 8 April, Egypt extended its nation-wide night-time curfew until 23 April. By 19 April, the total number of reported cases was just over 3,000 and by 23 April, 3,659 with 276 deaths. There is every indication that the number of new cases, and of deaths, will now rise rapidly despite the measures taken.
In the face of this, there are indications that Sisi’s dictatorship will be further strengthened following the Egyptian parliament’s Legislative and Constitutional Affairs Committee meeting on 18 April to approve new amendments to the law that regulates the state of emergency that has been in force for most of the last 40 years. Committee head, Bahaaeddin Abu Shoka, said it was ‘a miracle’ that the opportunity to do so had arisen at this time. He pointed out that the amendments giving the President new powers were proposed many years ago, but the current crisis is appropriate for them to be agreed because they are related to the health of the country.
In Morocco, the first reported case was not until the morning of 2 March. This was a Moroccan expatriate residing in Italy, who had flown in on 27 February. A second case was confirmed by the end of the day. This time it was an 89-year-old woman Moroccan also residing in Italy, who had returned to Morocco on 25 February from Bologna. A third case was confirmed on 10 March, a French tourist who arrived in Marrakesh. On the same day, one of the two first cases, a woman aged 89, died.
On 13 March, the Government of Morocco announced they had come to an agreement to suspend all passenger flights and ferry crossings to and from Spain, Algeria and France until future notice. The next day, the suspension of flights was expanded to include a further 25 countries. On 15 March, this suspension was extended to cover all international flights.
On 14 March, ten cases were confirmed, including a government minister Abdelkader Aamara, bringing the total to 18. The government now decided to shut down all schools, with effect from 16 March until further notice. King Mohamed VI announced the creation of an emergency fund of 10 billion dirhams (US$1 billion) in order to upgrade health infrastructure and support the worst affected economic sectors. On 19 March, a state of medical emergency was declared, to take effect the next day at 6:00 pm local time and to remain in effect until 20 April, with the possibility of a further extension.
The authorization of local state officials was now required for citizens to leave their homes, while making exceptions for workers at supermarkets, pharmacies, banks, gas stations, medical clinics, telecommunications companies, and essential freelance jobs. A direct 24-hour hotline was set up to ‘reinforce direct communication and urge vigilance to fight the impact of the coronavirus pandemic and safeguard the health of citizens.’
By the end of March, the total number of cases had reached 534, with 41 deaths. As of 7 April 2020, confirmed cases totalled 1,141, with 88 recoveries 88, and 83 deaths. Less than a fortnight later on 19 April, the total number of cases was 2,670, with 137 deaths; by 21 April there were 3,046 cases – not far short of the numbers suffered in Egypt – and 143 deaths. The lockdown has been extended to 20 May. The government has pardoned 5,654 prisoners and put forward procedures to protect inmates from the Covid-19 outbreak.
The government of Morocco acted rapidly and decisively. As in other north African countries, however, the peak of the epidemic is still a good way off. We shall have to see how the epidemic develops before we can really analyse the social and economic effects in distributional terms, that is, in terms of which sections of the population suffer most, but, as elsewhere, it is likely to be the less well-off in crowded urban areas who are the most vulnerable to the virus and the working classes and the poor whose livelihoods are most hard hit.
The statistics available so far suggest that most of the cases identified have been in the provinces with major urban conglomerations and the highest densities of population (eg 353 in Casablanca-Settat, 204 in Marrakech-Safi, 186 in Rabat-Salé-Kenitra and 160 in Fes-Meknès) with lower levels of incidence in more rural and remote regions in the north, east and south of the country.
In Tunisia, the first case reported (as in Morocco) on 2 March, was a 40-year-old Tunisian man from Gafsa in the interior, returning from Italy. Over the next week the number climbed to reach 13 confirmed cases by 12 March. Reaching 29 on 17 March, 60 by 20 March, 114 by 23 March and 173 by 24 March. By the end of the month it was 423, but later, although the numbers have continued to rise, the rate of growth has declined. As of 8 April, the total number of cases had reached just under 600, with 23 deaths and 23 recoveries. By 21 April the number of cases was 884, with 148 recovered and 48 deaths.
At the end of February, the government allocated 2.5 billion dinars (US$850 million) to combat the economic and social effects of the coronavirus health crisis. Among new measures, it was proposed to delay tax debts, postpone taxes on small- and medium-sized businesses, delay repayment of low-income employee loans and provide financial assistance to poor families. The Tunisian government also took swift action to halt international travel and ordered a lockdown of the entire country on 17 March, with a curfew and the army patrolling the streets (there is even a robot patrol operating in Tunis).
Mosques have been closed, as have most businesses, including cafés and markets. On 19 April, the curfew was extended to 4 May. Seventy-four suspected cases in Gafsa (an area of high labour migration) were placed under home confinement; two of them violated the confinement measures, and the local health directorate is taking legal action against them.
The impact on the economy has already been brutal. On 18 March, there was a 14.2% drop in the stock market index, and on 21 March, the flagship index of the Tunis Stock Exchange ended by falling by 7.3%. But it is the smaller businesses and their employees who will feel the effects of the lockdown as demand falls and incomes decline or even cease. It is not clear what measures the Tunisian government has put in place to support the economy and protect the most vulnerable.
Libya is a special case, as fighting has continued there ever since the overthrow of President Qadhafi in 2011. The country is divided between the forces loyal to the Tripoli-based UN-backed Government of National Accord (GNA) and those of Khalifa Haftar, the military commander who backs a rival administration in east. A fragile truce between the two parties to the conflict went into force on 12 January, but fighting continued, with each side blaming the other for starting it.
In mid-March, the GNA and Haftar’s forces both welcomed calls for a humanitarian pause in the fighting made by the UN and several countries, although the GNA said it reserved ‘the right to respond to daily assaults targeting civilians and public facilities’.
On 22 March, it was reported that, even before any cases had been recorded, the GNA had declared a night-time curfew and closure of public spaces starting on Sunday to keep the virus out of areas it controls. It also ordered the closure of restaurants, cafes and party halls and banned funeral and wedding ceremonies. The Haftar ‘regime’ has also imposed their own night-time curfew in areas under their control. Local residents under both ‘regimes’ are gearing up for shortages, while prices have been rising rapidly, particularly for essential items.
On 6 April, the crisis and emergency committee of the Municipality of Tajoura decided to form a scientific advisory committee consisting of specialized doctors in combating pandemics. It was reported also that the National Oil Corporation (NOC) had received a second shipment of medical equipment to help combat the novel coronavirus. The company hoped that the equipment would help doctors and nurses overcome the challenge posed by Covid-19. Another large consignment of other medical equipment is expected, to be distributed to areas in eastern, western, and southern Libya.
On 5 April, the UNHCR office in Libya expressed concern about the escalation in fighting in light of the spread of the Covid-19 epidemic. On Monday 6 April, Libya had recorded only 19 cases, including one death and two recoveries, according to the National Center for Disease Control. By 23 April, however, the number of cases had reached 59, with still only one reported death. The spread of Covid-19 in Libya remains relatively low for the time being; this may well change, however, in the coming weeks, for there is no single government, public health services are in disarray and there seems no end to the conflict.
One may well be sceptical about the role of the Bretton Woods institutions given their key role in the promotion of ‘globalization’ and of capitalism in Africa. Yet their responses, indicated at the start of this blogpost, are in line with the almost universal re-orientation – even in the USA and the UK – away from ‘neo-liberalism’ towards what might be termed ‘neo-Keynesianism’. This has seen a orientation to a much greater intervention by governments and by international and national financial institutions to bail out faltering private banks and corporations, to support businesses of all kinds, and even to provide some assistance to workers and the self-employed.
As in many countries around the world struggling to respond effectively to the immediate health needs of those affected by the epidemic, while at the same time safeguarding the key areas of their economies, there are deep contradictions in this ‘re-orientation’ – which may well prove only a temporary phenomenon before ‘business as usual’ is resumed. It is also the case that the response by the World Bank and the IMF, and any other countries sufficiently robust to allocate substantial resources to Africa at a time when they are struggling themselves, is likely to be ‘too little, too late’.
David Seddon is a researcher and political activist who has written extensively on social movements, class struggles and political transitions across the developing world.
Featured Photograph: A woman in an informal Syrian refugee camp in the village of Ketermaya, Lebanon (Ali Hashisho, 21 April, 2020)