In Ebola shadow, West Africa battles COVID-19 amid economic challenges

The west African countries of Guinea, Sierra Leone and Liberia are battling the novel coronavirus disease (COVID-19) pandemic from a position of mass poverty, economic fragility and weak healthcare systems.

After all, the COVID-19 pandemic struck the trio as it was still recovering from the devastating Ebola outbreak of 2014-2016 that killed over 11,000 people, including health workers. Collapsed economies and weakened health systems are posing a massive challenge in their fight against the virus (SARS-CoV-2).

Ebola, which originated in the forested region of Guinea in Meliandou, was eventually contained owing to a coordinated global effort and pool of international financial resources and experts. But with the global community shaken by COVID-19, Liberia, Guinea and Sierra Leone seem to be facing a particularly harrowing time receiving financial aid.

There have been, however, a few donations of personal protective equipment from institutions, including the Chinese billionaire Jack Ma and the sub-regional grouping, the Economic Community of West African States. But they can be described, at best, as a drop in the ocean.

For instance, Liberia needs $45 million to fund its response activities against the pandemic, according to Mosoka Fallah, head of the National Public Health Institute of Liberia.

The country’s budget for health for the fiscal year 2019-2020 was set at 14.1 per cent of the total budget. This allocation falls slightly below 15 per cent — the amount African countries pledged to spend a year from their national budget on healthcare under the nearly two-decade-old Abuja Declaration.

Sierra Leone and Guinea allocated 10 per cent each of their budgets to health.

International solidarity during Ebola outbreak

Billions of dollars flowed into West Africa sub-region to support recovery and build a resilient healthcare system during the Ebola outbreak.

According to the World Bank’s Global Ebola Response Resource Tracking, the United States, the United Kingdom, and Germany were the top donors to international Ebola response; they donated more than $3.611 billion by December 2015.

The US government allocated approximately $2.369 billion for Ebola response activities including technical expertise, resources to response and new emergency operation centres in Guinea, Liberia, and Sierra Leone.

Further, $1.6 billion was raised by the World Bank to support recovery in Liberia, Guinea and Sierra Leone. The European Union raised $940.9 million, followed by the African Development Bank which contributed $825.4 million for recovery in Liberia and other Ebola-hit countries.

It is unlikely that the trio would receive much international financial aid this time around.

“We cannot contain this outbreak alone without external financial support,” said Ahamed Sekou Traore, a Guinean political analyst.

He added: “We cannot also expect much assistance because countries that came to our rescue in times like these are impacted by the pandemic.”

As of April 10, 2020, the three countries had 257 confirmed positive cases of COVID-19, with maximum cases registered in Guinea (212).

The first cases reported there were imported by travellers from Europe.

Response and reactions to COVID-19 containment measures

The responses of the three governments to contain COVID-19 are similar to the measures taken elsewhere in the world to stall human-to-human transmission.

The measures included bans on public gatherings and closure of land borders, airspace and schools. The governments also declared a state of emergency and imposed night-time curfews to restrain movement earlier.

However, there have been apprehensions over such restrictive measures being devoid of incentives to cushion economic hardships for the poor. “We were restricted to our homes without water, electricity, and food,” said Amadou Wurie Barry, a resident of Freetown.

The city’s three-day lockdown was extended to 21 more days from April 7.

“Countries must improve timely identification of cases, testing capacity and contact tracing to control the spread,” said Richard Mihigo from WHO Africa Region Office.

With a total population of 25 million, the countries can only boast of thousands of tests. Personal protective equipment such as face masks, hazmat suits, gloves and ventilators are in short supply.

“If we don’t protect healthcare workers, all health systems will collapse,” said  Mamady TRAORE of Medicins Sans Frontieres, an international medical humanitarian organisation.

According to the US Centers for Disease Control (CDC), Liberia lost 8 per cent of its doctors, nurses and midwives to Ebola.  Sierra Leone and Guinea lost 7 per cent and 1 per cent.

There is now growing concern that frontline healthcare workers and facilities might face disastrous consequences once again—or serve as breeding ground for infections.

Trade, interrupted

The COVID-19 pandemic came on the heels of drastic austerity measures in Sierra Leone and Liberia and a political upheaval in Guinea.

Since October 2018, economic activities in Guinea have been severely affected due to the near-daily country-wide street protests by civil society groups and opposition alike over President Alpha Conde’s alleged attempt to change the constitution to sty for a third term in power.

Over 35 people including state security personal died in the clashes, according to human rights group Amnesty International. Nevertheless, the election for change of constitution, although boycotted by the opposition, still took place on March 22.

Liberia and Sierra Leone, on the other hand, implemented drastic austerity measures including temporary suspension of foreign travels by officials, cuts to the salaries of civil servants and tax hikes to deal with perennial deficits in their national budgets.

Some companies that operated in these countries before Ebola have either pulled out or laid off many staff members and scaled down their operations.

This was also in response to the reduction of prices of key commodities such as iron ore on the global market, which drastically affected their finances.

The trio operate a cash-based economy and rely chiefly on activities in the extractive industry to fund operations. The prevailing situation will, undoubtedly, affect the industry, thereby exacerbating financial struggles of these states.

Political fallout

Much cannot be said now about the political fallout in Guinea and Sierra Leone because there was not much happening on the political front to be threatened by the pandemic.

The fallout, however, may surface later, depending on the government’s management of the crisis.

Meanwhile, in Liberia, a cloud of uncertainty hangs over the mid-term election which could usher in a new 30-member senate and a constitutional referendum that is set to take a vote on a number of issues.

“We might fall into a constitutional crisis if the virus continues to spread and is not contained by September when election campaigns begin,” said Ibrahim Al-bakri Nyei, PhD scholar.

On April 8, 2020, the government of President George Weah declared a state of emergency in the Republic of Liberia for three weeks.

Previously, the government announced a state of public health emergency to ready its health organs such as the National Public Health Institute of Liberia for the fight.

But the latest decree empowers security forces to ensure that the measures dictated are respected.The declaration of a state of emergency effectively suspends some civil liberties and extends discretionary powers to the government.

“Elections may not be supported under such a situation,” said Nyei.

The situation presents a looming dilemma as the Constitution of Liberia is tacit on how and who should fill in the 30-member senate seats when elections do not take place on the scheduled date.

Lessons from the past

When a similar situation presented itself during the 2014 Ebola outbreak in Liberia, a group of civil society actors sued the government, praying the court to compel it to hold elections. After legal arguments, the court ruled in the favour of the petitioners and the government went ahead with the elections amid the outbreak.

Jump starting economies after COVID-19 will require offering some incentives to businesses to include tax holidays, borrowing from external financial sources and opening-up some sectors of their economies for investment.

On April 13, the International Monetary Fund announced debt relief for 25 poor countries across the world, with Africa topping the list. It cited the impact of COVID-19 on economies and livelihoods. Guinea, Liberia and Sierra Leone benefited from this debt reprieve.

The World Bank projected that economic growth in the Sub-Saharan Africa region will shrink from 2.1 per cent to as low as 1.5 per cent this year. 

The region will fall into its first recession for 25 years, compared with 2.4 per cent growth last year. The economic shrinkage will cost the region between $37 billion and $79 billion in lost output growth with key trading partners including China and Europe as well as steep fall in commodity prices, led by oil.

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