At the World Health Organisation’s (WHO’s) African headquarters in Brazzaville, Republic of Congo, staff members have been quietly impressed with how most African countries have responded to the pandemic. Although resources are scarce, the majority of leaders have taken difficult, proactive decisions to contain the spread of Covid-19, and are listening carefully to scientists and public health experts.
Most, but not all.
There is a short list of countries that the WHO is worried about. Insiders say this list includes Burundi, Cameroon, the Democratic Republic of Congo (DRC) and Eritrea. Madagascar, South Sudan, Somalia and Zimbabwe are also countries of concern. The list is topped by Tanzania.
“We are observing some countries take an approach to the response which is not quite what we are recommending. So certainly in Tanzania, we have observed that the physical distancing, including the prohibition of mass gatherings, took some time to happen,” said Dr Matshidiso Moeti, the WHO’s Africa head, at her weekly press briefing on Thursday. “We believe these were probably factors in expanding the number of cases. We are seeing a rapid increase in cases there.”
Tanzania’s ministry of health did not respond to a request for comment.
Moeti was being diplomatic. Tanzania only shut its air space to international commercial flights on April 14 — nearly three weeks after Kenya had done so. President John Magufuli has refused to place major cities such as Dar es Salaam, population six million-plus, on any kind of lockdown, saying that the economic damage would be too great. “So, you want me to order vehicles to stop transporting rice and potatoes to the city? You want me to direct all women selling fabric materials to close shop and go home? I won’t lock down Dar es Salaam, never,” he said in a press briefing on Wednesday.
At the same time, he warned that imported face masks may be “laced with coronavirus” and said that fumigation does nothing to kill the virus. There is no proof for either of these assertions.
Missing in action
But Magufuli himself has been conspicuous by his absence from both Dar es Salaam and the capital city, Dodoma. The press briefing last week was delivered from his home village of Chato, where he has been staying for the past few weeks. He has only been seen in public attending church, where he told citizens that the virus could be defeated by prayer alone and urged worshippers of all faiths to keep attending religious institutions.
“We are not closing places of worship. That’s where there is true healing. Corona is the devil and it cannot survive in the body of Jesus,” he said last month. This puts Magufuli, a Catholic, at odds with Pope Francis, who held Easter Mass in a deserted St Peter’s Basilica and has urged the faithful to stay at home.
Confirmed cases of Covid-19 in Tanzania have increased. In the week of April 14 to 21, the caseload quadrupled to 284 cases, including 10 deaths.
“It’s a disaster that’s waiting to happen. It’s heartbreaking for me,” said Fatma Karume, a lawyer and outspoken critic of Magufuli’s response to the pandemic. She wants the president to take decisive action to contain the virus, and measures to mitigate the inevitable negative effect on the economy.
In the absence of this leadership, many Tanzanians are taking on the pandemic themselves.
“You know, I’m really proud of people in Dar es Salaam,” said Karuma. “They are covering themselves, they are taking care of themselves. In every shop, they are making sure there is water and sanitiser before you go in. The general public have done a lot to try and mitigate. But unfortunately the government has not stepped up to the mark, and there is fear, because obviously there is distrust of government numbers.”
Amnesty International has criticised the government for silencing and censoring journalists for reporting on the disease.
It’s not just the public who are defying the president’s inaction, but also members of his government. Dar es Salaam regional commissioner Paul Makonda, after initially downplaying the threat, has ordered his constituents to wear face masks and observe physical distancing principles. Other senior officials are trying to work around the president.
“But everyone’s scared to take the larger measures. It’s very difficult when the top guy needs to approve all the decisions, and he is basically missing in action,” said one senior civil society activist, who asked not to be named. “This is a complete case study of how authoritarianism has paralysed an entire system into doing nothing.”
Rashid Abdi, an independent political analyst, said: “Tanzania’s problem stems from the top, when you have a government that is not entirely sold on the science. You also have a very evangelical president, who wants to be seen as the protector of the faith.”
‘Follow the data’
Magufuli’s passive, albeit prayerful, approach is mirrored in neighbouring Burundi. “Burundi is an exception because it is a country that has put God first,” said a spokesman for President Pierre Nkrunuziza. Although international arrivals are being quarantined, there is little to no testing, and reliable information about the spread of the virus is scarce. Just 11 cases have been officially recorded. Across the border, in similarly-sized Rwanda, there are 154 cases.
Burundi, like Tanzania, is scheduled to have presidential elections in 2020 — although, unlike Magufuli, Nkurunziza is not taking part.
Cameroon, too, seems to be reading from the same playbook. President Paul Biya has not addressed the nation since the first Covid-19 case in the country was confirmed on March 6. Limited measures, such as wearing face masks, have been put in place, but no stimulus has been announced. Health Minister Manaouda Malachie has said he will no longer give daily updates, but instead will focus only on positive developments being made — even as confirmed cases climbed to 1 430. Aid workers are blocked from the parts of the country where the government is fighting a civil war against Anglophone separatists.
The problems in Eritrea and the DRC are a little different. In Eritrea, President Isaias Afwerki has likened the fight against the pandemic to a “sudden war” and placed the country under lockdown, but has refused calls to release thousands of political prisoners held in overcrowded prisons — perfect breeding grounds for the virus. Thirty-nine cases have so far been confirmed.
In DRC, with 394 cases, fears centre on the government’s ability to enforce any kind of emergency measures. Recent history suggests that there is little trust in the state when it comes to diseases. This is partly why it has been so difficult to eradicate the latest Ebola outbreak in the northeast of the country.
Speaking about the countries that are failing to take the WHO’s advice, Moeti said: “What I can say is that we continue to urge these governments to follow the data, to be evidence-based in the measures that they are taking, and to work with partners who are willing to support the impact mitigation measures that we recognise can be very important.”