The death toll from COVID-19 in Africa has been substantially lower compared to countries in the Americas, Europe, and Asia. The World Health Organization (WHO) African Region reported more than 5.7 million confirmed cases and 139,718 deaths, as of September 13, 2021. Moreover, the mortality rate of COVID-19 per million in Africa is considerably lower than in all other WHO regions other than the Western Pacific. Evidence suggests that demographic age structure of Africa is the leading factor for the low morbidity and mortality of COVID-19 compared to other continents.
However, it’s important to note that Africa has the highest death rates in the world among critically ill COVID-19 patients with the major factor being limited intensive care resources. The pandemic has been a wake-up call for many governments to prioritize public health but also, many African countries had time to prepare for the worst but many missed the opportunity. For example, Uganda had more than a year to prepare for its second wave but referral hospitals still lacked medical oxygen and ICU beds when the second wave hit. This came at a time when there were reports in the media of covid deaths at Mulago hospital due to faulty oxygen pipes and claims that the contract to install oxygen pipes had been issued based on undue political influence and not merit which is a conflict of interest.
Corruption continues to undermine the regional and national health response to COVID-19 because corruption and emergencies feed off each other. Many governments in Africa were unable to provide the necessary care to COVID-19 patients due to the long-term underfunding of their health systems. Research from Transparency International indicates that where corruption is systemic, governments tend to spend less on healthcare. This is the reality in Africa, the health sector is underfunded in many national budgets yet public health should be treated as a priority.
Transparency International’s Corruption Perceptions Index (CPI) which ranks countries and territories based on how corrupt their public sector is perceived to be on a scale of 0 (highly corrupt) to 100 (very clean), Uganda’s average score for the last ten years is 26 percent and the East African nation continues to feature among the most corrupt states. In the 2020 CPI, Uganda ranked 142 out of 180 countries while in the recent Global Corruption Barometer 69 per cent of Ugandans surveyed thought corruption has increased in the previous 12 months and 46 per cent of public service users surveyed claimed to have paid a bribe in the last 12 months.
In many African countries, COVID-19 relief funds have turned into a cash bonanza for those in public offices. The pandemic resulted into government expenditure going up but when audits were carried out, some of the resources were unaccounted for. In South Africa, an audit of COVID-19 expenditures revealed overpricing, fraud and corruption. In Uganda, the Auditor General’s report to Parliament indicated that COVID-19 funds worth shs1.31 billion were unaccounted for and items valued at shs55.8 billion were distributed under the Office of the Prime Minister (OPM) but there was no enough evidence of acknowledgement to verify recipients.
Therefore, Africa continues to be the lowest performing region on the Corruption Perceptions Index with little improvements from the previous years due to inconsistencies in the performance of many countries. The pandemic has underscored the need for urgent action in the fight against corruption by highlighting gaps in national healthcare systems, misappropriation of relief funds and lack of transparency in public procurement. In countries like Angola, South Africa and Zimbabwe, the economic COVID-19 led to protests due to corruption and mishandling of resources amidst rising costs of living.
In order to build back better, African governments have got to fight corruption by strengthening accountability and transparency in their spending, strengthening oversight institutions and protecting civic space. It is important to set up or strengthen legal and institutional frameworks in order to prevent and mitigate fraud and corruption risks related to public health crisis management and economic recovery measures. By doing so in a reasonable timeframe and involving all relevant stakeholders, including anti-corruption bodies, civil society and the private sector, and strong monitoring and evaluation processes, governments can ensure that their responses to current and potential future health emergencies effectively sustain public health, national economies, and the well-being of the affected communities.
By Patricia Namakula
Head of Research and PR
