Africa: a new model?

Seen from Africa – in Burkina Faso, the COVID-19 crisis and its consequences are clearly perceptible, but life has gone on. The spectre of cancellations and restrictive measures was there, but not necessarily followed by that of fear. The number of infections did not reach the peaks that overwhelm hospitals; the pandemic is not the number one topic of discussion on the table. A table around which people gather, at the bar, at the maquis, because resilience is something experienced together. Feet on the ground, glass on a wobbly table, we watch the television trace the geometry of world news: the French Hexagon and the Brussels Pentagon, two models of access to care, blocked and divided. Meanwhile, Middle-earth goes back into lockdown. For a national of Western Europe, the news is almost a cognitive dissonance. Feet on the ground, glass on a wobbly table, we tell ourselves we are rather well settled here.

Scope: an account of two years of observation from Belgium and Burkina Faso, and cross-perspectives on the health crisis in Europe and Africa.

Global pandemic: meaning what?

The coronavirus pandemic has accustomed us to comparing nations through their figures, philosophising over the annual tally of the latest cases the way one counts back through an Advent calendar. It is understandable to want to situate oneself in the context of a global pandemic: but what do these terms mean? While the extent of the pandemic is global, its distribution and impact are heterogeneous. In other words, COVID-19 did not strike everywhere in the same way. While Europe is getting into a state, there are territories of indomitable holdouts... well south of Gaul. Initially presented as a mouse for the cat (or some other feline), Africa fared better than its neighbours with regard to COVID-19. Yet it is not a major topic of European news, or if it is, it immediately comes with shortcuts and attempted explanations. So the pupil from whom a good mark was expected would be the one we listen to explaining why someone else's results are better. Strange, for an era that brandishes the objectivity of figures like a religion and preaches the arrival of new pandemics. In order to learn the lessons of the past, perhaps we can listen to the pupil with the best marks; observe, open up and engage in dialogue. That is the proposal made here:

• State an observation about COVID-19 that is diffuse in European discourse, at least French-speaking discourse;
• Take inspiration from it, listen to what Africa can teach, without supplying the European explanations.

First of all, let us take the precautions of an objective analysis and start precisely from the figures.

It is the contrast that is striking when one looks at a world map of infections (Figure 1). Africa shows markedly fewer total cases (red spots). Several tracking tools are offered by universities ^[1], international organisations ^[2], African ones ^[3], or by the media ^[4]. We can discuss the figures, which obviously only include officially recorded cases, and the counting methods, which may vary between the countries whose data are compared. But what matters here, beyond accuracy, is the gap between the number of cases in Africa and in the rest of the world, including Europe, for the same tool. The various sources corroborate a clear gap (Figure 2). For the most sceptical, who doubt the figures at their source, another map ^[5] gets around counting biases by representing, for each country, the situation at a given moment relative to its own peak of infections (of previous cases; its “worst stage” of the epidemic). Each country is thus compared with itself. This avoids dwelling on each country's counts, while still observing an overall map: independent proportions showing a general trend up to D-Day. If we take as D-Day the last high point of COVID-19 in early 2022 (Figure 3) to show the trend at the end of the crisis – when an African hecatomb was still being announced and testing had multiplied – Africa appears less close to its previous infection peaks than other territories. Thus, the map of cumulative cases illustrates the total situation, the map of peaks takes the temperature relative to the past, and both show that Africa was in a less feverish situation right to the end.

Of course, the situation was not the same everywhere in Africa (Figure 4). Towards the end of the crisis, the infection peak was being approached in the Sahel belt to the East, where Kenya had announced a resurgence of cases^[6]. Some regions saw an upward trend at the end of 2021 ^[7], notably in the south ^[8] where Omicron made headlines, although it faded just as quickly ^[9]. One can understand the concerns about a “time bomb” ^[10] in Africa, but that does not change the fact that the overall difference with Europe was striking right up to the end of the crisis, when the last African peaks were shorter ^[11]. Moreover, where the figures approached those of a previous peak, if that peak was relatively low – again compared with the rest of the world – then the situation remained overall less chaotic than elsewhere. In other words, it was “less bad” in Africa.

If one finds it more solid to take stock on the basis of death counts attributed to COVID-19, one will see the same difference (Figure 2). Africa in general sits at the bottom of a sad ranking in which success is a matter of counting points as in golf rather than basketball.

Yes, but no

Despite the analysis of the figures, and notably the peak method, some will question their accuracy in Africa alone. Let us ask ourselves about the objectivity of that approach. Brushing aside Africa's pole position on the mere presumption that it alone is unreliable seems to stem from the remnants of a rather inglorious arrogance. There is no problem with questioning the figures, but doubt is healthy when it generates questions, not certainties: why doubt the figures from Africa and not from elsewhere? Let us nevertheless play the game. The WHO declared that Africa had three times ^[12], then seven times ^[13] more cases, which would change the ranking ^[14]. Let us multiply their figures (Figure 2) even by ten: Africa's position will still be better than Europe's.

We could point to a smaller number of screening tests and an African population that is younger overall ^[15]; but if there were a health hecatomb, we would know about it ^[16]. This rather suggests that there are many asymptomatic cases, which would also be worth a look.

As a reminder, the point here is not to minimise the impact of the disease in Africa, notably of the latest developments ^[17], nor to idealise or generalise; but to take an interest in an observation that is less dramatic than imagined and whose lessons may be rich for future crises. Why not do so?

Not seeing the elephant in the room?

“Without curiosity of mind, what would we be? (…)” said Marie Curie. The answer: sick.

The facts are there, yet they are not prominent in the discourse of Europe's political and media authorities, even though they talk about a global pandemic and lessons to be learned for future new diseases. To say that nobody talks about this difference would be a lie: some authors have noted that there was a lesson to be learned here, and have cross-checked relevant statements ^[18]. More broadly, the European French-language press (Belgian, French, Swiss for example) does echo a lesser impact in Africa, often relaying the same statements from international bodies ^[19]; but once it has been covered, can we say the information is treated at its true value? It is mainly the moments when cases surge that are highlighted when Africa is mentioned (as Omicron showed), or else doubts about the figures or access to vaccines. The emphasis is not placed on the gap (in cases, hospitalisations, deaths) and on what it could inspire. It is even comical now to read favourable presentations of Belgian and European results, in mid-2020, compared with the rest of the world including Africa ^[20], or recommendations made to Africa by authorities – French ones, for example ^[21]. It could be said that the information is treated superficially, and not with the aim of investigating to learn more. Yet that would be a most scientific approach. Especially for a Europe that commissions the fight against disinformation ^[22] and against the pandemic ^[23]. After two years, our way of handling information can be put into perspective: when the WHO Regional Director for Africa declared in 2020 ^[24] “Even though these cases recorded in Africa represent less than 3% of the global total, it is clear that the pandemic is accelerating”, was the figure cited treated with as much excitement as the acceleration? Note that in the article she confirmed her overall confidence in the figures.

At a time when science is mixed with the media, being content to say that “that's just how it is over there” would amount to treating the information as a curiosity, in the sense of an oddity ^[25]; presenting the African situation as a marginal data point amid a series of trends ^[26]. We would then have traded curiosity of mind for the curiosity of entertainment and the strange. Unless it is a refusal to consider the obvious because it constitutes, as the saying goes, “an elephant in the room” ^[27]. The African elephant could weigh heavily if new scourges were to leave us defenceless. “Nothing in life is to be feared, it is only to be understood” ^[28] Marie Curie also said.

So, what can we learn?

In order to arm ourselves for Tomorrow, this question should be answered through dialogue with our peers from Mother Earth, without supplying ready-made explanations. In the meantime, here are a few avenues of inspiration.

• Science – Fighting an epidemic requires understanding its behaviour, that is, which part of the population falls ill and dies from it ^[29]. In other words, the ins and outs of COVID-19's “flop” need to be investigated as much as those of its “success”, in order to avoid a headlong rush. So why disregard Africa in statistics and models from elsewhere? Why deprive ourselves of this enormous dataset, which is moreover the least alarming? Such a colossal data point cannot be treated as marginal.
• Ethics – What can be said of a statistically incomplete line of argument that seeks to derive health measures for everyone and apply them everywhere?
• Medicine – The heated debates we are having about vaccines and immunity are deprived of a whole field of expertise. Africa has experience of far deadlier epidemics, and less access to vaccines ^[30]; its experts have nothing to be ashamed of as regards their skills ^[31]. On European TV sets, where are the people who are foreign to the country but not to the subject, discussing the fate of the world?
• Philosophy – The continent is once again showing resilience ^[32]; this is all the more remarkable considering that its hospital infrastructure is more fragile or less accessible ^[33], that it faces other problems ^[34], and that its economy is affected by the global crisis ^[35]. Europe too may need others to shed Light on a situation. What if Reason were a mirage of the temperate zones? In a world presented as being in the grip of crises, depriving ourselves of African know-how may be more a matter of dogma than of paradigm. As Douglas Kennedy wrote, “Reasonable people are the ones who survive” ^[36].

Conclusion: Africa, a new model?

So, even when expressed with caution, the observation stands: as a whole, compared with its neighbours and when everything is put into perspective, the continent where humanity originated came through the crisis with its head held high. Could it also be the origin of future solutions? In any case, there is no longer any reason to consider that Europe holds them all. This is neither good nor bad; it is a godsend.

Whether thanks to its competence, its experience or its luck, Africa has much to teach. When will the supposedly established hierarchies be questioned? When will we anticipate crises and sit down – authorities, media and citizens of Belgium, France or Europe – at the table with our counterparts to ask them, humbly: “How do you do it?”

By Benjamin Sion, aka “Tiche Comedy”

The opinions expressed in this article are solely those of the author and do not necessarily represent those of BAM!

[1] Johns Hopkins University of Medecine. Resource Center. https://coronavirus.jhu.edu/map.html

[2] World Health Organization. WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/

[3] African Union. COVID-19 Surveillance Dashboard. https://au.int/fr/covid19

[4] Covid-19 en Afrique : une carte pour suivre au jour le jour l’avancée de l’épidémie. (2022, 14 January). Jeune Afrique. https://www.jeuneafrique.com/910230/societe/coronavirus-en-afrique-une-carte-pour-suivre-au-jour-le-jour-lavancee-de-lepidemie/

[5] Reuters. Coronavirus tracker. https://graphics.reuters.com/world-coronavirus-tracker-and-maps/

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[7] France24, Reuters and AFP (2021, 6 December). Covid-19 : l’Afrique a enregistré une hausse de 83 % des cas la semaine dernière. https://www.france24.com/fr/afrique/20211214-covid-19-l-afrique-a-enregistr%C3%A9-une-hausse-de-83-des-cas-la-semaine-derni%C3%A8re

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[21] Information report no. 560 (2019-2020) by Mr Jean-Pierre VIAL and Mrs Marie-Françoise PEROL-DUMONT, on behalf of the Committee on Foreign Affairs, Defence and the Armed Forces, tabled on 24 June 2020. https://www.senat.fr/rap/r19-560/r19-560_mono.html#toc55

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Photo sources:
© Tiche Comedy

Benjamin Sion, aka “Tiche Comedy”, a Belgian author-performer in Burkina Faso, is a coach and holds degrees in biology, economics and political science. African inspiration.
#tichetalk – https://tichecomedy.com – tichecomedy@gmail.com

Quotations from English-language sources are translated back here from the French.