By Trevor Bach
What Africa Can Teach the U.S. About Pandemic Response
EARLIER IN AUGUST Africa reached 1 million confirmed COVID-19 cases, a dubious distinction that is likely a severe undercount, as some countries fail to provide reliable statistics. Yet the continent has also produced myriad coronavirus success stories. Rwanda, in particular, has been lauded for its vigilant response to the pandemic: To date the country of 12 million has recorded around 2,200 cases and just eight deaths, among the lowest COVID-19 fatality rates per capita in the world.
U.S. News & World Report spoke with Youssef Travaly, vice president of the African Institute for Mathematical Sciences, and a senior fellow at the Africa-Europe Alliance. Travaly is the lead author of “Learning from the best: Evaluating Africa’s COVID-19 responses”, a Brookings Institution report published last month highlighting positive African responses to the pandemic. Travaly spoke over the telephone from his home in Kigali, Rwanda.
What’s it like there? What is the atmosphere?
How is life in Kigali? Ah, I think it’s just great actually. It’s very quiet, very peaceful. The first six weeks to almost two months, I think, it was the lockdown, total lockdown, meaning we were just at home so we could not go out. And after that the lockdown was removed, but now we can only go out between 5 a.m. in the morning to 9 p.m. in the evening, so this is how we live here.
It’s only 50% [of employees] in each company, nonessential staff they have to work from home. So it’s a kind of relaxed form of [quarantine]: We can move free, but we still have to work from home. Schools are still closed, gyms are still closed, swimming pools are still closed, but some activities are resuming. So now the airport is open, people can fly in and out. I mean churches are open, stores are normally open. So it’s a normal life but we take a lot of precautions.
I want to get to the Brookings report. In terms of these positive responses that you highlighted, what really stood out to you?
For me, the approach I took was to really focus first on positive responses, because I see if we have those responses, then the question is how we can roll out those good examples across the continent? And also the rationale behind that was to understand what were the key success factors for those positive responses. So I took a number of cases across the continent, because what was interesting was that Rwanda, Kenya, Senegal, South Africa – they had their first cases the same week.
So basically Rwanda – as soon as we had the first or the second case of COVID – they closed the airport and they imposed a lockdown directly. Now then the question was why was that lockdown successful? And there are really many factors. The first thing that is really clear is that over the last 10 years, the last to 10 to 15 years, Rwanda has invested a lot in digital infrastructure. So basically in just two, three days the country could turn cashless, and that was key. And they also put some incentives for people to use mobile money payment by waiving all the fees of electronic transactions – no charge when you are paying with your mobile phone.
Is that a big part of Rwanda’s success? So it’s sort of reducing the [level of physical] interaction?
Yeah. It was really about limiting the contact, contact between people when you make a payment, when you use money and so forth. I think, yeah, it’s a big factor. I think we have some statistics on the number of transactions, how it went up during that time.
And then of course people were very respecting of the recommendations of the government. People were not moving around. Even though there was the police – they would stop you and so on. So that was the first thing. And then the rest, it was really about testing, about tracing.
So contact tracing has been going well in Rwanda?
Oh yeah, definitely. Definitely. I mean it was really key, contact tracing. So they had a kind of command center, command post where they were really doing the contact tracing, so that was really something important.
One thing that stood out to me – I saw your report was talking about drones being used in Ghana and also in Rwanda. What do you make of that implementation of these high-tech ideas?
Actually that’s what I was talking about the preparedness of Rwanda, because actually drones are being used in Rwanda to transport blood, because Rwanda is a very hilly country. So they are using drones to transport blood, packets of blood to hospitals to deliver to hospitals, and they do that in something like 15 minutes, where if you have to drive it maybe would take you something like two hours.
So it takes blood from a village?
No, they have a center – they have a center in rural areas where they have blood that is stored there. And then when they get a request by WhatsApp, SMS, then they put it in a drone and then the drone goes and delivers to the hospital.
Wow that’s great.
Yeah, it’s really great. So it was a technology being used in Rwanda, which was then scaled up in Ghana. Then we had the COVID, the only thing they did was actually a kind of retrofit: So rather than using the drone facility, or infrastructure, for the packet of blood, they used that to transport COVID samples.
Are there things going on in other countries that really stand out to you?
The case of Kenya was interesting because Kenya has a very strong manufacturing base, and what they did was they quickly turned those manufacturing facilities into facilities to produce all the equipment for [a] health emergency. And that’s why in my report I insist that, going forward, we should make sure that African countries, they have a kind of flexible manufacturing facilities.
And then in other countries like Ghana, like [the Democratic Republic of] Congo, basically what happened is really some innovation around the production of ventilators… [In Togo and Ghana] there was really a homegrown innovation, because they managed to do that with young people and local materials, and that was really good because ventilators were one of the main issues.
Rwanda looks like it’s in better shape than the U.S. at this point. What should the West, or countries like the U.S., learn from some of these African responses?
I think for me what was clear is that Rwanda – they took this pandemic very seriously. So they started monitoring the evolution of the pandemic in December, they were watching what was happening. And I think this is one of the problems that I think Europe and the U.S. – they say, ‘OK, it’s something happening in Asia. It won’t reach us.’ And I think this is something that didn’t happen for sure in Rwanda.
Just take the example of the use of masks. There was a kind of top-down message [in some countries], saying that masks are useless, that it’s pointless to use a mask. So basically people – it took quite some time for people to use masks, but at the same time there was some scientific data that were published showing early trends in countries where people are wearing masks versus countries where people are not wearing masks. It was really clear that there was a difference, but even today if you look at Europe, they are not yet imposing the mask everywhere. Here the decisions have [been very clear]. There is no half-decisions. It’s really, we wear a mask, that’s it. We stay home, that’s it.
What’s the protocol with masks in Rwanda? Do you get fined if you don’t wear them?
The police will stop you right away, so there is no way you can go 300 meters without your mask. So you wear your mask, if you don’t have your mask I think they will stop you, they take you to a place, they keep you for a few hours and then they let you go home, and you are fined. But almost nobody is going without a mask in Rwanda. I think [the compliance rate] is close to 100%. … It’s not an option to go out without a mask.
