Health officials fighting the pandemic in Africa say they are watching the crisis in India “with total disbelief” and have warned that their continent may face a similar ordeal soon.

“What is happening in India cannot be ignored by our continent,” John Nkengasong, director of the Africa Centers for Disease Control and Prevention, said last week. “We do not have enough healthcare workers, we do not have enough oxygen … We cannot and should not find ourselves in [India’s] scenario because of the very fragile nature of our health systems.”

Latest statistics underline that so far Africa has escaped the worst of the pandemic. There were nearly 76,000 new Covid-19 infections in the third week of April, while India reported more than 400,000 new cases on Friday alone.

But though India, with 1.35 billion people, has a similar population size to the African continent, it has a more robust health system. According to latest World Bank figures, there are almost four times more doctors per inhabitant in India than across Africa. Unlike India, no African country manufactures significant quantities of drugs or vaccines, Nkengasong said.

The warning to increase resources in Africa comes as the pandemic’s brutal economic consequences on the continent become increasingly clear.

“The impact has been immense. These are countries with very limited social safety nets, already very high levels of debt and … very little resources to respond to a crisis of this magnitude,” said Murithi Murtiga, a Nairobi-based analyst with the International Crisis Group.

Studies have shown that millions of people in Africa will be pushed into poverty and many more forced to surrender hard-won gains in income and quality of life as the effects of the pandemic continue to surge across the continent.

woman in mask walking down street watched by a group of men
A woman in a face mask walks through Kibera Slums in Nairobi, Kenya, which responded to its third wave in March with an 8pm curfew. Photograph: Donwilson Odhiambo/Getty Images

Although analysts predict a steady economic recovery on the continent during 2021, the outbreak has undone years of growth.

The slow rollout of vaccines in Africa threatens to cause further misery, with new waves of infections likely to bring many more deaths and further economic damage.

The World Health Organization said last month that Africa had given fewer than 2% of vaccinations administered globally and was being left behind. The death toll on the continent is 120,000, though this is thought to be a significant underestimate.

In South Africa, one of the continent’s biggest economies and the country worst hit by Covid, Zweli Mkhize, the health minister, warned last week of a third wave of infections.

Covid has killed 55,000 people in South Africa, according to official figures, with a more transmissible variant fuelling infections in December and January. Excess mortality statistics suggest the actual toll may be two or even three times higher.

So far only 300,000 healthworkers, out of a total of 1.25m, have been vaccinated in South Africa, though authorities have pledged to expand the programme in coming months.

“What we would like is a situation where we vaccinate as many people as possible without really worrying about the next wave …. Everything about it remains uncertain …. when it is to arise, how bad it is,” Mkhize told members of parliament.

The continent’s vaccine rollout is hindered by the crisis in India, as the bulk of the vaccines supplied so far to Africa via the global vaccine-sharing facility Covax have been AstraZeneca shots manufactured there. India suspended its exports of the vaccine in March to cope with domestic demand.

It remains unclear when exports will resume, Nkengasong said, warning the situation in India could affect Africa’s vaccine rollout “for the weeks and perhaps months to come”.

Analysis by the Pew Research Center found that the recession caused by Covid has pushed 131 million people into poverty across the world. Sub-Saharan Africa and South Asia accounted for most of the increase, reversing years of progress.

Some 494 million people in Sub-Saharan Africa, out of a total population of 1.14 billion, were expected to be living in poverty ahead of the pandemic in 2020. That total has risen by 40 million, the Pew analysis estimated.

Though economic growth was patchy and benefits distributed unequally, sub-Saharan Africa had not suffered a depression for 25 years until the pandemic.

Murtiga described a “multilayered crisis”, despite fairly resilient economies which rebound quickly.

“Household budgets have collapsed, and during lockdowns there was limited support for those who lost livelihoods. At a macro level, there is very little fiscal space and this has left countries facing a tough task in terms of recovery,” he said.

The slowdown has hit those earning a living from informal urban jobs hardest, especially women. In Kenya, one study published earlier this year found many young people had given up education as they sought to earn money.

“Male youth are reporting being… [idle] in the homes because of the Covid-19 lockdowns, which means no work, yet the female youths are reporting additional workload at the household level,” said study adviser Dr Grace Wamue-Ngare, an associate professor at Kenyatta University in Nairobi.

In South Africa, statistics released by the South African Human Rights Commission revealed more than half of the country’s consumers who had borrowed money now have worrying levels of debt. The country’s middle class was being wiped out, one newspaper said.

Shopping malls across the country are full of shuttered businesses, with industry associations reporting thousands of restaurants shutting.

Before the pandemic, Africa had the second-fasting growing tourism sector in the world, contributing 8.5% of the continent’s GDP and employing 24 million people. Even the most optimistic forecasts suggest it will take two years at least for the visitors to return in similar numbers.

Ntokozo Dube, a tourist guide in Soweto, the township south of Johannesburg, has been unemployed for more than a year.

“We are just trying to survive the best we can. I’ve been knocking and knocking on doors to find some work but getting nowhere. It’s very tough,” Dube, 31, said.

South Africa has introduced relief programmes, but delivery has been patchy. Dube has received nothing, blaming “corruption”.

“People who have debts are having them collected. Food is expensive,” he said. “The people are suffering a lot.”

This content first appear on the guardian

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