PPE corruption scandal unmasked in South Africa

South Africans donated billions of dollars to protect key workers. But with bank accounts frozen and sports cars seized, questions are being raised about where the money went. 

What started as a rallying call for South Africans to stand together against the onslaught of the coronavirus pandemic, quickly disintegrated into a morass of bureaucratic bungling, corruption and outright looting involving multi-million-dollar tenders allegedly awarded to politically connected individuals tasked with supplying personal protection equipment (PPE). 

In March, South African President Cyril Ramaphosa addressed the nation regarding the Covid-19 pandemic.

He called on the people to be resolute and firm and to support the government’s decision to declare a national state of disaster, and lockdown the country for three weeks.

He also announced the creation of the Solidarity Fund – with an initial R150 million ($8.7m) from the state – to deal with the coming Covid-19 storm.

The speech, delivered with gravitas and frankness, shifted even his most fervent detractors, and the money poured in.

The families and businesses of the Oppenheimers, the Ruperts and the Motsepes immediately committed R1 billion ($58m) each.

Online internet giant Naspers kicked in R1.5 billion ($87.5m). Two-thirds of the cash was used to source, procure and distribute PPE and the remaining third paid directly into the fund.

Within weeks, the fund had attracted $30bn, and within six months some $142m had been disbursed on what the fund listed as ‘interventions and projects across three key pillars – Health, Humanitarian Relief and Behavioural Change’ – with huge sums spent to provide PPE for frontline health workers.

As the country moved into ever-decreasing alert levels, the regulations surrounding the lockdown became submerged in illogic and nonsense.

Retailers could sell T-shirts, but only if they were to be worn under a jacket; they could not sell open-toed sandals; the Department of Trade, Industry and Competition even placed absurd restrictions on e-commerce shopping.

There were rumours of fierce battles within the National Coronavirus Command Council (NCCC), headed by Cooperative Governance Minister Nkosazana Dlamini Zuma. 

The mood of the country shifted from determination and support to anger and disillusionment.

Then stories began to trickle in about the PPE contracts.

In April, the province of Gauteng’s Health Department’s Supply Chain Chief Director, Thandy Pino – just two weeks into her position – apparently warned her department head, Mkhululi Lukhele, and the Chief Financial Officer, Kabelo Lehloenya, that the department wasn’t complying with National Treasury procurement guidelines for Covid-19 PPE.

The amount involved was around R2bn ($116m).

A month later, Lehloenya resigned, and Pino was suspended while the SIU investigates her role in the tender awards. 

But the alarm bells went off in July when presidential spokesperson and confidant Khusela Diko was placed on leave following revelations that her husband, king of the amaBhaca people Thandisizwe Diko, had secured a $2.75m PPE contract.

By the end of July, the deal – which Diko withdrew from – along with more than 90 other tenders issued by Gauteng’s Department of Health, was being investigated by a nine-institution unit headed by the Special Investigating Unit (SIU).

The SIU was set up by the President on July 23 to deal with allegations of PPE corruption.

The probe into Khusela Diko, which includes the Gauteng health minister, Dr Bandile Masuku, and his wife, councillor Loyiso Masuku, has yet to be resolved, despite a marathon two-day hearing held mid-September. 

Questions really began to be raised, though, when a young businessman by the name of Hamilton Ndlovu posted a video showing him taking delivery of five luxury vehicles – three Porsches, a Jeep and a Lamborghini Urus SUV – worth roughly $645,000.

Ndlovu, who runs an ‘engineering solutions’ company, reportedly secured a $7.3m PPE contract in the Eastern Cape province.

At the time of going to press, Ndlovu’s bank accounts had been frozen and three of the cars seized pending an investigation. 

By mid-September, the SIU was investigating more than 658 PPE tenders and other pandemic-related contracts worth around $300m.

Meanwhile, Brig Hangwani Mulaudzi, spokesperson for South Africa’s elite anti-corruption unit the Hawks, confirmed officers were investigating more than 50 cases regarding substandard or falsified PPE.

This investigation followed on reports from the South African Bureau of Standards (SABS), which revealed that approximately 60 per cent of the medical-grade masks it tested did not meet its quality criteria. 

Ironically, the Hawks are also involved in investigating themselves after it came to light that four contracts worth $31.6m to supply the police with PPE were under investigation. 

The rot seems to be widespread. In the province of KwaZulu-Natal, the SIU is looking into the Department of Education and the Department of Social Development’s PPE contracts respectively valued at $28m and $1.25m. 

According to a report issued by the Auditor-General, Kimi Makwetu, the items were ‘priced at more than double, or even five times, the prescribed price’.

It goes on to say: ‘There are clear signs of overpricing, unfair processes, potential fraud and supply chain management legislation being sidestepped’.

The Auditor-General’s final report is expected in November.

It will be his swan song, as his seven-year term of office comes to an end. 

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Africa's antibody results explained

NewsAfrica cuts through the media hysteria and gets the lowdown on lockdowns, Covid-19 antibody tests and herd immunity in this Q&A with Professor Sunetra Gupta, a world-leading expert in theoretical epidemiology at the Department of Zoology, University of Oxford.

 

Q: Why are infections and hospitalisations falling across much of Africa when lockdown measures are being eased, or, in the case of Tanzania, never imposed at all?

A: It’s hard to think of any other explanation than the build-up of population-level immunity, also known as ‘herd immunity’. Social distancing may accelerate the decline.

 

Q: What percentage of the population needs to be infected for herd immunity to kick in?

A: This depends on how many people were resistant to the virus to start with.

Several studies suggest that previous exposure to seasonal coronaviruses [such as common colds] confer a degree of protection, and this can bring down the percentage that needs to be infected quite considerably, such that antibody levels of 15-20 per cent may be sufficient to reach what is known as the herd immunity threshold.

 

Q: Will exposure to the virus show up in antibody tests?

A: Antibody tests are highly variable in their specificity and sensitivity.

We now know that not everybody who is exposed makes antibodies, and also that they decay quite quickly.

This makes it difficult to interpret the results [of antibody studies].

There are, of course, reports of 40-50 per cent or even 70 per cent antibody positivity in certain populations which suggests that they were recently infected and have probably overshot the herd immunity threshold.

 

Q: Why do governments not test for the full range of antibodies, such as IgA antibodies and T-Cells?

A: It’s very difficult and expensive to test for T-cells.

IgA tests in saliva are being trialled.

 

Q: Given that studies found 12.3 per cent of people in Blantyre, Malawi, had IgG and IgM antibodies alone, what percentage of Malawians are likely to have had the virus and be protected by IgA antibodies and T-cells too?

A: I think most of these numbers have gone up since the study was conducted, but I imagine that we should expect similar levels of antibodies as Stockholm [where infections have disappeared through apparent herd immunity].

 

Q: How realistic was the concept of ‘social distancing’ for Africa, given its mega-cities and slums?

A: I think it’s totally unrealistic and can have devastating consequences for society [poverty, hunger etc], as we have clearly seen.

 

Q: Why have Africa’s health systems been able to cope better with the pandemic than rich nations, such as the UK, Italy and Belgium?

A: Part of it is down to the age structure.

We know that the risks are very low in people under the age of 65.

It could also be that exposure to other pathogens, especially other coronaviruses, is higher in Africa.

 

Q: Is talk of a second wave just media hysteria?

A: Lifting of lockdown in areas where the virus has not spread can of course result in a rise in infections.

Hopefully we will not see this in Africa.

Many pathogens exhibit seasonal increases over the winter months, this may be what is happening now in the UK, so it is likely that cases will rise again next winter in South Africa and elsewhere in the southern hemisphere, but this is just normal behaviour for a respiratory pathogen.

In a few years, we may get another real, wave due to the loss of immunity, as we see with other coronaviruses, but hopefully this will not cause a lot of excess mortality as you are often protected against severe disease and death in your second infection.

 

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Has Africa reached herd immunity?

With early antibody tests revealing the virus may have infected millions more Africans than first thought, Andrea Dijkstra speaks to some of the world’s leading experts and asks whether the fall in hospitalisations and deaths may mean herd immunity is well within reach. 

Early this year, experts estimated that the African continent would be especially hard hit by the pandemic, with high rates of transmission that could quickly overwhelm health care systems.

‘Between 300,000 and 3.3 million African people could die as a direct result of Covid-19,’ the United Nations Economic Commission for Africa (UNECA) predicted in April.

The organisation emphasised that sub-Saharan Africa would be particularly susceptible because 56 per cent of the urban population is concentrated in overcrowded and poorly serviced slum dwellings, and only 34 per cent of the households have access to basic hand-washing facilities.

‘When I heard that corona reached Kenya, I feared the worst,’ recalled ICU-nurse Francisca Mumbua, who works at the Covid-19 isolation facility of Machakos Referral Hospital in central Kenya.

‘On the TV, we saw people dying in large numbers in western countries like Italy. I thought that our continent would be hard hit with masses losing their lives, as most of our countries are poor and our healthcare systems are limited. We basically expected to be really overwhelmed.’ 

Nine months later, and Africa seems to have weathered the pandemic relatively well so far, with just one confirmed case for every thousand people and a little over 35,000 deaths – 3.5 per cent of the global total.

Even South Africa, the hardest-hit country on the continent, has seen a relatively ‘low’ number of deaths, with about 28 fatalities per 100,000 population, compared to 61 deaths per 100,000 in the United States, for example.

‘To our surprise, most of the people who suffered from Covid-19 had a very mild or asymptomatic form of the disease,’ said nurse Francisca Mumbea.

‘Other moderate cases were managed successfully despite the resource challenges faced by most of the African countries.’ 

According to the World Health Organization (WHO), more than 80 per cent of coronavirus cases in African countries were asymptomatic versus around 40 per cent in Europe.

‘There are simply not so many people in Africa dying from this virus as we see in, for example, Europe’, said Professor Yap Boum, an epidemiologist and microbiologist with Epicenter Africa, the research arm of Médecins Sans Frontières (MSF). 

Africa’s youthful demographics are definitely an important reason for the lower death rates, according to most experts.

The median population age in Africa is 19.7 versus 38.6 years in the US and 42.6 in Europe.

In Kenya, for example, half of the population is younger than 20, and only four per cent are 60 or above.

Meanwhile, in Italy, 29 per cent of people are aged 60 or over while only 18 per cent are aged under 20. 

Another difference is that coronavirus has also predominantly affected cities, which in Africa are home to younger people.

‘When people retire, they often go back to the village,’ explained Boum, who believed that this natural separation between generations might have helped to curb the virus in some African states. 

However, demographics cannot get all the credit for the continent’s successes. Africa’s youthfulness should have resulted in death rates being four times lower than Europe or the United States, according to a recent study called ‘COVID-19 in Africa: Dampening the storm?’.

The death rate is actually around 40 times lower than Europe and the US. 

According to the Kenyan pathologist Anne Barasa, a difference in genetics between Caucasians and people of African descent could explain the discrepancy.

‘We could have some differences in some of the genes that are associated with either the expression of receptors that the virus uses to enter our cells, or genes associated with an immune response against the virus thereby giving us a better protective response,’ stated the scientist from the University of Nairobi.

In the United States, however, African-Americans were especially hard hit by the virus and accounted for a disproportionate number of Covid-19 deaths.

This apparent discrepancy might be explained away by recent research from the Boston University School of Medicine, which discovered that patients living in predominantly African-American and Hispanic areas were more likely to be vitamin-D deficient, which put them at a higher risk of acquiring the infection. 

A growing number of experts also believe that another important factor is the types of pathogens – or viruses – that people are exposed to, which are often connected to the climate and the levels of hygiene.

‘One good example is malaria that you don’t find in Europe and the United States. In sub-Saharan Africa we are permanently exposed to malaria, typhoid, as well as other coronaviruses, which at some point might build our immunity,’ explained epidemiologist Yap Boum.

‘This might make us more equipped to respond to this new Covid-19 virus. And while people in Europe and the United States also have the flu and quite a number of viruses, many people live in more hygienic environments where they are less exposed to those pathogens.’

Such a view isn’t universally popular. Professor Salim Abdool Karim – widely seen as a leading voice on the pandemic response in South Africa – pointed to other areas of the world with similarly crowded slums that have been hard hit by Covid-19. ‘If this was the case, then why do we see such severe cases in India and Brazil?’ 

Potential underreporting of Covid-19–associated deaths has also been bandied around. However, to date, African countries have not reported acute health emergencies.

‘We haven’t really surveyed all deaths to determine whether or not there was possible Covid-involvement,’ said the Kenyan pathologist Anne Barasa, ‘although we haven’t had many unexplained deaths.’ 

The WHO acknowledged that coronavirus deaths might be under-reported in the continent but didn’t suspect a huge gap.

‘Although cases are being missed,’ WHO Regional Director for Africa Dr Matshidiso Moeti said at a virtual media briefing recently.

‘We are not seeing evidence of excess mortality due to Covid-19 or missing deaths.’ 

Crucially, small antibody surveys suggest far more Africans might have already been infected with the coronavirus than official infection rates suggest, which makes the lower death rates even more striking.

Immunologists from the Wellcome Trust Research Programme at the Kenya Medical Research Institute (KEMRI) in Kilifi, for example, tested 3,174 blood donors from around the country between the end of April and the middle of June, and found that 5.6 per cent of all the donors and 9.5 per cent of those based in Nairobi had Covid-19 antibodies  –  proteins the body makes when the infection occurs.

‘The results suggest [that] about one in 20 people aged 15-64 years have been exposed to SARS-CoV-2, which is in sharp contrast with the very small numbers of Covid-19 cases and deaths reported during the same period,’ wrote the authors of the paper, which has not yet gone through peer review and was published as a pre-print in July. 

If the survey’s results accurately reflected Kenya’s overall infection rate, then 2.5 million Kenyans would have had coronavirus in that period.

Such a high number of infections should have resulted in around 12,500 deaths using the World Health Organization’s conservative estimate of a 0.5 per cent morbidity rate. And yet, by midway through the survey, Kenya had only reported 71 deaths from coronavirus - far lower than the number of deaths reported globally in countries with similar levels of antibodies. Even by the end of September the country had reported only 700 deaths from Covid-19.

Other antibody studies in Africa have shown similarly surprising findings.

Two recent surveys done by the National Health Institute in Mozambique on around 10,000 people from the north-eastern cities of Nampula and Pemba found antibodies to the virus in five per cent and 2.5 per cent of participants respectively.

Mozambique has recorded just 58 Covid-19 related deaths. 

Researchers in neighbouring Malawi – where a lockdown was ruled unconstitutional, and the virus thus spread largely unchecked – found similar results.

They tested 500 asymptomatic health care workers in the southern city of Blantyre and concluded that 12.3 per cent of them had been exposed to the coronavirus. 

Immunologist Kondwani Jambo, of the Malawi-Liverpool Wellcome Trust Clinical Research Programme, who conducted the study, said: ‘Although health care workers are at higher risk to be infected, the outcomes do tell us that more people have been infected than estimated and the trajectory of the epidemic [in Malawi] is different from Europe, China and the Americas.’ 

Such a hypothesis might go some way to explaining a study among people who visited public health facilities for antenatal care and routine HIV tests in the Cape Town area. It found that 40 per cent of respondents had antibodies against Covid-19.

The researchers stressed that the results are preliminary and based on a skewed sample of 2,700 people, who aren’t representative of the overall population.

Still, the South African study suggested that ‘especially in poorer communities, a relatively high proportion of people has been exposed to and infected with Covid-19,’ according to Mary-Ann Davies, director of the Centre for Infectious Disease Epidemiology and Research at the University of Cape Town.

Professor Yap Boum said that he also found a high prevalence of Covid-19 antibodies in people from Cameroon. ‘During mobile screenings in [the capital] Yaoundé, we tested 3,000 random people and around 16 per cent already had antibodies.’

The regional representative for Epicenter Africa said that we have to be very careful with these smaller, not peer reviewed test cases, but added: ‘The results definitely tell us that more people have already had the virus than we found through regular Covid-19 testing. We have missed a large group of people, probably because they were not sick.’ 

Meanwhile, more and more experts have argued that these antibody studies are undercounting the number of people who have had the virus.

A team led by the Biostatistics Unit at Cambridge University’s School of Clinical Medicine argued, for example, that many of the antibody tests used in studies miss out mild cases where people have overcome the disease by producing low levels of antibodies.

Most of the surveys only look for two types of dominant antibodies – Immunoglobulin G (IgG) and Immunoglobulin M (IgM) – but fail to look out for another antibody, IgA, which often acts as the body’s first line of defence against viruses and bacteria. 

A study in Luxembourg, for example, discovered more than five times as many people had IgA antibodies than IgG antibodies.

While researchers in the Austrian ski resort of Ischgl found that a staggering 42.4 per cent of the population tested positive for antibodies when they added IgA testing to the mix.

In June, a paper by Sweden’s Karolinska Institute suggested another way in which antibody tests may have been undercounting the number of people who have had the virus.

They found that many people showed an immunological response to Covid-19 in their so-called ‘T-cells’ – another part of the body’s immune system – without necessarily showing antibodies in their blood. 

‘No single test can identify all individuals that have been infected by SARS-CoV-2,’ the immunologist Jambo acknowledged.

‘The IgG-based tests, like any other single test, underestimate the true proportion of the population that has had Covid-19, but they give you a minimum estimate useful for tracking the trajectory of the epidemic.’ 

Sunetra Gupta, a professor of theoretical epidemiology at Oxford University in the UK, acknowledged that some of these tests might have seriously underestimated the number of people who have been exposed to the virus.

She said: ‘Therefore, IgA tests in saliva are now being trialled. However, it’s very difficult and expensive to test for T-cells.’ 

In even more positive news, some scientists are even starting to argue that the fall in hospitalisations and deaths across the continent might be because Africa is already nearing ‘herd immunity’ – the idea that so many people have already caught the virus that there are not enough uninfected people for them to pass it on to, causing the virus to largely die out. 

‘In a few important case studies – Kenya, for example – what seems to be happening is the epidemic may be peaking earlier than our naive models predicted,’ Professor Francesco Checchi, a specialist in epidemiology at the London School of Hygiene and Tropical Medicine, told The Guardian.

He said a similar pattern had emerged in Yemen, where little was done to control Covid-19 because of the ongoing conflict there.

‘Yemen is one of the few countries where, to my knowledge, there is almost no prevention of Covid transmission,’ Checchi told the British newspaper.

‘The anecdotal reports we’re getting inside Yemen are pretty consistent that the epidemic has [...] passed. There was a peak in May, June across Yemen, where hospitalisation facilities were being overwhelmed.’ 

He added that this is no longer the case and concluded that, ‘it was possible that the population had accrued some sort of ‘herd immunity’, at least temporarily.’ 

Some experts argue that something similar is happening in parts of Africa where falling case numbers are not because the lockdowns were so successful, but rather they were so unsuccessful the virus spread like wildfire.

In many areas, like urban slums, lockdowns proved almost impossible to enforce, meaning large number of people might have already been exposed. 

‘I won’t say that a full country already managed to reach herd immunity,’ Yap Boum told NewsAfrica.

‘But in some specific clusters, 60 per cent of the people might have been already exposed [to the virus].’

The epidemiologist singled out Kenya as an example, where about 56 per cent of the population lives in urban slums.

‘Although the Kenyan government imposed a lockdown, over half of Kenyans didn’t have the possibility to lockdown as they are living in overcrowded informal settlements. 

‘They are sharing one toilet with hundreds of people, they live with many family members in a single bedroom house, have to move around through narrow alleys, and often don’t wear facemasks as they don’t feel the burden of the disease so much.’ 

He added the seroprevalence – or antibody results – will definitely be ‘high in these areas’, and said that he believed this might be the reason that infection rates are going down in Kenya. 

He continued: ‘In Cameroon, where we were not having any lockdown, and only bars were closed, infection cases are going down probably because many people already got the virus.’ 

However, some experts believe that the drop in Covid-19 cases in countries like Kenya and Cameroon should be treated with great caution as they might be connected to a decline in people getting tests.

In Kenya, for example, the number of tests performed per 10,000 people halved between August and September.

‘This decline closely mirrors trends for Nairobi and Mombasa counties but potentially may mask the national picture, as other counties are experiencing increasing case numbers,’ the WHO stated recently. 

A change in testing policy in South Africa could also have had an effect on the numbers of new cases, according to the WHO.

‘The country’s current policy of testing only those who present with symptoms makes full interpretation of case numbers difficult.’ 

More antibody surveys may help show the full picture. South Africa has recently initiated a national seroprevalence survey among over 30,000 people.

Meanwhile, a French-funded study is currently testing thousands for antibodies in Benin, Cameroon, Democratic Republic of the Congo, Ghana, Guinea and Senegal.

The Africa Centres for Disease Control and Prevention has also started administering coronavirus antibody tests in Cameroon, Morocco, Nigeria, Sierra Leone, Zambia and Zimbabwe.

And 13 labs in 11 African countries are participating in a global antibody survey coordinated by the WHO.

Government scientists often claim herd immunity will only be achieved when 60 per cent of a population have been infected, however many top immunologists dispute these widely reported claims. 

It is more likely, a team from the Liverpool School of Tropical Medicine argued, that the true figure lies between 10 and 20 per cent.

The 60 per cent figure is based on the idea that we are all equally likely to contract the virus. In reality, according to the team’s leader, Gabriela Gomes, there is a wide variation in an individual’s susceptibility to becoming infected.

This view was echoed by Dr Saad Omer, director of the Yale Institute for Global Health, who told the New York Times: ‘Herd immunity could vary from group to group, and subpopulation to subpopulation, and even by postal codes.’ 

The virus is thought to spread slowly in suburban and rural areas, where people live far apart, but rips through cities and households thick with people.

This became clear when researchers conducted a random antibody survey among households in the Indian city of Mumbai (Bombay).

They found a startling disparity between the city’s poorest neighbourhoods and its more affluent enclaves. Between 51 and 58 per cent of residents in poor areas had antibodies, versus 11 to 17 per cent elsewhere in the city. 

Furthermore, a neighbourhood of older people may have little contact with others but succumb to the virus quickly when they encounter it, whereas teenagers may bequeath the virus to dozens of friends and yet stay healthy themselves.

In the antibody study in Mozambique, the researchers noted a huge differentiation between people with different professions.

Ten per cent of the market vendors in Nampula had antibodies in their blood, while this was only the case with three per cent of bus and minibus drivers.

Once such real-world variations in density and demographics are accounted for, the estimates for herd immunity might fall. 

Other scientists warn that you cannot talk about herd immunity unless you’re 100 per cent sure that someone who has had the disease is going to be protected from contracting it again.

Recently, there were at least four separate cases of people who were re-infected with Covid-19 after they had earlier been infected, in Hong Kong, the Netherlands, Belgium and the United States.

‘Until we confirm that exposure to SARS-CoV-2 measured by antibodies is protective, we can’t really claim to be close to achieving herd immunity,’ the Malawian immunologist Jambo cautioned.

Other experts warned that cases in Africa might start to rise again, as many countries have only just started to loosen strict protective measures.

‘It’s too early to tell whether we are heading towards herd immunity, at least in Kenya, as we haven’t opened up completely,’ said the Kenyan pathologist Anne Barasa.

Her view was echoed by Professor Salim Abdool Karim, who said: ‘If we look at the data, close to 120 countries worldwide have completed their first wave of the pandemic, over half of them have also had a second wave.’ 

Such a pessimistic outlook, however, isn’t shared across the board.

Many scientists point to countries like Sweden, which unlike the rest of Europe didn’t lock down, and now isn’t experiencing a large so-called ‘second wave’, like the rest of the continent. The virus there peaked without a lockdown, and the country has experienced few hospitalisations and deaths in recent months. 

Cameroonian epidemiologist Yap Boum admitted that it’s extremely hard to predict if Africa will suffer from a second wave. 

He said: ‘While being cautious, I do think that if tens of millions of Africans have already been infected, this raises the questions of whether the continent should try for herd immunity.’ 

He pointed out that it will take time before a vaccine against Covid-19 will become available – assuming one is ever developed – and said African countries would not be the first to get it.

Meanwhile, measures to control the pandemic, like lockdowns, have crippled economies and could harm public health more in the long run.

In a recent WHO survey of 41 countries in sub-Saharan Africa, 22 per cent of countries reported that only emergency inpatient care for chronic conditions was available, while 37 per cent of countries reported that outpatient care was limited due to the pandemic.

With economies in ruins, and herd immunity potentially much closer than first thought, Yap Boum thinks Africa needs to stop mimicking the West. 

‘We need to be careful,’ concluded the epidemiologist.

‘But we also might need to be courageous.’ 

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Lockdown causes hunger epidemic in Nigeria

Nkiru James, a 45-year-old housewife and businesswoman, had managed her beauty salon for eight years when the Covid-19 outbreak happened.

For the first time in eight years, her salon was locked for more than two months because of the lockdown.

According to James, her earnings pay for the food for her family of six, while her husband’s monthly salary settles utility bills and house rent.

Unfortunately, her husband’s monthly salary has also been slashed due to the impact of the pandemic.

After one week of lockdown, her family could barely eat as the little money she saved before the lockdown didn’t last long.

The family waited, believing that there would be support on the way from the government or NGOs, but all was in vain.

She said: ‘We were hoping that before we finished the food we stored in the house, the government intervention would have reached us.’

It never came.

Fortunately for the hairstylist, a friend introduced her to a new line of business of buying and selling perishable foodstuff daily.

‘My friend took me to the market, where vegetables are sold in bulk, and gave me a small space to display the perishable food I bought, so I can make sales and refund part of her money.

‘If we were waiting for government, we would starve to death with our children,’ she said.

‘It is a stressful routine for me and there is still no real financial gain in it. The hair-making business was decent and less stressful.’

James’s experience of the lockdown period is nothing unusual, with most average families in Nigeria also being forced into hardship before, during and after the lockdown.

Patrick Dosu, 39, was already struggling to survive when the lockdown bit.

In January, Dosu, who drove tricycles for a living, suddenly found himself out of work.

The Lagos state government had just banned the use of tricycles and motorcycles in some major parts of the state, causing a sudden rise in unemployment.

About 14,000 motorcycle and 50,000 tricycle operators lost their jobs overnight, while the cost of public transport soared as companies took advantage of the sudden collapse in competition and raised prices.

Dosu, who has an Ordinary National Diploma (OND), had been struggling to find a new job when the Covid-19 outbreak further crippled his efforts.

He said: ‘I was stranded when the lockdown was announced.

There was no money to buy food for two days, let alone for a whole month.

He said the church, his friends and family members gave him money and food that stopped him and his wife and two children from starving.

But added: ‘Life is even more difficult for a common man like me after the lockdown.

‘Instead of looking for means to ease our suffering, the government has increased the electricity tariff and the fuel pump price as well.’

With a young population and high levels of poverty, the fear is that lockdown-induced poverty will kill far more people than Covid-19 ever could in Nigeria.

About 90 million people, or 46 per cent of the population, lived on less than $2 a day before the pandemic.

Unemployment was also rising before the coronavirus outbreak, and the situation has further deteriorated with the pandemic.

Nigeria’s unemployment rate came in at 27.1 per cent in the second quarter of 2020, the highest on record.

It was the first time since 2018 that Nigeria’s National Bureau of Statistics (NBS) published such figures. It compares to 23.1 per cent seen back in the third quarter of 2018.

According to World Food Programme (WFO), it has been necessary for many major governments to introduce incentives and economic relief programmes that not only provide a financial cushion for affected individuals, but also fight the broader economic disruption caused by the virus.

Such programmes are intended to help alleviate small-scale business stress and bolster economic growth.

Elizabeth Byrs, a WFP representative, said more than 3.8 million people, mainly working in the informal sector, already face losing their jobs amid rising hardship in Nigeria.

Meanwhile, analysts maintain that the support measures introduced so far have not made the desired difference in the lives of citizens.

‘The donations made by individuals, corporate organisation and developed countries are yet to be accounted for,’ said Azu Osumili, a radio journalist and political analyst.

As a means of mitigating the impact of the Covid-19 pandemic, the federal government created a Special Public Work programme of 774,000 jobs for 1,000 youths in each of the 774 local government areas in the country.

According to Festus Keyamo, Minister of State for Labour and Employment, the jobs are expected to provide modest stipends for itinerant workers to undertake drainage digging and clearance, irrigation canals clearance, rural feeder road maintenance, traffic control and street cleaning.

One of the youths who is well informed about the proposed federal government job intervention, Israel Ukpong (not his real name), said he is still waiting for the commencement of the project as announced by the government.

Ukpong, who used to work in a factory in Ogun state, said he also lost his job when the foreign nationals who ran the company he worked for left Nigeria at the start of the pandemic.

He stated: ‘Even the money and food they promised didn’t get to me. As it is now, I have no stable source of income. I go about taking menial jobs. Riding okada (motorcycles) would have been good, but then okada have been banned.’

To worsen the situation, the federal government through the Nigerian Electricity Regulatory Commission, more than doubled the cost of electricity.

Different stakeholders and some former leaders have expressed disgust and resentment at what they described as the insensitive hike in electricity tariffs and fuel pump price, saying that the increments are ill-timed and disregards the challenges currently faced by Nigerians.

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Lockdown is real killer in Africa

At the last count, Covid-19 had infected 35 million people worldwide, leaving more than a million dead.

Not since the Spanish flu of the early 20th century has the world witnessed such a rapid death toll from a viral disease.

In the 1918 Spanish influenza pandemic, more than 500 million people were infected worldwide, with 50 million deaths.

Global organisations and governments initially responded to the Covid-19 pandemic by calling on people to wash their hands and use social distancing to limit the spread of the viral infection.

The use of one subsequent measure of control – lockdown – has become very controversial, especially in Africa.

Total lockdown involves enforcing complete limitation of movement, and asking people to stay indoors for a minimum of two weeks – the presumed incubation period of the disease.

The aim is that the transmission chain of the disease would be broken, ultimately bringing it under control.

People have, however, questioned the wisdom behind such drastic measures, regarding it as panicky if not downright dangerous – not least because Africa and most of its 1.35 billion people are very disadvantaged.

According to a 2018 report by the United Nations, Africa was home to some 70 per cent of the world’s poorest people, with about 422 million – or one in three people in Africa – living below poverty line.

That’s nearly half a billion people living on less than $1.90 a day.

The effects of total lockdown will play out subtly in Africa. Many African children die before their first birthday, with 27 per cent of children not seeing out their first year in 2019.

Depressingly, the lockdowns may worsen this.

A study by one US charity predicted there would be an additional 2.3 million child deaths due to the disruption of health services during the lockdown this year.

Women have not been able to take their children to clinics for immunizations against neonatal tetanus, tuberculosis (TB), whooping cough and other antigens, all of which remain serious childhood killers in most communities in Africa.

An analysis by the World Health Organization (WHO) projected a resurgence of these childhood killers, and an extra 200,000 fatalities from TB alone because of disruptions to healthcare caused by the pandemic.

Access to anti-retroviral therapy has also been affected, according to the WHO.

There has also been a disruption in vital drug supplies because of lockdowns. It is predicted that this disruption could also lead to half a million deaths from Aids-related illnesses alone.

To make matters worse, it could also lead to drug resistance. This means that even after the lockdown has ended, Aids patients might no longer respond to the drugs used for their routine treatment, leading to complications from the disease and eventually death.

There are also serious concerns about how a disruption to the supply of mosquito nets and antimalarial drugs could be negatively impacting the fight against malaria in Africa, with several countries reporting rises in malaria deaths during the pandemic.

In Africa, it has become a tradition to use insecticide-treated bed nets against mosquito bites. Any disruption to their supply will cause deaths to rise.

According to World Malaria Report, 228 million cases of malaria occurred worldwide in 2018, leading to 405,000 deaths.

It is estimated that Africa accounted for 94 per cent of total global mortalities.

Apart from deaths, much of the poverty in Africa has been attribute to malaria, which is estimated to result in loses of about $12 billion a year from increased healthcare costs, reduced productivity and a decrease in tourism in African countries.

Malaria is also a serious contributor to infant mortality in Africa. It has been shown to cause abortions and still births, leading to some 200,000 infant deaths a year.

But it’s not just other diseases that are on the rise. Maternal health has also been severely affected during the lockdown.

Even in the US, where maternal mortality is low, it is known that maternity wards in some health facilities were converted to accommodate Covid-19 patients.

There were also offers of induced labour to get women in and out of hospitals as quickly as possible to limit exposure to infection with the virus.

Maternal health, meanwhile, has taken a deadly turn for the worse in Africa, where services have been less accessible and less affordable for millions of women in dire need of help.

A study in the medical journal The Lancet estimated there may be more than 12,000 extra maternal deaths in Africa because of the pandemic.

The predictions for neonatal deaths are even more staggering. According to the Johns Hopkins Bloomberg School of Public Health, anywhere between a quarter of a million and 1.1 million children might die because of problems created during the pandemic.

If true, it would echo the Ebola epidemic in West Africa, when, between 2014 and 2016, the use of maternal and neonatal services dropped so much, the rise in maternal deaths, neonatal deaths and stillbirths outnumbered the deaths caused directly by Ebola.

Moreover, a study by UN Women revealed that women faced a higher risk of gender-based violence because of Covid-19 lockdowns.

Cases of domestic violence, particularly against women and girls, as well as rape and sexual assaults, have increased in many countries around the world, including Nigeria, where an increase in health, financial and security worries are thought to have created tensions in confined, crowded households. 

There is an even more serious angle to this grotesque story: mass unemployment.

A vast number of Africans are not engaged in formal paid employment and rely on piece-meal work on farms, factories or construction sites, or in other unstable roles such as cobbling, wheelbarrow pushing or petty trading. According to World Bank reports, informal workers, most of whom are women, are responsible for more than 90 per cent of the workforce in sub-Saharan Africa.

Lockdowns have ensured that this crucial way of living is severely disrupted, resulting in hunger, malnutrition, frustration and despondency.

With so much disadvantage, many think the decision by governments to apply total lockdowns may have been misplaced.

They may be right. Nigeria, the most populous country in Africa, has recorded less than 60,000 cases of Covid-19 and just over 1,100 deaths in a country of up to 200 million people.

The hunger, starvation, malnutrition and deaths caused by the lockdown on such a large population may not be easy to track.

But it is easy to assume that many more people could have been killed by lockdown-induced poverty than the number attributed to the virus.

It may be easy to blame governments for taking hasty decisions on the lockdown issue. If truth be told, they may have been panicked into lockdowns.

The World Health Organization predicted 10 million cases within the first six months of occurrence of the disease, and cited the prospect of Africa’s fragile health systems being overwhelmed by the number of expected deaths.

Without emergency aid, other United Nations experts said, there could be 1.2 billion cases worldwide within six months and 3.3 million deaths.

With these loud predictions, many advanced countries went for a total lockdown, and predictably, many African countries followed suit.

But while the advanced countries may be able to pay their citizens not to work, African countries cannot afford such luxuries, and have been left in the lurch.

It is not so easy to correct the trajectory when dealing with a disease that has successfully defeated many expert predictions.

But we are now left to wonder how much sense there was in the total lockdown.

We are also left to ask whether in blindly following the lockdown route, African governments did not end up shooting themselves – and us – in the foot.

 

 

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