Dear Elisabeth.

Your post on what constitutes the risk factors for the coronavirus in Africa in reference to the Africa Centre remain true today, 4 months after the first COVID cases were recorded in Africa. High levels of poverty, crowded urban settlements especially informal settlements, and a weak health system remain the biggest challenge and fear to overcome the impact and effect of the COVID pandemic in many African countries. 

However, and to a certain degree, it remains a mystery how slowly the pandemic has spread within the African population. With earlier predictions (despite Africa's quick response) stating that the peak in many African countries would occur around April to early May. The majority of African countries in the beginning of the pandemic implemented preventive measures such as lockdowns,  mandatory quarantine for International travelers. Mandatory wash facilities and sanitizing stations we're enforced for the service industry and the wearing of masks was also made mandatory. 

See here the current number of COVID cases on the African continent:  africacdc.org/covid-19/

EXTRACT:

Zambia which in the recent past (2017 to 2018) had overcome the worst cholera pandemic in recent years,  was quick to replicate measures learned from its cholera response. while countries like Senegal and the Democratic Republic of Congo (DRC) also employed measures learned from the Ebola pandemic. Senegal recently made global headlines for the development of a quick testing kit for the coronavirus.

Based on how slowly the pandemic has progressed within African countries in comparison to Western countries, the general population in Africa has begun to relax measures, including lifting lockdowns, reopening schools, and churches.  Too soon we may ask? Will this change in approach have negative implications in keeping the numbers low? Many say that this was facilitated by the need to safeguard already crippled African economies.  With the economic effects of the COVID pandemic negatively affecting the achievement of the SDGs, including SDG 6. Ensure availability and sustainable management of water and sanitation for all.

See here an article on the effects of COVID on achieving the SDGs: www.thethirdpole.net/2020/04/28/pandemic...ater-and-sanitation/

EXTRACT:

This will have a direct impact on the pursuit of the Sustainable Development Goals (SDG) that the world pledged to in 2015, as most of the people who need to climb out of poverty live in developing countries. The UN had declared 2020-2030 as the ‘Decade of Action’, but the pandemic might undermine this. Though it is supposed to bring countries together to cooperate with one another and to strive for sustainable global development, that is yet to be seen. At the same time the fear of global economic recession has raised serious questions over the future implementation of the SDGs.

Regards,
Chaiwe

Dear Elisabeth,
Thank you for highlighting this. Since the first Kenyan incident on COVID-19 which was on 12^th March 2020, much of the risk factors that have been highlighted here have come to play:-The first record came from someone who had had International Exposure and did not undergo any self-quarantine or isolation.
-Majority of the cases, have been in the densely population urban towns (i.e. Nairobi and Mombasa). Cases that have been recorded in
smaller towns have been of people who have migrated from the said cities.
- Citizen cooperation with government guidance to mitigate the effects of the pandemic is closely tied to trust in the government. Initially the people would really follow the government directives. However, over time they are getting impatient and many people are moving around to fend for themselves.
-On May 26^th, the first COVID-19 case was discovered in Kakuma (refugee camp). Given that the risk factor (forced displacement) ranked high as written in the story, we are yet to see how this plays out. Fortunately, some individuals are taking it upon themselves to sensitize on the need to curb this disease. You can read this as captured by Al Jazeera.
Still hoping for the best as we wait and see.
Regards
Charlotte

I came across this page which I found very interesting: Mapping Risk Factors for the Spread of COVID-19 in Africa:  africacenter.org/spotlight/mapping-risk-...read-covid-19-africa
It was developed by the Africa Centre for Strategic Studies.

Much remains unknown about the  trajectory of the transmission  of COVID-19 in Africa. Many fear that with its high levels of poverty, weak health systems, and crowded urban areas, the virus could be particularly devastating. Others hope that with its warmer climate, youthful population, and experience fighting infectious disease, that Africa will be able to avoid the worst of the pandemic. This analysis provides a review of relative risk factors associated with the novel coronavirus as a means of generating potential insights into the varied and at times overlapping levels of vulnerability faced by each African country.

The risk factors that they have identified include: international exposure, health system, urban density, urban population, population age, government transparency, press freedom, conflict, displacement. 

Sanitation is related to many of them, in particular health system, urban density and urban population. But isn't it interesting that something like lack of press freedom is also a risk factor?

Regarding "urban population", the report states "Stay-at-home orders will be particularly difficult to maintain in African cities where many residents lack adequate shelter, sanitation, and the monetary means to stock up on supplies and to stop work."

Here an example of one their maps, showing the risk factor "density of urban areas":

Density of Urban Areas

They also did up a "Composite Chart of Risk Factors". Results:

• At the top, i.e. most at risk, are South Sudan, DRC Congo, Nigeria, Sudan, Cameroon, Egypt, Ethopia. 
• It put South Africa, Kenya, Zambia, Tanzania somewhere in the middle.
• Towards the bottom of the table, i.e. lower risk, are Malawi, Benin, Namibia, Botswana.

Regards,
Elisabeth