COVID-19 risk factors: The curious case of Africa's governance and preparedness

COVID-19 is now established in Africa, and requires appropriate prioritization of resources and customized control measures. Although there have been lower than predicted number of COVID-19 cases (6,839,159 (3.4% of global cases)) and fatalities (172,413 (4.1% of cases in Africa)) compared to global estimates from other regions, as of 3rd August 2021. The World Health Organization (WHO) has warned that poor mitigation strategies could worsen the current situation in African countries. Several aspects have been attributed to the lower COVID-19 magnitude observed in Africa that include: warmer climate, a youthful population, and previous experience in managing infectious diseases. However, the level of COVID-19 risk of exposure and vulnerability to develop complications varies greatly across the continent. At present, most COVID-19 disease trajectories have been predicted using mathematical models focused solely on demographic factors. We compared the global health security and governance indices in forty-one African countries, with a population of more than 2.5 million, and matched these to the magnitude of COVID-19 burden, to establish whether there is correlation. These findings suggests that more accurate comparisons of responses to COVID-19 can only be made within clusters of African countries that share similar governance and preparedness standards. We conclude that proper implementation of the continental framework on disaster preparedness and management is required for management of the COVID-19 pandemic.