A new assessment by the World Health Organization (WHO) shows that only 14.2%, or one in seven, COVID-19 infections are being detected in Africa.

1. Six insevenCOVID-19infectionsgoundetectedinAfrica
14 October2021
Brazzaville,14October2021 – A newassessmentbythe WorldHealthOrganization(WHO) shows
that only14.2% – or one in seven –COVID-19 infectionsare beingdetectedinAfrica.To reverse that
trendand curb transmission,the WHORegional Office forAfricatodayannouncedanew initiativeto
enhance communityscreeningforCOVID-19ineightcountries.The programme aimstoreachmore
than 7 millionpeople withrapiddiagnostictests inthe nextyear.
The WHO analysisusedthe COVID-19calculatordevelopedbyResolve toSave Liveswhichestimates
infectionsbasedonreportednumberof casesanddeathsandan infectionfatalityrate groundedin
population-basedstudies.Itfoundthatasof 10 October2021 the cumulative numberof COVID-19
infectionsisestimatedtobe 59 millioninAfrica,whichisseventimesmore thanthe over8 million
casesreported.
To date,COVID-19detectioninAfricahasfocusedonpeople reportingtohealthfacilitieswith
symptoms,inadditiontotestingarrivinganddepartinginternationaltravellers,leadingtolarge-scale
under-reportinggiventhe highpercentage of asymptomaticcasesonthe continent.
Since the start of the pandemicandas of 10 October,more than 70 millionCOVID-19testshave
beenreportedbyAfricancountries,whichisafractionof the continent’s1.3billionpeople.By
contrast,the UnitedStates,withabouta thirdof the population,hasreportedlyadministeredover
550 milliontests, while the UnitedKingdom,withlessthan10% of the populationof Africa,has
administeredover280 milliontests.
“With limitedtesting,we’re still flyingblindinfartoomanycommunitiesinAfrica.Mosttestsare
carriedout on people withsymptoms,butmuchof the transmissionisdrivenbyasymptomatic
people,sowhatwe see couldjustbe the tipof the iceberg.Testnumbershave beenrisinginAfrica,
but thiscommunity-basedinitiative isaradicallynew approachwhichshouldhelpsignificantlyraise
detectionrates.More testingmeansrapidisolation,lesstransmissionandmore livessavedthrough
targetedaction,”saidDr MatshidisoMoeti,WHORegional DirectorforAfrica.“
The countriesparticipatinginthe programme are Burundi,Cote d’Ivoire,DemocraticRepublicof the
Congo,Guinea-Bissau,Mozambique,Republicof the Congo,Senegal andZambia.Tokickoff
implementation,WHOhasdisbursedUS$1.8 milliontothe eightcountries.WHOwill support
countriestointerruptdisease transmission,throughactive case findingbydeployingteamsinlocal
communitiestoseekoutpossible contactsof people whohave testedpositive forCOVID-19and
offerantigenrapiddiagnostictests.
The initiative will use a“ringstrategy”,whichwaspioneeredsuccessfullyinthe eradicationof
smallpox inthe latterhalf of the 20th centuryto vaccinate people whoare mostlikelytobe infected,
and duringthe recentEbolaoutbreaksinWestAfricaand inthe DemocraticRepublicof the Congo.
The ring approachwill target people livinginsideacircle of 100 metresradiusaroundeachnew
confirmedcase topreventfurtherspreadof the disease.
In addition,eachhouseholdwithinthe 100 metresradiuswill receivehygiene kitsincludingface
masksand handsanitizersandanyone whotestspositivewillbe assessedforthe severityof their
conditiontodetermine whethertheyshouldreceive home-basedcare orneedtobe transferredto
designatedCOVID-19treatmentcentres.

2. The programme aimsto increase the testingcapacityineachparticipatingcountryby40%, ensuring
theyreach the WHO recommendedbenchmarkof 10 testsperformedper10 000 people weekly.
Currently,around20 countries – more than a thirdof Africancountries –do not reachthis
benchmark
All testingwill be carriedoutona voluntarybasisandwill be conductedusingWHO-approved
antigenbasedrapiddiagnostictests,whichcanproduce resultson-site inaslittle as15 minutesand
can be administeredwithminimaltraining.Rapiddiagnostictestsare considered highlyaccurate for
detectinginfectionsthathave reachedthe transmissiblestage.Currently,mostcountriescarryout
polymerase chainreactionorPCRtests,whichrequire reagentsandexperts,andare significantly
more time-consumingandexpensive than rapiddiagnostictests.
There have nowbeenover8.4 millionCOVID-19casesrecordedinAfrica,including214 000 deaths.
Despite adecline incase numbersinrecentweeks,vaccinationratesremainlow,withonly30% of
the continent’s54 nationshavingfullyvaccinated10% of theirpopulationagainstthe disease—
comparedwithalmost90% of high-incomecountries.Meanwhile,justunderhalf of the African
countriesthathave receivedCOVID-19vaccineshave fullyvaccinatedjust2% or lessof their
populations.
In the absence of enoughvaccines,amore proactive communitytestingeffortisespecially
importantforreducingtransmissioninAfricancountrieswhere arelativelyyouthfulpopulationis
contributingtoa highrate of asymptomaticinfections.Estimatesshow thatbetween65% and85%
of COVID-19infectionsinAfricagenerate few ornosymptoms.Asaresult,mostAfricansinfected
withthe disease donotseekouttreatmentinlocal healthfacilitieswhere mosttestingnow occurs.
Yet,asymptomaticindividualsare playingakeyrole infacilitatingtransmissiontovulnerable
individualswhocansufferseveredisease ordeath.
“PublichealthauthoritiesinAfricahave sofarbeenrightlyfocusedonmanagingthe casescoming
intotreatmentcentresandhospitals,”DrMoeti said.“But now isthe time togo on the offensive
againstCOVID-19,and workwithlocal communitiestobreaktransmissionchainsandstopwider
outbreaksfromhappening.”
Dr Moeti spoke duringavirtual pressconference todayfacilitatedby APOGroup.She wasjoinedby
Dr AlyNgonTambdou,DeputyChief Medical Officer,DakarHealthRegion,Senegal,andDrNgozi
EronduSeniorScholar,O'Neill Institute,GeorgetownUniversityandAssociate Fellow,Chatham
House Global HealthProgramme.
Alsoonhand to respondtoquestionswere DrRichardMihigo,Coordinator,Immunizationand
VaccinesDevelopmentProgramme,WHORegional Office forAfrica,DrFionaBraka, TeamLead,
EmergencyOperations,WHORegional Office forAfricaandDrThiernoBalde, Regional COVID-19
DeputyIncidentManager,WHORegional Office forAfrica.