"South Africa currently has the fifth-highest number of confirmed cases in the world and accounts for over half of Africa's confirmed cases. This could testify to a broader spread of the disease across the continent," Masauso said, pointing to Kenya and Ethiopia, both of which have reported record-high numbers of new cases over the past few days.
The reason why some African countries have significantly fewer confirmed cases than others could be due either to deliberate under-reporting or insufficient testing, the AHO head noted.
"While South Africa has the most cases, it is also doing the most tests. Earlier in July, South Africa was doing over 30 tests per 1,000 people, while Nigeria was doing 0.7 tests per 1,000 people, Ghana 10 and Kenya 3. Recent data shows that 80 percent of all testing in Africa is credited to 10 countries," Masauso noted.
Several other countries, including Tanzania and Guinea, have "purposely held back data," according to Masauso. While the health expert did not specify how much the real figure could differ from that officially reported, he suggested that the difference was most likely "significant."
As a case in point, Masauso cited some countries recently experiencing "a mysterious yet significant increase in 'natural deaths'" while reporting a low number of coronavirus cases.
"It took over three months for Africa to pass 100,000 cases, but less than three weeks for the number of cases to double. The vast majority of deaths — 70 percent — are confined to only five countries: South Africa, Algeria, Nigeria, Egypt, and Sudan. Infections are likely largely undetected," Masauso said.
The NGO chief voiced concern that COVID-19 was likely under-reported across the world.
With regard to Africa, in particular, he said shortcomings in accurate statistics by separate countries could hinder the continent's capacity to predict the peak of the outbreak and adequately prepare.
Africa to Face Pandemic Aftershock
Masauso said that the coronavirus pandemic is likely to leave Africa with grave economic and social implications that will require international assistance to avoid cancelling the continent's development over the past several years.
"When — or if — the pandemic ends, Africa will be faced with the aftershock. This could be any number of things, but we are currently seeing famine, noncommunicable diseases, and a lack of vaccination," Masauso said, adding that "In the long term, assistance will also be necessary for aiding economic recession and delivering the potential vaccine."
The AHO chief opined that the pandemic is undermining the continent's hard-won economic development over the past years.
"Efforts against poverty and development in the last decade can easily be undone by COVID-19. This is especially so for many countries that rely on tourism, which will take a long time to be restored to pre-pandemic levels," Masauso said.
Additionally, the NGO head fears that the coronavirus-compelled closure of schools could also set back recent education gains, especially for girls, which could threaten to refuel gender inequality.
There are also other needs of immediate urgency, according to Masauso, such as personal protection equipment and resources for increasing testing capacity, the lack of which is particularly concerning in the light of a recent upsurge of cases among medical workers, specifically in South Africa.
One way in which the NGO chief believes international financial institutions like the World Bank or the International Monetary Fund can alleviate the pandemic's pressure on struggling countries is by suspending debt payments until the economic shocks are mitigated.
Fears of Relapse of Common Diseases
Masauso also warned that the continuity of health services in Africa has been significantly undermined by the coronavirus pandemic, with the disruption of vaccination campaigns likely to revive outbreaks of common diseases like measles and polio.
"Noncommunicable disease prevention and treatment, HIV follow up, vaccination regimens, and natal care are all impacted by the pandemic. Like vaccination services, people may be unable or unwilling to get other health services," Masauso said, describing the impact on COVID-19 on health services as "deeply concerning."
The disruption of health services is thought to be due to a variety of reasons, according to the AHO head, including the fear of contracting the virus by both patients and medical workers, reasons why many hesitate to seek medical assistance and a downsizing in the operations of many medical facilities.
In countries like Kenya, which have imposed a coronavirus-related curfew, Masauso said there were reported drops in night-time admissions at hospitals. In Nigeria, as another cited example, many private clinics have closed due to a lack of protective gear. Additionally, he said many were fearing the stigma in the eyes of neighbors and family associated with being diagnosed with COVID-19, or of having to move to isolation centers.
The health expert voiced particular concerns about the disruptions that COVID-19 has caused for vaccination campaigns against measles, polio, malaria and other preexisting common diseases.
"Vaccinations for children have already been declining since the beginning of the year in countries like Congo [...] The case for polio is particularly concerning; mass vaccination campaigns have been put on hold for coronavirus," Masauso said, adding that Niger had recently experienced a "mini polio outbreak" in April.
Overall, the NGO chief's estimate is that close to 30 measles vaccination campaigns are at risk of being cancelled worldwide due to the COVID-19 pandemic, with low- and middle-income countries at bigger risk.
The latest WHO figures show that Africa is the world's second-least affected region, next to the western Pacific, with a little over 726,000 confirmed cases and 12,257 fatalities. The spread of the infection has recently notably accelerated, however, as the number of cases and deaths almost tripled in just one month since late June.
The global number of coronavirus infections has meanwhile topped 16.3 million, while the death toll has reached at least 650,805, according to the World Health Organization.
