The World Health Organization (WHO) today called for greater access to COVID-19 detection, testing and care among vulnerable populations grappling with the impacts of protracted conflict and humanitarian emergencies across Africa.

Sub-Saharan Africa is home to over 26% of the world’s refugees. Long-running conflicts in regions like the Sahel have led to the closure of health facilities and the flight of health workers. In Burkina Faso, 110 health facilities have been closed due to insecurity while services have been impaired in 186 others, leaving around 1.5 million people without adequate health care. In Mali’s central and northern regions, health services have been paralysed by persistent attacks. In 2019 alone, 18 attacks on health facilities were reported. So far this year, one health centre has been attacked.

“COVID-19 has exacerbated existing humanitarian challenges, particularly with regards to access to health services in many countries in the region,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “With the pandemic we have seen some humanitarian operations delayed due to lockdowns, curfews and the restrictions of movement for both personnel and cargo vital for COVID-19 response.”

Crowded settings such as displacement camps can heighten the risk of COVID-19 transmission due to difficult access to clean water, leading to inadequate hygiene, and where physical distancing is almost impossible.

The United Nations system has activated health clusters in eight countries where the humanitarian situation requires support from the international community, including Burkina Faso, Central African Republic, Chad, Democratic Republic of the Congo, Ethiopia, Mali, Niger and South Sudan. Although information on COVID-19 transmission in humanitarian settings remains limited so far, about 1800 COVID-19 cases have been reported in seven of these countries among the displaced, refugees, migrants or in areas affected by humanitarian crises. Due to the limited detection and testing capacity, the number is likely to be an under-estimate.

“WHO urges the humanitarian community and Member States to increase support to the millions of people in dire need of assistance in the region. If we don’t step up health services, including testing, tracing, isolation and care for people already living in precarious settings and displacement camps, COVID-19 could spark untold tragedy,” said Dr Moeti.

WHO has developed guidance on adapting COVID-19 mitigation in camp or camp-like settings, recommending health screenings for people arriving at collective sites and temporary isolation centres for suspected cases. WHO advises that activities like food distribution or education be adjusted to limit mass gatherings and strengthen infection prevention and control.

WHO is working with the United Nations Office for the Coordination of Humanitarian Affairs, the UN Refugee Agency (UNHCR) and other operational partners to raise awareness about COVID-19 among vulnerable populations, distribute medical supplies and implement preventive measures such as handwashing stations. Efforts are also underway to strengthen surveillance, train health workers, establish telehealth centres, and test and care for people who contract the disease.

The United Nations is implementing the Global Humanitarian Response Plan for COVID-19 to fight the pandemic in countries facing humanitarian situations. The plan identifies ways to address the immediate health and non-health needs related to COVID-19 for the most vulnerable populations through health, water, sanitation, hygiene, food and agriculture, logistics, education and protection. Of the 63 countries covered by the plan, 20 are in Africa.

Together with the World Economic Forum, WHO held a virtual press conference today with Dr Moeti; Hon Dr Pierre Somse, Minister of Health and Population, Central African Republic; Patrick Youssef, Regional Director, Africa, International Committee of the Red Cross; and Adhieu Achuil Dhieu Kueth, South Sudanese refugee from Dadaab camp in Kenya.