One size does not fit all: adapt and localise for effective, proportionate and equitable responses to COVID-19 in Africa

Drawing on knowledge exchange webinars run collaboratively between the Africa Centres for Disease Control and the Social Science in Humanitarian Action Platform in 2020, this publication considers positive examples of adaption that have emerged during COVID-19. The heterogeneous epidemiological picture for COVID-19 in Africa continues to generate debate. Modelling projections raise speculation about the phases and trends of SARS-CoV-2 outbreaks across the continent and how these differ from outbreaks elsewhere. Continental efforts drew praise in the first wave of COVID-19, and success has been linked to African experience of epidemics and to decisive leadership. Yet the tendency at the outset of the pandemic with initial responses to the threat of COVID-19 was for African governments to look to standard models emphasising central control, following the WHO and partly mirroring the stringent restrictions as already deployed in Asia and Europe. This scenario highlights the problems of generic approaches to response given very different settings in which a pandemic unfolds, suggesting that further attention should have been paid by decision makers to significant adaptation to African realities from the start. 

This paper contends that a critical part of adaptation and proportionality is a localisation of response that builds on people’s own inventiveness and the knowledge and experience of local organisations. The authors present a preliminary typology of important domains for localisation of public health and social measures, with a focus on interventions to protect people who are vulnerable—socially, economically, politically and also biologically, and call for acknowledgement of the importance of local-level responses and the need to support these and for the establishment of fora to share learning about adaptation and effective models. Streamlined funding mechanisms that allow for rapid flow of resources to support initiatives ‘from below’ also need to be strengthened.