What have previous flu-like pandemics looked like in Africa?

It occurred to me today that I hadn’t heard much about how previous flu-like pandemics have impacted African countries.  Being a geographer at heart, I thought I’d look up some maps.  I’m not an epidemiologist and am not making any predictions about how prior patterns of disease spread might replicate with the novel coronavirus / COVID-19.

I started with Wikipedia’s list of 20th and 21st century flu pandemics, and added seasonal influenza and severe acute respiratory syndrome (SARS), which isn’t the same as the flu.  Let’s work backwards in time, since air travel has become much less expensive and more common since the 1980s, and this really changes the modality by which disease can spread between countries.

The three post-1980 epidemics are coronavirus (2020), H1N1 / swine flu (2009), and SARS (2003).  Despite their weak health systems, African countries have not been highly affected by coronavirus to date.  Transmission of H1N1 was also fairly limited, and transmission of SARS appears to have been almost non-existent.  There’s a lot of debate about why coronavirus hasn’t spread, but two possibilities are the continent’s relatively weak air traffic links to other regions, and improvements in public health surveillance capability since 2000.

Coronavirus / COVID-19 (as of 12 March 2020)

Map showing that the outbreak is concentrated in China, Iran, Italy and the US
Source: Foreign Policy

H1N1 / swine flu (2009)

1280px-H1N1_map_by_confirmed_cases.svgScreen Shot 2020-03-14 at 10.02.32

Screen Shot 2020-03-14 at 10.02.45
Source: Wikipedia
110620383_spread_of_sars_640_v2-nc
Source: The Globalist

The pattern does look different for the seasonal flu.  Unlike temperate climates, where flu actually is seasonal, flu cases are reported year-round in many African countries.  Surveillance data on the flu in African countries is relatively weak and there are few country-specific flu vaccines available.  It’s possible that cases of the flu are often misdiagnosed as malaria, which is also highly prevalent.

Seasonal flu (2011 – 2016)

Global-maps-of-monthly-influenza-activity-2011-2016
Source: Newman et al. (2018)

Let’s look at the pre-1980 epidemics now.  These include outbreaks of H1N1 / Russian flu (1977), H3N2 / Hong Kong flu (1968), H2N2 / Asian flu (1957), and H1N1 / Spanish flu (1918).  I couldn’t find a good map for the Russian flu.  For the other epidemics, I could only find maps tracing the path of the outbreak, rather than displaying the number of cases.

The 1968 Hong Kong flu looks fairly similar to the transmission path for coronavirus, in that Latin America and Africa seem to have been minimally affected.  However, the 1957 Asian flu and the 1918 Spanish flu did impact Africa.  I’m not sure about the mechanism by which the 1957 flu spread, but in 1918 the flu was spread by some of the two million African soldiers who returned home after being forced to fight for their colonizers during WWI.  African countries had some of the highest mortality rates in the pandemic, with 2% of all Africans dying of the flu in only six months.

hong kong flu
Source: Rybicki (2015), via Twitter
Asian_Flu_Map-large
Source: Johns Hopkins School of Public Health

H1N1 / Spanish flu (1918)

spanish flu
Source: Thinglink

There are many reasons why we can’t conclude very much about the spread of the novel coronavirus in Africa based on patterns of previous outbreaks.  Transportation patterns, public health capacity, and the nature of the disease itself are all different for each pandemic.  It’s still important for African countries to continue preparing their health systems for a more widespread coronavirus outbreak.

Interesting academic articles for February 2020

Here’s what I’m looking forward to reading this month!

Kobina Aidoo and Ryan Briggs.  2019.  “Underpowered: Rolling blackouts in Africa disproportionately hurt the poor.”  African Studies Review.

Electricity demand exceeds supply in many parts of Africa, and this often results in rolling blackouts. This article argues that blackouts tend to concentrate on poorer places within countries, due to both economic and political factors. This argument is tested with an analysis of electricity availability across thirty-two neighborhoods in Accra and survey data from thirty-six African countries. Across these analyses, poorer people with a grid connection experience lower electricity supply than richer people. This article concludes by discussing implications for research on electricity availability, policymakers working on energy, and the distributive politics literature.

J. Andrew Harris, Catherine Kamindo, and Peter Van der Windt.  2020.  “Electoral Administration in Fledgling Democracies: Experimental Evidence from Kenya.”  Journal of Politics.

We examine the effects of national voter registration policies on voting patterns with a large-scale experimental study. Together with Kenya’s electoral commission, we designed an experiment in which 1,674 communities were randomized to a status quo or treatment group, receiving civic education on voter registration, SMS reminders about registration opportunities, and/or local registration visits by election commission staff. We find little evidence that civic education improves registration. Local registration visits improve voter registration, a relationship that increases in poorer communities. Moreover, local registration increased electoral competition and vote preference diversity in down-ballot contests in the 2017 Kenyan elections. Our results suggest that status quo voter registration policies constrain political participation and competition, and that inexpensive policy changes may attenuate the effects of such constraints.

Jeremie Gross, Catherine Guirkinger, and Jean-Philippe Platteau.  2020.  “Buy As You Need: Nutrition and Food Storage Imperfections.” Journal of Development Economics.

In this paper, we investigate whether and how a more steady supply of foodgrain in local markets impacts the nutritional status (measured with body-mass-indexes) of both children and adults, in a context characterized by large seasonal fluctuations in the price and availability of foodgrain. Taking advantage of the random scaling-up of a program of Food Security Granaries in Burkina Faso, we reach three conclusions. First, especially in remote areas where local markets are thin, the program considerably dampens nutritional stress. The effect is strongest among children, and young children in particular, for whom deficient nutrition has devastating long-term consequences. Second we argue that it is a change in the timing of food purchases, translated into a change in the timing of consumption, that drives the nutritional improvement. A simple two-period model shows that, once we account for various forms of storage costs, an increase in nutrition does not necessarily require larger quantity of food purchases or even consumption. Our last and unexpected conclusion is that the losses associated with foodgrain storage do not stem from physical losses in household granaries but rather from inefficient seasonal bodymass fluctuations. One plausible mechanism behind this particular storage imperfection rests on the households’ urge to consume readily available foodgrain.

Moses Khisa.  2020.  “Politicisation and Professionalisation: The Progress and Perils of Civil-Military Transformation in Museveni’s Uganda.”  Civil Wars.  

Problems of civil-military relations have been at the centre of recurring political crises in contemporary Africa. Routine military intrusion in politics characterised the first four decades of independent Africa. Citizens suffered at the hands of the armed forces, infamous for widespread human rights violations. One key response to this dual civil-military problem was to pursue a strategy of politicising the armed forces in order to make them a) subordinate to civilian authority and b) organically close to the public and protective than predatory. This also entailed the militarisation of politics ostensibly to bring the political class into closer conversation and collaboration with the military. To what extent did this strategy contribute to transforming civil-military relations? Taking the Ugandan case, this article argues that transformation was attained in making the military more respectful of citizens’ rights while simultaneously creating a fusion with the ruling class thereby subverting the very goal of professionalism.

Josephine Ahikire and Amon A. Mwiine.  2020.  “Gender equitable change and the place of informal networks in Uganda’s legislative policy reforms.”  Effective States in International Development working paper #134.

Uganda has had an uneven history and experience around gender equity policy reforms, particularly, from the late 1980s and early 1990s to-date. These range from the countrywide constitutional review processes of the early 1990s, legislative activism and reforms around domestic relations, land/property rights, and women’s access to public position, to mention but a few. While some of these gender reforms (commonly promoted through women’s collective mobilisation) were successful, other legislative initiatives faced intense resistance. This paper compares three policy cases – the 1997 Universal Primary Education policy, the 1998 legislative reform around spousal co-ownership of land and the 2010 Domestic Violence Act. Drawing on feminist institutionalism, the paper explores how gender norms operate within institutions (both formal and informal) and how institutional processes construct, reproduce or challenge gender power dynamics in policy reforms. The paper examines the place of informal networks and raises critical questions regarding ways in which women emerge as critical actors in securing and consolidating gender change, the strategies they draw upon to negotiate resistance, and whether the nature of policy reform influences the kind of resistance and (in effect) counterstrategies used to negotiate resistance to gender change. We also assess the implications these legislative processes have for activism around gender equity reforms. Findings indicate creative ways through which women draw on informal networks and networking practices to influence gender equitable change, often revealing the micro, subtly gendered dynamics that animate success or failure of a particular policy reform. We argue that the nature of policy reform, e.g. gender status policies or doctrinal policies, determines the nature and process of policy adoption.

Eric Mvukiyehe and Peter van der Windt.  2020.  “Assessing the Longer Term Impact of Community-Driven Development Programs: Evidence from a Field Experiment in the Democratic Republic of Congo.”  World Bank Policy Research working paper #9140.

Community-driven development programs are a popular model for service delivery and socioeconomic development, especially in countries reeling from civil strife. Despite their popularity, the evidence on their impact is mixed at best. Most studies thus far are based on data collected during, or shortly after, program implementation. Community-driven development’s theory of change, however, allows for a longer time frame for program exposure to produce impact. This study examines the longer term impact of a randomized community-driven development program implemented in 1,250 villages in Eastern Democratic Republic of Congo between 2007 and 2012. The study team returned to these villages in 2015, eight years after the onset of the program. The study finds evidence of the physical endurance of infrastructure built by the program. However, it finds no evidence that the program had an impact on other dimensions of service provision, health, education, economic welfare, women’s empowerment, governance, and social cohesion. These findings suggest that, although community-driven development programs may effectively deliver public infrastructure, longer term impacts on economic development and social transformation appear to be limited.

Cyril Brandt and Tom De Herdt.  2020.  “Reshaping the Reach of the State: The Politics of a Teacher Payment Reform in the DR Congo.”  Journal of Modern African Studies.

We analyse the politics of the reform of teacher payment modalities in the Democratic Republic of Congo (DRC) in light of the uneven territorial reach of the DRC state. The reform focused on extending this reach by paying all teachers via a bank account, replacing longstanding shared governance arrangements between state and faith-based organizations with a public-private partnership. By using qualitative and quantitative data, we map the political practices accompanying the implementation of the reform. While the reform itself was officially deemed a success, its intended effects were almost completely offset in rural areas. Moreover, governance of teacher payments was not rationalized but instead became even more complex and spatially differentiated. In sum, the reform has rendered governance processes more opaque and it deepened the existing unevenness in the geography of statehood.

Michel Thill and Abel Cimanuka.  2019.  “Governing local security in the eastern Congo: decentralization, police reform and interventions in the chieftaincy of Buhavu.”  Rift Valley Institute.  

In the Democratic Republic of the Congo (DRC or Congo), security governance is competitive, fragmented and marked by violence. Multiple actors—state and non-state—vie for influence and many areas of the country lack effective structures to ensure that their residents live in safety and security. In this context, the threat and use of violence has become central to the state’s efforts to maintain social control and public order. This tendency has come to shape the troubled relationship between Congolese citizens and the army and police, reflected in numerous fraught day-to-day interactions. Two ongoing processes— administrative decentralization and police reform—have been designed to turn a page on past practices, bring government and security closer to the population and, consequently, improve this relationship. While they have had some successes, they also risk the re-creation of existing governance dynamics within newly empowered local administrative and security-related entities.

Mary Hallward-Driemeier, Anna Kochanova, and Bob Rijkers.  2020.  “Does Democratization Promote Competition? Indonesian Manufacturing Pre and Post Suharto.”  World Bank Policy Research Group working paper #9112.  

Does democratization promote economic competition? This paper documents that the disruption of political connections associated with Suharto’s fall had a modest pro-competitive effect on Indonesian manufacturing industries in which his family had extensive business interests. Firms with connections to Suharto lost substantial market share following his resignation. Industries in which Suharto family firms had larger market share during his tenure exhibited weak improvements in broader measures of competition in the post-Suharto era relative to industries in which Suharto firms had not been important players.

Anne Buffardi, Samuel Sharp, Sierd Hadley and Rachel A. Archer.  2020.  “Measuring evidence-informed decision-making processes in low- and middle-income countries.”  Overseas Development Institute.

The evidence base on the practice of evidence-informed decision-making (EIDM) in international development is limited. Previous work has identified multiple roles that evidence could play; principles and desirable decision-making practices; and individual, interpersonal, organisational and contextual factors thought to influence the interpretation of evidence and decisions. Despite a proliferation of frameworks and guidance, there is a relative dearth of research on the extent to which and how they are applied in practice, at what cost and with what effects. EIDM faces measurement challenges, including investigation into largely undocumented and sometimes unobservable processes, multi-finality and equifinality (multiple pathways to multiple outcomes), often along extended time horizons, in addition to difficulties establishing counterfactuals. In the health sector, current indicators tend to cluster around two ends of a long change pathway: tracking upstream activities and immediate outputs, and downstream changes in health coverage and outcomes. Building on existing systems, future efforts could be directed at the ‘missing middle’ in measurement, filling notable gaps in defining what constitute quality EIDM processes, minimising biases in measuring these processes and investigating how evidence-informed recommendations make their way through the policy process.

Matteo Alpino and Eivind Moe Hammersmark.  2020.  “The Role of Historical Christian Missions in the Location of World Bank Aid in Africa.”  World Bank Policy Research Group working paper #9146.

This article documents a positive and sizable correlation between the location of historical Christian missions and the allocation of present-day World Bank aid at the grid-cell level in Africa. The correlation is robust to an extensive set of geographical and historical control variables that predict settlement of missions. The study finds no correlation with aid effectiveness, as measured by project ratings and survey-based development indicators. Mission areas display a different political aid cycle than other areas, whereby new projects are less likely to arrive in years with new presidents. Hence, political connections between mission areas and central governments could be one likely explanation for the correlation between missions and aid.

Abhishek Nagaraj and Scott Stern.  2020.  “The Economics of Maps.”  Journal of Economic Perspectives.  

For centuries, maps have codified the extent of human geographic knowledge and shaped discovery and economic decision-making. Economists across many fields, including urban economics, public finance, political economy, and economic geography, have long employed maps, yet have largely abstracted away from exploring the economic determinants and consequences of maps as a subject of independent study. In this essay, we first review and unify recent literature in a variety of different fields that highlights the economic and social consequences of maps, along with an overview of the modern geospatial industry. We then outline our economic framework in which a given map is the result of economic choices around map data and designs, resulting in variations in private and social returns to mapmaking. We highlight five important economic and institutional factors shaping mapmakers’ data and design choices. Our essay ends by proposing that economists pay more attention to the endogeneity of mapmaking and the resulting consequences for economic and social welfare.

Where did African countries get their names?

A map showing the literal translation of the name of every African country

Map of literal place names via Credit Card Compare

Quartz Africa recently had a good article on the unusual origins of many African country names.  A surprising number are colonial mishearings that stuck around.  Take Kenya:

Another mountain would yield a country’s name in East Africa, when the British came upon an imposing snow-capped mountain that the Kikuyu people called Kirinyaga (Where God dwells.) As they struggled to pronounce, Kirinyaga, they called it Mt. Kenya – the country would be named after this mountain.

Ever wonder why Mogadishu and Madagascar sound sort of similar?

Marco Polo, the 13th century Italian explorer, never visited Madagascar, but is believed to be responsible for mistaking it for Mogadishu and including it in his memoirs. This is the first written reference to Madageiscar. Thus, the corrupted Italian transliteration of Mogadishu, Madageiscar, eventually gave the world’s second largest island country its name.

But of course, others draw on more local history.

Zimbabwe would reclaim its name in 1979 just ahead of independence from the 13th-15th century kingdom of Zimbabwe, removing its colonial legacy name of Rhodesia, after Cecil Rhodes. … Ghana on its part would also reclaim its name at independence from the Ancient West African Kingdom of Ghana, after its British colonial legacy when it was known as the Gold Coast.

Africa Update for September 2019

Here’s the latest edition of my Africa Update newsletter.  We’ve got the Nigerian space program, trans-African highways, online therapy in Kenya, why the Sahara is bad for infant mortality, and more.

A long pier stretching out into the sea, viewed from aboveA stunning shot of Malindi pier by Peter Ndung’u

West Africa: In Cameroon, Anglophone separatists have been attacking children who attend government schools in an attempt to force the government to negotiate with them.  Political space is closing in Equatorial Guinea with the closure of a prominent human rights NGO.  Here’s a good background read on Equatorial Guinea’s oil-fueled politics.  In Nigeria, the descendants of enslaved people are still fighting for justice and social inclusion.  This was an interesting history of Nigeria’s space program.  Senegal’s sutura culture of privacy and modesty both constrains queer women and gives them space to pursue relationships.

Central Africa: Rwanda has lots of women in national decision-making positions, but their representation drops at more local levels of government.  In Uganda, paralegals are giving legal aid to trans people who have been arrested for not expressing a gender identity that matches their IDs.  Burundi has lost another independent media house with the forced closure of the BBC’s local bureau. The DRC’s dilapidated phone network briefly made it a hotspot for early mobile phone adoption in the 1990s.

A map showing that forced displacement in Africa is highest in Nigeria, Ethiopia, the DRC and SudanMap of forced displacement via the Africa Center

East Africa: This was an informative thread on the challenges of getting access to government IDs in Kenya.  In Nairobi, “informal housing” often includes multi-story apartment buildings, not just shacks.  One year after Eritrea’s peace agreement with Ethiopia, the borders are closed again and little domestic reform has occurred.  I didn’t know that one of Somalia’s major export products is dried lemons, mostly sent to the UAE for cleaning supplies.  Salaries for Somali army officers take up fully 20% of the country’s defense budget.

Southern Africa: South African has given women in customary marriages the right to inherit property.  Harare is running out of water.  3000 students in Mozambique are back in school after the government lifted a ban on pregnant people attending school.

3 trans african highwaysPerhaps one day we’ll be able to drive across the continent on completed highways (via Facts about Africa)

Economics: Six West African countries have committed to adopting a common currency, the eco, by 2020, but the underlying differences in their economies may make this difficult.  What can be done to get more investment flowing to local African entrepreneurs instead of expats?  This was an interesting long read about the state of the Nigerian banking sector.  Uganda’s high unemployment rates come from a lack of decent formal sector jobs, not low skilled job-seekers.  Here’s all you need to know about industrial policy in Kenya.

Health: In the DRC, high school students with Ebola have still found ways to take their final exams.  A corrupt procurement process left Kenyan hospitals saddled with expensive equipment they didn’t need, even as they were short of basic supplies.  Kenya’s national census is counting intersex people for the first time this year.  Wazi is a new online therapy program based in Kenya.  In Ghana, the national health insurance system is being undermined by the fact that the government rarely pays hospitals on time.  Less than half of Kampala’s toilet waste gets routed into water treatment facilities.

4 rose podcastRose Mutiso, Mawazo’s CEO, recording the introduction to the Nairobi Ideas Podcast

Environment: Check out the Mawazo Institute’s new Nairobi Ideas Podcast about African conservation leaders. Here’s how protecting Africa’s elephants could help to slow climate change.  These Kenyan activists successfully fought back against a plan to build a coal-fired power plant that the country didn’t really need.  Dust from the Sahara substantially increases infant mortality across West Africa, because small particulates damage babies’ lungs.

Arts + literature: Check out Dave Evans’ project to read one book from each African country this year.  African Storybook offers free downloads of kids’ books which are customizable in various African languages.  Don’t miss this new book on women’s activism in Africa.

An ad for the Macondo Literary Festival, which brings writers from Lusophone Africa and Brazil to Nairobi, from 27 - 29 SeptemberIf you’re in Nairobi later this month, don’t miss the Macondo Literary Festival!

Conferences + scholarships: Submit your papers on economics in Africa to the Centre for the Study of African Economies by October 18.  Here’s why all academic conferences should be in Ethiopia.  Apply to be a visiting fellow at the African Studies Centre Leiden.  The Ibrahim Leadership Fellowship gives young Africans the chance to work in various international organizations.  Chevening scholarships for MA study in the UK are open until November 5.  Female scientists in Africa should apply to Science by Women’s visiting fellows program in Spain by September 30.

Africa Update for July 2019

Here’s the latest edition of my Africa Update newsletter.  We’ve got the CAR’s only pediatric hospital, Zambian superheroes on Netflix, new books on medieval African history, the feminists of Cameroon, and more.

West Africa: Lagos alone accounts for 70% of Nigeria’s tax base.  Check out this reading list on Nigerian political history.  Here are 10 essential Nigerian recipes.  This was a great read about feminist organizing in response to the Anglophone crisis in Cameroon.  In response to increasing attacks by armed Islamist groups in Burkina Faso, the government has adopted a troubling policy of extrajudicially executing suspected sympathizers.

A map of protests in Africa, showing increased activity from 2007 to 2017
Protests in Africa, via ISS Africa

Central Africa: In the DRC, president Tshisekedi’s power continues to be constrained, with a majority of Cabinet seats going to ex-president Kabila’s coalition, and Kabila still living in the presidential villa. In Burundi, the ruling party has begun charging people a new “election tax” as often as they’d like to do so.

East Africa: This was a good profile of Hemedti, the former Janjaweed commandernow leading Sudan.  In South Sudan, decades of conflict has pushed most people away from growing their own food and towards purchasing it at markets.  I wrote about what traffic tickets can tell us about statebuilding in Kenya.  This was an interesting history of economic protectionism in Kenya.  A new Human Rights Watch report documents the disturbing record of extrajudicial killings by the Kenyan police.

lamu
A dhow off the coast of Kenya, by Khadija Farah

Southern Africa: So many Zimbabweans are trying to leave the country that the wait time for a passport is more than a year.  Netflix is launching its first original African animated series, about teenaged female superheroes living in Lusaka.  Congratulations to Botswana’s Gogontlejang Phaladi, who joined the ranks of great explorers by discovering a new body of water in Switzerland and naming it Letamo.

Public health: This is a remarkable story about the Central African Republic’s only pediatric hospital.  One of the coordinators of Liberia’s Ebola response team offers unconventional suggestions about incentivizing people to cooperate with Ebola vaccinators in the DRC.  The DRC is also one of the world’s largest quinine exporters, producing 30% of the world’s supply of the anti-malarial drug.  In South Africa, the urban environment in Johannesburg makes it difficult for women to get enough exercise.

aida muleneh
“Denkinesh: Part Two,” by Ethiopian photographer Aïda Muluneh

Research corner: Read about the challenging experience of being a female researcher in eastern DRC.  Check out TMC’s summer reading list on African politics, and this wonderful review of books on medieval African history.  Here’s what needed to improve the quality of research output at African universities.  Researchers in many African countries can get free online access to Taylor & Francis journals through their STAR program.  African students interested in a science PhD should apply to the RSIF PASET PhD scholarship program by July 22.

The arts: This is a great thread on affordable, contemporary architectural design across Africa.  Did you know that Bollywood films are huge in Somalia?  If you’re in Accra this summer, don’t miss the Accra Animation Film festival from July 27 – August 2.  African writers should apply to the Miles Morland writing fellowship by September 30.