A recent continental study by Partnership for Evidence-based Response to Covid-19 (PERC) has praised many Africa countries for waging an effective campaign to combat the spread of coronavirus despite their reputation for having fragile state health systems.

The continent, which has a population of more than one billion, has had about 1.5 million cases, according to data compiled by the John Hopkins University.

These figures are far lower than those in Europe, Asia or the Americas, with reported cases continuing to decline.

Africa has recorded about 37,000 deaths, compared with roughly 580,000 in the Americas, 230,000 in Europe, and 205,000 in Asia.

“The case-fatality ratio (CFR) for Covid-19 in Africa is lower than the global CFR, suggesting the outcomes have been less severe among African populations,” noted a recent continental study by Partnership for Evidence-based Response to Covid-19 (PERC), which brings together a number of private and public organisations.

Low testing rates continue to undermine the continental response however, there is no indication that a large number of Covid-19 deaths have been missed, said Dr John Nkengasong, the head of Africa Centres for Disease Control and Prevention (Africa CDC).

So what are some of the reasons for Africa’s relatively low death rate?

Quick action – The first case on the continent was confirmed in Egypt on 14 February. There were fears that the new virus could quickly overwhelm largely fragile health systems on the continent.

So, right from the beginning, most African governments took drastic measures to try and slow the spread of the virus. Public health measures – including avoiding handshakes, frequent hand-washing, social distancing, wearing of face masks, school closures and nationwide lockdown measures – were swiftly introduced.

Some countries – like Lesotho – acted even before a single case was reported.

Public support – In a survey conducted in 18 countries in August by PERC, public support for safety measures was high – 85% of respondents said they wore masks in the previous week.

“With strict public health and social measures implemented, African Union member states were able to contain the virus between March and May,” the report said.

It added that “minor loosening [of restrictions] in June and July coincided with an increase in the reported cases across the continent”.

Young population – and few old-age homes: The age of the population in most African countries is also likely to have played a role in containing the spread of Covid-19.

Globally, most of those who have died have been aged over 80, while Africa is home to the world’s youngest population with a median age of 19 years, according to UN data.

Favourable climate – A study conducted by researchers in the University of Maryland in the US found a correlation between temperature, humidity and latitude, and the spread of Covid-19.

Good community health systems – The Covid-19 pandemic came at a time when the Democratic Republic of Congo was dealing with its biggest outbreak of Ebola yet. Neighbouring states were on high alert, and the health screening of travellers for Ebola was extended to include Covid-19.