Burundi’s swearing-in ceremony on June 30 for new ministers of the National Assembly was accompanied by a statement from newly elected President Évariste Ndayishimiye pledging renewed efforts to curb the spread of COVID-19 in the small East African nation. Among the new policies is a 50 percent reduction in the price of soap and reduced rates for drinking water in Burundi’s urban areas.
This is a marked change from his predecessor, Pierre Nkurunziza, who was much more blasé about the threat of the virus to Burundi. Whereas other African countries were in some form of lockdown, Burundi kept restaurants, bars, and sports events open to the public, and top officials defended Nkurunziza’s lax attitude as a sign of his evangelical faith and belief in God’s protection.
They suspect the former president succumbed to COVID-19
Officially, Burundi has 170 confirmed cases, 115 recoveries, and one death, but they are likely undercounted. Nkurunziza’s death at the beginning of July was declared to be the result of cardiac arrest, but opposition leaders and foreign observers suspect the former president succumbed to COVID-19. There is concern that several members of Burundi’s political leadership may have been exposed to and are currently infected with the virus.
As the world continues to fixate on the COVID-19 pandemic, it is feared that efforts to combat malaria will fall by the wayside. Caused by a parasite, Plasmodium falciparum, which is transmitted by the female Anopheles mosquito, malaria is one of the most persistent and deadliest diseases in Africa.
In the Central African Republic, this concern is even more important as the country continues to painfully rebuild from a civil war that began in 2012 and wreaked havoc on the country’s already weak healthcare infrastructure.
There has been an uptick in malaria cases where artemisia-based treatments seem to be less effective than before
At the Pasteur Institute in Bangui, Dr. Romaric Nzoumbou-Boko is focusing his research on the possibility of a new strain of the Plasmodium falciparum parasite that may have developed a mutation that has made it resistant to treatments derived from the artemisia plant. Medical professionals in the capital of Bangui have noted an uptick in malaria cases where artemisia-based treatments seem to be less effective than before. If this were true, it would be a significant upset to public health in numerous countries, not just in Africa, where artemisinin extracted from the Artemisia annua plant has been used for prophylactic and therapeutic malaria treatments for years. The efficacy of this chemical extract has been proven in clinical trials.
Dr. Nzoumbou-Boko analyzed samples at two sites in Bangui between 2017 and 2019, and could not find a strain that had developed a mutation making it more resistant to artemisinin. Although his finding was reassuring, the noticeable decline in the impact of artemisinin on treating malaria is motivating Dr. Nzoumbou-Boko to pursue further research on a previously unreported Plasmodium falciparum strain that may have developed such a mutation. He is seeking to conduct further trials to map the parasite’s potential artemisinin resistance across the Central African Republic in order to develop more effective malaria treatments.
(Juba, SOUTH SUDAN) As COVID-19 spread across Africa, South Sudan, the youngest nation in the world, was one of the last African countries to report its first case. Despite having more time to prepare for the eventual arrival of the disease, the country has struggled in its response to the pandemic. Online and in hushed conversations behind closed doors, intellectuals and ordinary citizens are saying the country is on autopilot in its fight against the disease. To date, South Sudan has reported 1,776 confirmed cases of COVID-19 and 30 deaths.
A United Nations staffer who had flown into Juba days earlier tested positive for the SARS-CoV-2 virus on April 5, 2020. The case sparked outrage on social media against the UN for importing the disease. The incident exposed the sometimes-tense relationship South Sudan has had with the UN mission in the country since the South Sudanese Civil War began in December 2013. In just more than six years, until a peace deal was struck in February 2020, an estimated 400,000 people died in the war.
President Salva Kiir Mayardit and First Vice President Riek Machar Teny jointly launched the High-Level Task Force on COVID-19 to deal with the virus. This task force has so far coordinated and communicated to citizens the measures to mitigate the spread of the disease, informed by guidelines issued by the World Health Organization and the Centers for Disease Control and Prevention. The measures included a curfew; a ban on social gatherings, and the closure of all points of entry into the country, schools, and non-essential businesses, among others.
The sweeping plan has lacked coherence and the necessary risk analysis to develop an all-round plan that fits the South Sudanese context. Given the country’s history of violent conflict, many underlying social and political challenges complicate the response to the pandemic. This includes the neglected healthcare infrastructure, economic crisis, and food insecurity. Roughly half of the 11 million population are dependent on humanitarian assistance.
Weeks went by without a clear roadmap or decisions made by the High-Level Task Force (HLTF), which led to the suspicion that the entity had been reduced to merely announcing the number of infections instead of formulating strategic policies and measurements. Decision-making was flawed, and there was no clarity on whether it was the presidency driving the response or the HLTF.
It should be noted that South Sudan has a collegial presidency—established under the peace agreement—comprising the president, the first vice president, and four other vice presidents.
COVID-19 Outbreak among Cabinet Ministers
First Vice President Riek Machar shocked the nation when he announced on May 19 that both he and his wife Angelina had tested positive for COVID-19.
Several other cabinet ministers, including the defense minister, also tested positive for the virus. Thus far, more than ten other senior members of the cabinet have tested positive, although their identities have not been revealed.
This paralyzed the work of the existing COVID-19 task force. In response, a new body called the National Task Force Committee was formed to adopt the task of the defunct HLTF. Vice President Hussein Abdelbagi Akol was put in charge, but he tested positive barely two weeks after taking the leadership position, further plunging the country’s fight against the pandemic into uncertainty.
Since then, other leaders in government and civilian life have tested positive for COVID-19, including Vice President James Wani Igga, who is in charge of the economic cluster; several members of cabinet; as well as military and civilian leaders, of whom some have died.
The government’s mishandling of the pandemic will have dire consequences in the long term and exacerbate existing socio-political problems.
In the meantime, fighting between the army and armed opposition groups in Central Equatoria, and intercommunal violence in Jonglei and Bahr El Ghazal have created another layer of associated problems. There were reports of massive displacement of civilians, killings, kidnappings, and theft of cattle.
The pandemic’s effect on the economy is going to be much more devastating than the virus itself, mainly because it will have a serious direct impact on many more people. The government has worsened the impact by its approach to the pandemic, which has been described as a scorched-earth policy, rendering useless the indispensable sources of livelihood for many people.
It should be recalled that four out of five South Sudanese live below the poverty line, and these four work in the informal sector, which has been hardest hit by the government’s containment measures. A local said, “We made sacrifices for as long as those very orders were in place, yet reaped an exponential surge in cases of corona.”
The window of opportunity to contain the outbreak was misused. Now, most South Sudanese do not have a social safety net to endure directives that have rendered their sources of livelihood obsolete. Job losses have been reported as businesses cut down on employee numbers, and prospects for employment have dwindled under the cloud of COVID-19.
In recent months, the price of oil—which accounts for more than 90 percent of government revenue—has plummeted, further undermining the government’s capability to do anything meaningful in regard to socio-economic planning and wellbeing of citizens. As the containment measures have negatively impacted the economy, non-oil revenue has also diminished, eroding government’s ability to provide basic services.
Back to “Normal”
Some of the containment measures have since been relaxed. All points of entry have been opened for domestic and international traffic, and businesses are permitted to reopen providing they implement physical distancing and wearing of masks.
For now, ordinary citizens in the streets of the capital Juba console themselves with the knowledge that COVID-19 is less lethal than Ebola (which has fortunately not crossed the border from the Democratic Republic of the Congo or Uganda to the south), and that it is mainly the elderly and people with underlying health conditions who are at risk of developing severe complications. Most people have resumed their normal activities, disregarding COVID-19 guidelines.
Patrick Anyama is a freelance writer in Juba, South Sudan.
The Democratic Republic of the Congo declared a new Ebola outbreak after five people have died of the deadly virus disease in the city of Mbandaka in Equateur province.No one knows how the virus resurfaced during a time that travel restrictions are in place to stem the spread of COVID-19.
Less than two months ago, the DRC was on the point of declaring an official end to the Ebola epidemic that had lasted for two years and killed more than 2,000 people. Then new cases surfaced in Beni, the epicenter of the outbreak in the provinces of North Kivu, South Kivu, and Ituri.Yet the authorities believed the outbreak was in its “final phase”.
“This is a reminder that COVID-19 is not the only health threat people face”
The Ebola cases in Mbandaka come at a time that the country is also battling measles and COVID-19. “This is a reminder that COVID-19 is not the only health threat people face,” says Dr. Tedros Adhanom, director general of the World Health Organization. “Although much of our attention is on the pandemic, WHO is continuing to monitor and respond to many other health emergencies.”
WHO has sent a team to support the response to the new outbreak. Mbandaka is a busy transport hub on the Congo River, near the border with the Republic of Congo, so there is concern that the virus could spread.
The Largest Measles Outbreak in the World
In the past year, the DRC has also reported 369,520 measles cases and 6,779 deaths, according to WHO. Médecins Sans Frontières, which has teams working in various parts of the country to help with patient care, vaccination, and monitoring the spread, saysall twenty-six provinces of the country have been affected by the outbreak.
Young children are dying from a disease that can be prevented through vaccination. Whereas the rising number of measles cases in the rest of the world can mostly be attributed to a reluctance to use vaccines, in the DRC it’s caused by poor access to healthcare. Dr. Xavier Crespin, chief of health for the United Nations Children's Fund (UNICEF) in the DRC, saysa lack of investment in healthcare over the past five years, combined with vaccine shortages, high rates of malnutrition, and ongoing conflict, has created a “national crisis”. Logistical difficulties because of bad roads and long distances—the DRC is the second largest country on the continent—contribute to the problem.
The pandemic that crippled most of the world for months has lumbered through Nigeria, most prominently by claiming the life of Abba Kyari, President Muhamed Buhari's chief of staff. it is the northern city of Kano, where the virus seems to have claimed the most lives.
The city of about 5 million has seen a surge in deaths that the nation’s health authorities do not attribute to COVID-19, at least officially. The Nigeria Center for Disease Control (NCDC) has reported only forty-five local COVID-19 deaths, yet the people on the street know differently. Gravediggers say they cannot keep up with the demand for burials. Locals say a lack of transparency has complicated the issue in Kano.
“Authorities have claimed that these deaths were mysterious”
“Some sources reported that over a thousand persons had died from April 20 to May 4 in Kano State,” says Paul Alaje, an economist based in Lagos. “A recent report also has it that over a hundred people have died in the ten days leading up to May 4. Authorities in these states have claimed that these deaths were mysterious. There has been clarification, however, by the Presidential Task Force that most of the deaths are linked to COVID-19.”
The virus has likely spread far more widely here than the NCDC is reporting, Alaje says.
“Kano State has lost close to, if not more than, fifty prominent citizens”
The disparity between anecdotal accounts of mass deaths and the official health records of the authorities has triggered distrust in the Nigerian government’s narrative.
“From April 17 to May 17, 2020, Kano State has lost close to, if not more than, fifty prominent citizens, including at least seven professors, top serving and retired civil servants, media executives, captains of industry, first-class traditional rulers, and serving and retired security personnel,” reads a press release from the NGO Intersociety (International Society for Civil Liberties and the Rule of Law). “Deaths of their likes have also been reported in Zamfara, Nasarawa, Sokoto, Taraba, Jigawa, Yobe, and Bauchi states. The Kano harvest of deaths sprang up first on April 17, 2020, killing 150 in under four days.”
Whereas the official Nigerian death toll reported by the NCDC by June 2 was 299, Intersociety claims thousands have died: more than 1,500 people have died in Kano, 470 in Yobe, 200 in Jigawa, and 150 in Bauchi, according to Intersociety. These figures could not be confirmed by New Africa Daily.
“There are also independent or unofficial reports of more deaths of low-income and middle-income earners in Sokoto and others, but were wickedly kept from public knowledge,” says Emeka Umeagbalasi, chair of Intersociety’s board of trustees. Where these deaths are reported, they are attributed to other causes, including meningitis, Lassa fever, high fever, high blood pressure, hypertension, acute malaria, hepatitis B, typhoid fever, cough, and catarrh.
“Contradictions abound,” Umeagbalasi says. “Our firm demand is that all the infections and deaths in the northern states and similar ones in the rest of the country must be forensically detected and investigated, and their findings made public.”
Nigerian president Muhammadu Buhari reassured the nation in a late April broadcast that the mysterious deaths in Kano were not attributable to the virus. However, the lockdown in Kano was extended another month, but elsewhere lockdown measures were relaxed on May 2.
Several staffers were infected due to poor handling of samples
The government in Kano may have acted to conceal the true statistics, says Dr. Lazarus Ude Eze, a medical doctor who monitors infection surveys in Nigeria.
In fact, Kano’s spike in cases in late April reportedly sparked multiple crises linked to the government’s attempts to save face. First, shortly after Kano’s testing center was set up, several staffers were infected due to poor handling of samples; then some members of the Kano State Task Force got infected, too, forcing several medical staff to go into quarantine when they were needed the most. Meanwhile, Governor Abdullahi Umar Ganduje was seen spending his time lobbying the federal government to get a larger share of funding to battle the disease, which he previously said was not spreading in the state.
“The Kano situation as reported likely has been caused by a combination of meningitis, which kills several people about this time yearly due to the hot weather and poor ventilation,” says Dr. Tijjani Hussaini, coordinator of the state’s COVID-19 Technical Response Team. “Kano State is like any other place in the world battling with the scourge... We are in a rigorous investigation of the deaths in Kano, but as a scientist I can’t tell you exactly what the investigation will tell us about the cause of the deaths.”
Douglas Burton is a former US State Department official in Kirkuk, Iraq, and writes news and commentary from Washington, D.C.
Over the past two weeks, the incidence of COVID-19 cases in South Africa has almost doubled, and now there’s a testing backlog because of a global shortage of test kits. While the race to develop a vaccine continues apace, local healers are striving to produce indigenous remedies based on herbal wisdom and plant-derived active compounds known to alleviate symptoms of diseases such as flu, malaria, cancer, and HIV/AIDS.
South African media described the first two months of the pandemic as “the quiet before the storm.” When lockdown was imposed in late March, shutting down the country’s economy, hospital staff buckled up for a rocky ride and citizens impatiently waited for the first opportunity to resume business as usual.
Now, the southern tip of the continent prepares for a relaxing of the lockdown restrictions. Level 3 will allow most of the workforce to resume activities, schools to partly reopen, religious gatherings to take place, and shops to recommence selling alcoholic beverages from June 1.
However, a surge in the number of COVID-19 cases and an increase in daily deaths have created a dilemma for South Africans, who will return to their offices, schools, and places of worship amid fear and uncertainty.
Making a Case for Artemisia and Other Herbs
Since the beginning of May, African governments have scrambled to produce or buy herbal mixtures based on the artemisia plant.
Madagascan president Andry Rajoelina grabbed international headlines when he endorsed a local herbal tea named COVID-Organics, made of sweet wormwood (Artemisia annua). He went on to question the impartiality of the World Health Organization with regard to testing, and criticized the alleged Western polarization of the pharmaceutical industry.
In South Africa, the artemisia plant more commonly used in traditional medicine is Artemisia afra, known as wild wormwood, wilde-als (Afrikaans), mhlonyane (Zulu) or lengana (Tswana).
While scientists prepare to carry out clinical trials to test the potential of artemisia in the treatment of COVID-19, some people have already turned to traditional remedies.
“I drank wild dagga and sutherlandia three times every day and got better very quickly”
“I went to the clinic with high fever and COVID-19 symptoms,” says Irvin Mothibe from Soweto, south of Johannesburg. “They told me to quarantine myself, so I spent two weeks in a hut at Credo Mutwa Village. The great healer [Credo Mutwa, who passed away in March] had planted many medicinal herbs in the village. I drank wild dagga [Leonotis leonurus] and sutherlandia [Lessertia frutescens] three times every day and got better very quickly.”
Indigenous healers recommend a variety of natural solutions to their clients.
“When the pandemic arrived, we consulted among healers and we prayed to our ancestors,” says Sheila, a sangoma, or traditional healer, based in Alexandra, Johannesburg. “My recipe against the virus? A mix of sihawuhawu [nettle], isiphephetho[wild ginger], umavumbuka[Sarcophyte sanguinea], mayisaka [Thesium multiramulosum], and intolwane [Elephantorrhiza elephantina].”
“We are working on a product combining different local herbs and Artemisia annua, which is more potent than the indigenous Artemisia afra,” says Willem Bronkhorst, a director at the African National Healers Association. “I don’t know yet how effective this will be against COVID-19, but I can say for sure that it will help.”
Many healers from Johannesburg suggest they use artemisia in combination with valerian, mint, garlic, moringa, African potato, and cayenne pepper, ingredients that can easily be found on the shelves of a supermarket or pharmacy. “You can boil them and drink them hot or cold,” says Mmapelle Khunou. “Some sangomas prefer to mix them with porridge, to make it easier for patients to take the medicine.”
“It’s important to use the right quantities, depending on the person and how bad the disease is,” she clarifies. “If you are advised by the wrong healer or take herbs without prescription, you could harm yourself.”
What Standards for Herbal Remedies?
It is risky to believe in the existence of a miracle cure against an unknown disease. The World Health Organization does recognize the importance of traditional medicine and its achievements, but there are rigid requirements in place to ensure the quality, safety, and efficacy of a product.
“There are many therapeutic options that are being suggested as possible treatments for COVID-19,” says Stavros Nicolaou, a senior executive at Aspen Pharmacare Group and a key contributor to South Africa’s medical response to the pandemic. “At his point in time, there are no registered treatments that cure COVID-19. Whilst there might be many candidates or established medicines under investigation, none of these have been proven under clinical trial conditions.
“The pharmaceutical industry will continue investigating these candidate medicines under appropriate clinical trial conditions, and would only be in a position to make them available when they have been proven effective and safe in clinical trials, and when the necessary medicines regulatory agencies have approved them for specific indications.
“This approach is for all medications, including indigenous and herbal medicines,” Nicolaou says.
“The medical profession is trying to engage with indigenous healers, because they do a tremendous job in communities and provide health to the people”
“Artimisinin [a compound derived from Artemisia annua] is a powerful active ingredient,” says another pharmaceutical expert. “However, one needs to apply rigorous controls in the production chain to guarantee its standard quality. The medical profession is trying to engage with indigenous healers, because they do a tremendous job in communities and provide health to the people. But the healers also have to adhere to the conditions required of the medical profession.”
These requirements, however, raise suspiciousness among many healers: “We also took an oath,” Mmapelle Khunou says. “The problem between us and Western doctors is that we put the people first, instead of profit.”
Doctors, Psychologists, and Community Leaders
Indigenous healers do not just provide medical advice. Their input ranges from psychological to religious factors, while tightening the social fabric. Two months of lockdown tore families, villages, and townships apart, forcing a transformation in everyone’s life.
“Men are no longer able to provide for the family,” says Khunou. “If my man can’t do his job, I will question him and ask him to make a plan. But he is also human and has his weaknesses. His manhood is questioned: some men snap and become violent, and households grow apart.”
The recognition of traditional healers as essential workers would facilitate the diffusion of health practices and create awareness about the rising costs of the epidemic.
“I don’t believe in this virus,” says Violet, a resident of Alexandra. “Have you met anyone who has it?”
In the streets of the township, people walk and commute casually. Even where social distancing and the use of masks are possible, habits prevail. Small crowds gather in front of spazas (small shops). To buy a kota(a meal of a quarter loaf of bread, processed meat, and chips), you have to close your eyes to basic hygiene requirements.
“What about masks?” asks another local. “They tell us to wear them, but we don’t know why. Cloth masks become dirty and can also carry diseases.
“When the government makes announcements,” he adds, “they speak a language many people don’t understand. We heard no vernacular in the news; old people don’t even know what’s going on.”
A Rainbow Jigsaw Puzzle
When the first COVID-19 case was reported in South Africa, the nation was already on the verge of a financial crisis, while afflicted by profound inequality. President Cyril Ramaphosa has repeatedly called on his fellow citizens to embrace cohesion and brotherhood in facing the pandemic. However, despite the spirit of ubuntu (humanity towards others) that unites South Africans, there are visible discrepancies when it comes to the same residents taking practical action.
It is difficult, for a government, to answer to the business world while supporting millions who live in extreme poverty. Similarly, it is challenging for people with completely different upbringing and heritage to live shoulder to shoulder and understand each other.
It is also difficult to bridge the gap between private and public health, international standards and tradition. Equality in South Africa is long due. It is too late now to try to bridge tremendous gaps while the pandemic is raging on. COVID-19 is killing thousands in far better prepared countries, with state-of-the-art healthcare and cohesive populations.
What South Africa can do—and has done in many past instances—is to accept its uniqueness and take advantage of its complexity. If businesses and informal traders can sit at the same table, if medical experts and traditional healers could abandon prejudice and stigma to enter the same lab or the same ndumba (sacred hut or shrine), they could find a shared solution that speaks many languages: a medical, psychological, and cultural approach to be followed in all South African cities, townships, and villages for the benefit of all.
Alessandro Parodi is a Johannesburg-based reporter with a passion for cultural studies and urban ethnography. He is a regular contributor to the Italian-South African weekly publication La Voce del Sudafrica and the travel magazine Nomad Africa. (Twitter: @apnews360)
Manash Das is a freelance photojournalist based in South Africa and India. His work mainly focuses on humanitarian issues, conflicts, and daily life. (Twitter: @manashdasorg)
South African president Cyril Ramaphosa has announced that the lockdown alert level for the country will be lowered to level 3 with effect on June 1, which would allow most people to return to work and even to places of worship. The total number of confirmed COVID-19 cases in South Africa is just shy of 26,000, the highest of any country on the continent.
Economists say the impact of the pandemic will plunge the country into a protracted recession
Ramaphosa’s decision comes after weeks of pressure from civil society groups and opposition political parties to reopen the economy, which had been subjected to one of the harshest lockdown protocols in Africa. Economists say the impact of the pandemic on South Africa’s economy, along with its quarantine measures, will plunge the country into a protracted recession.
In the final quarter of 2019, South Africa entered a recession as power cuts by the state utility Eskom took a toll on the economy, and public finances were strained by bailouts to struggling state-owned entities.
In its April 2020 World Economic Outlook, the International Monetary Fund projected that South Africa’s GDP would contract by 5.8 percent in 2020, from growth of 0.2% in 2019. The country will require significant international assistance to blunt the worst of the pandemic’s impact. This poses a problem, as South Africa’s recent credit rating downgrade by Moody’s will make it more difficult to access funds.
Togolese doctors are set to begin a series of tests to assess the efficacy of traditional herbal medicine for the treatment of patients with COVID-19. Professor Majesté Ihou Wateba, dean of the University of Lome’s Faculty of Health Sciences, cautioned that these remedies won’t cure the disease or kill the virus, but they might help to strengthen the immune system by helping the body to produce antibodies that will fight the virus. Clinical trials are set to begin over the coming days.
A Caution Against Wild Claims
Togo’s approach is more measured than that taken by Madagascar, where President Andry Rajoelina has touted Covid-Organics herbal tea—which contains the dried leaved of sweet wormwood (Artemisia annua)—as not only a treatment but also a cure for the disease. The drink quickly grew in popularity and attracted interest from several other African nations.
The World Health Organization issued a warning not long after Raojelina’s announcement, urging vigilance when using traditional medicine but still recognizing the potential of traditional remedies as viable treatments.
Dr. Tedros Adhanom, director general of the World Health Organization, said in a media briefing on Africa Day, March 25, that the continent’s COVID-19 numbers may not “paint the full picture” regarding the public health impact of the pandemic. He said Africa had reported only 1.5 percent of the world’s total tally of COVID-19 cases and less than 0.1 percent of global deaths attributed to the virus, but these numbers could increase as testing capacity improves.
Access to critical medicines such as vaccines and anti-HIV drugs has declined
The Africa Centers for Disease Control and Prevention estimates that only 1.8 million Africans have been tested, only just above 0.1 percent of the continent’s total population. Part of this can be attributed to the soaring costs of materials needed to conduct tests, with richer nations edging Africa out on the global market. The WHO reported on May 22 that Africa had passed the 100,000 threshold for confirmed cases, and that the virus had spread to every country on the continent.
A WHO model has projected that COVID-19 could infect a quarter of a billion Africans and kill 150,000 people within a year.
Still, these numbers look good in comparison with the statistics from other continents, but COVID-19 in and of itself isn’t the only threat to Africa. Due to pressures from the pandemic, access to critical medicines such as vaccines and anti-HIV drugs has declined, along with elective surgeries. What’s more, the drop in wildlife tourism, which provides funding for conservation efforts, has meant that poaching has escalated, further threatening endangered wildlife in Africa.
Tunisian’s ongoing battle against COVID-19 has produced a separate medical casualty: access to reproductive services for Tunisian women.
A recent study conducted by the Tawhida Ben Cheikh Group and the Tunisian Association of Midwivery found that 10 percent of Tunisian women giving birth did so at home during lockdown, as opposed to the normal rate of 0.1 percent. The reasons included a fear of infection, no means of transport, and a lack of access to personal protective equipment because most of it had been reserved for use by medical personnel.
Some expressed concern that more politically conservative streams of Tunisia’s government are using the pandemic to curtail reproductive rights by closing family planning centers and limiting pre- and postnatal consultations, abortion, and contraceptive services during the lockdown. This has led to an increase in clandestine abortions.
Tunisia was the first African country to implement a national family planning program
Fortunately, Tunisia’s healthcare system is relatively robust and the country has one of the lowest maternal mortality rates of the Maghreb. In 1963, seven years after gaining independence from France, Tunisia became the first African country to implement a national family planning program, after revoking colonial laws restricting abortions and the sale of contraceptives.
In response to a petition initiated by the Tawhida Ben Cheikh Group urging the authorities to ensure access to sexual and reproductive health services, the Ministry of Health included access to contraception and abortion in a list, published on April 24, of essential healthcare services during the COVID-19 lockdown period.