Principles for Independence: Maintaining African Autonomy in the Age of COVID-19

Dan Dunham, Research Analyst, Security & Intelligence Policy Lab
ddunham@africacfsp.org

Africa is no stranger to combatting public health crises, and the renewed growth seen in many nations, coupled with the optimism of a new generation of younger and more reform-minded African leaders, means that there is a real opportunity to emerge stronger from the COVID-19 pandemic. To do so, however, it is important that African nations preserve their autonomy, and maintain a focus on the protection of self-determination, democratic representation, and their own national interests above those of external powers that seek to use COVID-19 aid as a lever of power.

Combating COVID-19 Across Africa

The COVID-19 pandemic is a worldwide challenge, pressing nations to respond to the medical needs of their populations, contain the spread, and manage the economic fallout that comes with lockdowns and travel restrictions. Amidst this backdrop, global power competition has continued unabated, and if anything, the pandemic has only accelerated the strategic tension between nations such as the People’s Republic of China, Russia, and the United States. This global power struggle has played out across several continents, but nowhere is this dynamic more visible than in the continued efforts by these nations to expand their influence in Africa.

Despite the slow initial spread of COVID-19 on the continent, recent months have brought on a swift increase in the number of cases with the total number of infections in Africa recently surpassing three million, a figure that is likely under representative of the total number of cases due to shortfalls in testing capacity.¹ Due to limitations in the medical infrastructure of many African nations with rudimentary public health networks, there is a serious risk posed by the lack of facilities, supplies, equipment and personnel. Given these challenges, there is a pressing need in several of these critical healthcare areas. Fortunately, the international community, which is struggling with its own pandemic response even among developed nations, has been willing to step in and provide medical equipment and other forms of assistance to several nations that require such supplies. Not surprisingly, the United States, China and, to a lesser extent, Russia have all provided assistance or expressed a desire to do so in dozens of nations across Africa.

“Due to limitations in the medical infrastructure of many African nations with rudimentary public health networks, there is a serious risk posed by the lack of facilities, supplies, equipment and personnel.”

The United States has committed more than $1.6 billion worth of COVID-19 aid globally and has made contributions to 39 African nations to date with a total in the hundreds of millions of dollars-worth of assistance. Figures for aid provided thus far have included $17.9 million to Cameroon, $33.9 million to the Democratic Republic of the Congo, and $41.3 million to Nigeria, among others. Provision of aid has included health assistance, disease surveillance, and the transfer of medical equipment, with a significant portion of the COVID-19 funding appropriated by Congress marked for foreign assistance.² Specific US Government Africa-focused initiatives have also shifted the allocation of assistance, with Power Africa, a USAID-led partnership designed to stimulate the energy sector across Africa, redirecting $4.1 million in power to support the health sector and hospitals.³ Similarly, the US Africa Development Foundation dispersed working capital to approximately 300 African enterprises and entrepreneurs in the 21 nations with which it works.⁴

China has focused heavily on publicizing and leveraging its own donations of medical equipment to highlight its growing role on the continent. Indeed, China remains eager to enhance the perception of its growth as a global power, particularly in Africa where it has been keen to cultivate new links and expand the network of its Belt and Road Initiative. Recent donations have included more than 30,000 units of Personal Protective Equipment (PPE) from China’s People’s Liberation Army to the South African Defense Force; 150,000 units of medical protection materials to the Nigerian military and Bauchi state; and provisions for a new infectious disease center at Nouakchott National Hospital in Mauritania.⁵

Russia, meanwhile, is seeking to return to its former posture of engagement with Africa that was a hallmark of the Cold War, and Foreign Ministry Spokeswoman Maria Zakharova announced on 11th June that about 30 African states have requested assistance from the Russian government. Russia claims that to date, its donations have included 28,000 units of expendable materials for labs given to the Democratic Republic of the Congo, medical modules, and mobile health unit components for Djibouti, and testing kits for South Africa and Guinea. ⁶

These examples don’t include the numerous contributions pledged by billionaire philanthropists, which comprise an additional element of influence that can be exerted through medical donations. Many notable examples of such private donations rival and in some cases exceed figures pledged by national governments. Among these have been $100 million committed for the global effort to defeat COVID-19 by Bill Gates, a substantial portion of which is earmarked for Africa; $1 billion by Twitter CEO Jack Dorsey, who had previously indicated he planned to relocate for six months to Africa and has been an enthusiastic supporter of increased economic involvement there; and Chinese billionaire and Alibaba co-founder Jack Ma, who pledged to donate over 1 million testing kits to nations across the continent.⁷ While not directly government sponsored, such donations should not be viewed separately from the larger competition for influence. Indeed, the goodwill and economic ties generated by such private philanthropy often engender closer relations among the countries involved and facilitate growing government linkages.

“While many transfers of COVID-19 aid are done with purely altruistic motives in mind, many times this aid comes with an implicit expectation that the receiving government will at some level be more inclined to support closer ties or provide reciprocal measures down the road.”

The international response, like the COVID-19 pandemic itself, is in many ways unprecedented. Taking place at a time when China, Russia, and the United States are engaged in increasing global power competition, there is growing pressure on African governments to select a partner of choice. Unfortunately, while many transfers of COVID-19 aid are done with purely altruistic motives in mind, many times this aid comes with an implicit expectation that the receiving government will at some level be more inclined to support closer ties or provide reciprocal measures down the road. With the scope of the international assistance effort in mind, and the large amount of assistance on offer, it is more important than ever that African nations consider their independence, autonomy, and core national interests when accepting such aid.

“From a security perspective, the influx of COVID-19 assistance carries with it the possibility that such resources will have an impact on the stability of individual African states, but also on their relations with one another and within the larger strategic context of their balance between the United States, China and Russia.”

A positive interpretation of the increasing amount of foreign assistance being offered is that it is a reflection of the generosity of many members of the international community, eager to provide assistance to other nations similarly struggling with the impacts of the pandemic. Unfortunately, however, not all providers of such assistance should be viewed equally, particularly in the case of nations such as China and Russia that have demonstrated predatory behavior in similar areas in the past. With increasing pressure being placed on African leaders to align with such global powers and to accept economic and military assistance that often comes with additional clauses and conditions, even the most altruistic-seeming aid should still be viewed within this context. From a security perspective, the influx of COVID-19 assistance carries with it the possibility that such resources will have an impact on the stability of individual African states, but also on their relations with one another and within the larger strategic context of their balance between the United States, China and Russia. With this in mind, there are some principles that African nations and their political leadership can keep in mind when navigating the waters of COVID-19 aid in an era of global power competition.

Awareness of Strategic Motive

Despite the need for these supplies, the motives of such donations cannot be separated from the strategic ambitions of the international actors providing them, particularly in the case of China and Russia. In many such instances, this kind of involvement has come at the expense of autonomy, and with the potential erosion of self-determination for African countries. Before the COVID-19 pandemic, African nations often faced a dilemma when it came to the acceptance of foreign military assistance or offers of economic development. Though appealing in many ways, the immediate benefit of many such projects had to be weighed against the possibility that such engagement would bring with it a change of alignment with international partners as well as the possibility of additional clauses and conditions that disadvantaged the recipient. In the past, this kind of conditioned-resource giving was a standard operating procedure, particularly during the Cold War when conditioning foreign assistance based strategic relationships and political reforms was viewed as a powerful tool of influence. In other instances, International Monetary Fund loans came with the requirement for structural reforms to economic and political institutions that often inadvertently exacerbated existing issues and failed to provide the promised level of growth.⁸ More recently, China’s focus on increasing its influence in Africa has led to the expansion to its expand Belt and Road Initiative on the continent, with a $60 million fund established for projects across Africa in 2016 coupled with the offer of large loans that often exceed the ability of impoverished nations to pay them back.⁹ In many cases, the national infrastructure of Belt-and-Road participants becomes collateral, putting at risk African nations’ sovereign control of major facilities. A precedent for this was seen in the recent leasing of Sri Lanka’s strategic Hambantota port for 99 years as a result of the country’s inability to pay off significant debts owed to China, a scenario which poses a stark warning given the similarly large amount of debt owed by African nations. ¹⁰

Prior to COVID-19, 20% of African government debt was owned by China, making China the largest single creditor nation, with combined state and commercial loans exceeding $132 billion between 2006 and 2017.¹¹ With African debt already at a substantial level, nations have petitioned for debt relief only to be confronted with provisions in loan agreements stipulating the transfer of assets to Beijing as a result. A recent example of this can be found in Zambia, where China demanded the transfer of collateral in exchange for debt deferral or forgiveness, and Zambian officials found themselves negotiating the transfer of the country’s third largest copper mine, Mopani, as a result.¹² In addition, when Chinese direct investment takes place, it rarely provides direct benefit to local populations. An example of this can be found in the ongoing construction of a new port in the oceanfront town of Kribi, Cameroon, where the largest deep-water facility of its kind in Central Africa is being constructed. Of the project’s estimated $1.3 billion budget, 85% is being financed by the Export-Import Bank of China, with the rest falling to the government of Cameroon.¹³ Despite the large injection of capital, locals complain that Chinese workers who have been brought in to work on the project are reaping the majority of the benefit, while residents see little in the way of economic opportunity.

While Russia has made less substantial inroads from an economic perspective, it still manages to flex its might by relying on security contracts, often in the form of paramilitary private military contractor organizations providing military relief to over-extended government forces. This can be seen most recently in the Wagner Group’s deployment of approximately 160 personnel to the Cabo Delgado province of Mozambique to assist over-extended government security forces in their effort to combat a nascent Islamic jihadist insurgency.¹⁴ Taken as a whole, these influence operations comprise an extensive array of activities, and showcase the dilemma that African leaders face in balancing competing external influences with their own sovereign interests.

“National leadership in African nations would be well served to view and accept the donation of medical supplies and assistance with an understanding that such assistance may instigate larger strategic ambitions on the part of the benefactor.”

With COVID-19, these kinds of calculations have become amplified in the context of medical assistance for which there is a crucial and immediate need. Donations of medical assistance are an important and generous way for the international community to lend assistance. However, African leaders should view such contributions intentionally and objectively in light of global power competition, as nations like China and Russia have made no secret of their desire to expand influence and hold greater sway over foreign partners in developing regions. As such, national leadership in African nations would be well served to view and accept the donation of medical supplies and assistance with an understanding that such assistance may instigate larger strategic ambitions on the part of the benefactor. This is not to say that the nations of Africa should not accept such assistance – indeed, if the transfers come without stipulation, the public health need suggests that they do so without delay. However, if other ambitions are at play, such an acceptance should come with a clear understanding that doing so should not leave the recipient in any way beholden to the donor nation.

Preservation of Autonomy

One of the fundamental motivations for nations to increase their influence in competitive spaces like Africa is to build a body of activity aimed at changing the behavior of individual states, ideally with the outcome of making such nations more likely to follow the lead of the influencing nation. This comes in various forms, both on the incentive end with foreign assistance, security cooperation and economic development, as well as the coercive end such as the use of sanctions, debt, and discontinuation of assistance. Oftentimes, elements of both coercive and compelling action are utilized to build influence. Unfortunately, many such activities have traditionally come at the cost of a loss of sovereignty for African states. While several international actors such as the European Union, Japan, and the United States have sought to use more incentive-based measures to build influence, others have relied on more coercive means to compel shifts in alignment. Medical assistance during a pandemic lies at an interesting point on this spectrum of influence, nominally being of an incentive-based nature, but with the complicating fact that the serious lack of domestic medical infrastructure in many African nations leaves them with a need for such assistance that makes its provision a necessity, not simply a luxury.

For African leaders saddled with limited ability to respond to the pandemic, and facing a combined threat from the pandemic, drastic loss of economic growth, and widespread unrest and discontent, the possibility of medical assistance becomes even more enticing. Given the lifeline this can provide, and the impact that even modest donations can have, it becomes easier to put questions about influence aside until a later date when the immediate threat is past. Perhaps even more troubling is the temptation to view such benefactors in a less critical eye than usual, given the need. This isn’t to disparage the global effort to assist nations less able to respond to the pandemic – indeed, if anything, the international response has been particularly heartening – but rather it is important to be realistic about the history of foreign relations with Africa and the way many benefactors view the region as a place for competition.

“Now more than ever it is crucial for African leaders to resist efforts by external actors to erode their independence of action and gain influence through a campaign of erosive activities.”

Africa is a continent that is coming into its own, and its rapid population growth, large youth population, and vast wealth of resources makes it poised to be a region that leads the global conversation in the 21^st century. Now more than ever it is crucial for African leaders to resist efforts by external actors to erode their ability to act independent of external interference. While medical donations are important, they should not be seen as a favor which must be repaid. The preservation of African autonomy, even in instances where medical assistance is paramount, must be a priority concern when accepting such aid.

Investment in Domestic Capacity

Though the provision of medical aid through donors is an important element of the African response to the COVID-19 pandemic, healthcare capacity remains a key area in which the continent remains underinvested. Unfortunately, both capacity and capability in healthcare systems in Sub-Saharan Africa continue to lag behind the demands of the rapidly expanding populations. For context, in April 2001, heads of African Union (AU) member states met in Abuja, Nigeria, and pledged to work toward a goal of allocating at least 15% of their annual budget to improvements in the healthcare sector. Ten years after the pledge, only eight of the fifty-five AU countries were on track to meet their goals, with most nations spending less than half of what would be necessary to attain them.¹⁵ Today, the situation is not much improved, a fact that is reflected in several key metrics that have showcased how demand far outpaces supply, both in terms of production of health products, number of facilities, and the amount of qualified medical professionals available. Sub-Saharan African nations spend half as much as the global average investment (as a percentage of GDP) in healthcare, while analysis by the World Health Organization shows that African nations underperform across all six evaluated metrics of service, including availability of essential health service, financial risk protections, service satisfaction, health security, and coverage of a number of health targets that include both essential interventions and more general social and political support.¹⁶ Local pharmaceutical production continues to be an area where serious shortcomings exist, with only 37 out of 54 African states having any level of domestic pharmaceutical production. Africa imports 70% of its pharmaceuticals as a result.¹⁷

One of the primary limiting factors in improvements to African healthcare infrastructure is a lack of government efficiency and endemic corruption and bureaucracy, which has hampered efforts to improve such investment. In many instances these problems are exacerbated by governing structures that have traditionally allowed politicians to steer contracts and work to particular individuals or well-connected companies in exchange for political or monetary support. This occurs due to a lack of oversight – without concrete benchmarks and metrics from which performance can be assessed and contracts maintained or cancelled, it becomes easy to divert resources and difficult to track results. A reliance on informal payments, bribes, lack of documentation, and fraud also plays a leading role in hampering development of the healthcare sector.¹⁸

Against this backdrop, foreign medical assistance for the pandemic could be relied upon by corrupt governments, further slowing genuine healthcare investment. If anything, the current pandemic highlights the extreme need for a global focus on healthcare capacity, but especially in the context of Africa’s poorly developed medical sector, which provides a clear case for why this kind of investment is more critical than ever. Aside from pharmaceutical production and the creation of domestic capacity to produce PPE, an added focus on recruiting, training, and retaining qualified healthcare professionals in Africa is paramount to mitigating the impacts from COVID-19 as well as the other healthcare challenges Africa currently faces. From a security perspective, issues related to insufficient healthcare systems fuel conflict by increasing discontent with governing institutions and create economic uncertainty for families that lose the means to pay for unforeseen health issues. It limits opportunity by driving down economic growth and increases the personal sense of uncertainty and anxiety associated with everyday life, destabilizing societies and providing added cleavages that can exacerbate ethnic, tribal, religious or international conflicts. This threatens to increase the severity of many of the ongoing conflicts that continue to plague the continent, from the Sahel to the Lake Chad Basin and beyond. For this reason, African leaders should use this opportunity to recommit to the development of the African health sector, and avoid the temptation for aid donations to slow progress in an area that should be a priority for combatting the current pandemic and preventing such impacts from other healthcare challenges.

Prevention of the Politicization of Aid Distribution

By virtue of their role, central governments have the responsibility to determine how such aid is distributed and to which areas the assistance is provided. By association, this determines which individuals or groups benefit. The temptation to use aid for political ends is an age-old issue, and the road of allurement for international aid to be used for the enrichment of entrenched political power is a well-trod one. In the case of the current pandemic, the ingredients exist for such enticement to be even more seductive. Because of the unprecedented nature of the crisis, there is almost universal need for supplies and care across every regional, ethnic, and political group in Africa. In addition, governments are on the whole ill-equipped to meet this demand with the existing infrastructure in place, as indicated above. Lastly, the rapid infusion of badly-needed equipment means less donor stipulations on usage, as well as weakened oversight by existing governing institutions such as health ministries, already overburdened with the demand for response.

Indeed, the donations provided by actors like China provide an added risk of being subverted for political gain. An analysis by researchers published in the European Economic Review looked at foreign aid to 14 sub-Saharan African countries over the period of 2000-2012 and found strong evidence that African leaders adopted a strategy of steering Chinese aid towards regions with a high concentration of political supporters. The same analysis, however, found no evidence of such aid redirection for World Bank aid, suggesting that when sourced from traditional donors and with more checks and balances attached, such assistance is far less susceptible to political manipulation.¹⁹ This should serve as a cautionary warning of the ease with which donor nation assistance can be subverted for political purposes.

“Fair and equitable distribution of foreign assistance is essential to the tackling of the COVID-19 crisis in Africa”

Fair and equitable distribution of foreign assistance is essential to the tackling of the COVID-19 crisis in Africa, but ensuring that aid donations are distributed in this manner also prevents a gained-reliance on political capital accrued through undemocratic and unsustainable methods. By relying on the distribution of aid to protect their political base, African leaders inadvertently erode their own governing authority, making themselves beholden to gifts from foreign leaders rather than the strength of wholly-earned popular support. As a result, it is critical that the misuse of COVID-19 assistance be avoided at all cost.

Conclusion

The COVID-19 pandemic poses a unique challenge for Africa. Though the responses of individual nations have varied significantly, certain factors have made the African response to COVID-19 a more difficult undertaking than in many other parts of the world. A lack of public health infrastructure, little domestic medical and pharmaceutical production, and a tightly interconnected social fabric based around local market economies means that fighting the disease will take additional effort on behalf of African governments and institutions. The international response to provide relief to African nations working on the front lines to combat this pandemic has been substantial, and while in many cases these donations are motivated by a genuine sense of goodwill, there is a global power competition context that cannot be denied. Like all forms of aid, COVID-19 assistance can be used as a form of leverage, and donor nations can easily use the provision of such assistance as a means of seeking greater influence, with the ultimate aim of shifting the policy of African nations in their favor. Further, a lack of focus on improving African healthcare and the diversion or misuse of medical aid can exacerbate an already fragile situation, shackling those nations receiving such assistance to greater influence from nations such as China and Russia that have shown less hesitation in using assistance for strategic gain.

Fortunately, Africa is a continent that is no stranger to combatting public health crises, and the renewed growth seen in many nations coupled with the optimism of a new generation of younger and more reform-minded African leaders means that there is a real opportunity for the nations of Africa to emerge from the pandemic in a resurgent manner. To do so, however, it is important that African nations preserve their autonomy, and maintain a focus on the protection of self-determination, democratic representation, and their own national interests above those of external powers that seek to use COVID-19 aid as a lever of power. For this to happen, awareness is key, a renewed investment in public health is crucial, and a commitment to fairness and transparency is essential. The pandemic should not be an open door for pernicious actors to quietly erode African independence and leverage a global emergency for their benefit. Rather, now is an opportunity for African nations to capitalize on the generosity of the international community to treat the citizens who need care the most, increase confidence in the public health system, and chart a course toward recovery.

Please Share this Article