1.Background

A pandemic is an outbreak of a disease that occurs over a wide geographic area and affects an exceptionally high proportion of the population.There have been a number of pandemics since the beginning of the 20th century: the H1N1 pandemic of 2009, the Spanish flu of 1918/19, as well as flu pandemics in 1957 and 1968. Among the best known pandemics is the Black Death, a plague which spread across Asia and Europe   in the middle of the 14th century and in Africa later .

Disease shapes cities.  In history some of the most iconic developments in urban planning and management, such as London’s Metropolitan Board of Works and mid-19th century sanitation systems, developed in response to public health crises such as cholera outbreaks. Now COVID-19 is joining a long list of infectious diseases, like the Spanish flu  in New York and Mexico City, SARS in 2003 or MERS or camel flu of 2015 or the deadly Ebola Virus Disease from the Congo forest and  in West Africa in 2014, likely to leave enduring marks on urban spaces. While the first EVD in 1976 were confined in the forest environments in the Congo n South Sudan, when in 2014-2016  it hits the large urban agglomerations in Sierra Leone, Liberia and Guinea, its impact were huge with over 28 600 cases and more than 11300 deaths on June 2016

Emerging infectious disease has much to do with how and where we live. The ongoing coronavirus is an example of the close relationships between urban development and new or re-emerging infectious diseases. The world has already registered close to 890,000 cases with a total death over 44,000. Given uncertainty there is likelihood that in coming days the million mark will be crossed and at a rate of 5% death rate 50,000 fatalities can be counted .

Like the SARS pandemic of 2003, the connections between accelerated urbanization, more far-reaching and faster means of transportation, and less distance between urban life and non-human nature due to continued growth at the city’s outskirts became immediately apparent.

2. Covid 19 pandemic and the vulnerability of African cities

Weak urban planning, informality and  huge infrastructure deficit would leave  cities and human  settlements in Africa  highly vulnerable, should the rapid spread of the Coronavirus-COVID-19 continue in the coming weeks and  months . The daily reports coming from capitals are on the rise and Africa has not yet reach the peek of the crisis.

So far, Coronavirus-COVID-19 has been dramatically reported in high- and middle-income nations such as China , India , Korea but also in Europe in Italy , France , Spain…where effective health systems are in place, and conditions are generally sanitary. Over this last week the pandemic situation in the US has sharply degraded putting this country ahead of all nations with over 200,000 reported cases on April 1 with more than 4000 deaths. The rapid increase of the pandemic in Europe and the US is really worrisome . The wide and speedy  propagation of the pandemic during the last four weeks has seriously tested the cities resilience and apparent capacity limits  of the health systems of advance nations and unfortunately so far, these are on the edge of failure .

On March 31, 5430 cases have been reported in Africa with a total of 174 reported deaths so far and 335 recovery .But while these figures are doubling from a week ago  this could be  under reported figures according to WHO, whose Head,  the Ethiopian Tedros Adhanom has pushed  the alarm button over Africa’s preparedness for the coronavirus   pandemic, telling the continent to « prepare for the worst ». While the virus is multiplying there are fears that lockdowns will only bring significant hardship for the poor people of the continent, many of whom living daily on hand to mouth without formal employment and unable to accumulate to buy enough food and sanitary supply to face long confinement that governments are threatening to enforce should the cases rise in the coming weeks.

In so far, the number of cases in South Africa has crossed the 1300 mark with 5 deaths and Burkina Faso has recorded the first Sub-Saharan fatality due to the virus. Today close to 6000 cases in  50 countries across the region are affected (only  ,Comoros , Lesotho and Malawi and São Tomé and principe  are still free )and healthcare system has  long had an acute lack of resources and critical facilities are extremely limited. In order to face the pandemic most African countries have imposed huge restrictions and taken a range of extraordinary measures such as state of emergency and night curfews to try to combat the crisis. Negative early  reactions from youth and informal settlements have been noticed and policy brutality came across to bring back order to maintain effective security curfews.  In many countries borders are closed ,  airlines are grounded and flights are suspended!

But what will happen if the disease spreads to cities in low-income nations like Africa ? Can African countries afford to implement full confinement and total lockdowns for weeks given the state of the economy and poverty of the majority of their population ? What are the conditions in the informal settlements and will the population be able to sustain such hardship without mass demonstrations and civil unrest’s?

The overall assessment is that across the region, many countries are facing serious urban challenges  and many low-income settlements lack basic infrastructure and services. Unsafe water, inadequate sanitation, open drainage and refuse dumps… are prime reasons for the high prevalence of infectious diseases. 

Based on UN HABITAT’ work the region is still harboring majority of its urban populace in informal settlements. (over 60%). And as a consequence of poor planning, lack of effective transport systems , good housing conditions and infrastructure deficit,  slum spaces are crowded, people are forced to share accommodation and – when available – toilets. Residents are constantly on the move, often traveling on packed mini-buses – to workplaces within settlements, between settlements, between the city and rural homes. Given weak economic conditions and people vulnerabilities, attempting  to control this kind of movement would be extremely difficult.

3.The  weakness of  expert recommendations

The emergence of Coronavirus or COVID-19 in Africa and in poor neighborhoods of  cities would present the usual settlements vulnerability syndrome and would, without doubt, be a major challenge to contain.

Amongst the  current recommendations for preventing the spread of the disease include thorough washing hands frequently – but this is extremely difficult where clean water access is limited. Many UN habitat projects including Wash campaigns, safer cities Programme  and  the Participatory Slum Upgrading Programme PSUP include water and sanitation, information, and health  supply components to help alleviate the poor living conditions of the majority o the population.

Isolation is another strong recommendation to defeat the virus– but this is almost impossible to put into practice in settlements where population density is extremely high like in many cities and slum neighborhoods in Africa . Self-quarantining – staying at home for at least 14 days – is scarcely an option for the urban poor who often rely on daily wages from casual labour to sustain family subsistence . But given high rate of the virus spread, countries such as South Africa, Morocco and Rwanda…[1] have legislated total confinement and lockdown. Others such as  Burkina , Côte d’Ivoire, Cameroon , DRC,  Kenya , Sénégal  South Africa have decided state of emergency with night curfews to curve the pandemic.

However in many of those countries, the level of urban poverty , the fragile living conditions, and the high prevalence of slums neighborhoods have created negative reactions to state of emergency and curfews. The poor population living in informal settlements are trapped between dying inside with no water and food supply or fighting out to fetch a daily living . The decision is hard but most likely you will find them in the streets unless governments are able to provided them with enough supply during a total confinement an option that many governments are contemplating if the situation come to be worsened as predicted by WHO..

4. A new planning approach towards  “people first” in Africa

Short-term efforts are focused on containing the spread of infection. The longer term – given that new infectious diseases will likely continue to spread rapidly into and within cities – calls for an overhaul of current approaches and policies  to urban planning and development in the region . The lesson to learn for Africa from this  pandemic is to come back to the fundamentals of urban planning and human settlements and to place people first at the center of the vision of our cities and towns in order to efficiently deal with future epidemics and pandemics . Far too long the planning process , land management and housing policies have been more oriented to market and infrastructure provision rather than taking into account what is the people need for safety and security and well being.

Low-income settlements need more effective infrastructure. Often labelled by city authorities as ‘informal’ or ‘illegal’, these settlements do not receive required investment for basic services such as piped water, sanitation, transport or electricity. They are not served by primary healthcare facilities or regular solid waste collection. And yet these settlements often house over half of a city’s population, being the only affordable dwelling option for many African cities residents.

Recognizing the existence of affordable, though grossly inadequate, forms of housing that in effect subsidize labour costs for the rest of the city’s inhabitants is a first step not only towards addressing the challenging living conditions of low-income settlements, but as a way of helping contain the spread of new and deadly contagious disease such as Coronavirus.

Emerging infectious disease has much to do with how we plan our cities , how we move and where we live. The ongoing coronavirus is an example of the close relationships between urban development and new or re-emerging infectious diseases.

We need to understand the landscapes of emerging extended urbanization better and make it people safety  focused  if we want to predict, avoid and react to emerging disease outbreaks more efficiently.

First, we need to grasp where disease outbreaks occur and how they relate to the physical, spatial, economic, social and ecological changes brought on by massive and rapid urbanization as it has been the case in many countries in Africa . Second, we need to learn more about how the newly emerging urban environments can themselves play a role in stemming potential outbreaks. Planning effective open spaces and urban forests and parks , large recreation open places  could be effective places to serves as open health facilities when pandemics happened . It is unfortunate that the percentage of open spaces in many African cities is as low as 10-15 percent,  make cities and streets crowded,  dense populous and at time rather unsafe .

Rapid urbanization enables the spread of infectious disease, with peripheral sites   and informal settlements being particularly susceptible to disease vectors like mosquitoes or ticks and diseases that jump the animal-to-human species boundary.

Infrastructure is central: diseases can spread rapidly between cities through infrastructures of globalization such as global air travel networks. Airports are often located at the edges of urban areas, raising complex governance and jurisdictional issues with regards to who has responsibility to control disease outbreaks in large urban regions.

We can also assume that disease outbreaks reinforce existing poverty and  inequalities in access to and benefits from mobility infrastructures. These imbalances also influence the reactions to an outbreak. Disconnections that are revealed as rapid urban growth is not accompanied by the appropriate development of social and technical infrastructures add to the picture.

Conclusion

The massive increase of the global urban population over the past few decades has increased exposure to diseases and posed new challenges to the control of outbreaks. Urban researchers need to explore these new relationships between urbanization and infectious disease. This will require an interdisciplinary approach that includes geographers, public health scientists, sociologists and others to develop possible solutions to prevent and mitigate future disease outbreaks.

It’s a bit early to take on lessons learned from  Coronavirus-COVID-19, but we probably need to have a big conversation about the value versus the risks of densification. Clearly urban densification although an opportunity, is and has been the problem with some of this. COVID-19 puts a fundamental challenge to how we plan and manage urbanization in Africa . Rethinking density management is a key for long-term survival in a pandemic situation .

Part of this means thinking about decentralization of essential services and properly providing health services to all regions in our countries.  Unfortunately in many countries in Africa the best hospitals and health facilities are often located in the capital cities leaving the rest of the nation without the necessary health facilities to deal with pandemic such as Coronavirus or other epidemic like Ebola .

As discussed with UN Habitat  the organization must urgently  deploy its expertise and proven crisis management know-how , to help African countries combat the Coronavirus pandemic. The organization can leverage necessary funding from the UN global trust fund for Coronavirus as well as from the African development bank -AFDB USD 3 billions fund for the pandemic.

The deep knowledge of urban Africa , the crisis management lessons learnt from Rwanda, Mozambique , DRC, Somalia , Liberia, CAR, South Sudan and the slums management capacities must be a clear asset in assisting  people  to develop strategies through water and sanitation, wash campaigns, washing hands,

 Bubbling up are some core questions about what we’ve been told is desirable, home grown planning and  urbanization versus what makes sense from an infectious disease perspective to help Africa deal effectively with the Coronavirus. Clearly UN habitat has a critical role to play and must play it given its background knowledge and expertise .

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