“I think we are not resourcing COVID-19 priorities equally across the board, and I think that [is] where we are making a mistake as a nation.” – African national government official
The COVID-19 pandemic is an unprecedented event in the present age. For more than 18 months, governments worldwide have been facing the same threat with significantly different resources, institutional arrangements, and priorities. Every government has had to make tough decisions ranging from implementing protective measures (social distancing, handwashing) to enforcing strict lockdowns. With a focus on evidence-based decision-making and building linkages among research, learning, and effective action, USAID tasked the Water for Africa through Leadership and Institutional Support (WALIS) Program to study the WASH response to COVID-19 in Africa. WALIS sought to understand how the response developed, the degree to which evidence informed decisions, and what lessons can be drawn for future emergencies. Under the COVID-19 and WASH Response Study, WALIS specifically focused its research on how coordination, finance, monitoring, and organizational capacity influenced the WASH response to the COVID-19 pandemic.
The first reportedly confirmed case of COVID-19 in sub-Saharan Africa was detected in Nigeria on February 25, 2020. That same week, the African Union and the Africa Centers for Disease Control and Prevention (CDC) released a COVID-19 Joint Continental Strategy that identified the lack of WASH facilities as a concern and includes the objective “implementing rigorous hand hygiene in all congregate settings, such as schools, prisons, stadiums, transportation hubs, offices, shopping malls, and large religious congregations.” Through a literature review and online survey in eight countries—Kenya, Liberia, Madagascar, Malawi, Nigeria, Senegal, Uganda, and Zambia—the WALIS COVID-19 and WASH Response Study found that key measures generally put in place did focus on handwashing and hygiene promotion, infection prevention and control, and continuity and affordability of essential WASH services and products.
Following the online survey, the study conducted in-depth key informant interviews in three countries: Liberia, Madagascar, and Malawi. All three countries had quickly declared national emergencies in March 2020 and activated emergency response systems (the Incident Management System in Liberia, the Operation Control Center in Madagascar, and the emergency cluster system in Malawi). All three countries developed national COVID-19 response plans using a multi-sectoral framework that initially included WASH. As the pandemic evolved, all three countries faced challenges in their COVID-19 response such as insufficient coordination at the highest political levels, lack of government funding, limited national WASH monitoring data, and low capacity at the local government level.
The Understanding WASH Response to COVID-19 in Sub-Saharan Africa technical report and the accompanying three country case studies summarize how these challenges developed and affected the WASH response, ranging from a prioritization of funding for health measures over WASH measures to development partners largely funding WASH activities instead of national governments. Looking ahead, the study outlines opportunities for future research to better understand how country systems and capacity gaps can be improved and to elevate the importance of preventative WASH measures in the face of COVID-19. As cases from the third wave begin to wane and vaccinations are rolled out across the continent, this time can be used to better communicate the role of WASH to high-level political bodies, coordinate activities between stakeholders, and align priorities, resources, and communications for future outbreaks and emergencies.