Africa is emerging from the New Year travel season without a significant upsurge in COVID-19 for the first time since the start of the pandemic.

A total of 20 552 new cases were recorded in the first three weeks of January 2023, a 97% slump compared with the same period last year despite an uptick in cases in South Africa, Tunisia and Zambia over the past two weeks. The drop in reported new cases may be partially due to low COVID-19 testing rates, but of critical importance is that hospitalization for severe illness, as well as deaths have reduced significantly. As of 22 January 2023, there were 88 COVID-19-associated deaths reported in the region compared with 9096 in the same period 2022.

“For the first time since COVID-19 shook our lives, January is not synonymous with a surge. Africa is embarking on the fourth year of the pandemic with the hope of moving past the emergency response mode,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, with variants continuing to circulate, it’s important that countries stay alert and have measures in place to effectively detect and tackle any upsurge in infection.”

In 2022, Africa witnessed no major pandemic peaks, with upsurges lasting an average of three weeks before petering out. In contrast, the continent experienced two pandemic waves driven by more transmissible and lethal variants in 2021.  

With the gradual slowdown in cases over the past year, a low-level transmission of the virus is expected to continue in the coming months with possible occasional upticks. It is crucial that countries maintain capacities to detect and respond effectively to any unusual surges in cases.

Over the past year, while African countries stepped up efforts to broaden vaccination, only 29% of the continent’s population has completed the primary series of vaccination as of 22 January 2023, up from 7% in January 2022. However, vaccination among adults aged 18 years and above rose from 13% in January last year to 47% currently.

Nonetheless, just four countries in the African region have vaccinated more than 70% of their population, 27 have vaccinated between 10% and 39%, while 11 have reached between 40% and 70% of the population. Vaccination among high-risk populations has seen some progress, with 41% of health workers fully vaccinated in 28 reporting countries, and 38% of older adults in 23 countries.

To further increase coverage, in addition to vaccination campaigns, it is important to integrate COVID-19 vaccination into routine health care services that take the needs of the most vulnerable into account. So far, 12 African countries have started integrating COVID-19 vaccination as part of regular health services.

“As the pandemic’s trajectory evolves, so should our approach. We are supporting countries to set up effective ways to ensure that COVID-19 vaccines are available, accessible and provided for the long run,” said Dr Moeti. “We know from experience that huge immunization gaps can provide a perfect springboard for the resurgence of vaccine-preventable infections. Even though COVID-19 cases are falling the pandemic can take an unexpected turn. But we can count on vaccines to ward off a catastrophic outcome.” 

COVID-19 vaccination remains critical in protecting against severe illness and death, as the virus remains in circulation and continues to mutate.

In Africa, Botswana and South Africa are the only countries to have detected the XBB.1.5 Omicron sub-variant, one of the sub-lineages with public health implications. Genomic sequencing has slowed down as COVID-19 testing rates have declined. Over the past week, just three countries met the WHO benchmark of five tests per 10 000 population per week compared with 25 in the same period in 2022.

So far this year, 1896 sequences have been submitted. In the same period last year 7625 sequences were carried out. Sequencing is crucial to keeping track of variants as well as helping to mount timely and effective response.

Dr Moeti spoke today during a press conference. She was joined by Hon Wilhelmina Jallah, Minister of Health, Liberia; and Professor Tulio de Oliveira, Centre for Epidemic Response & Innovation (CERI), Stellenbosch University, South Africa.

Also on hand from WHO Regional Office for Africa to answer questions were Dr Thierno Balde, Regional COVID-19 Incident Manager; Dr Phionah Atuhebwe, Vaccines Introduction Medical Officer; and Dr Patrick Otim, Health Emergency Officer, Acute Events Management Unit.