The COVID-19 pandemic has cost hundreds of thousands of lives in the world’s richest cities but poses an even greater threat to cities in the developing world. There are now more than 150,000 confirmed cases of coronavirus across Africa, in all 54 countries, with South Africa and Egypt the worst affected.
One of the most pressing concerns for Africa is that over half the population (excluding in North Africa) live in overcrowded informal settlements. In these areas where several people have to share one badly ventilated room, diseases such as COVID-19 spread fast and it is impossible to practice physical distancing whether in homes or outside.
Other preventative measures are equally challenging. Only a third of households in Africa have access to basic handwashing facilities and in many informal settlements piped water is a luxury. And as a large majority of the workforce is informally employed, and most cannot work from home, they still need to use public transport and cannot follow social distancing.
Low-income households are particularly vulnerable to COVID-19. Low-income groups usually face higher rates of chronic health conditions, such as diabetes or heart problems, and are likely to suffer from illnesses such as diarrhoea, gastroenteritis, malaria and tuberculosis. They also have poor access to health services. For instance, Kibera in Nairobi, one of Africa’s largest informal settlements area, has a child mortality rate two to three times higher than the average of the rest of the city. These conditions can make the coronavirus more deadly for these groups, as the risk of becoming seriously ill from COVID-19 increases with poor health.
However, there are some affordable actions that can help reduce the risks of infection in Africa’s informal settlements:
There is an urgent need to supply water, sanitation, soap, disinfectant, hand sanitizer, and overall personal protective equipment. Portable handwashing stations are critical in informal settlements, even if they just consist of buckets, soap and water tanks. These are particularly necessary at locations where contact is more frequent, such as markets, bus stations and health facilities. In Nairobi, UN-Habitat has provided hand-washing facilities in two informal settlements which have been used for over 350,000 handwashes.
People living in informal settlements lack the space to self-isolate or shelter at home. Local governments should provide temporary and emergency accommodation to everyone without adequate housing to enable social distancing. Local authorities could use underutilised spaces and repurpose buildings such as stadiums, and school and community centres for emergency shelter.
Local authorities also need to impose moratoriums on evictions due to rental and mortgage arrears. They should stop forced evictions of informal settlements and slums during the pandemic. The COVID-19 crisis offers an opportunity to demonstrate that it is possible to provide housing and land tenure security to all.
Basic services, particularly to vulnerable communities, must be a priority for national and local governments. These should include water, food, and sanitation and, for the poorest, cash transfers. They also need to ensure health centres and hospitals offer services to all and look at providing primary health care through community workers.
There is a wider need to leverage community-driven initiatives. South Africa is developing community-driven responses and strengthening networks. Community organisations can identify the most vulnerable in communities and devise practical, innovative ways to support families and disseminate prevention information.
Finally, data is a key instrument and an enabler for evidence-based programming and responsiveness in combating COVID-19. To this end, data should be complemented with local knowledge: communities can play a lead role in helping decision-makers to understand the local challenges and contexts quickly.
In a post-COVID world, cities must be empowered to assume stronger leadership in coordination roles and to take on responsibilities for health and security and the governance and management of public and urban affairs.
There should be a move towards liveable cities that reduce overcrowding, with affordable, accessible housing, as well as parks and open spaces. Healthy cities would include buildings and transport that promote improved energy efficiency and environmental sustainability and would provide essential services including health to all.
The response to COVID-19 in informal settlements provides an opportunity to rethink urban planning and find innovative sustainable ways to eradicate slums. Local authorities will have to be the driving force in reducing inequality, supported by national government policies to leapfrog into a sustainable urban future with safer, more accessible, and more resilient cities.