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Covid-19 in the Horn of Africa

Gaining Trust in a Crisis

SWP Comment 2020/C 20, 06.05.2020, 8 Seiten



On reaching the Horn of Africa, the corona virus will have encountered countries already facing a multitude of challenges. Prolonged armed conflict, drought and insecurity have turned more than eight million people into refugees in their own countries, and a further 3.5 million have fled to neighbouring countries where they live in overcrowded refugee camps. All the countries in this region are in a fragile state of political transformation or have been severely weakened by war and govern­ment failures. They possess neither the capacity to contain the Covid pandemic nor to mitigate the resulting unemployment, poverty and hunger. In order to guard against jeopardising the process of democratisation in Sudan and Ethiopia, special emphasis should be placed on social security systems and gaining the trust of the popu­lation. This requires an emergency aid package from abroad that will ensure the economic survival of all countries in the region. However, long-term support should be con­ditional on guaranteeing that most of the investment goes into developing state capacities for critical infrastructure and social security.

The legitimacy of the government and the degree of trust the population has in its leader­ship are key to effectively combating Covid-19 and coping with its consequential losses. These factors will determine whether a country can enforce life-saving measures or whether social unrest breaks out.

How a country is governed now will shape the relationship between the state and the population in the aftermath of the pandemic. Although there is currently strong support for incumbent governments, approval may start to wane if there is an upsurge in infec­tion rates, starvation or riots.

Meanwhile, the danger of authoritarian regimes becoming entrenched increases the longer the executive retains supreme power. For example, the government in Somalia is preventing journalists from being critical in their reporting. The govern­ment in Ethiopia is blocking Internet com­munication in certain parts of the country. Fears are also growing that Prime Minister Abiy Ahmed will impose a state of emer­gency to further postpone elections, dis­solve parliament and appoint a caretaker government. This would damage the gov­ern­ment’s legitimacy and make reconcilia­tion more difficult in this politically and ethnically fragmented country.

Drastic measures to prevent the virus from spreading have been taken by all the countries in this region. There is a very real risk that food shortages, starvation, looting and social unrest will lead to state failure and armed conflicts. The longer the restric­tions apply and the more people governments are unable to feed, the more un­stable the region will become.

Current Situation in the Horn

Many countries in the Horn of Africa are still in the early stages of the pandemic. Although the number of cases is low, so is the level of testing, making it difficult to draw any accurate conclusions.

Sudan’s response to the outbreak was Rapid. The government closed its borders before a single case of Covid had been iden­tified in the country. Night-time curfews apply throughout Sudan and a comprehen­sive lockdown was imposed in the capital, Khartoum. The Sudanese prime minister is still riding on a wave of support from the population. The experience of the country’s recent overthrow and renewal has largely united the Sudanese people. Nevertheless, the government’s position is built on sand, as it cannot fully rely on its institutions which are still mainly staffed by members of the old regime.

Acts of sabotage and disruption by rep­resentatives of the old regime are increasing. For example, General Hamad, the gov­ernor of the capital, refused to enforce a ban on assembly for mosques in Khartoum. Islamists from the ranks of the former Bashir regime are holding demonstrations against the Prime Minister’s government and call­ing for the military to take power. Attacks on state institutions in protest at restric­tions on free movement and gov­ern­ment curfews have been reported in the north, and could increase nationwide. The balance of power between the military and civilians in the transitional government still remains finely poised. Moreover, the armed oppo­sition has also responded positively to the United Nations Secretary-General’s ap­peal to declare a temporary ceasefire as a result of the crisis.

The situation in neighbouring Ethiopia is somewhat different. Up until March, Ethiopian Airlines continued to fly to China daily. The government was late in appeal­ing to the population to stay at home. In contrast, Ethiopian manufacturing busi­nesses reacted quickly. Textile factories switched production to protective face masks. Prime Minister Abiy Ahmed is play­ing the role of a regional crisis coordinator. Ethiopian Airlines are flying aid deliveries to the continent via Addis Ababa. Abiy Ahmed has also successfully presented him­self in the media as a representative of the continent, mobilising the necessary aid in­vestments through op-eds and letters. In the country itself, however, confidence in the government is waning, at least in some quar­ters. Rumours of dictatorial measures and pending arrests of political opponents are rife, especially on the Internet.

The situation is most desperate in Soma­lia and Southern Sudan. Acute conflicts in both these Horn countries have caused mass displacement and there is little hope of political rapprochement or a ceasefire, like the one currently in place in Sudan. Despite the peace treaty, the population’s trust in its former opponents in South Sudan is fragile. Violent clashes between enemy groups continue to take place. More than half of the population is dependent on food aid and a functioning health sys­tem has not yet been set up. More than 2.2 of the 12 million inhabitants mainly live in neighbouring countries as refugees and around 1.5 million are displaced in their own country. Humanitarian aid organisations are overseeing the provision of sup­plies, partly under the protection of the UN peacekeeping mission UNMISS. Since the government has, yet again, outsourced the provision of basic supplies for its popu­lation to international aid organisations, it is not expected to take on management tasks in this crisis. The government in Juba is un­likely to use the crisis to build con­fidence and its legitimacy is therefore likely to dwindle further.

Of all the countries in the region, Somalia faces the greatest challenges. A third of all 15 million Somalis depend on food aid, 2.6 million have become internally displaced due to war or drought and just under one million live as refugees in neighbouring countries. The central government in Moga­dishu is in political conflict with some of its federal states. These conflicts are exacerbated by hostile camps in the Gulf Cooperation Council (GCC). Qatar and Turkey support the central government in Mogadishu, while the United Arab Emirates and Saudi Arabia are providing financial support to the states. This situation is only widening the gap between the country’s government and its states. As a result, capacity-building is impossible and measures cannot be im­plemented. Meanwhile, the jihadist al‑Sha­baab is arming itself and carrying out more attacks against Somali security organs and the African Union (AU) mission.

Complicating factors in the Horn of Africa region include the consistently dis­astrous healthcare and the poor health of its inhabitants who often suffer from mal­nutrition and tuberculosis. Another enor­mous challenge is the high population density in the urban areas and the refugee camps. The large number of day-labourers and workers in the informal sector with no savings is also a major problem. Because people with underlying health issues are particularly at risk from Covid-19, and espe­cially those over 60, therefore the youth factor might yet have a positive effect in the Horn of Africa. The average age in the region is less than 20 years.

If the state is unable to provide a certain level of social security, it will be difficult to convince the population that it has to accept work bans, restrictions on free move­ment and curfews because of Covid-19.

Structural and actor-related factors

How the policies of the actors in the Horn of Africa will change as a result of the Covid-19 crisis depends on various factors: the legitimacy of the government, corre­sponding economic development and, last but not least, the role of external actors during the crisis.

Legitimacy, leadership and acceptance

State capacities, such as administrative capac­ity and the ability to maintain critical infrastructure, will be critical in dealing with the virus and the economic and social ramifications of the pandemic.

In its urban centres, the Sudanese lead­er­ship can rely on the sense of unity result­ing from the successful revolution against the Bashir regime. This gives it an advan­tage over those countries in which ethnic, social or religious differences divide society. There is still a fine balance between the civil and military forces in the government, which compels them to act jointly. If the government does take on coordination tasks and starts supplying the population with necessary provisions, this will help stabilise the country.

If Ethiopian Prime Minister Abiy suc­ceeds in uniting the population with good crisis management, his Medemer project (Amharic for synergy or coming together) could bring about social stabilisation even in a period with economic problems. In Ethiopia, parliamentary elections, originally scheduled for May 2020 and then for August 2020, have been postponed in­definitely due to Covid-19. What would have caused criticism and violent reactions from the opposition a few weeks ago, now enjoys almost unanimous support.

If the prime minister does manage to navigate Ethiopia through the crisis in a relatively stable manner, his coalition of parties will most likely secure victory in the upcoming elections. This is an opportunity that could quickly go begging if he employs repressive politics, like blocking the Inter­net and telecommunications in the state of Oromia. In order to maintain the legitimacy of his government, he must ensure trans­parent communication and include both the opposition and the states. However, if Prime Minister Abiy Ahmed is unable to convince the populace of the need for the restrictions and if he is unable to involve the local level in combating the virus, Corona could fast become a catalyst for growing conflicts that would break out along ethnic and religious lines.

Covid-19 presents the Somali govern­ment with existential challenges. Even before the pandemic, approval of President Mohamed Abdullahi Famajo’s government was not overwhelming. The country has almost no functioning critical infrastruc­ture, a third of the population is dependent on food supplies, and furthermore, there is an open conflict with al-Shabaab. In addi­tion, the lockdown in place for troops from the African Union Mission (AMISOM), is weakening the response to al-Shabaab. Apart from disputes between the central govern­ment and the states, its repressive approach to the media and journalists has made the task of building trust more dif­ficult.

The new government in South Sudan was not officially sworn in until 22 Feb­­ruary 2020, right at the very beginning of the pandemic. Since it gained independence from Sudan in 2011, the county has been governed by rivals, President Salva Kiir and Vice President Riek Machar. The gov­ern­ment alliance failed twice because of wrangling between the two camps. The result was bloody civil wars that left South Sudan in extreme poverty, with ethnic disparity and no critical infrastructure for health, education and transport.


All the countries in the Horn of Africa are suffering from a serious shortage of medical care and equipment.

With 557 ventilators and over 570 in­tensive care beds, Ethiopia is well ahead of all the other countries in the region. Sudan has 80 ventilators and 200 intensive care beds, but only 40 of them are in public hospitals. Somalia has 25 intensive care beds, but not a single ventilator, and South Sudan has 24 beds and 4 ventilators.

Although Ethiopia has invested more in health and education in recent years, the country only has 0.1 doctors per 1,000 in­habitants, in Somalia this figure is even worse at 0.023.

Healthcare in Eritrea is similar to that of Ethiopia. However, the country has per­sisted with its isolationist position, despite the Corona crisis. Not even the aircraft with aid supplies from Chinese billionaire Jack Ma, which were to be distributed across Ethiopia in the Horn of Africa, received a landing permit in Eritrea.

In Sudan and South Sudan, the dis­crepancy between official spending on the health­care sector and shortages on the ground is particularly striking. According to the World Health Organization, Sudan’s budget, at 6.34 percent of GDP, is not far short of the average for member states of the Organization for Security and Coopera­tion in Europe (OSCE); in Southern Sudan, as much as 9.76 percent of GDP is allocated to healthcare. In fact, there are 0.43 doctors for every 1,000 inhabitants in Sudan, and 0.15 in South Sudan. For comparison, the density of doctors in member states of the Organization for Economic Cooperation and Development (OECD) is an average of 2.89 per 1,000 inhabitants. This seems to con­firm the suspicion that the healthcare sys­tem is particularly susceptible to corruption.

The gap between the numerically small elite and the majority of the population is also clearly evident in healthcare. While there is little investment in the domestic, public health sector, the elite mainly go abroad to receive treatment, and the travel restrictions put in place due to Covid-19 and the global overload of health systems are currently making it difficult for them to travel abroad. That is when the need to in­vest in your own country becomes more obvious.

For transition governments, in particu­lar, this situation also represents an oppor­­tunity to combat corruption in the health­care system. Strategic investments in social systems that are supported by the popula­tion and controlled locally could now set an important course for the future.

However, if governments are unwilling to take responsibility for public healthcare, this could lead to widespread opposition to, or even attacks on, wards where Covid-19 patients are being treated. As with Ebola, there would also be a risk of corona testing stations being attacked, as they are con­sidered places which spread the virus.

Factors that serve old, colonial patterns make things worse: the lack of solidarity in Europe, the racist treatment of Africans in China and disturbing statements by French doctors that Africa would make a good test­ing ground for Covid vaccines. The anony­mous racist abuse on the Internet and verbal attacks by Donald Trump on Tedros Ghebreyesus, the former Foreign Minister of Ethiopia and now Director General of the World Health Organization, are also seen on the continent as humiliating. In Africa, xenophobic reactions are felt by the Chi­nese, Europeans and humanitarian aid workers who are being blamed for intro­ducing the virus. This, in turn, affects the supply of healthcare. People might even refuse to receive humanitarian aid by inter­national organisations as a result of the behaviour described above and for other reasons: the spread of conspiracy theories, shutting down journalists, the lack of trust in state media, non-transparent communi­cation by the authorities and the repressive enforcement of curfews.

Food security

The Horn of Africa is persistently afflicted by severe droughts, floods and famine; an infestation of locusts is currently swarming the region and fields cannot be cultivated because of armed conflicts. Large swathes of the population depend on food aid. Ethio­pia and Sudan have grain reserves, but these are not sufficient to feed the affected population for a long period. In both coun­tries, less than ten percent of the popula­tion is still dependent on humanitarian aid. However, one third of the population of Somalia and 60 percent of South Sudan rely on external aid. Food prices are expected to rise as logistics centres, ports and transpor­tation will all be affected by Covid-19 re­stric­tions. As a result, pinch points and shortfalls in aid deliveries can be expected.

This will require coordinating the UN organisations. It will be important for coun­tries in the region to develop a functioning supply infrastructure and to build up stocks.


Lockdowns and border closures will mean that economies that are already weak will face more overwhelming challenges and will slip into recession.

Although a large portion of the popula­tion works in agriculture, on average, half of gross national product (GNP) is generated in cities. If food prices are to rise as a result of short­ages, this will initially affect the urban popu­lation hardest, since they already lack the income they need to survive the lockdown.

Regional trade in goods, although small, has also been restricted by the Covid meas­ures. When Somalia closed its border, trade in the common stimulant Qat collapsed, and Kenyan and Ethiopian cultivators were left without any income.

A downturn in the global economy ap­pears inevitable. The fall in the price of oil could have positive effects, for example by lowering fuel prices. However, since major lenders are located in the Gulf States, an eco­nomic downturn in these countries will also have a negative impact on the Horn of Africa.

Many people in the Horn have some social security in the form of money trans­fers from family members working abroad. Since unemployment is increasing world­wide, social security, healthcare, tuition fees and food security can no longer be financed by remittances from abroad. The Gulf States will be particularly relevant for migrant workers from the region. After the 2008 financial crisis and the Saudi Vision 2030 project, which aims to supply the labour market in Saudi Arabia with local workers, Saudi Arabia sent home more than 300,000 people who were working in the low-wage sector. Even now, thousands are being forced to return home to the Horn from the Gulf States every week.

Governments that have so far paid little attention to the social security of their popu­lations now have an increasing obligation.

Covid-19 aid packages

The EU, international financial institutions and the G20 have taken measures to cushion the most severe economic declines. The G20 countries want to introduce debt rescheduling for the least developed countries. This will apply to $20 billion of debt and come into force from May. And it could apply to all the countries in the Horn. However, none of these countries was named in rela­tion to the debt moratorium announced by the International Monetary Fund (IMF).

Of the €3.25 billion the EU is making available to African countries to deal with the Covid-19 crisis, for the Horn of Africa, the majority will go to Sudan (€80 million), €10 million will go to Ethiopia, €27 Million to Somalia and €5 million to South Sudan. Ethiopia also received €76.5 million from the World Bank and South Sudan €7 mil­lion. Somalia, in particular, has benefitted from the debt relief programme.

Access to the international financial insti­tutions is particularly difficult for Sudan. Thanks to its support for jihadist groups such as al-Qaida and its involvement in attacks against the US embassies in Nairobi and Dar es Salaam, the US placed the Bashir regime on its list of State Spon­sors of Terrorism (SST) in 1993. Sudan is currently in negotiations with the US ad­ministration to be removed from the list. This would pave the way for debt relief and urgently needed financial support. But the negotiations are proving tough and com­plex. With the current pandemic still ram­pant, it is all the more important to find alternative ways of providing support to stabilise the country.


The Horn of Africa is the most conflict-ridden region on the continent. At the same time, it hosts the most and largest peace missions, both from the United Nations and the African Union.

The situation in socially, ethnically or religiously fragmented societies is currently very worrying. Conspiracy theories abound on social media and the virus is being used as an opportunity to encourage the use of violence against the supposed guilty parties.

Since the onset of the Corona crisis, two different reactions have been observed in countries with armed opposition groups. In Sudan, some of the armed opposition groups are conducting peace negotiations with the interim government and a politi­cal solution has become possible. Even those groups that are not currently involved in negotiations are following the UN Sec­re­tary-General’s call for a temporary ceasefire.

The response from jihadist groups such as al‑Shabaab has been quite different, how­ever. They are highlighting the weak­nesses of the government and the AU Mission with increased attacks on security organs. In March, members of al‑Shabaab brazenly met up for a multi-day strategy conference in Somalia. Al-Shabaab is able to use as political leverage humanitarian and medi­cal aid for the people suffering in the areas it controls.


The response to Covid-19 from all internal and external actors involved in the Horn of Africa should not be to rely on more isola­tionism, but on more networked thinking and action. Alongside short-term humanitarian aid from outside, long-term invest­ment in social security systems is also required.

As can be seen in the Horn of Africa, individual philanthropists such as Jack Ma or Bill Gates are providing more visible sup­port than state actors. However, in order to meet the challenges, the work that con­tinues to be done by multilateral organi­sations financed and controlled by the member states of the United Nations is essential.

What actors in the countries themselves should do

The governments of Horn countries are faced with the challenge of how to best achieve two main goals: regime stability and protecting the population. If they now focus only on keeping themselves in power and neglect the population, the crisis could end in chaos. By contrast, investing in their healthcare systems and communicating openly with the population would increase acceptance for the measures they put in place and strengthen the legitimacy of the government. Actively combatting corrup­tion, especially in the health sector, should also be seen as an opportunity to gain the population’s trust. In order to do this, they will need to introduce anti-corruption measures, to develop structures and involve the populace in transparently determining the country’s needs.

Overcoming the Corona pandemic will require solidarity. If this is lacking, for example because the population mistrusts the state power, then the virus quickly becomes ammunition for those who want to exploit it for selfish purposes and pro­mote fragmentation.

Widening social safety nets will give the governments greater legitimacy and increases the population’s trust in them. The latter is essential for governments to impose and effectively implement measures and restrictions. This is the only way to mobilise communities to ensure that infec­tions are contained in the long-term. As Ebola has shown, it is the local associations, village and religious communities, families and clans that can effectively contribute to the containment of the virus and provide social support and care. It is, therefore, all the more important that representatives of religious communities, village leaders, women and youth associations as well as neighbourhood committees are involved and provided with funds. Even if it were desirable to involve the police and military in logistics and supply, this step must be con­sidered carefully. Each case must be examined individually to determine the ex­tent to which the security authorities are regarded as repressive organs that are en­forc­ing the will of the authoritarian elites, or whether they have earned the trust of the population.

Germany and Europe

There are several challenges for Germany and Europe in dealing with Covid-19 in the Horn of Africa, but there are also opportu­nities.

In recent years, Germany has proven to be a reliable partner for those Horn coun­tries in transition. It should, therefore, now move forward and not shy away from taken on the role of aid coordinator within the EU. This is especially true in Sudan, whose situation as a transition state is fragile, but has enormous geostrategic importance. Hosting a Sudan conference that would put together a package of funds from Europe, the US, the Gulf States and also from inter­national financial organisations would be a step in the right direction.

Options need to be developed for Sudan that give it to access the IMF’s aid fund despite being on the SST list. Europe could also assist Sudan in negotiations to access funds from international development orga­nisations and the World Bank. In addition, Germany and Europe could lobby the Paris Club for debt relief. The bulk of Sudan’s foreign debt – ranging from $50 to $60 billion – is owed to members states of the Paris Club.

Debt relief is an important measure that can be swiftly implemented to give Afri­can states greater financial leeway in the Covid‑19 crisis.

However, investments should not be made without accompanying control mecha­nisms. Authoritarian and repressive governments should not be allowed to use Covid-19 aid measures to help them main­tain power. It is vital that these investments are tied to expanding social infrastructure and democratic controls.

The United Nations

The United Nations should play a proactive coordinating role in this acute crisis. It has a wealth of experience in coping with crises, ranging from containing epidemics to man­aging refugee camps and peace mis­sions. Since the US government has stopped sup­porting the World Health Organization, it is imperative that Germany and Europe step up their efforts to provide multilateral solu­tions and increase their funding.


The task force put together by the African Union AU Agency for Disease Control and Prevention (CDC) could become a perma­nent institution once this crisis abates and set itself the task of improving national security systems and advancing interconnectedness throughout the continent. The Covid-19 pandemic could become a decisive turning point for the regional Intergovernmental Authority on Development (IGAD). The focus of its predecessor, IGADD, found­ed in 1986, was on regional development and drought control. Concentrating on these tasks would be forward-looking and preven­tative, in the event of further pandemics and climate-related crises in the Horn of Africa.

Dr. Annette Weber is a Senior Fellow in the Middle East and Africa Division at SWP.

© Stiftung Wissenschaft und Politik, 2020


Stiftung Wissenschaft und Politik

ISSN 1861-1761

(English version of SWP‑Aktuell 30/2020)