How will Africa cope with an outbreak?

In a red-roofed building at the edge of the University of Abuja Teaching Hospital campus, the walls are freshly painted, a crew is laying pipes for refurbished bathrooms, and others are hauling in furniture.

The single-story concrete structure, meant for trauma victims at the largest health-care facility in the Nigerian capital, is being rapidly repurposed to quarantine patients diagnosed with the coronavirus, putting it on the front lines of Nigeria’s—and Africa’s—efforts to contain the illness. “We are moving, we are going to get there,” Yunusa Thairu, the leader of the hospital’s coronavirus response team, tells staff crowded into an auditorium next door. “Let’s be confident. This is not a death sentence.”

Across Africa, officials are bracing for a rapid spread of the pathogen. The worry is an outbreak could devastate the region, which accounts for 16% of the global population but just 1% of health-care spending. There’s little money for ventilators and other life-support equipment needed for severe cases of Covid-19, and any sustained fight against the coronavirus would steer resources away from malaria and HIV, which kill hundreds of thousands every year. If Italy, with 41 doctors per 10,000 people, is struggling to contain the disease, virus trackers fear what would happen if it were to sweep across Africa, where there are just two doctors per 10,000. “It will be worse in an African setting,” says Nathalie MacDermott, an infectious disease specialist at King’s College London.