Central African Republic

Information last updated: 24 April, 2020

  • Population: 203.9 M
  • Population +65 yo: 3%
  • GDP Per Capita: 956 USD
  • Informal employment: Not available
  • First registered case: 14 March
  • Hospital beds: 2.20 (per 1000 people)

Status

Temporary closure of schools, bars, airport and bans on gathering of more than 15 people (with no set end date). Despite low infections reported in the country, and no casualties reported yet, the Central African Republic remains as one of the world’s most fragile countries to deal with Covid-19.

  • Percentage of cases treated in hospitals : 27% (on April 11).

Response set up and capacity

The government, and particularly the Ministry of Health and Population, is officially in charge of responding and coordinating the response. However, three-quarters of CAR’s total territory are rebel-controlled areas where the government’s power to impose coronavirus containment measures is practically non-existent.

The capacity of the public health system is extremely weak – with lack of qualified personnel, testing and medical equipment – and is very dependent on external aid. 

Stakeholder Mapping

Entities / Organizations

• The president of CAR and the government, in particular the Ministry of Health and Population, are officially in charge of responding and coordinating the response

• Institut Pasteur de Bangui: WHO reference laboratory

• Hôpital de l’Amitié : Unique treatment center in Bangui

• Armed groups that control large swathes of territory

Additional actors

• National Emergency Public Health Response Center (COUSP) including members of the Health cluster (including WHO, UNICEF, UNOCHA, and large-scale NGOs such as International Federation of the Red Cross, Médecins sans Frontières (MSF), etc.)

• Other active UN agencies: MINUSCA, WFP, UNDP

• Civil society groups and NGOs at regional, national and local levels

• International donors such as the World Bank or IMF

Mitigating factors - What is being done?

  • March 19: Following the discovery of the first case, restrictive measures were prescribed by the Government including the self-quarantine of all travelers from areas with local transmission.
  • March 26: The Government strengthened prevention measures, that are to date, still enforced. These include the closure of schools, universities, bars and places of worship, the closure of the airport (with several exceptions such as for humanitarian or cargo flights) and restriction of internal travels, a ban on any gathering of more than 15 people and the extension of the self-quarantine period from 14 to 21 days. Alongside these measures, foreign travellers with previous travel to countries with local transmission are banned from entry. 

Recently published photos show people crowded in markets and congregating inside bars that, from the outside, purport to be closed.

Other national measures that have been put in place include the establishment of a WHO-supported National Emergency Cell, with six commissions related to COVID-19. In addition, communication efforts from the government and nonprofit organizations are being scaled up, including through a radio and television network, leaflets and brochures, messages on social networks and a call center in charge of disseminating barrier gestures by SMS. Nevertheless, WHO have announced an insufficient production of awareness-raising materials. A programme to counter misinformation and rumors is also being rolled out.

With regards to international humanitarian response, it estimated that 401 million would be required for the humanitarian response plan in 2020. In March, 68.4 million had already been mobilized, representing 17% of the funds. Furthermore, the UN launched on March 25 a global appeal to urgently raise $2 billion to fund humanitarian assistance in the most at-risk countries, including the Central African Republic.

Risks, vulnerabilities, obstacles

Potential actions and demands

WHO recommendations include:

Medical Care

  • Reinforce the equipment of the treatment center: “Hôpital de l’Amitié”
  • Build and equip another COVID-19 case treatment center in Bangui
  • Rehabilitate, create new and equip isolation centers.

Health Monitoring

  • Appoint a person responsible for epidemiological surveillance at points of entry within the Ministry of Health
  • Train additional rapid response and contact follow-up teams
  • Train and equip laboratory technicians in district hospitals and similar institutions to collect, store and transmit samples from suspected COVID-19 cases
  • Revise collection tools; etc.

WASH and prevention

  • Filling gaps in personal protection equipment
  • Improving access to water and soap, especially in areas affected by the humanitarian crisis
  • Placing hand-washing facilities in health facilities, IDP sites and entry points; etc.

Communication

  • Strengthen the capacities of the Emergency Line
  • Carry out perception surveys on COVID-19
  • Strengthen the capacities of community media within the country
  • Decentralize activities in districts outside Bangui.

In addition, in CAR, many communities live outside of government supervision and face entirely different social and environmental circumstances to each other. Therefore, some observers suggest that local communities should be consulted to find locally-suitable versions of transmission control.

Key resources

Contributor(s): Inès Biette.

The C-19 Global South Observatory is a collaboration between