Compared to Tanzania, Ghana has experienced significantly higher confirmed cases of COVID-19 and consequent deaths, despite announcing stricter containment measures earlier. What explains the difference? Isaac Haruna Ziaba looks to law compliance and global economic integration as determining factors, and argues debt relief could be tied to enforcing further particular measures.
On 9 April 2020, the World Bank’s bi-annual report bemoaned Africa’s fiscal capacity to contain the coronavirus. Albert Zeufack, a World Bank Chief Economist, highlighted Africa’s poor fiscal position and rising public debt, which makes it unable to contain the virus without the bilateral debt relief necessary to release enough funds for the fight against COVID-19.
Nonetheless, African countries vary in income levels, implying unequal fiscal constraints on countries’ capacities to manage the virus. Accordingly, Tanzania, a low-income country with a per-capita income of US$1,050.7, should be theoretically less likely to contain the virus than Ghana, a low middle-income country with a per-capita income of US$2,202.3.
Thus, unlike Tanzania, Ghana imposed a three-week lockdown on two of its vibrant commercial cities, banned places of worship and other public gatherings, and closed its borders. Surprisingly, however, the total number of confirmed cases and deaths in Ghana as of 15 May 2020 stood at 5,638 and 28 respectively, far higher than Tanzania where the last released data on 29 April 2020 showed 509 confirmed cases and 21 deaths.
These figures show how Ghana is trailing behind Tanzania in containing COVID-19 despite Ghana’s stringent measures. However, it is possible that, unlike Ghana, Tanzania may be under-reporting its cases given the apparent opaqueness in the release of COVID-19-related data.
Nevertheless, it is likely that the differential outcomes in confirmed cases and deaths appear better in Tanzania than Ghana largely because of the combined effects of differences in law enforcement and compliance and integration into the global economy.
Law enforcement and compliance
Countries with high enforcement of and compliance with basic life-saving regulations, on such issues as sanitation, are said to be more likely to contain public health crisis such as COVID-19 than their counterparts. Ghana ranks almost twice higher than Tanzania in the World Just Project (WJP) Rule of Law Index, suggesting that law enforcement and, perhaps, compliance, are better in Ghana relative to Tanzania.
Moreover, Ghana’s capital, Accra, ranks ahead of Tanzania’s commercial capital, Dar es Salaam, in terms of the cleanest city in Africa, implying Accra has much better sanitation measures generally. This, in addition to Ghana’s WJP higher score, should lead us to expect higher compliance with COVID-19 rules in Ghana such as social distancing, hand washing with water and soap, sanitiser and facial mask use, among other measures.
Nonetheless, granted that Accra’s COVID-19 confirmed cases by 15 May was 4,314, 8.5 times higher than the entire cases in Tanzania combined, it appears that either Tanzanians are generally complying with COVID-19 preventive measures more than Ghanaians or Ghanaians are simply disregarding these measures more than Tanzanians.
On the one hand, despite falling behind Ghana in terms of WJP scores, as a regular Uber, taxi, and bajaj passenger in Dar es Salaam, Mwanza, and Geita, I observed a high level of compliance with zebra-crossing and other traffic regulations during my fieldwork in Tanzania in December 2019 and January 2020. On the contrary, it is common knowledge that Ghanaian drivers of all classes generally violate similar traffic regulations with impunity because of limited enforcement of such regulations. This might mean that Tanzanians are generally observing COVID-19 rules more than their Ghanaian counterparts.
There is also the issue of population. Ghana’s 2018 population density of 131 people per square kilometre is twice as high as Tanzania’s of 64 people per square kilometre, which may also explain the growing COVID-19 cases in Ghana.
This density does not hold, however, at the subnational level between major urban areas. Dar es Salaam’s population density is approximately 3100 per square kilometre or twice as high as Accra’s of about 1300 people per square kilometre, implying that social distancing may work much better in Accra than Dar es Salaam. This, in addition to Ghana’s stringent measures, should lead to a lower number of confirmed cases and deaths in Accra. Yet, that Dar es Salaam’s cases are fewer suggests that Tanzanian urban dwellers may be relatively complying with requisite preventative measures.
On the other hand, it is fascinating that Ghanaian government officials, with the intent of mitigating a COVID-19-triggered food crisis, shared hot meals to the ‘poor’ and ‘vulnerable’ in society in public places. These food distribution exercises gathered hundreds, if not thousands or millions, of people without regard to social distancing rules, creating a breeding ground for the virus in the process.
If Ghanaian officials’ behaviour flouts social distancing rules, it only serves to incentivise citizens to disregard such rules, perhaps explaining Ghana’s growing cases.
Integration into the global economy
Tanzania and Ghana vary in their integration into the global economy. President Magufuli of Tanzania has never travelled outside Africa since becoming president in November 2015. Meanwhile, following his election in December 2016, President Akufo-Addo of Ghana has embarked on several international travels outside Africa and his last 12-day visit to four European countries, including UK, Norway, Switzerland and Belgium, came at a time when these four countries had recorded a total of 58 COVID-19 cases while Europe’s total was 909.
Nonetheless, the President and his officials, having come into contact with an infected person in Oslo, the Norwegian Ambassador to Ghana, returned home and continued their routine official duties, interacting with the rest of the Ghanaian populace. It is unclear whether these state officials have been tested or self-isolated.
Ironically, nevertheless, the Norwegian Embassy in Ghana shut down and quarantined its staff because of possible contacts of staff with the Ambassador. Again, while the Ghanaian President and his officials may have failed to self-isolate, they nevertheless subjected their citizens returning from abroad to mandatory quarantine three-weeks later.
Thus, it is possible that some of the huge delegations that accompanied the Ghanaian President in his trips abroad may have returned home infected. The behaviour of the Ghanaian authorities sharply contradicts that of the Botswanan President, Mokgweetsi Masisi, who, after his trip to Namibia in March, went into a voluntary 14-day self-isolation despite Namibia having reported only three cases. Later in April, when Botswana had 20 confirmed cases and one fatality, President Masisi and all Botswana’s MPs were quarantined for 14-days after they were exposed to the virus when a nurse on duty in parliament tested positive for COVID-19.
The differing presidential trips abroad suggest how Ghana and Tanzania, while seeking to overcome aid dependence, oddly see more or less integration into the global economy as a virtue.
Moreover, unlike Tanzania, Ghana is now an aviation hub in West Africa. In 2018, 1,975,803 international passengers passed through Ghana’s only international airport while 1,481,557 international and domestic passengers were recorded across Tanzania’s two international airports and 27 domestic airports.
Although there is no comparable data in 2019, the figure in Ghana for international passengers stood at 2,110,593.
Besides, Tanzania was less exposed to the virus because the number of potentially infected international passengers were distributed, however disproportionately, across the country’s two international airports in Dar es Salaam and Kilimanjaro, compared to Ghana where all such passengers arrived in Accra, the country’s hotspot.
The comparison also shows that while countries with high numbers of international passengers passing through tend to be those most financially agile to contain the virus, such countries are also likely to have more COVID-19 cases, which can take a toll on their fiscal wherewithal to fight the virus. Negotiating bilateral debt relief on the basis of which countries are more exposed and vulnerable to the virus, taking into consideration their extent of integration into the global economy and their existing fiscal space, could create a semblance of fairness in fighting the pandemic’s further spread.
Photo: A drone shot of the vast landscape of Ghana, Accra by Virgyl Sowah on Unsplash.
This is a rather poor comparison. How many tests have been carried out in Tanzania? Obviously if they’re not testing or don’t share the data on number of infections and deaths accurately etc, the figure will be low. Contrast this with countries such as Ghana which have ramped up testing and publish their data on infections and deaths everyday. My point is that unless both countries are really carrying out rigorous testing in the same way it is hard to compare cases. Tanzania’s President outright prevents tests from being carried out unlike the Ghanaian President who has been very evangelical about it. He was tested after his travels too, so it is not accurate to suggest that he just went back to country and started fraternising without any precautions. See this piece in the Guardian for more information on Tanzania’s approach to testing:
https://www.theguardian.com/global-development/2020/may/19/tanzanias-president-shrugs-off-covid-19-risk-after-sending-fruit-for-tests
Thanks for your comment Sammy. It seems like you did not read the article well. I argued that one of the reasons Tanzania’s case is low is, perhaps, because it is underreporting its cases. I even gave the last date they published their confirmed cases (29th April 2020). However, my knowledge of both cases led me to look beyond the potential underreporting of cases in Tanzania as an explanation for the cross-national variation we observe in Ghana and Tanzania.
Again I will be happy if you can refer me to an article that says that the Ghanaian President and all his officials got tested following their return from Europe on 4th March. May be taking a second look at the article would make you much more critical in evaluating the piece.
Nice researched and written…..you have raised interesting and thought-provoking angles to this whole covid responses by countries….
An excellent discussion, Haruna. You identify two key paradigms for discussing the incidence and growth of the case numbers. Good information for planners and policy makers to factor into the decision making process.
Interesting revelation Mr Ziaba,Ghana’s rapid spread of the virus largely depends on the extent to which we flout the rules laid down to prevent the spread of the virus. It will interest you to note that in these abnormal times ,some menace still believe the virus is meant to infect only ‘a group of people and not them’.
You should delete this post because this is a poor comparison. How do you compare two countries one with actual data and another one without it…?
I don’t see how it is possible to compare these two countries’ responses to COVID-19, since Ghana has rolled out testing at speed, while Tanzania stopped testing three weeks ago, for political reasons. As a result, nobody really knows the current state of the outbreak in Tanzania. The premise of the post is therefore mistaken – it is simply impossible to assess whether “Ghana is trailing behind Tanzania in containing COVID-19” or not.
Just in dar-es-salaam 95 %of population quarrentine d themselves, Tanzania was on lockdown ni international flight were allowed to land on Tanzania or on Zanzibar. People may complain about how president Magufuli didn’t follow the rules from WHO, but he did,
Bogus comparison, this is what LSE produces nowadays? Comparing a country that does NO testing and not keeping ANY records with one that tries to do so? Followup with Aljazeera coverage over nighttime burials in Tanzania…estimates are in the thousands already for hte number of deaths!
Awesome!
Does it really make sense to compare these two countries in terms of the number of confirmed cases? Ghana has conducted over 150,000 tests. Tanzania has carried out a fraction of that and has not announced an update on the number of cases in a month now. The national laboratory stopped carrining out tests for weeks after the government expressed concerns over accuracy. Evidence from Tanzania’s neighbours suggest there is a high infection rate. Zambia for example closed the border with Tanzania because of such a high number of infections coming across. Kenya has now done the same. In Uganda, the hospital at the border with Tanzania has reportedly been inundated with Covid-19 patients. This should really be part of the discussion here rather than taking at face value that Tanzania has a lower infection rate than Ghana.
Jane, Ben, Rob, and Concerned citizen of Tanzania: Thank you all for your criticisms. I think that you criticisms are misplaced. Paragraph four of this article reads “HOWEVER, IT IS POSSIBLE THAT, UNLIKE GHANA, TANZANIA MAY BE UNDER-REPORTING ITS CASES GIVEN THE APPARENT OPAQUENESS IN THE RELEASE OF COVID-19 DATA.”
This admission by the article suggests that Tanzania’s figures are not necessarily accurate. So your concerns are addressed in the comparison. However, beyond the fact that Tanzania has been opaque in managing COVID-19 relative to Ghana, the article looks at two key factors that might be explaining the potential variation in confirmed cases we observe across these countries.
I provided both qualitative and quantitative data to support the thesis that variation in law enforcement and compliance and differences in global integration, as measured by the number of international flights and different presidential trips abroad, could advance our knowledge on why Ghana’s cases are growing exponentially compared to Tanzania.
The article does not conclude that the differences in cases imply that the Government of Tanzania is doing something better than the Government of Ghana in containing the virus. It would be great if you could take a second read.