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Assessing the impact of Covid-19 on older people in the African Region: a study conducted by the World Health Organisation Regional Office for Africa

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Executive Summary

The COVID-19 pandemic has had a significant impact on older persons both globally and in the African region. Although overall the region’s population is younger relative to many other world regions, the WHO AFRO region has a population just over 62 million older people and is ageing rapidly, with the number of older people expected to triple in the next three decades (Aboderin et al., 2020).

As has been the case in other countries, risk of severe illness and mortality among people infected with COVID-19 has mainly been concentrated among people with co-morbidities, particularly non-communicable diseases (NCDs). Older adults are also at significantly greater risk of complications from COVID-19 and case fatality rates increase significantly with age due to reduced immunity (Bandaranayake and Shaw, 2016) and the increased likelihood of pre-existing chronic disease (Clark et al., 2020; Kuylen et al., 2021) as well as reliance on other people due to frailty and disability (Wilkinson, 2020). Persons over 60 represent a significant proportion of lives lost in the global pandemic(Comas-Herrera et al., 2020) and over 50% of the deaths in the region (WHO Regional Office for Africa, 2020) In resource-constrained African countries, older persons are at enhanced risk of COVID-19 mortality due to poor access to critical care (Biccard et al., 2021). Case fatality rates and excess mortality figures have been significantly higher among older people across the region

The UN Secretary-General’s Policy Brief on the Impact of COVID-19 on Older Persons (United Nations Sustainable Development Group, 2020) highlighted the vulnerabilities of older people and impacts – mortality, economic well-being, mental health, vulnerability, abuse and neglect, as well as the work that older people do as essential workers and care providers. He called on older people to be integrated into the overall socio-economic and humanitarian responses to covid and for health, social and long-term care services to older people to be strengthened. One year on, it is important to assess the impact of the pandemic on older people in the region and understand to what extent the call to include older people was heeded.

This report aims to achieve the following objectives:

• Gather and analyse health, social and economic data available on COVID-19 in older people in countries including those most affected by COVID-19.

• Conduct critical analysis of COVID-19 mitigation measures that have been implemented by countries including essential health services for older people, gaps and needs to be further addressed by African countries.

• Document experiences, good practices and lessons learned that can be shared among countries.

• Propose concrete actions in mitigating COVID-19 impact in older people

• Propose priority actions in the recovery period in context of the UN Decade of Healthy Ageing 2021-2030 for WHO AFRO and for African countries.

Methodology

The study primarily a desktop review, complemented with regional and national stakeholder interviews for six country case studies.

The review of the grey and published literature and existing data sets included: distillation, review and comparative synthesis of existing data and evidence from official global databases and available WHO data, repositories, scientific and grey literature and continental reporting mechanisms. We captured evidence for the continental-level and country-level data for the 47 countries in the WHO AFRO region to produce a) an analysis of the impact of COVID on older persons at the national, sub-regional and regional level;

b) critically analyse COVID-19 impact mitigation measures at the national, sub-regional and regional level.