Why Do so Many African Leaders Die of COVID-19?

Abstract

This paper provides evidence that the COVID-19-related mortality rate of national government ministers and heads of state has been substantially higher than that of people with a similar sex and age profile in the general population, a trend that is driven by African cases (17 out of 24 reported deaths worldwide, as of 15 February 2021). Ministers' work frequently puts them in close contact with diverse groups, and therefore at higher risk of contracting COVID-19, but this is not specific to Africa. This paper discusses four non-mutually exclusive hypotheses for the Africa-specific trend, involving co-morbidity, poorly-resourced healthcare and possible restrictions in accessing out-of-country health facilities, the underreporting of cases, and the disproportionate impact of the so-called ‘South African’ variant (501Y.V2). The paper then turns its attention to the public health and political implications of the trend. While governments have measures in place to cope with the sudden loss of top officials, the COVID-19-related deaths have been associated with substantial changes in public health policy in cases where the response to the pandemic had initially been contested or minimal. Ministerial deaths also result in a reconfiguration of political leadership, but we do not expect a wave of younger and more gender representative replacements. Rather, we speculate that a disconnect may emerge between the top leadership and the public, with junior ministers filling the void and in so doing putting themselves more at risk of infection. Opposition politicians may also be at significant risk of contracting COVID-19.