Can poorer nations survive Covid-19? If coronavirus is wreaking havoc in western Europe, think how destructive it will be in Africa

He and his neighbours are taking turns to fetch buckets so that people can wash their hands. But even finding water takes time and effort. “We share the same toilets, all of us”, he says.

On Friday night, a curfew was imposed across Kenya, including in the slums of Nairobi. It was chaotic, with police beating up offenders, some of whom simply hadn’t made it home in time because of the punishing traffic. “They are telling us to choose between hunger or Covid 19”, says Njoroge.

The coronavirus has turned life upside down in rich countries like nothing else in most people’s lifetimes. Millions may die, and even if the measures our governments have taken succeed in preventing that, the hit to our economies will last much longer than the lockdowns. But though this challenge may seem incalculable from our comfortable living rooms, the one facing poorer countries is likely to be much more severe.

In most of Africa and the Indian subcontinent, health systems are bare, governments are weak and people are desperately poor. In cities, large proportions of the population live in slums like Mathare without much access to clean water. In Mumbai; 42% do; in Lagos, the figure is 66%. China has high levels of poverty too of course, but in trying to control its epidemic, it was able to use the full weight of its authoritarian state. The Nigerian state does not have such capabilities.

There is reason to hope poorer countries in Africa and Asia will avoid the worst of the epidemic. Some early research suggests the virus may spread less effectively in hot, humid climates. Populations are generally much younger — in most of Africa, the median age is under 20; in India, it is 27 — and young people do seem more likely to be able to shrug it off. Iran, which was hit early by the virus, has so far reported relatively fewer deaths than other countries in a similar point in their epidemic, despite its considerable poverty.

And for all that their states are weak, societies that are used to deaths from transmissible diseases such as malaria, tuberculosis and cholera are resilient in ways comfortable western societies are perhaps not.

But even if death rates did not reach the peaks seen in other populations, if the virus spread widely, it could still be devastating. There are over three billion people in Africa and the Indian subcontinent; if half were infected, and 0.5% died, that would be 7,500,000 deaths. And we have no idea what the effects would be on people who may already be sick with other diseases. Some 25 million people in Africa are living with HIV. In India 15% of the population are undernourished and half of all adult women are anaemic.

Truly effective social distancing measures might be impossible to carry out, but poor countries have to try them anyway. In India, where the state is more capable than many African nations, Narendra Modi’s government has banned all flights in and out of the country and ordered a 21-day lockdown. South Africa locked down before Britain. In Nigeria, where most of the population live on less than $1.90 per day, the army is reportedly ready to enforce social distancing.

But the results have not been altogether reassuring. Lathi-wielding cops in Mumbai have chased down people defying the measure. And there are unintended consequences to a lockdown. Migrant workers, fearing being trapped in fetid dormitories with no work, have started traveling home to their villages, crowding bus shelters. One financial analyst in Mumbai tells me vegetable prices have soared, even as farmers are having to throw away produce in the countryside.

It is worse still in even poorer places. In Goma, a big city in conflict-hit eastern Congo, it is worse. My colleague Olivia Acland has reported on how food prices have shot up since Rwanda closed its border. Eastern Congo only recently recovered from an epidemic of Ebola. People are worried that they may starve.