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When the Liberian political entrepreneur Charles Taylor began an insurgency in 1989, he did so with arms and men from nearby Burkina Faso, whose leader Blaise Compaoré was practically a pyromaniac, lighting conflagrations in Sierra Leone and Ivory Coast as well. When Nigeria, which sees itself as the West African regional hegemon, sent troops to Liberia in 1990, ostensibly as a West African peacekeeping force (the Economic Community of West African States Monitoring Group), the aim wasn’t only to stabilize Liberia and prevent Taylor from taking power, but also to rein in Compaoré’s ambitions and cement Nigeria’s status as the West African powerbroker.

In a recent article in the Journal of Modern African Studies, some colleagues and I found that just 30 percent of African conflicts since 1960 were “internal” and the remainder a mixture of “internationalized internal” and “interstate”: fully 70 percent were actually internationalized in one way or another.

In the DRC, the U.N. Force Intervention Brigade (FIB) is a combat force to supplement the peacekeeping mission, with the aim of suppressing violent insurgents in the east of the country. The most powerful of those armed groups are backed by Rwanda. The FIB’s main troop contributors are South Africa and Tanzania—both of which have political interests in keeping Rwanda’s ambitions in check.

During the last 15 years, as the African Union and United Nations, along with regional organizations such as the Economic Community of West African States, have constructed a new peace and security order for Africa, these patterns of armed interstate rivalry have not gone away

pan-African cooperation to support anti-colonial insurgencies in southern Africa; of mutual destabilization in the Horn of Africa, as Ethiopia sought to cement its position as regional hegemon and undermined governments in Somalia and Sudan and they reciprocated; of Libya’s invasion of Chad and sponsorship of rebels across the Sahel and West Africa to try to establish Muammar al-Qaddafi as the big man of Africa; of rivalries between Nigeria, Ivory Coast, and Burkina Faso fought out in Liberia and Sierra Leone; and of how the path towards Africa’s “great war” in the Democratic Republic of Congo (DRC) was paved by interstate armed rivalries and proxy wars in the African Great Lakes, the Nile Valley, and Angola.

Similar calculations underpin Chad’s dispatch of special forces to Operation Barkhane in Mali, which is a French-led military intervention to fight al Qaeda in the Islamic Maghreb and other insurgent groups. Scores of Chadian soldiers have died, a price that the country’s government is willing to pay because of its own security interests

The backbone of the African Union Mission in Somalia, a combat mission against the militant group al-Shabab, is made up of troops from next-door Ethiopia and Kenya, both of which have used force against Somalia many times over the previous decades. So far, the mission has suffered somewhere between around 750 and 1,150 fatalities—losses that could only be borne by countries with national-security stakes in the outcome.

old patterns of cross-border conflict are now replicated under the banner of peacekeeping

Last year’s peace deal for South Sudan was first and foremost a pact between the country’s two meddlesome neighbors, Sudan and Uganda

Peace agreements for countries such as the Central African Republic, Mali, and Somalia first cater to the interests of the regional powerbrokers and only second deal with internal issues

conflicts are likely to follow the established patterns of combining covert intervention and support to proxies, but overt wars cannot be ruled out

Migration policies are often based on misperceptions, said Johnson Sirleaf. Africans make up only 14 percent of global migration flows and the vast majority stay within the African continent, according to the Ibrahim Forum Report. About 65 percent of the world's migrants come from Europe and Asia.

"These are people moving across borders carrying skills, carrying capital, carrying technology, information, creating jobs, paying taxes,"

Johnson Sirleaf said African and European countries must work together to regulate migration, not try to stop it.

The continent averages less than one intensive care bed and one ventilator per 100,000 people, Reuters found.

Donations have poured in from a foundation set up by Chinese billionaire Jack Ma, and the World Bank is helping procure more than $1 billion worth of equipment for Africa.

even in a best-case scenario, Africa could need at least 111,000 more intensive care beds and ventilators - more than 10 times the number it has at present.

Tanzania, publicly criticised by the WHO for not restricting large gatherings, has sometimes gone for days without updating its coronavirus figures and has refused to tell donors anything about its public health resources

In Madagascar, where the president is pushing a botanically-based remedy untested in an international clinical trial, the health ministry took five weeks to respond to Reuters questions about the number of ventilators in the country.

The WHO does not have the funds to carry out detailed surveys on a regular basis, Yao said. "Information is critical for us to better help," he told Reuters. "It's difficult to anticipate their overall needs if you don't have accurate information."

around 685 tests have been carried out per million people - far below the 37,000 per million in Italy or 22,000 in the United States.

South Africa accounts for 30% of Africa’s tests, although it has less than 5% of the population. Nigeria, which has 15% of the population, has carried out just 2% of testing; it began by testing strategically then broadened it out, Health Minister Osagie Ehanire said. Chad and Burundi have carried out fewer than 500 tests each. Chad said it didn’t have enough testing kits and staff after many of them had fallen ill; Burundi did not respond. Tanzania carried out 652 tests and identified 480 cases.

the World Bank is helping more than 30 African nations source medical supplies. South Sudan recently received a donation of five ventilators, bringing its total to nine. But the new ventilators have yet to be plugged in because the isolation centre is being expanded

Intensive care beds are expensive, difficult to run, and very unevenly distributed. Chad, an oil-rich but impoverished nation of 15 million people, has only 10, whereas the island nation of Mauritius, a financial hub home to 1.2 million, has 121.

The continent’s three giants - Nigeria, Ethiopia and Egypt - have 1,920 intensive care beds between them for more than 400 million people

Kenya has 518 beds in its public and private facilities, but 94% are already occupied by non-COVID-19 patients

Under a best-case scenario - what Imperial College researcher Charlie Whittaker described as a complete lockdown for an indefinite time - at least 121,000 critical care beds will be needed at the peak of the pandemic on the continent, Reuters found. That compares with 9,800 at present

Africa has no history of building ventilators. South Africa’s state-owned defence company Denel plans to begin making them, and institutions in Kenya and Senegal have developed prototypes. But authorities in Senegal say they’ve only certified imports before; it could take months to get a prototype certified and mass-produced.

In many nations like Nigeria, South Sudan and Zimbabwe, electricity is extremely unreliable and hospitals depend on diesel-powered generators. Some health facilities in poorer, often rural, areas are unable to pay for the constant refueling and maintenance they need.

Continent-wide, one doctor serves an average of 80,000 people, World Bank data shows. There are more in wealthy Mauritius - 2 doctors per 1,000 - but countries like Liberia, Malawi or Burundi have far fewer.

only nine countries have one or more physicians qualified to administer anaesthetics per 100,000 people, according to the World Federation of Societies of Anaesthesiologists. Most have staffing levels comparable to Afghanistan or Haiti.

The Africa CDC, set up by the African Union in 2017, worked with the WHO to rapidly roll out testing. In January, only South Africa and Senegal could test for the new coronavirus, but now all African countries can perform tests apart from tiny Lesotho and the island nation of Sao Tome and Principe.

Private hospitals are generally better staffed, but their revenues have dropped by an average of 40% since March, mostly due to a decline in elective surgeries and regular outpatient chronic treatment, said the Africa Healthcare Federation, an umbrella organisation for the private healthcare sector. Private hospitals are also having to spend more on protective equipment, and private insurance companies are delaying settling claims in many countries, said Dr. Amit Thakker, the head of the federation.

numerous leading humanitarian organizations have no specialized anti-trafficking training available for their staff members. Others are still discussing and debating their strategies—months into the pandemic and at a time when international lockdowns mean an estimated 75 percent of humanitarian operations are temporarily on pause.

funding cuts may be exacerbating the very thing that anti-trafficking actors are working to confront: Earlier this month, the World Food Program was forced to slash its food distribution programs by up to 50 percent in trafficking hot spots including conflict-stricken Yemen and refugee camps in Uganda, positioning already socially and economically vulnerable communities on even shakier ground

Restrictions on movement during the coronavirus pandemic won’t stop trafficking. Millions of people are still in captivity, and it’s a common misconception that trafficking must involve crossing international borders.

“You have an increase in economic inequality, stigma, separation from family, the death of family members,” she said, “all of which are well established risk factors for trafficking, and all of which are also the results of both major and localized outbreaks.” The influx of UN peacekeepers (as seen during local and regional outbreaks such as yellow fever in Brazil and Lassa fever in Nigeria) poses an additional risk,

“Trafficking data is unreliable, and so is outbreak data,”

Within two and a half years of the first diagnosis of Ebola in 2014, more than 11,000 people in Guinea, Liberia, and Sierra Leone had died after contracting the virus, and over 16,000 children had lost one or both of their parents. Child sexual exploitation soared: the United Nations Development Program reported that teenage pregnancy increased by 65 percent during the outbreak in Sierra Leone, while research by Plan International, World Vision and Save The Children revealed 10 percent of young people knew of girls who were being forced into prostitution following the loss of a family member. The U.S. Department of State also acknowledged in its 2016 Trafficking In Persons Report that governmental anti-trafficking activities were on pause in Ebola-affected countries—leaving thousands of people at risk.

despite reports of trafficking during the pandemic, governments are redirecting resources away from counter-trafficking activities—placing added pressure on the humanitarian sector to step up

“It’s what happens when people don’t have livelihoods, don’t have social support, cannot afford health care, cannot afford child care. Even in normal circumstances we would say we need to address the factors that make people vulnerable to trafficking. This pandemic has made these things very obvious.”

It may not be possible to predict exactly when an outbreak such as the coronavirus will strike, but it’s not the first time a crisis has seen family structures collapse and left vulnerable groups at risk of exploitation. “It concerns me that this trafficking risk is not being integrated in any systematic way to humanitarian response plans right now,”