(JOHANNESBURG) — Africa’s confirmed coronavirus cases have surpassed 1 million, but global health experts say the true toll is likely several times higher, reflecting the gaping lack of testing for the continent’s 1.3 billion people.

While experts say infection tolls in richer nations can be significant undercounts, large numbers of undetected cases are a greater danger for Africa, with many of the world’s weakest health systems. More than 22,000 people have died of COVID-19.

The World Health Organization calls the milestone a “pivotal point” for Africa as infections in several countries are surging. The virus has spread beyond major cities “into distant hinterlands” where few health resources exist and reaching care could take days.

Immediately knowing they were at a disadvantage, African nations banded together early in the pandemic to pursue badly needed testing and medical supplies and advocate for equitable access to any successful vaccine. Swift border closures delayed the virus’ spread.

But Africa’s most developed country, South Africa, has strained to cope as hospital beds fill up and confirmed cases are over a half-million, ranking fifth in the world. The country has Africa’s most extensive testing and data collection, and yet a South African Medical Research Council report last week showed many COVID-19 deaths were going uncounted. Other deaths were attributed to other diseases as people avoid health centers and resources are diverted to the pandemic.

It’s all a warning for Africa’s other 53 countries of what might lie ahead. While dire early predictions for the pandemic have not played out, “we think it’s going to be here at a slow burn,” the WHO’s Africa chief, Matshidiso Moeti, said Thursday.

Just two African countries at the start of the pandemic were equipped to test for the virus. Now virtually all have basic capacity, but supplies are often scarce. Some countries have a single testing machine. Some conduct fewer than 500 tests per million people, while richer countries overseas conduct hundreds of thousands. Samples can take days to reach labs. Even in South Africa, turnaround times for many test results have been a week or longer.

“We are fighting this disease in the dark,” International Rescue Committee expert Stacey Mearns said. In addition, Africa has just 1,500 epidemiologists, a deficit of about 4,500.

African nations overall have conducted just 8.8 million tests since the pandemic began, well below the Africa Centers for Disease Control and Prevention’s goal of 13 million per month. Countries would love to increase testing if only supplies weren’t being snapped up by richer ones elsewhere.

Africa CDC director John Nkengasong said estimating the true number of cases on the continent is “very tricky.” Some 70% of infections are asymptomatic, he has said. Africa’s young population also might be a factor. Without a dramatic increase in testing, “there’s much we don’t know.”

But some experts are making their best guesses.

Africa likely has at least 5 million infections, said Ridhwaan Suliman, a senior researcher at South Africa’s Council for Scientific and Industrial Research. He believes the true number in South Africa alone is at least 3 million. The country has conducted far more tests than any other in Africa — more than 3 million — but in recent days about 25% have come back positive. Because of shortages, South Africa largely limits testing to health workers and those showing symptoms.

Experts see South Africa as an indication of what’s to come elsewhere.

Sema Sgaier, an assistant professor of global health at Harvard and director of the Surgo Foundation, thinks the number of infections across Africa could be more than 9 million. The U.S.-based Institute for Health Metrics and Evaluation puts the number at more than 8 million. And Resolve to Save Lives, led by Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention, estimates it could be 14 million.

For Resolve to Save Lives senior vice president Amanda McClelland, the more worrying number is not the overall cases but the health workers infected across Africa — now about 35,000. That affects care for everyone on a continent whose shortage of workers has been called catastrophic.

Reflecting the pandemic’s diverse nature across Africa, just five countries account for 75% of confirmed cases: South Africa, Egypt, Nigeria, Ghana and Algeria. Nigeria alone could have had close to 1 million cases by now if Africa’s most populous country hadn’t acted quickly, the Africa CDC’s Nkengasong said.

Still, with insufficient testing, people live with the fear that loved ones may have had the virus without knowing for sure.

In Burkina Faso, Yaya Ouedraogo lost his uncle and cousin in April. Both were in their 70s with a history of high blood pressure and diabetes, and both had complained of shortness of breath, fever and body pain, he said.

“They had all the symptoms of coronavirus, but in certain areas no one was investigating it and they didn’t get tested,” he said.

The WHO Africa chief has said officials don’t think the continent is seeing a “silent huge epidemic,” with thousands dying undetected, but she acknowledged under-reporting of cases.

“What we’d like to see — to be able to be really confident — is higher testing rates,” Moeti told reporters last week, and she criticized the “very distorted global market” in which richer countries have the bulk of testing materials while poorer ones scrape by on just hundreds of tests a day.

Moeti also worries about a related danger for which even less data exists: the number of deaths from diseases such as malaria, HIV and tuberculosis as resources are diverted to COVID-19.

Whatever Africa’s real coronavirus toll, one South African church has quietly been marking the country’s “known” number of deaths by tying white ribbons to its fence. The project’s founders say each ribbon really stands for multiple people.

Already, the Rev. Gavin Lock wonders about what to do when the length of fence runs out. Maybe they’ll change the ribbons’ color to represent 10 people, or 50.

“It’s a work in progress,” he said.

___

Associated Press writer Sam Mednick in Ouagadougou, Burkina Faso, contributed to this report.

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(Bloomberg Opinion) — Next week the U.S. will try to get the U.N. Security Council to do something it has been trying to get its allies to support for the last year: Extend the U.N.’s conventional arms embargo against Iran, which is slated to expire in October. The resolution will almost certainly fail, but that doesn’t mean America’s Iran policy has to be a failure.Secretary of State Mike Pompeo announced that the U.S. would introduce the resolution on Wednesday, a day before he announced that his senior envoy on Iran policy, Brian Hook, would be leaving. The U.N. Security Council would make an “absolute mockery” of its mission to maintain international peace and security, Pompeo said, “if it allowed the No. 1 state sponsor of terrorism to buy and sell weapons freely.”Pompeo is not wrong. One of the many flaws of the 2015 Iran deal is that it allowed for the arms embargo to expire in the first place. That concession was in part at the behest of China and Russia, which were part of the negotiations, and the two nations are likely to use their veto at the Security Council to scuttle the resolution. Thus the U.S. strategy to extend the embargo is destined to fail.U.S. Ambassador to the United Nations Kelly Craft has acknowledged as much. “Russia and China are going to be who they are,” she told me in an interview this week at the Aspen Security Forum. “I’m not going to be able to change their minds. However, what we can do is change the way other countries look to them and look at them, and that’s what’s important.” In other words, Pompeo’s strategy in the short term is to shame two great-power rivals at the U.N.But Pompeo has another card to play. If and when the U.S. loses the U.N. vote to extend the arms embargo, it could still theoretically impose it — “snap back” is the diplomatic term — through a provision of the 2015 nuclear deal that President Donald Trump withdrew from in 2018. As Pompeo told reporters Wednesday, that is “an option that’s available to the United States, and we’re going to do everything within America’s power to ensure that that arms embargo is extended.”On the surface, it’s a strange maneuver. The snap-back provision of the U.N. Security Council resolution that codified the Iran nuclear deal was designed as a tool for states that were a party to that agreement. As Anthony Blinken, a former deputy secretary of state and adviser to Joe Biden’s presidential campaign, said this week at the Aspen Security Forum: “Snap back needs to be invoked by a participant in the deal.”Others disagree. Richard Goldberg, who managed the maximum pressure campaign against Iran at the U.S. National Security Council, told me the U.N. resolution that codified the nuclear deal “was drafted precisely to defend the U.S. right to snap back, in any scenario, at any time.” If Iran is in breach of its commitments, he said, the U.S. has the right to snap back previous resolutions that were lifted as a result of the nuclear deal — regardless of whether the U.S. remains a party to that agreement.Regardless of the legalities of the current or future conventional arms embargo against Iran, there is a very good chance that Russia and China will move to arm the Iranians anyway. International law has not stood in the way of these countries before. China has already begun discussions for closer security partnership with Iran.For now, Pompeo’s play at the U.N. is mainly symbolic. As Craft told me, the rest of the world will see that China and Russia “have blood on their hands.” But anyone who’s paid attention for the last 75 years probably knew that already.The most realistic strategy for the U.S. moving forward — under either Trump or Biden — will have to be unilateral. It’s foolish to expect the U.N. to promote security and peace in the Middle East when two of the permanent members of the U.N. Security Council do not have the same interests as the U.S. and its allies in the region.A better approach is for the U.S. to use its Navy, its allies and its vast intelligence capabilities to interdict arms shipments to Iran. The U.S. has used this strategy before, under President George W. Bush against North Korea. It should consider it again when it comes to Iran.This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.Eli Lake is a Bloomberg Opinion columnist covering national security and foreign policy. He was the senior national security correspondent for the Daily Beast and covered national security and intelligence for the Washington Times, the New York Sun and UPI.For more articles like this, please visit us at bloomberg.com/opinionSubscribe now to stay ahead with the most trusted business news source.©2020 Bloomberg L.P.

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(COLOMBO, Sri Lanka) — Sri Lanka’s powerful Rajapaksa brothers secured a landslide victory in the country’s Parliamentary election, according to results released Friday.

Prime Minister Mahinda Rajapaksa is most likely to be sworn in the same position by his younger brother, President Gotabaya Rajapaksa.

The election results could enable them to change the constitution and strengthen dynastic rule.

“Sri Lanka People’s Front has secured a resounding victory according to official results released so far,” Gotabaya Rajapaksa said in a Twitter message. “It is by belief that that the expectation to have a Parliament that will enable the implementation of my ‘vision for prosperity’ policy will be reality tomorrow,” he said.

The Rajapaksas’ Sri Lanka People’s Front won 128 seats out of the total 196 seats while its main opponent had obtained only 47 seats, the election commissions’ results showed.

Sri Lanka’s parliament has 225 seats, of which 196 members are directly elected while 29 are named from a national list according to the number of votes received by each party or independent group.

The Rajapaksas’ party will get more seats from the national list, which will be announced later Friday.

The brothers need 150 seats or control of two-thirds of seats in Parliament to be able to change the constitution. However, analysts say any attempt by Gotabaya Rajapaksa to push for changes that will strengthen presidential power at the expense of those of the prime minister may trigger sibling rivalry.

Sri Lanka had been ruled by powerful executive presidents since 1978. But a 2015 constitutional amendment strengthened Parliament and the prime minister and put independent commissions in charge of judiciary appointments, police, public services and the conduct of elections.

Gotabaya was elected president last November after projecting himself as the only leader who could secure the country after the Islamic State-inspired bombings of churches and hotels on Easter Sunday that killed 269 people. Since being elected, he has said he had to function under many restrictions because of the constitutional changes.

However, Mahinda Rajapaksa is unlikely to cede any of his powers that might shrink his influence as he works on promoting his son Namal as his heir. Namal and three other members of the Rajapaksa family contested the election and are likely to control key functions in the new administration.

The landslide victory also raises fears of weakening government institutions such as independent commissions for elections, police and public service.

Votes were counted Thursday after the election on Wednesday, which was held under an election commission that emphasized following health guidelines to prevent the spread of the coronavirus.

More than 70% of the country’s more than 16 million eligible voters cast ballots.

The election was originally scheduled for April, but it was twice postponed because of the COVID-19 pandemic. Sri Lanka has largely contained the spread of the virus with 2,839 confirmed cases, including 11 deaths.

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