The spread of COVID-19 has slowed down economies, increased poverty and gender-based violence, and showed just how ill-prepared many countries’ public healthcare systems are for a global pandemic.

In sub-Saharan Africa, one of the poorest regions in the world, COVID-19 is not the only critical issue that needs to be addressed.

At coronavirus’ onset around the continent in March, it existed alongside challenges such as poor access to quality education, hunger, lack of sanitation facilities, and other issues, such as the effects of global warming and climate change.

Liberia’s former deputy health minister Tolbert Nyenswah, told science and development platform, SciDev, that the pandemic threatens progress made in achieving the United Nations Sustainable Development Goals (SDGs).

“[COVID-19] is a serious setback as some African countries do not have concrete and targeted plans for achieving the SDGs,” said Nyenswah.

He added: “With the increasing number of cases and countries on the African continent, [the] COVID-19 outbreak is stretching the already hard-pressed health care systems to prevent, detect, and respond to infectious disease epidemics and health emergencies.”

As different countries in Africa continue taking steps against COVID-19, here are four humanitarian issues that should not be forgotten.

1. Increasing hunger in East Africa

The second wave of swarms of locusts hit East Africa in April. The swarms have been destroying grazing fields and farming land in Kenya, Somalia, Ethiopia, Djibouti, Eritrea, South Sudan, Uganda, and Tanzania since the beginning of 2020 — eating enough food to feed 35,000 people daily. 

East Africa is historically one of the most food insecure places in the world, according to the United Nations Food and Agriculture Organisation (FAO). “In the region as a whole, more than 40% of people are undernourished, and in Eritrea and Somalia the proportion rises to 70%,” FAO said in a statement.

The statement said that Djibouti, Ethiopia, Eritrea, Kenya, Somalia, Sudan, and Uganda, have a combined population of 160 million people. It added that 70 million of people in the region live in areas that experience regular "extreme food shortages".

FAO also warned that the damage caused by the current swarms could be 20 times more destructive than the previous attacks. 

“The current situation remains extremely alarming in East Africa where it is an unprecedented threat to food security and livelihoods since it coincides with the current growing season,” FAO said in a statement. The swarms have already caused damages worth $8.5 billion (R156 billion).

Cyril Ferrand, FAO’s resilience team leader in East Africa, told the Guardian that the locust attacks of 2020 are the most damaging swarms when it comes to food security, and that more than 20 million people will experience food shortages and hunger.

2. Armed conflicts are increasing the number of internally displaced people around the continent

Armed conflicts have become life as usual in parts of Mali, Cameroon, Burkina Faso, and other parts of sub-Saharan Africa.  Northern Mali has been in conflict since 2012, when insurgents attacked the historic town of Timbuktu before the war spilled over to other areas in the region. 

There were 280,000 internally displaced people recorded in the country between January and December 2019. Meanwhile, there are 19 million internally displaced people in sub-Saharan Africa, according to the United Nations Children’s Fund (Unicef).

That’s four out of 10 internally displaced people globally. Wars and armed conflict don’t just threaten human health and lives. They impact a country’s progress in meeting the targets set by the United Nations Global Goals.

“Countries that have experienced violent conflicts in the recent past are among the most vulnerable countries and face bigger challenges in meeting the targets than other developing countries,” according to a report by the United Nations' Department of Economic and Social Affairs.

At the moment, Mali, Burkina Faso, the Democratic Republic of the Congo (DRC), South Sudan, Mali, and Chad  — which are currently experiencing some sort of conflict or recovering from it — are ranked at numbers 144, 146, 156, 154, and 157 on the World Bank’s Human Capital Index (HCI).

The HCI measures the knowledge, skills, and health that people gain throughout their lives to enable them to realise their full potential as productive members of society.  It measures how countries deliver on health, education, and economic targets, and their life-long impacts on citizens. The current index is made up of 157 countries.

3. Girls’ rights and access to education 

Child marriage and lack of education are among some of the greatest challenges faced by girls in Africa. According to UNICEF, there are 12 million girls in Africa who are forced into marriage before they’re 18 years old.

Early marriage increases the likelihood of death as a result of complications from pregnancy and childbirth, while children born to underage mothers are more likely to have low birth weight or die within a month of being born.

Girls also bear the brunt of sub-Saharan Africa’s low access to education. Some 9 million girls aged between six and 11 in the region will never get the opportunity to go to school. The figure is 6 million for boys. Meanwhile, 23% of girls are out of primary school, compared to 19% of boys.

“Thirteen out of 15 countries in the world where more than 30% of primary school age girls are out of school are in sub-Saharan Africa,” Agnes Odhiambo, a senior researcher at Human Rights Watch, said in African Arguments.

“As girls get older, the gender gap in education steadily widens,” she continued. “By upper secondary school (grades 10 to 12), there are gender disparities in 91% of the region’s countries.”

Odhiambo said the pandemic could threaten progress already made in improving access to education, and added that COVID-19 school closures have harmful effects that could span a girl’s lifetime.

“Schools typically provide safe spaces for girls. When they are in school, they are less likely to be forced into marriage. During this pandemic, however, schools are not there to protect girls,” she added.

4. Floods, cyclones, and other impacts of global warming

Despite being responsible for just 2% to 3% of global carbon emissions, Africa is more vulnerable to climate change and its effects are already being felt.

From unpredictable and extreme weather like droughts, floods, and cyclones, to humanitarian crises like malnutrition and hunger, climate activists around the continent say it is becoming increasingly urgent for Africa to make a stand for climate action.

Floods displaced almost 107,000 people, and killed 31 people in Madagascar in January. Meanwhile, more than 7.7 million people in Zimbabwe will face food insecurity as a result of back-to-back droughts.

These are not the only climate-related humanitarian disasters that the continent has experienced in recent months. There have also been floods and droughts in East and Central Africa. In Somalia, droughts in September 2019 left 2 million people on the brink of hunger, and 3 million more without a guaranteed daily meal.

Climate change impacts food and economic security. It also worsens the impact of armed conflicts as it limits humanitarian access to affected populations, according to Bernt Apeland, Secretary General at Norwegian Red Cross.

In Mozambique, Malawi, and Zimbabwe, Cyclone Idai — which hit in March 2019 and resulted in the worst floods in Southern Africa in more than 20 years — was followed by hunger, sexual exploitation and a cholera outbreak.