The Covid-19 pandemic revealed selfish attitudes in international relations, most notably when developed countries hoarded vaccines and did not share them with developing countries, especially in Africa. However, there have been signs of humanitarian solidarity among the countries of the South within the boundaries of their limited resources dedicated to humanitarian relief.
Egypt carried out robust health diplomacy in Africa by sending medical and technical aid to mitigate the impacts of the pandemic, and Egypt’s political leadership adopted diplomatic initiatives at regional and international conferences to promote Africa’s right to the fair distribution of vaccines to offset the pandemic.
Egyptian humanitarian action in Africa indicated two things. First, there was the importance of its approach in linking humanitarian and development diplomacy in Africa by combining emergency relief with technical and training assistance, including in the health and disease-control sectors.
Second, there was Egypt’s robust comeback to the African fold after its membership of the African Union (AU) was suspended in 2013. Egypt was reinstated one year later and participated in the Malabo Summit in Equatorial Guinea in 2014, represented the African continent at the UN Security Council in 2016, and chaired the AU in 2019.
There are still challenges facing Egypt’s humanitarian role in Africa in the face of epidemics and disasters, however, especially since this role recently became part of a push to support Egypt’s national interests on the continent.
The first challenge regards Egypt’s humanitarian role and national interests. Theoretically, countries send aid to others in need based on the principles of neutrality, independence, and prioritising humanitarian motives.
However, in reality it may be difficult to separate this philanthropy from a country’s interests, whether in a long-term strategy, such as building a safer global climate, since the assumption is that solidarity is linked to global security, or in a short-term one intended to serve commercial and security interests, as well as establish influence and soft power by influencing the policies of the recipient country in favour of the donor.
Accordingly, humanitarian aid can become politicised, which manifests itself in international relations due to the flow of global humanitarian funding and reflects the structural geopolitical disparity of strength and weakness in the global system.
The 2021 Global Humanitarian Assistance Report put together by the international group Development Initiatives showed that the countries that donated the most in humanitarian aid in 2020 were the US, Turkey, Germany, the EU, the UK, and others, while the countries that received the most were Syria, Yemen, Lebanon, South Sudan and the Democratic Republic of Congo. The recipients are usually the subject of conflicting interests by the major donors.
The tool of humanitarian aid has also accompanied international conflicts since the Cold War, and it followed Western military interventions in Somalia, Iraq, and Afghanistan and is now part of today’s ongoing US-Chinese competition in the world arena.
Over the past two decades, there has been a tendency in global humanitarian trends to reduce the politicisation of humanitarian aid by linking it to peace-building and development and adhering to efficient direction and sensitivity in sending aid to afflicted regions.
However, this has not always prevented political interests from remaining a motivator behind the flow of humanitarian aid. Since Africa is in dire need of this aid due to state failure, conflicts, refugees, terrorism, poverty, disease, epidemics, and other issues, countries there are a good target for using humanitarian aid to serve the interests of competing foreign powers.
Based on the link between what is humanitarian and what is political, we can understand Egypt’s interest in playing a humanitarian role in Africa.
Essentially, this is due to geographical connections, a joint historical heritage, the spirit of African solidarity and unity which Egypt has supported since the continent’s independence from colonialism, as well as the vital interests which Egypt shares with other African countries. These include security, stability, bolstering economic relations, influence, regional stature and soft power.
Egypt’s interests have come under serious pressure in Africa over the last decade, with its water security being threatened by Ethiopia’s Grand Ethiopian Renaissance Dam (GERD), instability in Sudan, the spread of terrorism in Libya, and the heightened interest of foreign powers in Africa that has diminished Egypt’s regional role on the continent.
Although Egypt is not a major donor of humanitarian aid to Africa compared to the US and Europe, it has created a humanitarian role for itself either through limited resources or giving expertise to aid affected communities, or joint funding with regional institutions and donor countries.
One quarter of Egypt’s diplomatic representation is concentrated in Africa, which allows it to attend to the needs of countries facing crises or disasters. Egyptian institutions and experts have extensive experience in infrastructure that meets the needs of Africa and makes it possible to export Egyptian expertise to African countries.
Even though Egypt’s regional role on the continent has waned as other regional powers have gained traction, Cairo has maintained its image as a peace-building state that has not bloodied its hands in African conflicts. In fact, Egypt now participates in eight of the nine peacekeeping missions in Africa, which means there is a general acceptance of its humanitarian role in African countries, confirmed by Cairo being the headquarters of the AU’s Centre for Post-Conflict Reconstruction and Development (PCRD).
Africa has also once again become the centre of attention for the Egyptian leadership, which plays an influential role in reviving foreign policy. After focusing on the home front after the 25 January and 30 June revolutions, since he came to power in 2014 President Abdel-Fattah Al-Sisi has jumpstarted action on the Africa front by participating in most African summits.
Al-Sisi’s visits to Sub-Saharan African countries have also come in third place in his overseas travels, with 30 visits during his seven-year rule, including to 12 Sub-Saharan African countries (Ethiopia, Equatorial Guinea, Rwanda, Uganda, Kenya, Tanzania, Gabon, Chad, Guinea, Senegal, Cote d’Ivoire, and South Sudan). He has also visited several Arab African countries, including Sudan, Algeria, Tunisia, and Djibouti.
These advantages for Egypt, coupled with mounting pressure on its southern and western borders, have fuelled the revival of its humanitarian role. The Egyptian Fund for Technical Cooperation with Africa (EFTCA) was established in 1980, and one of its tasks was to provide grants and humanitarian aid to the African continent. The EFTCA was replaced by the Egyptian Agency of Partnership for Development (EAPD) in 2014. Meanwhile, the contributions of various ministries and institutions, such as the ministries of defence and health and population, the Red Crescent, Al-Azhar, various universities and others, have grown in providing humanitarian and technical aid to Africa.
Health diplomacy is a facet of the humanitarian role of governments, and it overlaps with humanitarian and political issues.
It involves the geopolitical use of medical aid to mitigate epidemics and diseases in order to achieve specific interests, either globally and strategic or direct and short-term. These two types of interests have been motivators for health diplomacy in Africa. When the Ebola epidemic spread in West Africa between 2014 and 2016, for example, cooperative global diplomacy emerged, especially between Europe and the US, to provide medical aid to these countries to combat the epidemic.
Egypt participated in this global effort by contributing $1 million to the African action plan against this epidemic in 2014.
In contrast, global cooperation has been lacking during the Covid-19 pandemic, even though this is a more global, not regional, outbreak which has fuelled the US-China dispute. The administration of former US president Donald Trump blamed Beijing for spreading the pandemic, and Washington went as far as to suspend its funding to the World Health Organisation (WHO).
The pandemic also put economic pressure on donors around the world that were unable to pay their dues for humanitarian aid. For example, according to UN reports, demands for funds for humanitarian relief around the world came to $37 billion in 2021, but the response was only 46 per cent at $17.2 billion. This shortage in funds decreased the work of UN and NGO humanitarian agencies and NGOs in conflict areas.
The Covid-19 pandemic also highlighted the unjust distribution of vaccines. While the US and European countries succeeded in vaccinating 70 per cent of their populations against Covid-19, the African countries had reached less than two per cent of their populations by December 2021.
This means the pandemic will have a worse impact on Africa, especially in terms of a political, economic, and health backlash, particularly with the emergence of the Omicron variant in Africa and the rise in infections by other mainly endemic diseases, such as malaria and others, resulting from the disruption of health services and the focus on combating Covid-19.
With negligible global cooperation, some governments, such as Egypt’s, have chosen health diplomacy either bilaterally or regionally to advance their interests. Egypt sent medical humanitarian aid to China, the US and Italy in 2020, and the pandemic was an opportunity for Cairo to expand its humanitarian role in the field of health in Africa, which needed more health and medical clinics, medicines, and so on.
Egypt appeared to have a relative advantage in health diplomacy in Africa for two reasons. First, it has qualified medical workers, a pharmaceuticals industry, technical expertise and experience in combating disease, and more of all of these things relative to its African peers.
In the case of Hepatitis C, Egypt was able to slash the cost of supplying the medicine Sovaldi from the US to less than one per cent of its regular price, for example. As a result, the disease has lessened in incidence thanks to the 100 Million Health campaign in recent years.
Second, Cairo focused its medical action in Africa before Covid-19 on transferring its expertise, training, and building hospitals in African countries through the EAPD, the Ministry of Health and Population, and other Egyptian medical centres. For example, an Egyptian wing was created at the Ethiopian Cardiac Centre in 2016, as well as other clinics in Ethiopian hospitals such as St Paul’s Hospital and the Black Lion Hospital.
The pandemic thus cemented the link between Egypt’s humanitarian and development roles in Africa, building regional capital for Egypt in African societies. More than half of the continent’s population of 1.3 billion people are unable to access health services, and African countries rely on importing medicines since less than two per cent of consumed pharmaceuticals on the continent are manufactured there.
There are several aspects of Egypt’s humanitarian actions in Africa, although it is difficult to determine their size and percentage of GDP since they are dispersed among several Egyptian agencies and institutions.
Egyptian humanitarian and medical aid to Africa is focused on the Nile Basin region, the Horn of Africa, and the Sahel, which have the most impact on Egyptian interests in Africa.
In terms of emergency aid, Cairo provided urgent medical supplies and medicines to help the African health sectors mitigate the impacts of Covid-19. President Al-Sisi gave directives in September 2020 to send medical aid worth $4 million to 33 African countries during the crisis.
Medical aid in 2020 and 2021 went to Libya and Tunisia (North Africa) and Sudan, South Sudan, Somalia, Uganda, Eritrea, and Djibouti (East Africa). Egypt also responded to flood victims in 2020 and 2021, especially in Sudan and South Sudan, by sending urgent food and medical supplies through the ministries of defence and health and population.
In terms of medical convoys, these usually focus on treating patients, dispensing medicines for free, and combating specific diseases in Africa. Egypt participated in medical convoy diplomacy before and after the start of the Covid-19 pandemic. According to Ministry of Health statistics published in February 2016, six medical convoys went to Somalia, the Democratic Republic of Congo, Sudan, Burundi, and Uganda in 2012. Four went to Chad, Somalia, Sudan, and Tanzania in 2013; two to Sudan and South Sudan in 2014; and three to Eritrea, Ghana, and Sudan between the end of 2015 and February 2016.
Egypt’s medical convoys also included Equatorial Guinea, where they established a quarantine regimen for the 2015 Africa Cup of Nations. In 2019, Al-Azhar sent medical convoys to Sudan, Nigeria, Chad, the Central African Republic and Burkina Faso, as well as South Sudan for an eye clinic in February 2020. Another eye clinic went to Tanzania in August 2021 and Djibouti in November 2021.
In terms of technical aid, the Foreign Ministry’s EAPD focuses on training Africans in aspects of state building, in which Egypt has a relative advantage compared to others in Africa, including health, judiciary, food security, peace and other things. It also provides medical and humanitarian aid, sends experts, and raises money for development projects through cooperating with local and international partners such as the African Development Bank (AFD), the Islamic Development Bank, the Arab Fund for Technical Assistance to African Countries (AFTAAC), and the Japan International Cooperation Agency (JICA), which assists in training programmes.
According to the EAPD’s official Website, more than 7,000 participants from 42 countries have benefited from these training programmes. The EAPD has also created several health centres, such as two clinics for eye and dental care in Eritrea and one clinic in South Sudan.
This role of the EAPD is a continuation of the activities of the EFTCA, which sent 8,000 experts to African countries between 1980 and 2013, as well as delivering financial grants and humanitarian and medical aid during times of disaster and disease outbreaks.
Regarding health initiatives, Cairo worked to export its experience in the 100 Million Health initiative to Africa in cooperation with the WHO. During its presidency of the AU in 2019, the political leadership launched an initiative to treat 100 million Africans with Hepatitis C in 14 countries, after Egypt’s success in dealing with this disease at home.
The initiative was implemented in South Sudan, Sudan, Chad, Djibouti, Ethiopia, Eritrea, Somalia, Mali, Equatorial Guinea, Uganda, and Tanzania. According to the Ministry of Health, by November 2020 more than 37,000 Africans had been identified during this campaign.
Regarding conference diplomacy, the Egyptian political leadership has been remarkably effective, especially regarding the Covid-19 pandemic in Africa. For example, President Al-Sisi participated in a mini-summit in July 2020 with several African leaders to confront the impact of Covid-19 and mobilise the resources of the AU.
At a summit on financing the African economies in Paris in May 2021, he called on the world community to provide the necessary support for African countries as an act of justice and solidarity in the face of the pandemic.
It is notable that Egypt reinforced its humanitarian discourse in confronting Covid-19 with a developmental one to further embed its role on the continent. It agreed with China and Russia to manufacture the Sinopharm and Sputnik-G vaccines, respectively, making Cairo the hub for manufacturing and distributing the vaccines to Africa.
Egypt faces fierce competition from regional and international powers in the field of humanitarian work, especially Turkey, the Gulf states, South Africa, and others.
These are actors that link humanitarian aid with building geopolitical and geoeconomic influence in regions that are vital to Egypt’s interests, especially in east and west Africa.
Due to this competition and Egypt’s limited resources for humanitarian aid, there is a need to raise the efficiency of humanitarian spending in Africa. However, this faces problems, such as the absence of an Egyptian national strategy that defines the nature of goals and priorities in the field of humanitarian aid, as well as the lack of a general institutional framework that brings together various governmental and non-governmental institutions under one umbrella to work on Egypt’s humanitarian diplomacy in Africa.
This institutional framework should help in dealing with red tape when local institutions are sending aid overseas, sending or resending aid without adequate coordination or research about humanitarian needs in afflicted countries, or having to send limited aid to more countries. One of the problems the EFTCA faced was having to send development and humanitarian aid to 44 countries. The problem persisted when the EFTCA was replaced by the EAPD, which delivered aid to 42 countries.
This weakens the political benefit of aid because Egypt is not a major donor that can cover aid in large swaths of Africa.
It is notable that despite the revival in Egypt’s humanitarian role in Africa during the Covid-19 pandemic, there is still a serious deficit in defining this role and its dimensions. For example, the websites of the EAPD and Egyptian Red Crescent do not include regular reports on annual activities that show the volume and value of humanitarian aid. This means Egypt should issue an annual humanitarian report to give a clearer picture to public opinion overseas of the humanitarian aid it provides.
There is also the problem of Egypt relying on humanitarian tools that are closely linked to official state institutions and only cooperating with African governments in humanitarian relief due to Egypt’s weak civil society and inability to create unofficial paths that can influence African societies. This reduces the ability of Egypt’s humanitarian role to serve its interests.
Despite criticisms of Egypt dabbling in popular diplomacy in Africa after the 25 January Revolution, because it was not institutionalised, sustainable, or experienced enough to deal with the African countries, unofficial humanitarian and development efforts still remain undeveloped.
There is a growing trend, however, to integrate Egypt’s private sector in combining humanitarian and development diplomacy in Africa. For example, there was the opening of an Egyptian medical centre in Uganda in October 2021 through cooperation between the Egyptian government and Egyptian pharmaceutical companies to increase their exports to the African countries.
By expanding the role of the private sector in African humanitarian aid, Egypt would be able to circumvent the funding gap for humanitarian aid and not submit to the agendas of global partners when funding humanitarian relief or the training that Egypt delivers in Africa.
In conclusion, Egypt needs to create a national index to improve the efficacy of spending on humanitarian relief by institutions that send aid to Africa. This would provide a proper assessment of the performance of institutions such as embassies and commercial offices, which play a role in assessing humanitarian needs and priorities in afflicted states.
It is also important to benefit from Egyptian academic institutions interested in Africa, since these can give early warning of the need for humanitarian aid at times of crisis and disaster, helping to trigger an Egyptian humanitarian response in Africa.
* The writer is a researcher at Al-Ahram.
*A version of this article appears in print in the 17 February, 2022 edition of Al-Ahram Weekly.