As the coronavirus pandemic has swept across the world in 2020, it has become increasingly evident that in the vast majority of countries on the African continent, most deaths are never formally registered. Reliable data on a country’s deaths and their causes are hard to come by, which means governments can miss emerging health threats — whether Ebola or the coronavirus — and often have to formulate health policy blindly.

Covid-19 is often said to have largely bypassed Africa. Some epidemiologists posit that its youthful population was less at risk; others that prior exposure to other coronaviruses gave some protection. But like other diseases, its true toll here will probably never be known, partly because elevated mortality rates cannot be used as a measure as they are elsewhere.

Stéphane Helleringer, a demographer who has worked on mortality in several African countries, said that on the African continent, “There are very, very few countries that even attempt an estimation of mortality based on death rate.”