At the time of writing (April 2020), Africa, accounting for only 0.8% of confirmed cases and 0.6% of deaths worldwide, is marginal to global analysis of coronavirus. This situation seems very likely to change, given the fragility of African health systems, the prevalence of underlying health conditions such as AIDS and tuberculosis, the density of urban populations, and the difficulties faced by many households in achieving social distancing, isolation, and frequent handwashing. These potentially catastrophic factors may be offset by Africa’s youthful age structure and practices of social solidarity which often remain very strong. We can certainly hope that the direct impact of the pandemic will continue to be limited across the continent. But the indirect consequences, such as the undermining of the World Health Organisation, the interruption and likely refocusing of global health research, and the abrupt interruption of networks of trade and investment, seem likely to be disproportionately negative in Africa.