COVID-19 poses significant challenges to an already strained rural context in Africa. The growing direct impact of COVID-19 is affecting health, in terms of morbidity and mortality, as well as quickly overburdening health care services with negative repercussions for non-COVID related health problems, but even before COVID-19 had spread in Africa, the socio economic impact was felt. The sharp decline in demand and production from the most economically developed countries where contagion had initially hit hardest—China, EU and the USA—has caused a global recession, with direct repercussions in Africa. With the spread of the virus in the continent, containment measures, including social distancing, closing of schools, the prohibition of gatherings and the closure of non-essential businesses and economic activities may have devastating consequences.