Between 300,000 and 3.3 million African people could die as a direct result of COVID-19 (coronavirus), depending on measures taken to stop the spread. Africa is particularly susceptible because 56 percent of the urban population is concentrated in overcrowded and poorly serviced slum dwellings (excluding North Africa) and only 34 percent of the households have access to basic hand washing facilities. Even if the spread of COVID-19 is suppressed in Africa its economic damage will be unavoidable. The impact could be the slowing of growth to 1.8 percent in the best case scenario or a contraction of 2.6 per cent in the worst case. This has the potential to push 29 million people into extreme poverty. A $100 billion fiscal stimulus is needed to immediately address the urgent healthcare needs, provide safety net for the most vulnerable, protect jobs and support economic activity where possible.