Official data substantially underreports the number of Covid-19 cases and deaths in Africa as testing and surveillance capacities are limited in many countries. Estimations of excess mortality show that Africa compares relatively favorably to other world regions, but the reporting gap is particularly high. The authors show that the contraction of economic activity in 2020 was less severe than initially feared but still the worst on record and the first recession in 25 years —with a significant variation across countries. Despite the beginning recovery, the authors expect that the pandemic is likely to have longer-term implications for development as both human and physical capital accumulation have been disrupted by the Covid-19 shock, and fiscal space and monetary policy options are exhausted in many African countries. To reduce the foreseeable pressure on health systems and the economy, the dramatically low vaccination rate of about 5 percent in Africa has to be increased. The international community needs to ensure that a sufficient and affordable supply of vaccines is provided quickly.