Nearly six months since the London School of Hygiene and Tropical Medicine predicted that every East African country would have more than 10,000 cases, only three of the 19 are reporting that many.

At the start of the COVID-19 pandemic, a lack of health care infrastructure, a history of corruption and a growing economic relationship with China in many African countries led the global community to predict Africa would be the continent hardest hit by COVID-19.

But with over 1.2 billion people, Africa has just over 1.4 million confirmed cases of COVID-19 and 35,182 deaths. The United States, on the other hand, with 7.4 million confirmed cases and 209,502 deaths, has more than five times as many cases and six times as many deaths as the entire continent of Africa–with just a quarter of the population.

Where did the predictions go so wrong? While it’s possible many cases have gone unrecorded due to a lower rate of testing across the continent, that’s not the only reason for such low case numbers.

Over the past 60 years, many African nations have established pandemic response infrastructure due to outbreaks such as Ebola and HIV/AIDs. Countries like Rwanda, for example, have instituted aggressive testing, contact tracing and government-supported quarantine and acted early, treating citizens with candor and allowing them to prepare.

As former Rwandan Minister of Health Dr. Agnes Binagwaho put it, “Rwanda has the highest rate of trust from the population to the health care and vaccination system in the world… we have also brought the services to where the people are living at the community level and also ensured that there will be no stock shortages.”

As the total number of global coronavirus deaths surges past 1 million, these measures could serve as a model for the rest of the world.