The World Health Organization expects the number of Covid-19 deaths in its Africa region to fall sharply this year, compared with 2021, the agency said on Thursday. The prediction was a hopeful one for the world’s least vaccinated continent, though it reflected a vast undercounting of past coronavirus infections and deaths in official tallies.

W.H.O. scientists reported that the agency’s statistical modeling forecast about 23,000 Covid deaths in 2022 in the 47-nation region, which includes most of the African continent. That would be a decline of more than 90 percent from the roughly 350,000 deaths the organization now estimates occurred in 2021.

“We are turning the tide on last year’s catastrophically high Covid-19 death toll in the African region,” Dr. Matshidiso Moeti, the W.H.O.’s regional director, said at a news conference Thursday.

One important factor contributing to the expected decline, Dr. Moeti said, was that vastly more people in Africa have had past coronavirus infections than the official case counts would indicate — and therefore, many more people have some level of immunity that could protect them from severe illness or death, if not from being infected to begin with. The issue of why official death rates in Africa are so low has been a mystery, with experts theorizing a variety of reasons could be playing a role, including the continent’s young demographics, hot weather and low population density in many areas.

Since the pandemic began, the region has reported a total of 11.9 million confirmed infections and more than 253,000 deaths from the virus, according to the W.H.O. But the W.H.O. study, published in The Lancet Global Health, found that there were probably 70 times that many cases that were never confirmed by testing.

For that reason, a bit more than half of the region’s population of 1.1 billion people probably acquired some level of immunity by the start of 2022, though only about 14 percent had been fully vaccinated. (The vaccination rate has since risen to 18 percent.)

A study by South African researchers, published last week but not yet peer-reviewed, found that as many as 98 percent of people in that country had antibodies from either a past infection or vaccination or both. Even so, many still became infected in the nation’s latest virus wave, which began in April and was driven by BA.4 and BA.5, new subvariants of Omicron. New deaths remained far lower, though, than previous waves’ peaks.

To prevent more deaths in the region, Dr. Moeti said, it will be crucial to vaccinate more people who are 65 or older or who have medical conditions that make them especially vulnerable. Vaccine hesitancy, the easing of pandemic restrictions and a variety of logistical problems have hampered vaccination efforts in many countries.

“While the advances in reducing death rates is a huge achievement, and testament to the unwavering efforts of countries and partners, that number is still unacceptably high,” she said.

The W.H.O. study found that death rates from the virus last year were twice as high in the region’s high-income and upper-middle-income nations, particularly those in southern Africa, as they were elsewhere. Dr. Moeti attributed that to higher rates of comorbidities in the more affluent countries, including diabetes, H.I.V., obesity and hypertension.

Noting that new virus variants are continuing to emerge, Dr. Moeti said the organization expected more than 166 million new infections in the region this year.

Livia Albeck-Ripka contributed reporting.

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