The new coronavirus, officially named SARS-CoV-2, has created unprecedented instability around the world. According to the Johns Hopkins Coronavirus Resource Centre, as of 21 April, more than 2.5 million confirmed cases and more than 170 000 deaths have been reported.
These numbers are largely from outside Africa, with the US having the highest number of infections – just over 810 000, followed by Spain, Italy, France and Germany. The African country that ranks highest on the list of infections is Egypt, at number 50, with a reported number of 3 490 cases, closely followed by South Africa with 3 465 cases, at the time of publishing this article.
Africa, it seems, has had a head start at managing Covid-19, but time isn’t enough. This is according to two researchers, Wafaa El-Sadr, MD, MPH, global director of ICAP at Columbia University Mailman School of Public Health, and Jessica Justman, MD, ICAP's senior technical director, and associate professor of epidemiology, who published their work in the New England Journal of Medicine this month.
Their paper, titled "Perspective", urges a coordinated global effort in the face of the Covid-19 pandemic, with "countries around the world [taking] concrete steps to assist Africa in staying ahead of the curve, even as they confront their own epidemics".
Africa spared, for now
The impact of the virus that knows no borders has caused the US, China, Europe, among many others, to be in turmoil, say El-Sadr and Justman. Amid this, Africa has been largely spared the devastating effects. With “creative actions”, African leaders are “aiming to meet [the coronavirus] head on”. This is, however, only the beginning, they argue.
“Rather than inviting relief or complacency, the numbers from Africa are like the early drops of rain before the clouds open up. Despite the slow arrival of Covid-19, a storm is building, and the 1.2 billion people living in Africa are at tremendous risk. Most African countries remain woefully unprepared for what’s coming,” the authors wrote.
El-Sadr and Justman make a few chilling points to back their view, among them:
- Kenya has only 200 intensive care beds for a population of 50 million.
- Mali and Liberia, for example, have only a few ventilators for millions of people.
- Health facilities tend to be overcrowded and understaffed in urban communities throughout Africa.
- In rural areas, the issue of concern is infrastructure: poor roads and unreliable transport make it difficult for people to access care.
And while a lack of advanced care in Africa is a pertinent issue in battling Covid-19, that’s not where the obstacles end, according to the authors: “In many communities, people live together in close quarters, which makes physical distancing, a critical prevention strategy, more difficult. Millions of people live without access to clean running water, which makes frequent handwashing all but impossible.”
Coupled with this, they make the point that the spread of the virus may see a mounting increase in infected people as winter approaches in the Southern Hemisphere. Whether warmer weather can curb the new coronavirus is still a matter of debate: one Chinese study dampened hopes that the virus might fade as warmer weather approaches.
Africa’s experience in dealing with epidemics
“Confronting epidemics is not new to Africans, and their experience may prove to be an advantage,” El-Sadr and Justman said, further drawing on Africa’s history in responding to many other infectious diseases before Covid-19. Among them are HIV, malaria, tuberculosis, and Ebola, which has helped to strengthen health systems.
But, despite, mitigation measures set in place by many African governments, including closing borders and implementing nationwide lockdowns and vigorous testing, El-Sadr and Justman believe Africa cannot confront the threat alone and that “coordinated global support is essential” to combat the fight against the virus.
“We believe that during the next few weeks, countries around the world should take concrete steps to assist Africa in staying ahead of the curve, even as they confront their own epidemics.
“These steps may include donations of coronavirus test kits, personal protective equipment (PPE), ventilators, and other life-support equipment or, at a minimum, ensuring that African countries are not priced out of the market for these commodities,” they state.
That’s not where the support must end, they continue, while also advocating for funding and technical support that will allow much-needed national information campaigns to promote safe behaviours and counter the stigma of disease among many communities.
“Vulnerable populations, particularly the poor and people engaged in the informal economy, will need to be supported during periods when movement of people is restricted,” they added.
Support already received
In February this year, the Bill & Melinda Gates Foundation committed $100m in funding to the coronavirus response in an effort to strengthen detection of the virus, isolation and treatment strategies, according to a previous Health24 article.
Up to $20m of this amount has been earmarked towards enhancing protections for at-risk populations, both in Africa and South Asia, and would include helping public health authorities in these regions to “strengthen their emergency operations centres, implement effective disease surveillance efforts and improve their capacity to safely isolate and treat confirmed cases”, the Foundation’s press room announced.
President Cyril Ramaphosa also announced a number of "quick and targeted" interventions such as a Solidarity Response Fund to help the fight against Covid-19 and to support vulnerable South Africans – and more than more than R2 billion was donated in the first two weeks after announcement of the fund.
Among them, Naspers contributed R1 billion's worth of personal protective equipment (PPE) and other medical supplies in China, News24 reported. According to Fin24, R1 billion was pledged by Oppenheimer Foundation, and R1 billion by the Motsepe family and associated businesses, with funds going towards purchasing sanitisers, disinfectants, PPE, as well as other equipment and resources required to fight the pandemic.
During a WHO Africa Media Leader Briefing on Covid-19, from the World Economic Forum on 16 April, Dr Matshidiso Moeti, WHO Regional Director for Africa explained that the WHO’s budget includes $300 million in aid for African countries’ fight against Covid-19.
“In the Sub-Saharan region, we have 47 countries, and each of the countries’ offices has developed a plan of how they are going to work with the government locally, and then we have a regional office team that’s working on this.
“And, overall, we will be giving about $300 million for the next six months in order to support what countries are doing,” Moeti said.
On the topic of US, President Donald Trump’s decision to freeze funding to the WHO, and the impact this will have on the organisation supporting African countries, Moeti commented: “The United States is the number one contributor to our budget, so the impact of this decision will be quite significant on areas such as polio eradication… in Africa.
“This decision we are very much hoping will be rethought because the US government is an important partner, not only in financial terms, but also an important strategic partner,” she said.
However, despite donations and pledges, a lack of resources is still an issue, as African countries, including South Africa, continue in their struggle with a shortages of masks, hand sanitisers, PPE, critical care hospital beds, and life-saving ventilators, among other things.
El-Sadr and Justman make a critical point, saying that resources and attention should not be diverted from Africa’s ongoing threat from other infectious diseases, such as HIV, TB, and malaria, and conclude that other countries should work to mobilise their support for the continent: “Africans are doing their part. Now is the time for us to do ours.”
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