State of play

As of May 8th, 12 pm PT, the Africa Centers for Disease Control and Prevention (Africa CDC) Dashboard reported a cumulative of 54,434 confirmed COVID-19 cases, 2,080 deaths, and 18, 857 recoveries. The first case from the African continent was reported on 14 February 2020 in Egypt. Eighty percent of Africa’s cases are accounted for by 10 countries with widespread transmission in seven of them. Generally, the five hardest-hit countries include South Africa, Algeria, Nigeria, Ghana, and Cameroon. On the brighter side, the WHO said a few countries, including Eritrea, Namibia, and Seychelles, have gone 10 days with no new cases. Comoros is the latest country to report a case on 30 April 2020. 

 

A stitch in time...

The response by most African governments to the pandemic was quite fast. Some of the measures taken include declaring a national state of disaster and implementing a nationwide lockdown by South Africa and Malawi. South Africa even went ahead to institute a controversial ban on the sale of cigarettes and alcohol. Due to economic reasons, South Africa has since the beginning of May eased up its restrictions. Nigeria began screening passengers at international airports nearly one month before the detection of the first case. Other measures taken include public education on best practices, such as promoting good hygiene and social distancing, discouraging large public gatherings, the mandatory wearing of masks in public and at workplaces, and the suspension of all international travel to or from the most-affected countries. According to the Partnership for Evidence-Based Response to COVID-19 (PERC), such measures have given African countries a huge advantage in limiting the spread of the virus compared to the increasing numbers seen in other regions of the world i.e. the United States and Europe.

 

Silver lining

Whilst the Covid-19 scourge is of momentous proportions, it has demystified the long-held myths that African countries did not have arrows in their quivers. We have witnessed unprecedented levels of response interventions by the public and private sectors as well as in academia. Though the fight is far from over, several African countries appear to be so far winning in this tackle against COVID-19. Senegal, for instance, has developed a $1 test kit (test resembles pee-on-a-stick pregnancy technology) originally made to test for Dengue Fever that could produce results within 1o minutes. In order to avoid the $16,000 price tag for each imported ventilator, Senegalese engineers are working on 3D printing of their own machines. In Ghana, drone technology is being used to deliver COVID-19 tests especially from rural-bound regions to urban laboratories. Ghana has one of the highest testing rates on the African continent and has so far been able to test over 100,000 people out of the 120,000 people traced while still maintaining a relatively low fatality rate (18 deaths out of 3091 confirmed cases). In Kenya, medical and engineering students have made history by innovating Kenya’s first home-grown ventilator. With airports on lockdown, Kenya has also embarked on the mass production of personal protective equipment (PPE). Entrepreneurs in Cameroon (Kmerpad) originally producing reusable sanitary towels have redirected their efforts to the production of PPE. With 271 confirmed cases and 133 recoveries, Rwanda is yet to record any death due to COVID-19. Despite its close proximity to South Africa, Lesotho still remains untouched by the current pandemic!  

 

There is still room for improvement 

Given its weak health systems, Africa is being met by several challenges in its bid to tackle Covid-19. First, apart from the burden already posed by endemic infectious diseases, health systems of the African continent are facing an additional non-communicable disease burden including injury and cancer. The impact of COVID-19 on the existing burden of disease is yet to be quantified but it will evidently stretch health systems further leading to graver consequences. Given that during the Ebola virus outbreak more lives were lost due to malaria than due to the Ebola outbreak itself, we should not let this happen again. So far COVID-19 has disrupted vaccination efforts in Chad, Ethiopia, Nigeria, and South Sudan, leaving approximately 21 million children unprotected. This should not be the case. While intensifying COVID-19 response, African Governments should ensure that healthcare interventions such as measles and BCG vaccination efforts among others are still ongoing. If anything, they should equip these health workers to kill two birds with one stone; carry out the vaccinations while educating the public on COVID- 19 measures.

 

Secondly, the issue of mental health is still a taboo on the continent yet there is a need to support the healthcare workers on the frontlines of the COVID-19 pandemic. Unfortunately, some of these healthcare workers have faced stigma and isolation due to their proximity to the disease yet need to be guided on how to preserve their mental health and still remain sane for their families and communities. One study showed that compared to the global average of nine mental health workers,  Africa has 1.4 mental health workers per 100,000 people. Experts report that nearly 50 percent of families, survivors, and those who had contact with survivors of Ebola had PTSD and depression, something that could potentially reoccur post-COVID-19 if effective measures are not taken. The majority of the larger African population still struggles to understand the pandemic, meaning that survivors of COVID-19 or those that test positive are stigmatized to the extent of receiving death threats. African governments will have to bring all stakeholders on board to tackle this one -- political, religious, traditional, civil society leaders and even community leaders should educate people on how to mentally deal with the crisis. Counseling centers in the form of emergency text/call lines should be set up both in the community and in isolation centers to reassure those in panic and to guide them on how to navigate their environment while protecting those around them. While campaigning for safety measures, African governments should also intensify their campaign against the stigmatization of COVID-19 victims by passing fines to its perpetrators as well as empowering the public on how to better support the affected. Other challenges that still persist within African health systems include the shortage of testing kits, PPE, ventilators, healthcare staff among many others.

 

Lessons to be Learnt 

With adversity, there is always room for opportunities. If there is any continent for which this saying serves true at the moment it's Africa. While the pandemic presents numerous challenges, it also presents countless opportunities and lessons to be learnt for the African continent. African governments need to invest more in their health systems instead of relying on healthcare abroad. It is not uncommon for African leaders to squander tax-payers money while being flown abroad for cures while the people they are meant to serve are dying in poor healthcare systems. Now, karma has it that these officials have to be treated in the same health facilities that they failed to develop in the first place! First, it was Ebola and now this, chances are that there will be more pandemics in the future. Let it not come as a surprise to us, governments should budget and invest accordingly in epidemic response.

 

Secondly, COVID-19 presents an opportunity for Africa to build on its diagnostics capabilities going forward. The fact that Senegal could develop a $1 test kit that could produce results within 1o minutes is a testament to the huge potential within the continent to do more for its people without constantly relying on imported diagnostics. The same goes for the local production of PPE on the continent. Why import loads of PPE when we can produce it ourselves? Thirdly, blessed with numerous vegetative cover and countless herbal and plant species, COVID-19 presents an opportunity for the African continent to research on the role of traditional medicine in finding cures for diseases. Madagascar’s president presented claims that Artemesia annua could be a possible treatment for COVID-19. The WHO said it is working with research institutions in the selection of traditional medicinal products that can be investigated for efficacy and safety for COVID-19 treatments. Beyond COVID-19, who knows what other medicinal plants are out there and what they can cure?

Thus far, the response from African countries, given the resources at their disposal, has been impressive. However, a lot more needs to be done in the Health sector. On the other side of COVID-19, we must then undertake the important task of full-proofing our systems. Prevention is better than cure. 

The COVID-19 story is one that is constantly evolving and with so many moving components by the millisecond. All we can hope for is that we will come out stronger at the end of it all. This too shall pass!

 

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