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Mabingué Ngom: We will have to learn from the health crisis

COVID-19 in Africa

Mabingué Ngom: We will have to learn from the health crisis

The Director General of the United Nations Population Fund (UNFPA) in West and Central Africa talks to Guillaume Weill-Raynal about the upheavals caused by the coronavirus and how his organisation is helping to fight it.

Africa, because of its fragility, risks finding itself at the heart of this pandemic. What is your strategy for this emergency?

First of all, we must salute the rapid reaction of many heads of state in the region. Africa benefits from the experience acquired during previous pandemics.

I am thinking in particular of the Ebola virus epidemic which had its epicentre in the Mano River region, between Guinea, Liberia and Sierra Leone. These countries, and their neighbours, were able to familiarise themselves with the methods of preventing and combating these crises. This is what allowed them to prepare fairly quickly for a response; it is quite remarkable.

However, the situation is difficult in the region, which faces many other challenges. The entire Sahel and the Lake Chad region is already affected by humanitarian problems. The occurrence of this new epidemic could make the region even more fragile.

How and by what means can we contain this pandemic?

The answer must be holistic. We should not focus exclusively on the medical aspects. This is precisely what we have learned from the Ebola experience. We must invest in community mobilisation.

We should not focus exclusively on the medical aspects. This is precisely what we have learned from the Ebola experience. We must invest in community mobilisation.

Money is an important tool, but it cannot by itself stop the evolution of this pandemic. We must prevent any difficulties that may affect the supply chain. This is precisely the reason why we need community mobilisation. The health system alone cannot solve the challenges we face.

This mobilisation is likely to take time. What are the tools for immediate action to deal with a situation that risks getting out of hand? Africa seems to be in danger…

It is true that Africa is in danger, like all the countries of the world, and perhaps even a little more because of its traditional weaknesses and in particular those of the health system. But the Heads of State acted quickly and took important steps to contain the rapid spread of the disease on the continent.

Furthermore, by investing in community measures and by promoting measures such as social distancing, many countries are showing that it is possible to contain the disease, even in countries where the health system is very weak and who do not have the capacity to manage a large number of patients.

On a strategic level, this is justified: if you do not have a health system capable of taking care of a large number of patients, you must invest in other areas such as social distancing, community mobilisation, prevention, surveillance, etc. In these areas, African countries are making progress, but support from the international community would be extremely beneficial.

You talk about the experience acquired during the fight against AIDS and Ebola. But this pandemic seems unprecedented.

Our approach must be holistic, while taking into account local social and economic realities. We must find rapid solutions to the uncertainties that face us.

The first thing is that we must act quickly! We must then avoid falling into the trap of medicalisation. And third, we must initiate the community response. Finally, we must find the means to have strategies, concrete actions, which allow us to get around the imperfections of the health system, which suffers from a deficit of materials, equipment and human resources.

Our approach must be holistic, while taking into account local social and economic realities. We must find rapid solutions to the uncertainties that face us.

This holistic approach will take time. Should we consider that it implies the acceptance of a certain level of mortality?

I sense that Africans are well prepared for this. Perhaps it is because the pandemic started in Asia, spread to Europe and then to the United States, before reaching Africa. Or perhaps it comes from the lessons learned during previous pandemics, which created this capacity for reaction, and for proactivity.

But something has certainly happened. From what I see in the region, things are not going as badly as some people anticipated. In Senegal, in particular, the response to the health crisis seems very appropriate to me.

How do you think that things will develop from here?

Today we have 14,524 confirmed cases, 788 deaths, and 2,570 recoveries. In the next five or six weeks, I think it will not be so bad, although of course we would have preferred to avoid all of these difficulties and suffering. I was struck by developments in certain countries such as Niger, Burkina Faso and Senegal where most of the cases have already been cured.

The trends depend on the use that the countries make of the lessons learned and on which barrier methods are best at containing this pandemic capable of very quickly disrupting the most robust health systems. With the diversity of responses and health systems, it would be more appropriate to speak of the course things take in individual countries rather than an African trajectory.

How do you work with other UN agencies? Is there a pooling of efforts to provide a common response?

We have made significant progress in this area. In the coming days I will chair a meeting of regional directors. This executive committee has been assembled to ensure the monitoring and quality of the United Nations response in terms of country support.

This committee allows us to take care of the emerging issues that deserve our attention. We are progressing very well in terms of coordination and teamwork. For example, we are working on setting up a medical hub in Senegal or Ghana. We have also designed a structure that allows us to make group purchases of products.

The United Nations system is organised in each country to provide a coordinated, coherent and effective response, alongside the government. We are also working in coordination with our headquarters so that the United Nations takes a leadership role.

Will your role be changed in the post-pandemic era? Will the upheaval of this health crisis lead to the birth of new paradigms?

Yes, I think so. I think that in the future we will have to find solutions to remedy the failure of health systems and their lack of resources. We will not only have to learn to prepare for this type of crisis, but also to respond quickly. Two weeks ago, the office that I head launched an initiative, “Back to business”, to ensure that we are ready to face the return to normalcy.

We must learn the lessons from this health crisis – lessons that we could have learned decades ago.

I also particularly appreciate the initiative taken by the United Nations Economic Commission for Africa to seek debt relief. Indeed, nothing will be as before. We must learn the lessons from this health crisis – lessons that we could have learned decades ago. We must be ready for the next pandemic. The world is very poorly prepared for this pandemic. This is the main lesson that we must learn from the unfortunate experience we are living today.

On a daily basis, in the field, are your teams participating in the fight against the pandemic?

Yes of course! Using the lessons learned during the Ebola crisis, we are guiding our representatives on the ground so that they can ensure that the national responses of each country are inspired by the best possible practices.

We have also developed strategies that enable community engagement. For example, in Senegal, actions are underway with youth and women’s organisations, and other traditional organisations, to support surveillance, prevention, and care for people infected with coronavirus.

We are also working on the acquisition of products, be it caregiver protection equipment or tests. We also participate in the recruitment of personnel to enable countries to meet the demand for care. We finance all these actions!

We are also ensuring that all pregnant women in maternity services – who are particularly at risk – are protected, as are the caregivers who work in those services.

Finally, in Africa as elsewhere in the world, confinement has led to an increase in domestic and marital violence. We have designed instruments that allow us to follow the evolution of these problems and to provide adequate responses in support of people affected by these problems.

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