Africa’s world-leading pandemic response

Africa’s leaders, institutions, and researchers must be given the recognition they deserve for taking proactive and highly effective measures to combat the Covid-19 virus, writes Peter Burdin.

It was early evening on 18 February 2020 and almost everyone had gone home. But in a quiet corner of the African Union complex, Dr John Nkengasong stood over a desk examining data. In his third year as Director of the Africa Centre for Disease Control (CDC), Nkengasong had only recently witnessed the outbreak of Ebola. Understanding the signs, Nkengasong knew what was coming, with news breaking just days earlier that Egypt had found Africa’s first case of Covid-19.

At this early stage of the pandemic, Europe had hardly begun to grasp the threat of Covid-19. Yet, Africa was already on high alert. Quickly springing into action, on 22 February, the Africa CDC convened an emergency meeting with all 55 health ministers across the continent to devise an Africa-wide Covid-19 response strategy.

Shortly after, Cyril Ramaphosa, the President of South Africa and Chairman of the African Union, began arranging weekly video calls to coordinate Africa’s response in the weeks and months to follow.

With a response strategy in place, the Africa CDC ordered 1m emergency test kits from Germany, while the Louis Pasteur Institute in Senegal immediately began training technicians to test for the novel virus. This meant that by the end of February, 42 countries could test for Covid-19 when only weeks before, there were none.

‘Never before had Africa managed such a response,’ says Peter Piot, director of the London School of Hygiene and Tropical Medicine. ‘Remarkably, they acted even before they had a problem.’

Reducing the rate of infection

Indeed, as early as 15 March, several countries across Africa closed their borders, cancelled flights, and imposed strict lockdown measures to prevent an influx of cases. Notably, South Africa implemented one of the strictest lockdowns globally before a single death had been recorded, contributing to a rapid decrease of the rate of infections from 42% to 4%.

Many countries across Africa also seized the opportunity to combine existing emergency health care protocols with innovation to improve response effectiveness. For example, landlocked counties such as Rwanda, which rely on cross-border travel to import essential goods, adopted a system to digitally share the Covid-19 test results of truck drivers with neighbouring countries to prevent cross-border contamination.

Meanwhile, research students in Senegal built multifunctional medical robots to lessen the load on healthcare workers, and a PHD student in South Africa developed a web-based Covid-19 dashboard to share pandemic updates in real-time.

International collaboration

Recognising the importance of international support, African leaders also took active steps to collaborate with international actors to tackle Covid-19. For instance, in March, the African Union brought together finance ministers from across the continent to write a joint letter to the IMF, World Bank, and European Commercial Bank to ask for immediate additional resourcing of $100 billion.

African states also worked with funders and development agencies to partner with leading international biomedical companies to deliver essential services. For example, the Chinese genomics firm BGI opened a factory in Ethiopia in September 2020, which can produce 6m highly accurate and affordable Covid-19 test kits a year, providing localised production in Ethiopia that can benefit countries across Africa.

As part of a wider roll-out of emergency testing laboratories across the US, Europe, Middle East and Asia, BGI also worked with partners to open a laboratory in Gabon with the capability to test up to 20,000 Covid-19 samples a day, thereby significantly improving local capabilities in detection and diagnosis.

Highly effective measures

Through taking these proactive and innovative policy decisions, Africa managed to avoid the worst of the coronavirus storm. Indeed, by October 2020, Africa, which makes up 17% of the world’s population, recorded 3.5% of Covid-19 deaths. As Dr John Nkengasong reflects, ‘If you brought the people who fought the 1918 pandemic and showed them what we have done, they would look at us with total admiration.’

Many commentators explain Africa’s low death-rate as a result of the continent’s young population, relatively low incidence of non-communicable comorbidities, lower population mobility, and low population densities outside of cities. However, Africa’s leaders, institutions, and researchers must be given the recognition they deserve for taking proactive and highly effective measures to combat the virus.

How to tackle future threats

As Africa now looks to widen the rollout of the Covid-19 vaccine across the continent, countries must continue to prioritise innovative solutions and rapid action, whilst harnessing the spirit of international collaboration to deliver results. This must also be said for tackling other health challenges beyond the pandemic, with international private-public partnerships playing a vital role in improving public health infrastructure across Africa.

Indeed, building stronger links with the international healthcare industry, funders and agencies will serve to better position Africa to tackle future viral threats, taking advantage of international genomic capabilities to sequence, for instance, novel diseases in record time and ensure effective action is undertaken fast.

However, to benefit from international partnerships, Africa will need support to keep its borders open, with the likes of BGI’s Huo Yan Covid testing labs serving as a vital resource to help the continent open up. These Huo Yan testing labs can be found at Africa’s busiest airport, Addis Ababa Bole International Airport in Ethiopia, as well as across eight countries in Africa, including in Botswana and Togo.

In 2019, the Global Health Security Index ranked counties in terms of preparedness for pandemics, with the US identified as the most prepared, and most African countries deemed the least. However, it is clear this prediction could not have been further from reality, with Africa’s pandemic response widely recognised as world leading.

Indeed, for Africa, the legacy of the Covid-19 pandemic is such that Africa will now be even better placed to tackle health challenges in the future, with systems for regional and international collaboration in place to pioneer innovative and proactive solutions.