Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future

Author(s): Dr. Leonard Mboera

Kapata N, Ihekweazu C, Ntoumi F, Tajudeen R, Chanda-Kapata P, Mwaba P, Mukonka V, Bates M, Tembo J, Corman V, Mfinanga S, Asogun D, Elton L, Arruda LB, Thomason MJ, Mboera L, Yavlinsky A, Haider N, Simons D, Hollmann L, Lule SA, Veas F, Abdel Hamid MM, Dar O, Edwards S, Vairo F, McHugh TD, Drosten C, Kock R, Ippolito G, Zumla A.

Soon after the novel coronavirus, SARS-CoV-2 (2019-nCoV), was first identified in a cluster of patients with pneumonia (Li et al., 2020), in the Chinese city of Wuhan on 31 December 2019, rapid human to human transmission was anticipated (Hui et al., 2020). The fast pace of transmission is wreaking havoc and stirring media hype and public health concern (Ippolito et al., 2020) globally. When the World Health Organization (WHO) declared the disease, (now officially named COVID-19) a Public Health Emergency of International Concern (PHEIC) on 31st January 2020 (WHO, 2020a), the Director General Dr Tedros Ghebreyesus justified the decision by stating that WHOs greatest concern was the potential for the virus to spread to countries with weaker health systems. Repeated outbreaks of other preventable emerging and re-emerging infectious diseases with epidemic potential have taken their toll on the health systems of many African countries. The devastating 2014–2016 Ebola Virus Epidemic (WHO, 2020b) in West Africa, demonstrated how illprepared the affected countries were to rapidly identify the infection and halt transmission (WHO, 2020d; Largent, 2016; Hoffman and Silverberg, 2018; Omoleke et al., 2016). Similarly, the smoldering remnants of the 2018–19 Ebola Virus outbreak in the Democratic Republic of Congo, have demonstrated even for health services with considerable experience of dealing with a certain emerging pathogen, geography and sociopolitical instability, can hamper the response (Aruna et al., 2019). A recent analysis of the spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the WHO Africa Region highlighted that 41 African countries (87% of the continent) had at least one epidemic, and 21 countries (45%) had at least one epidemic annually (Talisuna et al., 2020). The top five causes of epidemics were Cholera, Measles, Viral haemorrhagic diseases, malaria and meningitis. Seven countries which experienced over 10 events, all had limited International Health Regulations (IHR) capacities which are now being developed. Most sub-Saharan African countries are operating at maximum capacity with the huge existing workload in hospitals and clinics. The WHO’s Joint External Evaluation reports, conducted since 2016, suggest that the ability to respond to an International Health Regulation hazard, such as the importation of an infectious disease like COVID-19, requires almost universal improvement across sub-Saharan Africa


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