CONCERTED EFFORT

The continent surprised the world with its co-ordinated strategy to tackle the COVID-19 pandemic, laying the foundations for building an Africa that is more resilient and united than ever before

If COVID-19 has shown the world one thing it is the significance of high-level leadership and co-operation in determining the trajectory of the pandemic in different regions of the world. AU member states reacted swiftly when the first cases of coronavirus were noted in China, deciding on a Joint Continental Strategy for COVID-19 Response based on co-operation, co-ordination, collaboration and communication.

This joint strategy goes beyond the immediate public-health response (preventing infection, severe illness and COVID-related deaths) by also aiming to mitigate the huge economic and humanitarian cost of the pandemic. The continent has been widely praised for its handling of the devastating crisis. ‘Faced with a public-health emergency of unprecedented scale, Africa has demonstrated solidarity and collective leadership in acting quickly,’ the respected science journal Nature notes, while the London-based Financial Times writes, ‘the continent’s response to coronavirus has been remarkable. […] In much of Africa, and in spite of wincing budgetary constraints, policy has been well co-ordinated and, so far at least, surprisingly effective’.

At the start of 2020, Africa had about a month to prepare as the virus spread from Asia to Europe and North America, where it caused mayhem even in wealthy economies such as Italy, Spain, the UK and the US. Consequently, many AU members took extreme measures early on, imposing total lockdowns (as in South Africa and Rwanda) or curfews (Burkina Faso and Senegal) to flatten the infection curve. Most African countries fully closed their borders and some also stopped all international air traffic.

Well before the first infection was reported on African soil (on 14 February 2020 in Egypt, followed by sub-Saharan Africa’s first case in Nigeria on 27 February), the Africa Centres for Disease Control and Prevention (Africa CDC) established an emergency operations centre for COVID-19, on 27 January 2020. The AU had launched Africa CDC only three years previously, in January 2017, to ‘support public-health initiatives of member states and strengthen the capacity of their public-health institutions to detect, prevent, control and respond quickly and effectively to disease threats’. The continent-wide body operates through five regional collaborating centres located in Egypt for North Africa, Gabon for Central Africa, Kenya for East Africa, Nigeria for West Africa and Zambia for Southern Africa.

On 3 February 2020, Africa CDC established the Africa Task Force for Coronavirus (AFTCOR) to provide AU members with expertise and technical support in detecting and containing the pandemic. In close collaboration with the WHO, the task force set up working groups for surveillance, including screening at points of entry; infection prevention and control in healthcare facilities; clinical management of people with severe COVID-19 infection; laboratory diagnosis and sub-typing; and risk communication and community engagement. When AFTCOR was founded, only two laboratories in Africa (in Senegal and South Africa) were able to test for coronavirus, but with the help of the WHO, this number was increased to 26 by late February, and to 43 by mid-March 2020.

Shortly afterwards, the AU COVID-19 Response Fund was founded in a drive to raise additional funds to strengthen the continental effort of equipping, training and advising public-health and healthcare delivery systems. The fund aims to finance, among others, Africa CDC’s pooled procurement of diagnostics and medical commodities such as test kits.

Testing is key to the continent’s joint strategy, as it is the prerequisite to identifying and isolating coronavirus cases. Therefore, the AU rolled out the Partnership to Accelerate COVID-19 Testing (PACT), which is mobilising experts, community workers, supplies and other resources to ‘test, trace and treat’ COVID-19 patients timeously.

In September, the WHO announced it would make 120 million antigen rapid diagnostic tests available to lower and middle-income countries. This would render testing simpler and more affordable because, unlike the widely used PCR (polymerase-chain reaction) test, rapid antigen tests don’t require expensive laboratories or trained lab technicians. These tests cost a maximum of US$5 per unit and provide results in 15 to 30 minutes, rather than days.

According to the WHO, the first rapid tests were being rolled out in up to 20 African nations from October. Dr John Nkengasong, Director of the Africa CDC, welcomed the development, saying that ‘antigen tests are an important complement to PCR testing, and are crucial to expand testing capacity throughout Africa. The beauty of antigen testing is that it is fast and gives quick results. It will allow healthcare workers to quickly isolate cases and treat them while tracing their contacts to cut the transmission chain’.

Several international government partners are directly supporting PACT and the Joint Continental Strategy for COVID-19. The government of Japan pledged a donation of US$1 million to the Africa CDC, while the German government delivered 1.4 million test kits as part the EU global response. The EU has supported Africa’s COVID response with more than EUR26 million, through a variety of actions intended to bridge gaps in supply and capacity, as well as cushion the impact on the continent.

‘Partnership is key to winning the battle against COVID-19 locally and globally because no country can manage the pandemic alone,’ according to Nkengasong. ‘That is why, as a continental body, Africa CDC is working with several partners and exploring all markets to unlock the supply-chain system for diagnostics and medical supplies for AU member states, and we are delighted to see the EU coming out strongly to support our initiatives.’

Previously, African heads of state had demonstrated their support for their close economic partner China. While countries such as the US heaped blame on China for causing the ‘Chinese virus’ or ‘Kung flu’, Africa participated in an Extraordinary China-African Summit on Solidarity against COVID-19 to underline the nations’ shared future. At the summit, China pledged to make its vaccine development and deployment (when available) a global public good, particularly for African countries. The continent is currently involved in at least three other COVID vaccine trials, most of them under way in South Africa.

In another partnership, the AU through the Africa CDC together with the African Export-Import Bank and the UN Economic Commission for Africa (UNECA) launched the Africa Medical Supplies Platform – a single online marketplace to enable the supply of COVID-19-related critical medical equipment in Africa. The platform helps AU member states purchase certified medical equipment such as diagnostic kits, personal protective equipment and clinical management devices with increased cost effectiveness and transparency. There is a strong emphasis on promoting ‘made in Africa’ manufacturers of medical equipment with relevant certification.

‘We are engaging private-sector stakeholders and governments to adopt policies to urgently bolster the production and supply chain of critical medical and associated resources that Africa needs to respond to COVID-19 in a manner that promotes the economic and social development of the continent,’ says Vera Songwe, Executive Secretary of UNECA. She also suggested in a panel discussion that Africa should produce its own drugs internally (for example by Egypt, Kenya, South Africa, Ethiopia and Cameroon) instead of importing more than 95% of its demand (at a cost of US$14.7 billion).

Referring to UNECA estimates that due to COVID-19, Africa’s economic growth might shrink from 3.2% to –2.8% in 2020 and plunge an additional 20 million people into poverty, Songwe said that the crisis was an opportunity to do things differently. ‘We need to talk about Africa and the African Continental Free Trade Area [AfCFTA],’ she said, describing it as the continent’s blueprint for growth and its own plan to ride out the current crisis. She added that ‘we need to ensure that as we build the AfCFTA and trade integration, we begin to build stronger, much more robust monetary and fiscal systems that can ensure that as a continent we actually can work with each other in a more effective way’.

In discussions about the continent’s ongoing multifaceted challenges, several AU leaders have also asked their counterparts to embed key questions surrounding nutrition, gender equality and climate issues in the union’s COVID recovery. This seems a big ask, especially while the world is still waiting for a commercially available vaccine that would keep the virus in check. However, Africa surprised the rest of the world with its initial reaction to the pandemic. So there’s no reason why the continent’s leadership shouldn’t be able to continue on this path, collectively using the global crisis to build back a more united and resilient Africa.

By Silke Colquhoun
Image by Gallo/Getty Images