Covid-19 in Africa a hidden enemy
WHEN the coronavirus hit Tanzania in mid-april, President John Magufuli called for three days of national prayer to seek God’s protection from the scourge. Barely a month later, he claimed victory over the disease and invited tourists to return.
His rush to reopen came despite alarm from the World Health Organization (WHO) over an almost total lack of information on the spread of the virus in the country of 55 million people, which has one of the region’s weakest health-care systems.
Sharing information is vital to tackling the pandemic in Africa – both for planning the response and mobilising donor funding – public health experts say. As things stand, it is impossible to gauge the full severity of the contagion across the continent.
According to the latest data, Africa, with a population of 1.3 billion, had more than 493 000 confirmed cases and 11 600 deaths. By comparison, Latin America, with roughly half the population, had 2.9 million cases and 129 900 deaths.
The official numbers make it seem as though the illness has skirted much of Africa, but WHO special envoy Samba Sow has warned of a “silent epidemic” if testing was not prioritised.
By Tuesday, 4 200 tests per million people had been carried out across the continent, according to an analysis of figures from the Africa Centres for Disease Control and Prevention (CDC).
Interviews with health workers, diplomats and local officials revealed not just a scarcity of reliable testing in most countries, but also the lengths governments have gone to prevent news of infection rates from emerging, even if that meant they missed out on donor funding.
“We cannot help a country against its will,” said Michel Yao, head of emergency operations for the WHO in Africa.
Tanzania confirmed its first case of Covid-19 on March 16. The next day, the government convened a task force to co-ordinate the response with international partners including the WHO, foreign embassies, donors and aid agencies, sources said.
This body never met again with outsiders, two foreign officials familiar with the situation said.
Tanzania’s health minister Ummy Mwalimu and a government spokesman did not respond to questions about their handling of the Covid-19 crisis.
Tanzania has not published nationwide figures since May 8, when it had recorded 509 cases and 21 deaths. Days earlier, Magufuli dismissed testing kits imported from abroad as faulty, saying on national television that they had also returned positive results on samples taken from a goat and a pawpaw.
According to three emails sent from May 8-13, the WHO believed it had reached an agreement with the government to let it take part in joint surveillance missions around the country. However, a WHO spokesperson said these were all cancelled on the day they were due to start, with no reason given.
Donors have released about $40 million (R680m) to fund Tanzania’s coronavirus response, two diplomatic sources involved said. But the country’s lack of engagement meant it had missed out on “tens of millions of dollars” more, another official said.
The WHO cannot compel co-operation and must tread carefully.
When WHO officials expressed concern in late April about a lack of measures to contain the virus in Burundi, the country expelled its top representative and three other WHO experts without explanation on May 12.
Burundi’s 55-year-old president, Pierre Nkurunziza, died in early June this belief that hydroxychloroquine was this wonder drug”, Rajasingham said. More than 1200 people signed up in just two weeks, but that slowed to a trickle after some negative reports.
“The national conversation about this drug has changed from everyone wants this drug… to nobody wants anything to do with it,” she said. During the 2009-2010 swine flu outbreak, the experimental drug peramivir was widely used without formal study, Drsbenjamin Rome and Jerry Avorn amid speculation he had come down with Covid-19. The government said he had suffered a heart attack.
Burundi’s new president, Evariste Ndayishimiye, has promised measures to tackle the pandemic, including mass testing.
While some countries won’t share information, others can’t: their health systems are too broken to carry out any large-scale testing, surveillance or contact tracing.
“Even at the best of times, collecting quality data from countries is not easy because people are stretched thin,” said John Nkengasong, director of the Africa CDC.
South Africa is one of the few to have rolled out mass testing. But it had a backlog of more than 63 000 unprocessed specimens as of June 10, because global suppliers were unable to meet its demand for laboratory kits, according to the health department.
The national laboratory service declined to disclose the current backlog. of Brigham and Women’s Hospital in Boston noted in the New England Journal. The drug later gave disappointing results and was approved merely for less serious cases of flu.
Patients are best served when we stick to science rather than “cutting corners and resorting to appealing yet risky quick fixes”, they wrote. The pandemic will do enough harm, and damage to the system for testing and approving drugs “should not be part of its legacy”. – AP