Covid 19: Time for Sadc to pull a David on Goliath
THE 2019 novel coronavirus (Covid-19) caught the entire world flat-footed. With the global health emergency, came a high demand for supplies of gloves, ventilators, masks, testing materials and personal protective equipment (PPEs).
In turn, a few suppliers of these and tight competition between rich and poor countries to buy, emerged.
A story published by the New York Times recently told a sad tale of how developing nations in Latin America and Africa were failing to secure adequate materials and equipment to test for coronavirus, partly because the United States and Europe were outspending them.
Outlined the story: “Scientists in Africa and Latin America have been told by manufacturers that orders for vital testing kits cannot be filled for months, because the supply chain is in upheaval and almost everything they produce is going to America or Europe. All countries report steep price increases, from testing kits to masks.”
This piece of news is chilling for poorer African nations, in particular those from Southern African Development Community (SADC), whose health systems before Covid19, faced numerous challenges.
The burden of communicable diseases like tuberculosis, and HIV and Aids among others and challenges in procurement of medicines also crippled health systems of most SADC Member States.
Now, the additional challenge of Covid-19 pandemic puts countries under intense pressure to compete with economically masculine countries for procurement of supplies and equipment to fight the stalking virus.
This could prove a herculean task for many countries in the SADC region.
The first Covid-19 case in SADC was recorded in early March this year. By May 7, 15 of the 16 SADC Member States had been affected by the pandemic.
As at May 7, Zimbabwe had recorded 34 confirmed cases, South Africa (7808), Zambia (146), Botswana (23), Tanzania (480), Mozambique (81), Namibia (16), Eswatini (123), Malawi (43), Madagascar (158), Angola (36), Democratic Republic of Congo (863), Mauritius (332), Seychelles (11) and Comoros (8).
Only Lesotho had no recorded cases.
The fact that all affected nations are “feeding” from the same small plate is a wake-up call for the region to do things differently.
This is why Member States should form a strong united front in purchasing supplies to fight Covid-19.
When Covid- 19 penetrated the region, the SADC secretariat took 10 coordinated regional actions in response to the pandemic.
These included disaster risk management, the suspension of regional face-to-face meetings, mobilisation of regional support towards containment of the COVID-19 pandemic, and mitigation of its socio- economic impact on the region.
It also urged Member States to adopt guidelines on Harmonisation and Facilitation of Cross Border Transport Operations across the region during the COVID-19.
Most importantly, the implementation of the SADC Pooled Procurement Services for pharmaceuticals and medical supplies to provide sustainable availability and access to affordable and effective essential medicine and health commodities was recommended.
Speaking to The Herald, senior officer — communication and public relations, Ms Barbara Lopi said they have encouraged Member States to utilise the Pooled Procurement Services for pharmaceuticals and medical supplies for the procurement of the needed supplies for prevention, treatment and control of COVID-19 and any other epidemics.
She said the advantage of buying in bulk as a region means negotiating for economic prices, adding there are opportunities to go and bid as a block and buy bulk commodities and negotiate for a good price.
“We are in an emergency and I think every Member State wants to get their requirements in as far as medical equipment and other stuff related as soon as possible. Most are going directly,” she revealed.
The SADC secretariat, she added, is in the process of compiling a list of pharmaceutical manufacturers in the region.
“The list can be shared to Member States so that they can also think of trading within the region, buy from a neighbouring country instead of going all the way out in terms of purchasing some of the related medicines and equipment,” said Ms Lopi.
She said the secretariat cannot push Member States to implement the SADC Pooled Procurement Services for pharmaceuticals and medical supplies, but can only advise and provide information.
Ms Lopi revealed that SADC was compiling information on the needs of Member States in terms of PPEs and medication that is required.
So far they have submitted a proposal to the African Development Bank (AfDB).
“We hope that if this proposal succeeds, we can pool procure the required medications and other equipment that will be required by Member States,” she explained.
Ms Lopi said they currently do not have any record of which Member States have gone to acquire through the pool procurement.
She said they have designed a guideline on what the process is and the procedures to follow.
In SADC Member States, communities, health professionals, activists and funders are seemingly worried about the shortage of essential test kits, PPEs, among other materials.
They hope countries in the region do not continue going for Covid-19 supplies shopping, solo.
Executive director, Community Working Group on Health (CWGH) Zimbabwe, Itai Rusike, said he is worried that some SADC Member States face a challenge to secure the COVID-19 commodities for effective prevention and care approaches.
He said the SADC Business Council on April 1, 2020 called for greater clarity on the classification of essential goods and duty free facilities for importation of COVID-19 related equipment to enable their smooth flow and therefore adequate foreign exchange is also needed to secure these imports.
“Zambia and Zimbabwe, reliant on imports of these products, have implemented temporary suspension of customs tariffs on COVID-19 related essential medical products and equipment,” he said.
Mr Rusike believes that there is a risk in being a region where supply depends on imports.
“South Africa, the biggest producer of soaps, surface-active agents, respiratory masks, protective spectacles, garments, suits and gloves in Africa has recently introduced export restrictions of COVID-19 related products, including alcohol-based hand sanitisers, face masks and hydroxychloroquine,” he noted.
According to Mr Rusike, scarcity breeds speculation and Member States like Botswana, have invited reports of predatory price increases for these products.
“While recognising the need for countries to secure supplies for their populations without undermining trade agreements, there is equally a need for regional dialogue and measures to ensure cooperation on regional needs, and between relevant national authorities, appreciating that the region is not collectively secure until all its countries and communities are,” he explained.
In the meantime, said Mr Rusike, countries that turned away from import substitution industrialisation policies are now looking at how they can locally produce these critical products.
For example, in Zimbabwe, Government made available an initial $33 million in seed capital to State universities to make PPEs to prevent a national shortage of the materials needed to fight the coronavirus.
Chinhoyi University of Technology and Midlands State University are producing face masks, University of Zimbabwe and Bindura University of Science Education are producing sanitisers, while the Harare Institute of Technology has developed a ventilator and has the potential to make 40 per day, in addition to producing 1 000 litres of sanitiser a day.
Speaking to The Herald, Dr Katlego Mothudi, managing director of the Board of Healthcare Funders ( BHF) based in South Africa said since Covid-19 was a global crisis, instinctively leaders across the world, in both the rich and poor countries, were focusing their resources on the healthcare needs of their populations and interventions to support themselves first.
“In terms of issues around trade and medical supplies, because Covid-19 has been declared a pandemic there has been restrictions imposed on international trade in some countries.
“As a result, a lot of countries that depend on imports are heavily affected; because countries are also, first looking at supporting their populations and then looking at the distribution of excess where there are excesses,” he said.
According to Dr Mothudi, it is worth noting that a number of development institutions are providing support, entities such as the World Health Organisation (WHO), World Bank, World Economic Forum (WEF) and AfDB are reaching out to support a lot of countries that are under distress and cannot secure resources.
“In fact, during a conference held on 29 April 2019 via webinar hosted by Anadach Group on Covid-19 in Africa: Leveraging the Private Healthcare Sector, the AfDB announced an extensive support process for African countries. They are looking at supporting both the public and private sector entities involved in Covid-19 response,” he said.
Dr Mothudi explained that it was important for procurement to be done through the donor community or international organisations, relevant healthcare representative bodies, and other regional institutions such as WHO, WEF or AfDB, as these channels would have a better chance for regional procurement, rather than through the State.
“This is because Covid-19 has been declared in terms of the Disaster
Acts, as a result a lot of countries have laws that confine and empower them to act within the regional framework and not as individual states,” he said.
“In South Africa, for example, because this has been declared as a disaster in terms of the Disaster Management Act, one of the things promulgated includes restrictions on exports, which immediately puts restrictions on what the South African government can do and what individual companies can do. In essence, within the context of Covid19, the approach should be from a regional perspective.”
There are pros and cons of each country procuring individually, given the impact of Covid- 19 on communities and weak health systems.
“First, there is likely to be price fluctuation as a result of increased demand, said Dr Mothudi. Second, certain countries might have embargoes levied against them as a result of diplomatic tensions, and these may put further pressure or restrictions in the event that these countries opt to go at it alone.
“It may be easier for the SADC region to procure collectively.”
Dr Mothudi said SADC needed to be ready to address individual country needs at a regional level.
“Diplomatic relations play a critical role in times of crisis, and where there aren’t strong relationships at the level of the State, the regional relationship can be supported in circumventing some of those diplomatic relations at the level of individual countries,” he said.
There needs to be more discussion and collaboration, not only between States, but also between the various sectors.
“One of the biggest challenges with a lot of the countries is that we are still thinking in terms of State and non- State entities — whereas we need to think in terms of common protocols and negotiations; whether they are within the State or private sector should not be a factor.
“We need to be thinking in terms of how we can leverage the various pockets of excellence that exist within healthcare and the different sectors,” said Dr Mothudi.
Dr Mothudi said there should be concerted efforts within countries and across the region to work together, not as private or public sector providers; but as one healthcare system for all efforts, testing and tracking efforts; and these should be reported as country or regional figures and not as private sector or public sectors test or figure.
“By so doing, we run the risk of polarising efforts instead of improving our efforts,” he said.
Dr Mothudi said the BHF, as an industry body, had engaged with the regulators across SADC through members in the eight countries they represent in the region; giving extensive inputs on regulatory changes and coordinating negotiation platforms that will look at pricing of services relevant to Covid-19.
The BHF, he said, was working with WHO around tracking and investigations of Covid-19 in the region.
If Member States fully implement the SADC Pooled Procurement of Essential Medicines and Medical Supplies, they can become the biblical David, have the courage, faith, and overcome Covid-19, the Goliath that seems impossible to defeat.