COVID-19/AFRICA

This is not the first time that African countries have faced an epidemic. To an extent, they are or should be better equipped to fight the disease. In D R Congo, which just recently stopped seeing new Ebola cases, doctors are aware of the seriousness of the problem. “Congolese doctors and nurses have already been involved in the Ebola response in Liberia, Sierra Leone and Guinea. In addition, prevention messages are easy to disseminate through the population because people have just come out of the Ebola epidemic. People are already mobilised,” says Rodriguez Kasando, communication expert for behavioural change and community engagement in the country. “Confinement and social distancing are new preventive measures for the Congolese already accustomed to hygiene measures to protect themselves against the Ebola virus. Therefore, awareness must emphasise social distancing in addition to hygiene measures taking into account the mode of infection by air of the COVID-19 which does not exist in the Ebola virus,” says Kasando.

“From our experience on the cost of the Ebola response, the US$135 million envelope in the contingency plan being provided for COVID-19 cannot cover the need for awareness, the purchase of protective and screening equipment, the purchase of medicines and the payment of personnel involved in the response,” insists Kasando and advises that the Congolese government should seek assistance from partner countries and international financial institutions to “mobilize the necessary funds to acquire the support infrastructure and purchase equipment such as respirators, which are currently insufficient”.

The Alliance for International Medical Action), or ALIMA, which collaborates with the Institute Pasteur of Dakar on testing and supports the infectious disease unit at the Fann University Hospital on the management of suspected and confirmed

HUMAN AND MATERIAL RESOURCES ARE LARGELY INSUFFICIENT SO THE MORTALITY RATE LINKED TO COVID-19 IS EXPECTED TO BE 3 TO 5 TIMES HIGHER THAN IN THE REST OF THE WORLD, SAYS AUGUSTIN AUGIER, EXECUTIVE DIRECTOR OF THE ALLIANCE FOR INTERNATIONAL MEDICAL ACTION

cases, is calling for immediate deployment of health experts, medications and other medical supplies to Africa. The organisation has warned that in many African countries, whose health systems are among the most fragile in the world and who have far fewer resources than those available in Europe, China or the US, the situation is potentially catastrophic. The executive director of the organisation Augustin Augier said that in sub-Saharan Africa, health systems are already fragile and the pandemic’s spread to these regions could lead to a much higher mortality rate than in the rest of the world. “Since human and material resources, such as hospitalisation and resuscitation beds are largely insufficient, the mortality rate linked to COVID-19 is expected to be 3 to 5 times higher than in the rest of the world,” said Augier. The preventive measures taken by African countries to date are legitimate and welcome, he said. However, some of them make the circulation of humanitarian personnel and the delivery of materials, essential for humanitarian assistance, almost impossible at a time when the need to fight COVID-19 will increase.

South Africa, too, is learning from its past experiences. Public health expert Kerrin Begg of Stellenbosch University and a member of the Western Cape Province Outbreak Response Team reveals that outbreak response teams in all of the country’s nine provinces are providing emergency refresher training to medical staff about how to contain the spread of the virus, and on aspects such as thoroughly sterilising ventilators and other equipment.

There are learnings from tuberculosis which too is an airborne, droplet distributed illness. “Staff who have experience working in South Africa’s tuberculosis hospitals or with tuberculosis patients will probably be best equipped and prepared to be handle the crisis. They already know to wear masks at all times, to wash hands regularly, to ensure good ventilation in a room and the need for isolating patients. They know how to take

off their personal protective clothing and how to dispose it properly. They know how important it is to thoroughly clean a ventilator, for instance, before you use it on a new patient,” explains Begg.

“Strategically, our government must be commended because the stance taken is stronger than that of countries such as the UK and the US in their initial stages,” says medical virologist Denis Chopera, programme executive manager for the sub-Saharan African Network for TB/HIV Research Excellence (SANTHE) based at the Africa Health Research Institute in Durban. “When HIV started emerging in South Africa in the 1980s, the country

A health worker talks to a resident in Cape Town, South Africa, during the 21-day nationwide lockdown to create awareness on the spread of coronavirus disease

took a backseat on handling it. This was because of poor leadership at the time, and certain beliefs. We did nothing for a long time. By the time we fully responded, it was too late,” he remembers.

He is hopeful that the strong measures put into place, along with factors such as a warmer climate and a younger population, will see South Africa through the pandemic. “We previously learnt the hard way that we need to be at the forefront when trying to curb a virus. The cost of drastic measures far outweighs the cost of doing nothing, even if it costs the economy millions,” said Chopera.