‘We can’t afford to become the COVID-19 continent’

THE Continent recently interviewed John N Nkengasong (JNN), director of the Africa Centres for Disease Control on a wide range of issues. Here are the excerpts:

The Continent: In the United Kingdom they are talking about getting back to normal by their summer. What sort of vaccine timelines should we be thinking about in Africa?

JNN: In April and May we should hopefully begin to see vaccinations start to pick up here. Covax and the African vaccine acquisition task team (Avatt) will begin to ship.

This is the timeline I predicted. At the start of the pandemic everybody said the right things about global solidarity and equitable access, but that didn’t translate into action. We failed to translate our public pronouncements into action.

Everybody outside of Africa is guilty of that, too. The Chinese president made a strong pronouncement at a summit with African presidents. The G20 made pronouncements. But this didn’t really translate into action.

What should Africa do to avoid being in this situation again if or when another pandemic arrives?

We need a new public health order for our security as a continent. That will hinge on four things.

First, we must invest in manufacturing — here on the continent — in the three interventions: diagnostics, vaccines and therapeutics. Remember in March last year when other countries and blocs were testing? We were not. And that invited stigmatisation: “Africa is not testing”.

Until we made all the noises, organised, got diagnostics from China and started testing.

Second, we have to be very deliberate in our public health workforce development. We need 6 000 epidemiologists. We only have 1 900 on a continent of 1,2 billion people. That’s like going to a gunfight with a knife. We need 25 000 frontline responders. We only have about 5 000. That’s not acceptable. Third, we need to strengthen our public health agencies, like the Europeans are doing. They are very quietly empowering their CDC to make its own decisions and have the legal mandate to co-ordinate. Africa CDC is a wonderful vision of our heads of States, but we must give it the autonomy and latitude it needs to work. If you do that, you create a network of national public health institutions that become your “military bases” across the continent.

Lastly, we must engage the private sector. I have learnt a lot in this pandemic by working with people such as Donald Kaberuka, Strive Masiyiwa, Benedict Oramah and Vera Songwe.

They are not public health experts but we come together nearly every week and we think through the issues.

The Continent: Can you talk us through how the AU and Afreximbank secured vaccines outside of the Covax mechanism?

JNN: Covax represents a symbol of global co-operation and solidarity, but it has always been very clear that they will give you, as a continent, 20% of your vaccines. And there is no way you can get rid of COVID-19 with 20% vaccination. We need at least 60%.

Europe is trying to vaccinate 80%. The United States is trying to vaccinate everybody. They will finish vaccinating, impose travel restrictions and then Africa becomes “the continent of COVID-19”.

So that means we had to find additional vaccines. South Africa’s President Cyril Ramaphosa took that argument to the AU’s heads of State in August, with Strive Masiyiwa, and made a case for that.

And they said: “Good … go ahead.” And he put together Avatt and told them to go out there, unapologetically and aggressively, and find us a vaccine.

And they did. They secured the first 270 million doses in the spirit of complementing what Covax is going to give us, to get us to 60%.

The Continent: Tanzania’s President John Magufuli has implied, for the first time in months, that there is COVID-19 there. Have you been able to engage with the country?

JNN: We have been using all channels to engage Tanzania. People say: “What is the AU doing? What is the Africa CDC doing?” But that’s not how these things work. There is a lot that is being done very quietly. There is no point in shouting — Tanzania is a sovereign State, and given the intellectual capacity and capability that exists in Tanzania, it probably has some of the best health experts on the continent.

We knew they would get there. We continued to engage through different channels, including providing assistance. We are very encouraged by the signals that are coming out of Tanzania.

The Continent: What do you think about the call for a waiver on patents for COVID-19 vaccines at the World Trade Organisation?

JNN: I’m very supportive of it, but we should look at it in a comprehensive way. Let’s think through how we get continental manufacturing. We don’t need to start by transferring intellectual property. Look at what Serum institute is doing in India. It’s not intellectual property, it’s just: “OK, you can manufacture there.”

In the coming weeks, Africa CDC will be convening a meeting and we will bring all stakeholders to that — member States, investors, banks, development partners and their funders — to have a comprehensive discussion, about how a continent of 1,2 billion people, potentially 2,4 billion in 30 years, cannot be reliant on Serum Institute, a family business in India, to secure its health security. I don’t know of anything that has challenged the continent after independence more than this current pandemic.