Covid-19: How far Africa?
NATURAL and man-made catastrophes have caused significant destruction and loss of lives throughout human history.
Disasters accompany a wide variety of events with multiple causes and consequences often leading to a cascade of related events. The African continent has not been spared of these events.
The outbreak of the 2019 novel coronavirus (Covid-19) is a huge threat to countries with weaker health systems. Many African countries fall into the ligament of developing nations, largely characterised by poor health facilities, high mortality rates of women and children, failure to cope and manage medieval diseases such as cholera and typhoid. These are exigencies of poor economies that should finance public service such as health. In almost all cases of biological and physical shocks, Africa stands out as the most vulnerable geography which is a cause for concern given the scaring harms of Covid-19.
The outbreak, stemming from outside Africa is not only limited to be a public health threat, but is contributing significantly to escalation of conflicts in sub-Saharan Africa resulting in complex emergencies and destruction of socioeconomic structures.
This is a disaster, and we should interrogate Africa and Zimbabwe’s disaster risk management. Interestingly, there is evidence of political will and commitment by African governments to counter disasters.
Disaster, by concise definition of the United Nations is a serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources. This is exactly what Covid-19 has made societies into.
Africa’s political and policy commitment In November 2012, the 62nd session of the Regional Committee for Africa adopted a comprehensive 10-year regional strategy for health disaster risk management (DRM). This was intended to operationalise the World Health Organisation’s core commitments to health DRM and the Hyogo Framework for Action 2005-2015 in the health sectors of the 47 African member states. More specifically, it intended to ensure availability of relevant policies, strategies, and capacity to guide health sector DRM interventions, reduce the occurrence and number of emergencies that progress to disasters, and improve risk management capacities as well as preparedness, responsiveness and recovery.
The strategy has six components: 1. Establishment of an institutional framework for health DRM. 2. Establishment of adequate health sector capacity for risk management. 3. Establishment of a relevant framework and capacity for assessment and mapping of health risks and vulnerabilities. 4. Implementation of resilience-building interventions in health facilities and at a community level. 5. Strengthening systems for adequate preparation, and timely and adequate response to and recovery from disasters. 6. Generation and dissemination of relevant information on hazards and their impact on public health. From these six, let us interrogate if our relative states have those in place, if they do, then we are equipped.
Drawing from experiences in responding to disasters and consistent with Health For All principles, the World Health Organisation (WHO) recognised the importance of an all-hazard and whole-of-health approach for health sector disaster management. The World Health Organisation articulated its core commitments to health DRM in the World Health Assembly Resolutions 64.10 and 65.20. Adopting and adhering to these ratifications means that African states are effectively contributing to the reduction of disaster risks using a multidisciplinary approach to build health system and community resilience against Covid-19.
Are we going where we are coming from? Despite the regional commitment, in the last three decades, Africa has borne a significant disaster burden, largely due to the effects of climate change, environmental degradation, rapid urbanisation, increasing poverty, and increased disputes over land, resources, ethnic identity, and political and religious ideology. Of the 30 biggest complex emergencies and epidemics that occurred globally between 1995 and 2004, Africa accounted for 17 emergencies and 25 epidemics. Too huge a disaster for a single continent, yet clear evidence of the continent’s vulnerability to disasters that could be avoided if the economy was different.
The 2014/15 outbreak of ebola virus disease (EVD) in West Africa, one of the most recent disasters on the continent, resulted in the infection of 28,610 people and 11,308 (39,5%) deaths in the three principally affected countries namely Guinea, Liberia and Sierra Leone, making it unprecedented and the largest outbreak in the history of the disease. At that point, Europe and Asia were spared. They dedicated much of their resources to assisting Africa fight Ebola out of humanity, yet at the same time protecting themselves from a possible global threat. The ebola outbreak resulted in the death of hundreds of health workers, disrupting health services delivery and reducing gross domestic product by 3-13%, which negatively impacted on the economy of the countries principally affected which were Guinea, Liberia, and Sierra Leone. The impact of disasters on public health and the health systems of affected populations include destruction of health facilities, looting of essential medicines and medical equipment, displacement and death of healthcare workers resulting in further disruption of health services delivery, communicable diseases outbreaks, mental health and psychosocial problems, and increased malnutrition. This is what African countries and Zimbabwe in particular should be weary of during this disaster response time.
I am reminded of the September 17, 2018 case were several Harare City Council employees were suspended on allegations of fraud after overcharging goods and medicine to fight the cholera outbreak.
They were swindling from a $10 million funding from Econet group. Such is common in developing countries, and it becomes rife when there are such shocks to the public health system. Disaster Risk Management also entails vigilance in resource distribution and management especially in overwhelmed states which are already grappled with previous disasters that are still under attended.
While Africa has not been hard hit by the coronavirus compared to Asia and Europe, risk reduction is important now, than ever. We need to draw lessons from the past. Until now, the management of disasters has been limited to preparedness and response, with little understanding of the need for risk reduction and post-disaster recovery.
However, the 2005 introduction of the Hyogo Framework for Action ( HFA) 2005-2015 resulted in a global paradigm shift from limited emergency actions to more comprehensive approaches to disaster management. The Sendai Framework for Disaster Risk Reduction (SFDRR) 2015-2030, which succeeded the Health For All 2005-2015, reinforced the need for a broad approach to disaster risk management (DRM).
The SFDRR emphasised the need to strengthen health disaster risk reduction (DRR) and stipulated the strengthening of national health systems as a means of achieving DRR.
Public Health disaster is a challenge worldwide.
However, the emergency response is better when a strong public health preparedness system is established. The lack of these modalities in Africa makes disaster management impossible and devastating.