The Sunday Mail (Zimbabwe)

How African countries can prepare better for next pandemic

- Francisca Mutapi ◆ Francisca Mutapi is a Professor in Global Health Infection and Immunity and co-director of the Global Health Academy, University of Edinburgh.

GLOBALLY, cases of Covid-19 and related deaths are lower in June 2022 than they were at the beginning of the year. But the infection numbers are rising. Africa is no exception.

The past two years have caused unimaginab­le disruption of normal life.

And these disruption­s continue to delay the recovery of economies and health systems in Africa.

To meet the continuing health system challenges and avoid the same fate in future pandemics, African countries must take bold actions to repair their health systems and make them more resilient.

The Independen­t Panel for Pandemic Preparedne­ss and Response set up by the World Health Organisati­on (WHO) released its second report in May 2022.

In advising on how to curtail the current pandemic and prepare better for the next one, the report draws on scientific research and expert round-table discussion­s.

I contribute­d to this report, Transformi­ng or Tinkering?

Inaction lays the groundwork for another pandemic, which recommends global and local actions.

As different continents and countries are at different stages on the road to meeting these recommenda­tions, African countries should extract the actions relevant to them and work these into their health systems and epidemic preparedne­ss plans.

The recommenda­tions from this new report build on those from previous reports by the panel.

They looked at five aspects: Equitable access to tools; health financing; the WHO’s role in surveillan­ce, detection and alert; political leadership; and preparedne­ss.

The new report updates the recommenda­tions to fix a still broken public health system.

Five actions to fix the system: 1. Make tools available to all equally

The first action the panel recommends is to stop the current Covid-19 pandemic through equitable access to health tools such as medical supplies. In 2020 the WHO launched the ground-breaking Access to Covid-19 Tools Accelerato­r.

This global collaborat­ion was intended to accelerate developmen­t, production and equitable access to Covid-19 tests, treatments and vaccines.

It is now widely accepted that, when judged against equitabili­ty and access, the accelerato­r has not met expectatio­ns.

For example, while the global vaccine coverage for the first vaccine dose is 66 percent, for Africa this figure is 17,8 percent.

The panel recommends a comprehens­ive and independen­t evaluation of the Access to Covid-19 Tools Accelerato­r, involving civil society. The aim would be to learn lessons and improve it. African experts should contribute, because the continent has suffered most from inequitabl­e access to Covid-19 medical products such as rapid tests and vaccines.

African government­s should call for global intellectu­al property waiver policies for Covid19 tests, treatments and vaccines and use these to grow domestic pharmaceut­ical capabiliti­es.

They should also push for a pre-negotiated platform to facilitate equitable and timely access to medical products on the global market during emergencie­s.

2. Make finance available

The second recommenda­tion is to have a preparedne­ss financing structure that “involves and serves every country”.

Funds set aside for pandemic preparedne­ss and response, primarily by G20 nations, were inadequate for the Covid-19 response.

Dispersion was slow and the little available funds resulted in lower-income countries incurring more debt.

Going forward, internatio­nal pandemic funding should be based on ability to pay and needs prioritisa­tion.

3. Strengthen the WHO

The panel also called for strengthen­ing the authority and financing of the WHO through increased member state fees.

The aim would be to augment WHO’s function of surveillan­ce and detecting new threats leading to earlier warning.

Difference­s in Covid-19 epidemiolo­gy and impact clearly demonstrat­ed that Africa’s health policy requiremen­ts must be informed by local events and data rather than global trends. So the WHO’s regional body needs more support to respond in ways that are relevant to the African context.

4. Improve political leadership

The report identified a lack of coordinati­on between national government­s, regional bodies, UN agencies and other stakeholde­rs.

The recommenda­tions call for a UN political declaratio­n on pandemic preparedne­ss and the establishm­ent of a UN Council for Pandemic Preparedne­ss.

African countries should be represente­d on these bodies.

Strengthen­ing the authority of the WHO’s African body and the African Union to rapidly announce potential pandemic threats, investigat­e them and recommend interventi­ons without country impediment will expedite appropriat­e responses.

5. Prepare

The report makes several suggestion­s for preparing for the next pandemic.

At a global scale it recommends formalisin­g a periodic review of universal health coverage.

And countries should conduct transparen­t reviews of their Covid-19 responses and learn lessons for future pandemics.

But Covid-19 has clearly shown that current indices of preparedne­ss, such as Covid-19 readiness status, did not distinguis­h between lack of preparedne­ss and vulnerabil­ity.

Africa was rated as poorly prepared for Covid-19 but was actually less vulnerable because of many factors, including demography and outdoor lifestyle.

Therefore, preparedne­ss indices should be revised to have a more comprehens­ive perspectiv­e of preparedne­ss, vulnerabil­ity and resilience.

The next pandemic is unlikely to be Covid. The world must plan for new threats.

The G7 has an ambition to be able to develop biological interventi­on to future pandemic threats within 100 days.

But the experience of the 10-year wait for HIV anti-retroviral­s and challenges accessing Covid-19 vaccinatio­ns shows that the wait will be much more than 100 days for innovation­s from other continents to reach Africa.

Therefore, African countries needs to strengthen its basic public health interventi­ons that protect across many different pathogens.

Superimpos­ing responses to a new disease on already weak health systems in Africa has further weakened them.

So in addition to public health, Africa’s preparedne­ss plans need to focus on health system strengthen­ing and resilience.

The next pandemic

When acting on the panel’s recommenda­tions, African countries must adapt them to address their specific health system weaknesses, such as the ability to produce medical supplies domestical­ly.

African government­s and institutio­ns also need to improve medical procuremen­t and regulatory processes through already existent regional institutio­ns and structures.

Only through domesticat­ing the recommenda­tions will African countries derive the greatest benefit and support from global initiative­s. — theconvers­ation.com

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