What the World Can Learn From Africa’s Covid-19 Response
By: Weel Matouk
Tags: Babies, Health, Humor, Life, Coronavirus

What the World Can Learn From Africa’s Covid-19 Response

The Lagos government conducts community testing and search samples for eligible cases in order to contain Covid-19 cases in Nigeria. Photo: Olukayode Jaiyeola/NurPhoto/Getty Images

The United States has had a less than successful handling of the Covid-19 pandemic. From the government response to individual protests, the American response has abounded with politics and failures that have led to unfortunately high fatalities.

While the U.S. has floundered, other countries have succeeded. Many have praised the response from countries like New Zealand and Singapore, but other countries, particularly in Africa, have done well, too.

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Africa’s Covid-19 response includes many lessons that “first world countries” could benefit from implementing.

If you stay ready, it takes less to get ready

Few countries have escaped the grasps of pandemic outbreaks, yet many have readily forgotten the realities of these health crises. The United States had the H1N1 pandemic in 2009, yet disbanded dedicated pandemic response teams in 2018. Conversely, African countries retained the health systems used for previous pandemics.

“Much of the success was attributable to the public health infrastructure that had been put in place before now. The emergency coordination structures— from the national to the state and below—were already there,” explains Chizoba Wonodi, MD, MPH, DrPH, director of Nigeria programs at the Johns Hopkins’ International Vaccine Access Center.

For example, much of the contact tracing measures implemented in countries like Nigeria drew from the experience of contract tracing for the previous Ebola outbreak response and from the emergency operating centers used for polio, Wonodi says.

“[The African] system of health already is inclined more toward these communicable diseases as opposed to a lot of other countries,” explains Javed Ali, MD, the International Medical Corps director of emergency response, Africa region. He adds that aspects of surveillance, reporting, and data collection are ingrained in many aspects of primary health care in a way that is not necessarily as common in the United States.

Leaderships needs cohesive, clear, and united messaging

While U.S. politicians differed widely on their opinions related to Covid-19 management, politicians in Africa struck a unified tone. African citizens got consistent messaging from the government and public health leadership.

“Africa’s response demonstrated African unity,” says Daniel Fagbuyi, MD, Obama administration public health/biodefense appointee and an emergency physician. “They were very cohesive,” he adds. “Leaders were working together, collaborating, and communicating. They were able to orchestrate a better response than even some of the high-powered and wealthy Western countries, including the United States.”

Africa Center for Disease Control and Prevention (Africa CDC), led by Director John Nkengasong, collaborated with government officials from the African Union countries to develop the Africa Joint Continental Strategy for Covid-19 Outbreak and the African Union Covid-19 Response Fund.

Ali adds that joint partnership also created the African Medical Supplies Platform which helped ensure that medical equipment, such as personal protective equipment (PPE), could equitably be distributed across countries in the region.

The African response also benefited from communication that its citizens could readily understand.

“Africa is well acquainted with risk communication because of Ebola. They were able to implement those risks and risk mitigation modalities in local languages, understandable to people,” Ali says.

“[The response] wasn’t piecemeal as opposed to what happened in the United States and other countries where they’re having the discussion back and forth, whether you should be wearing a mask, whether we should lock down or not. Science ruled, they realized, and they did not take things for granted,” adds Fagbuyi.

Citizens should promote the collective good over individual autonomy

A significant hindrance to the U.S. Covid-19 response emerged from the dissent among American citizen’s beliefs relating to the severity of the disease and prevention tactics.

“There was good buy-in by [African] citizens, meaning their citizens were willing to actually listen to their governments and their leaders,” Fagbuyi explains.

The overwhelming majority of the 54 African nations implemented partial or full shutdowns and mandated African nations use masks in public spaces. Countries like Morocco even threatened jail sentences for mask-use violations.

When it comes to stringent rules, “it may not necessarily always be welcome, but it is acceptable, and they will follow those types of rules,” adds Fagbuyi. “While in the U.S., our autonomy takes precedence [over community].”

Wonodi explains that Nigeria offered an isolation and treatment center that allowed Covid-19 positive individuals to quarantine and receive care without personal cost.

Simple public health measures matter as much as medical innovations

An overreliance on treating disease versus preventing them can do more harm than good, experts say. Many African countries’ health systems have a strong focus on prevention.

“High-tech medicine is great, advanced diagnostics and therapeutics are great, they should not exist at the detriment of good old public health,” Wonodi says.

Nigeria did not have enough ventilators, Wonodi recounts. Yet they implemented robust public health measures early on, such as monitoring ports of entry, screening arrivals, collecting contact information of international arrivals for contact tracing, and closing their borders. This gave the country a head start in curtailing importation and transmission of the infection and contributed to their lower case counts as compared to countries with more advanced medical technology.

Africa does have certain intrinsic differences from the United States that could explain some of the successes. Compared to North America, Africa has a younger population and a lower prevalence of chronic conditions such as obesity and diabetes. According to Wonodi, other immunological and environmental factors may also be a factor in explaining the lower rates of cases and fatalities.

Still, the lessons can apply.

The West has often viewed African health initiatives through a savior lens; that the West needs to teach Africans about health care yet not the reverse. The truth is global health care is a symbiotic relationship. Learning lessons from the strong African response could help the United States achieve a better Covid-19 response.