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COVID-19: Charting a sustainable path to response, recovery and resilience in Africa

COVID-19: Charting a sustainable path to response, recovery and resilience in Africa

By Abiodun Awosusi
on August 17, 2020

The novel coronavirus has spread from China to over 170 countries – including all African countries – with millions of cases and hundreds of thousands of deaths globally. Egypt recorded Africa’s first COVID-19 case on February 14, 2020. In six months, the continent has gone from one to a million confirmed cases with over 700, 000 recoveries. Africa has had relatively fewer deaths than other parts of the world: the unique conditions on the continent require countries to now chart a path to sustained response, recovery and resilience as the pandemic unfolds.

The continental response has been remarkable. The African Union (AU) continues to provide responsive political and technical leadership in close collaboration with African leaders, ministers, experts and development partners. The AU Chair H.E. President Cyril Ramaphosa appointed four special envoys to facilitate international support for an effective African response to the economic consequences of the pandemic. The Africa Centers for Disease Control and Prevention (Africa CDC) leads the implementation of the COVID-19 continental strategy with support from the World Health Organization, regional and national health institutions as well as development partners. The African Union Development Agency (AUDA-NEPAD) is implementing the continental response plan for key interventions across multiple sectors in AU member states. 

The United Nations Economic Commission for Africa (UNECA) estimates at least $100 billion is required for health and social protection interventions, and another $100 billion for Africa’s economic stimulus. In response to the vast needs, the World Bank Group and the International Monetary Fund deployed rapid disbursement instruments to support African countries. While the African Development Bank (AfDB) issued a $3billion social bond alongside a $10billion COVID response facility, the AfreximBank launched a $3billion trade support facility. New partnerships across multilateral, regional and national financial institutions have led to additional financing in response to the crisis. There is a global effort to ease the debt burden on several African countries with minimal future consequences. In addition, the AU Commission established the COVID Relief Fund while also mobilizing business leaders and the private sector to support national, regional and continental institutions to implement preparedness and response plans. Private sector coalitions, philanthropic foundations and citizen groups continue to donate to support national and continental responses.

Governments across the continent have deployed aggressive border-control, public-health and economic measures to tackle the crisis using lessons from past epidemic responses. These crucial efforts at continental, national and subnational levels are commendable but we must not become complacent. With over a million confirmed cases and growing “collateral damage”   on other health programs on the continent, it is important to sustain response and design data-driven plans for recovery and resilience with particular attention on:

Diplomacy for Access to Tools and Capital

An effective public health response to the pandemic in Africa hinges on timely access to essential preventive, diagnostic and therapeutic tools. Although there is a growing global research collaboration to rapidly develop tools to combat COVID-19, export restrictions have impeded access to vital medical supplies, diagnostic and therapeutic tools for the response in Africa. Global health institutions, key governments and leading philanthropies launched the Access to COVID-19 Tools (ACT) Accelerator Coalition on April 24. The European Union led the global pledge for billions of dollars on May 4 to accelerate production and distribution of health technologies to combat the virus. More investments have been announced across the world in June and July. Although it could take several months before viable vaccines are widely available, there are encouraging results from clinical trials for therapeutics for treatment of COVID-19 patients. We need to use creative means to alleviate ‘’community fatigue’’  in order to sustain widespread use of prevention measures like use of masks and personal hygiene.

It is commendable that the G20 and G7 leaders committed to deploying all necessary arsenals to win the war against COVID-19. We urge an extension of that commitment for access to all essential tools for low- and middle-income countries especially those in Africa. African leaders, institutions and experts have crucial roles to play in facilitating access to medical supplies, medicines, vaccines and other health technologies required to combat coronavirus on the continent. African leaders in key global health and multilateral institutions can leverage their expertise and networks in close collaboration with the AU Commission and development partners to effectively negotiate timely and equitable access through viable channels. There is an opportunity to maximize the Africa Medical Supplies Platform, COVAX Facility and other relevant platforms to aggregate demand, financing and supply of much needed health technologies with continuous community engagement for adoption and efficient use. A dynamic global landscape demands tactful approaches to gain access, save lives and livelihoods.  

Partnerships for Sustainable Production

The economic impact of COVID-19 in Africa demands an unprecedented public policy response for economic recovery. Every crisis is an opportunity for meaningful reforms. Key multilateral and international financial institutions were created after major crises. The Coalition for Epidemic Preparedness Innovations (CEPI) was founded to tackle epidemics through cutting-edge research and investments. The Global Fund was created to beat AIDS, tuberculosis and malaria with potential value in extension of its mandates to emerging epidemics. There is growing consensus that the world will be different after the pandemic subsides: a new socioeconomic order is emerging hinged on digital and technological advancements, glocalization, sustainability and equity. This is the perfect time to speed up continental, regional and national reforms to integrate markets reflecting these themes and open opportunities for effective economic diplomacy among countries and development partners.

The pandemic is arguably the most important test of Africa’s resolve for inclusive economic development. The crisis lays bare the continent’s overreliance on global supply chains for access to vital medical supplies, medicines, vaccines and other health technologies, as well as food items. Africa imports more than 80% of its food with imports estimated to be $110 billion by 2025. Over 70% of medicines used on the continent are also imported. We have an opportunity to leverage continental economic integration to build partnerships for regional and continental value chains that can guarantee health and food security. Malnutrition is a major cause of disability and deaths in Africa: It contributes significantly to poor health outcomes, limiting crucial ‘grey matter infrastructure’ development in children with lasting impact throughout life. Worsening food insecurity as a result of COVID-19 heightens the risk. While aggressive public-health measures remain important to curtail viral transmission and health impact, current national and continental responses to the pandemic create a vital foundation for continental integration to build robust food and health supply chains.  This requires increased investments in research for development, knowledge management, intellectual property protection, technology transfer and access to capital.  

Investments in Resilient Systems for Health and Wellbeing

In view of the social, economic and political impacts of the pandemic across the world and particularly in Africa, there is a need to embrace a transition from health system strengthening to investments in systems for health. The World Bank predicts that Africa will experience its worst recession in decades as a result of the impact of the pandemic. Dwindling national revenues, reduced remittances and foreign direct investments, significant shocks to specific sectors and job losses are likely to weaken efforts to boost domestic resource mobilization for sustainable development. A transition from vertical programming to health system strengthening in global health and development will be insufficient to overcome the multidimensional impacts of COVID-19. Several commentaries have explored key areas of focus for reforms based on the WHO’s health system framework but emerging realities show that multisectoral system strengthening for better health outcomes is the most plausible path to health for all.

Africa is vulnerable to systemic risks particularly epidemics and climate shocks. The pandemic also exposes the complex interactions between state capabilities, poverty, inequality and social protection. Leveraging the response to COVID-19 to reinforce investments in a system-based approach to address these risks can boost proactive recovery and resilience. The African Union is well-positioned to work through the African Risk Capacity   and the Africa CDC with UNECA, AfDB and development partners to strengthen systemic risk prediction, assessment and management tools for disasters and epidemics – building on current partnerships. These initiatives could be linked to accelerated development of statistical and identity systems alongside social protection schemes.

Ongoing institutional investments to tackle the pandemic particularly in the Africa CDC and national public health institutes are central to addressing not just epidemics in the future but also the double disease burden on the continent with the rise in incidence of non-communicable diseases. Effective community mobilization today through formal and informal channels strengthens community systems which are central to adoption of scientific, financial and digital tools for optimal productivity as the world gradually embraces a wellbeing economy that works for the people and planet.

The current landscape is likely to change significantly within the next twelve months as the global race for effective and safe therapeutics and vaccines shapes future policies. Data-driven decisions hinged on strategic partnerships, digital transformation, self-reliance and productive investments can ensure the continent is on the right path to recovery and resilience.

About Abiodun Awosusi

Director of the Capacity Investment Lab and Health Economist at Health Systems and Development Enterprise. Chair of the African Alliance for Health Technology Access.

About Marius Adeniyi

Research Fellow, Health Systems and Development Enterprise
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