Can Africa build its capacity to deal with the coronavirus in time?
Opinion / 9 February 2020, 07:30am / Shannon Ebrahim
As the AU Summit commences in Addis Ababa today there is a glaring omission on the agenda - the danger that the coronavirus poses to the continent, and the capacity of African countries to deal with it.
On Tuesday last week, Dr Ambrose Otau Talisuna from the World Health Organisation’s (WHO) Africa Office said the risk of an outbreak on the continent was very, very high, and that there were significant concerns about the ability of Africa’s fragile health systems to cope.
There have been no confirmed cases of infection on the continent, which some say is due to the fact that respiratory infections spread more readily in cold weather when people spend time together indoors.
In the 2009 flu pandemic, there were fewer cases and deaths in Africa in proportion to population than in Europe and the US. But Africa is not immune, and will need to brace itself for the inevitable.
The growing global concern about the dangers is due to the fact that it is airborne (spread by airborne droplets) so it can rapidly spread among travellers, health-care workers, and other patients, making it more contagious than Ebola.
Ebola, though more deadly, can be spread only by human contact. Experts are concerned that fever detectors at airports might fail to detect early-stage coronavirus when patients are asymptomatic but the virus can be transmitted.
The unknowns are also causing great concern as medical professionals don’t yet know enough about transmission and whether or how it can mutate.
The speed at which infections have been growing in China, with well over 20000 infected, suggests that an outbreak in Africa could overwhelm fragile and under-resourced health systems. Infections have been confirmed in 25 countries other than China.
What is urgently needed is to build the capacity of African states to speedily diagnose the disease, and build the infrastructure necessary to quarantine affected people.
The AU should prioritise discussing the threat of the coronavirus at the level of heads of state, and the summit is an opportune moment to do so, considering that the continent’s leaders will reconvene only mid-year.
That is not to say African countries are not seized with the issue. The Africa Centre for Disease Control - the AU institution established to strengthen the capacity of member states to respond quickly and effectively to disease threats - has activated its Emergency Operations Centre. The Africa CDC is obtaining test kits, preparing lab facilities and working with airlines on screening.
Only six countries are able to test for the virus - South Africa, Senegal, Nigeria, Ghana, Sierra Leone and Madagascar. The WHO has said an additional 29 African countries will receive materials to conduct testing by the end of the week.
The WHO announced it would scale up preparedness in Africa, particularly in 13 priority countries: Algeria, Angola, Ivory Coast, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda and Zambia. Authorities in most of the countries have set up screening at airports, and the WHO is calling on governments to “step up their readiness”.
South Africa is using non-invasive thermometers at its ports of entry, with health officials going on board international aircraft to determine any sick travellers. Ivory Coast, where the continent’s first suspected case was reported, has also installed thermal imaging cameras at airports.
African airlines that have cancelled flights to and from China include RwandAir, Kenya Airways and Air Mauritius, while Air Tanzania postponed its maiden flight to China. But Ethiopian Airlines, which operates regular flights between five African cities and its new $360 million (about R5.4bn) Chinese-built terminal in Addis Ababa, said flights would continue from China, which is a big investor in the country. Flights from China are also continuing to Nigeria, Africa’s most populous country, with 200million people.
Many countries, including Mozambique, have suspended visas for visitors from China and blocked travel to the country. But with a million Chinese nationals living in Africa, and about 80000 African students studying in China (4000 of which are in the epicentre of the outbreak in Wuhan) the chances that the virus could be transmitted to African countries increases.
The reality is that disease surveillance systems throughoutAfrican countries are weak and most of the continent lacks diagnostic capability, for example laboratory capacity, so identifying cases and controlling the outbreak could be difficult, especially in resource-constrained countries. Poorly equipped hospitals, some of which lack basic supplies and reliable electricity, present a serious risk in terms of the virus spreading.
Zimbabwe, for example, has a crippled health system. Its health sector has shortages of basic medicines. Doctors have complained about not having adequate gloves and sometimes use their bare hands while masks and goggles are non-existent.
Prince Butau, the treasurer of the Zimbabwe Hospital Doctors Association, which represents 1000 doctors who anchor government hospitals, has lamented that hospitals are empty, and patients are turned away to die somewhere else.
Poor funding is a major cause of the collapse. Zimbabwe’s finance minister allocated $694m for the health sector last year against an annual need of $1.3bn.
With a health system its knees like in Zimbabwe, and probably many other impoverished countries across the continent, how would an outbreak of the coronavirus be effectively contained and treated?
China, with all its resources, admitted to being short of face masks and liquid soap, and has been asking for support for medical equipment and supplies. But at least China has state-of-the-art hospitals, with two of the country’s top 10 hospitals in Wuhan.
China has constructed three new hospitals in Hubei with more than 1000 beds each, all operational within 10 days of the plans being made. China’s Ministry of Finance committed about $1.3bn in emergency funds for Wuhan and Hubei. Zimbabwe would not have the revenue or the capacity to replicate such emergency plans.
If there was an outbreak in Zimbabwe, the threat to South Africa would be the porous borders between the two countries and the high volume of irregular migration. Such a scenario needs to be considered and contingency plans put in place.
With the coronavirus spreading at a speed beyond the expectations of medical experts, as a country, we cannot afford not to develop emergency plans for worst-case scenarios. It was the rapid mobilisation at the top level in China that catapulted the nation into instant reaction and saved lives.
* Shannon Ebrahim is Independent Media's Foreign Editor.