The COVID-19 pandemic in Africa and the coordinating role of WHO.

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Seventh meeting of the EU–Africa Economic and Social Stakeholders Network, European Economic and Social Committee, 2 March 2021
Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti

The COVID-19 pandemic in Africa and the coordinating role of WHO

Greetings to Mr Carlos Trindade, President of the African, Caribbean, and Pacific and European Union partnership, to our moderator, to my fellow speakers and to all the partners and colleagues who joining this network meeting.

I am very pleased to join you for this important event to talk about the COVID-19 pandemic in Africa including the coordinating role of WHO.

As to the situation, there have now been more than 3.9 million COVID-19 cases in Africa and 104,000 people have sadly lost their lives.  Some countries, including South Africa, Algeria, Kenya and Ghana have been severely affected.

We have seen two epidemic waves, with the second wave overwhelming health systems in some countries. I think people are aware that the most affected country on the continent has been South Africa and the hot spots there. The health systems were quite overwhelmed and there have also been some major challenges in countries like Malawi, Zimbabwe and Zambia. We recognize that there are still risks of further waves as countries ease restrictions on movement amid mounting pressure and frankly population fatigue that we have seen in Africa and certainly very vividly in some European countries. So, the roll out of the vaccines, as has already been mentioned, is incredibly important.

Overall, we have seen fewer cases and deaths in African countries than the modelling (that we and other organizations initially carried out) projected, in part because countries led rapid and determined response efforts, building on lessons from past severe epidemics of Ebola, cholera, yellow fever, and other diseases. There was also strong continental and sub-regional collaboration, cross-border information sharing on positive cases, and screening at points-of-entry on the continent.

It was lucky that we have in Africa, populations generally that are younger and less mobile than in other regions perhaps because of challenges of movement and they are mainly rural still and that we think helped to limit the spread and severity of COVID-19 in many of our countries.

So, the African continent accounts for only 3.5% of the global total of cases, whereas we make up 16% of the global population. This is good news, but we know that African countries have had tremendous problems having access to sufficient testing materials and kits and there is a certain degree of underestimation of the number of cases and we are encouraging countries now to carry out antibody surveys just to see to what degree there has been exposure to the virus among the population.

As I said African countries or government took action early. They restricted movement and gathering, including closing borders, schools and businesses. We know that this has had a devastating impact on livelihoods, particularly among the most vulnerable households and communities. African economies have been pushed into recession for the first time in 25 years, with the IMF projecting that Africa will be the slowest-growing large region in 2021.

So, the recovery from this crisis will require our collective and sustained attention for years to come.

Looking back at the response to the pandemic, this time last year WHO convened the first partnership coordination meetings in Africa, and although there were only a few cases at that time in Egypt, Algeria and Nigeria, there was recognition that we needed immediate action to coordinate our efforts and make the most of the scarce resources and capacities to save lives. We brought together civil society organizations, the UN and other international agencies, bilateral partners and donors in Dakar and Nairobi and we agreed with them how to work together on the key intervention areas of the response.

We’ve also worked very much with the Africa CDC to help countries expand diagnostic capacities for COVID-19. For example, when we started only two African countries could diagnose the virus and within a couple of months, we had 40 African countries supported to set up this capacity. We worked with sub-regional professional associations to train health workers in surveillance, infection prevention and control, and how to treat cases, first in-person then after the lockdowns started, we did a lot of online training and we have reached over 200,000 health care workers with training.

In every African country, our country teams are positioned probably as the closest advisers to ministries of health, and we have convened health partners regularly to help coordinate the response, as well as advising some of the high-level multisectoral taskforces established by national authorities.

What we’ve observed is that the response in Africa has benefited greatly from the intense campaign led by the private sector, philanthropists and business leaders who mobilized themselves and their networks to fill critical gaps, including facilitating access to essential supplies and providing services like testing, transportation and critical care.

Communities and their networks have also played a central role. Civil society groups got the message out about wearing masks, physical distancing, washing hands and delivered health kits to communities. We know that sometimes it was very difficult for people to carry out these measures in the context of the way in which they are living.

We saw countries expand their infrastructure to respond to the pandemic in different ways. They repurposed existing health facilities and space, they built temporary structures and constructed new buildings in some cases. This led to a dramatic scale-up of hospital bed capacity – more than tripling from 13,000 to 44,000 beds. There was also an increase in the medical oxygen supply, with the number of oxygen plants in the Region almost doubling from 68 to 126. Admittedly, there are still huge gaps in access to oxygen and the production capacity in Africa. This pandemic has highlighted this problem, which is important not only for the response to COVID-19.

To overcome global supply chain disruptions, WHO worked with partners to create the COVID-19 supply portal. This platform has facilitated delivery of more than 3400 oxygen concentrators, 70 million items of personal protective equipment and 14 million test kits to African countries.

So, now countries are embarking, it’s already been said by our colleague from the European Union, on a new phase in the response, with the roll out of massive immunization drives – and this too will require active civil society engagement, including to combat misinformation around vaccines. I was very happy to hear Mr Kodhe say that this work they are already doing. It will also require investments in infrastructure, including cold chain capacities to move and store the vaccines and make sure that they remain effective.

The COVAX Facility, which already has been mentioned, was established by WHO, Gavi and the Coalition for Epidemic Preparedness Innovations, towards ensuring equitable distribution of COVID-19 vaccines. We thank very much the partners that are supporting financially and in other ways, this platform and we recognize that equity continues to be an active challenge in access to vaccines between different regions in the world.

We have spent the past months working intensely with countries to prepare for the roll out of COVAX vaccines once they arrive in countries and we are already celebrating the first deliveries in Ghana and in Cote d’Ivoire. We’re expecting deliveries in Angola and Nigeria and a number of countries in the next few weeks.

Now the work with immunization partners, like UNICEF and community-based groups, is being scaled-up to roll out vaccination campaigns.

Recognizing that there is a lot of misinformation around, we have established the Africa Infodemic Response Alliance, with partners like the Red Cross, the Africa CDC and organizations that do fact checking so that we track and respond to misinformation as it happens and make sure that communities, through their various networks and informants, are receiving the correct information.

We know that these vaccines are really a life-saving tool but sustained public health measures, including communities being supported to adhere to the prevention measures, continue to be crucial to bring about the end of the pandemic.

Looking ahead, our collective support to countries needs to apply the lessons that we have been taught by COVID-19, to build more resilience into national health systems and into societies.

Good practices, like the impressive work by the private sector, should be become part of the new normal in partnerships for health and for development.

We have seen that when disaster strikes, countries need to be able to mobilize additional capacity, including infrastructure, quickly, temporarily, sometimes, and affordably. So, together we need to work on innovating to consider how this can be done in ways that contribute to building local capacities for the next crisis to serve other health needs into the long term.

At the same time, COVID-19 has reaffirmed the need for investment in strengthening basic infrastructure, like access to water and sanitation, because we should not forget other areas that are important for basic health and for controlling the spread of infections. All of this emphasizes that the multisectoral response is extremely important.

It’s already been said but I’d like to emphasize that this pandemic has reignited discussions on expanding manufacturing capacities in Africa, including in the pharmaceutical sector, so that essential supplies can be produced locally and at affordable prices. The Africa Continental Free Trade Area can create an enabling environment for accelerated action in this sense.

We have seen a lot of innovation come out during the pandemic – African scientists and experts developing technologies that are appropriate and affordable. We’d also like to advocate that these be supported, produced, expanded, and integrated into our health care systems.

We will also advocate for greater civil society participation in emergency preparedness and response, not just to mobilize civil society when there is a crisis but that they become part of the planning, the strategizing and the design of the readiness and resilience of our health systems and societies.

In the recovery from COVID-19, partnerships, and the support of networks, like the EU–Africa Economic and Social Stakeholders Network, will therefore be vital to restoring livelihoods and advancing sustainable development in Africa.

So, I look forward very much to our conversation today and to our continued collaboration going forward.

Thank you very much for your attention.