Remarks by the WHO Regional Director for Africa, Dr Matshidiso Moeti
Good afternoon to all the journalist colleagues joining this press conference on the COVID-19 pandemic, where we will discuss a new WHO community testing initiative that seeks to dramatically improve the case detection rate in participating countries. Donc, bonjour, bom dia et bienvenue à tous nos collègues journalistes.
I’m pleased to be joined for this conversation by Dr Aly Ngon Tambdou, the Deputy Chief Medical Officer of the Dakar health region who will provide an update on how Senegal is taking forward the new initiative. Bienvenue Dr Tambdou. Dr Ngozi Erondu, a Senior Scholar at the O'Neill Institute at Georgetown University also joins us to provide insights on the importance of rethinking testing strategies.
There have now been more than 8.4 million COVID-19 cases in Africa and sadly 214,000 lives have been lost. In the past week, there were 42,000 new cases, a decrease of 35% compared to the previous week. In most countries, cases are trending downwards or plateauing, but a few are still reporting increases, including Angola, Gabon and Cameroon.
With 67 million Africans now fully vaccinated, equal to only 4.9% of the continent’s population, hundreds of millions of people remain vulnerable to severe COVID-19 illness and death. Thirty-one countries have only 2.4 per cent of their populations fully vaccinated.
So, we are by no means near the finishing line for this pandemic. For the end to be in sight, vaccination rates must dramatically increase, case management capacities should be expanded, and basic public health measures, including active case finding and testing, should be reinforced.
Throughout the pandemic, concerns of under-detection and underestimation of the burden of COVID-19, have been raised across all parts of the world. In Africa, with our low vaccination rates it is vitally important to have a better grasp of where and how the virus is circulating in our communities.
As WHO in Africa, we are using a model to estimate the degree of underestimation. Our analysis indicates that as few as one in seven cases is being detected, meaning that the true COVID-19 burden in Africa could be around 59 million cases.
The proportion of underreporting on deaths is lower, our estimates suggest around one in three deaths are being reported. Deaths appear to be lower on the continent in part because of the predominantly younger and more active population.
With limited testing, we’re still flying blind in far too many communities in Africa. Most tests are carried out on people with symptoms, but much of the transmission is driven by asymptomatic people. Estimates suggest that between 65 and 85 per cent of COVID-19 cases are asymptomatic. The reported cases we see could therefore just be the tip of the iceberg.
In tracking how many countries meet WHO’s recommendation of 10 tests per 10,000 people each week, consistently around 20 countries – more than a third of African countries – do not reach this benchmark.
Now is the time to go on the offensive against COVID-19 to address these testing challenges. WHO’s new community testing initiative is a radically new approach which shifts from passive to active surveillance through working with communities.
Local authorities in hotspot districts will use antigen-detection rapid diagnostic tests, which are reliable, affordable, easy-to-use and provide results in around 15 minutes, so that individuals can quickly know their status. Using a ring-based testing strategy, all individuals living within a 100-metre radius of a case will be eligible for voluntary testing.
To kick off implementation, WHO has provided funds to eight countries participating in the initial pilot programme. Experts have also been deployed to countries to start the operations.
It is expected that more than 7 million people will be tested through this new initiative – increasing the testing capacity in each participating country by 40%. An additional 360,000 cases are anticipated to be detected, with around 75% being asymptomatic or mild cases eligible for home-based care.
Ramping-up testing in this way, will help us to quickly contain future flare-ups of COVID-19 by breaking chains of transmission. As societies start looking towards a post-pandemic future, this community testing strategy is a key component in transitioning towards localized management of COVID-19 outbreaks. This is an approach that we would like to be adopted more broadly and lessons from this project will be shared so that countries can adapt it to their specific contexts.
I also want to mention that COVID-19 is not the only outbreak rattling the continent at present. The Democratic Republic of the Congo has announced a resurgence of Ebola in North Kivu province. There are now two confirmed cases of Ebola, both people have unfortunately died. Initial genomic sequencing indicates that the new cases likely represent a new flare-up of the 2018 to 2020 Ebola outbreak, most likely transmitted by a persistently infected survivor or a survivor who experienced a relapse.
WHO experts are on the ground supporting local authorities with contact tracing, surveillance, testing and vaccination – which began yesterday in Beni. Fourteen people were vaccinated on the first day. More than 220 contacts have been identified and teams are monitoring their health.
In closing, the recognition that there are millions of undetected COVID-19 cases in Africa, makes even more urgent, the need to speed-up access to vaccines.
End-of-year celebrations are fast approaching, and we saw last year, that intense travel and gathering in December led to a surge in cases. So, countries should be preparing now for a fourth possible wave – as WHO we are providing support to reinforce community engagement, surveillance, case management and other critical capacities.
We are also urgently urging wealthy countries, most of whom have vaccinated two-thirds of their populations, to share significant doses of vaccines now rather than next year.
Finally, for all of us to be able to reconnect with family and friends in the way we would like, after this incredibly difficult year and a half, I encourage everyone to get vaccinated as soon as you have the opportunity to do so and to keep-up the preventive measures.
I look forward to our discussion with my fellow panellists today and I thank you once again for joining us.