African countries are still dissatisfied with the effect of measures, such as closures, to limit the spread of COVID-19. Although painful, it was an important part of the successful response to public health by many African leaders.
The rapid reactions by most African countries meant that they were able to avoid the large-scale loss of life seen elsewhere. The 1.8 million infections and 44,000 deaths recorded mid-November on the mainland is a huge loss. They are still far from the catastrophic predictions made in March and April.
But the battle is not over yet: the Africa Centers for Disease Control recently warned of a fresh wave of infections, reporting nearly 9,000 cases per day. With the closure and opening of the borders, this figure will definitely rise.
If good public health measures have helped Africa tackle its first COVID-19 wave, a response led by scientists and researchers should be central to any current and future threats. This has been emphasized by several top Afrikaans scientists who at a recent webinar convened to discuss the next steps to limit the pandemic.
The strong leadership that many African countries showed during the pandemic is certainly a lesson to others. But strong leadership requires good science. For Africa, this means that research for treatments and vaccines for COVID-19 must take place here, led by African scientists and adapted for this specific context.
Lessons from Africa
Global solidarity may be lacking in the fight against COVID-19, but regional cooperation is not particularly prevalent in Africa. As the director of the Africa Centers for Disease Control, John Nkengasong, pointed out, “the continent came together very quickly”.
Under his leadership, 55 health ministers met in Addis Ababa in February to develop a joint African strategy for the COVID-19 outbreak.
One of the decisions taken was to develop a platform to train 100,000 health workers and to procure general diagnostic supplies. Called the “Partnership to Accelerate COVID-19 Testing in Africa (PACT)“, the initiative was drawn up for several countries and resulted in 12 million tests being taken.
Many countries have closed borders and applied closures. South Africa has introduced one of the strictest in the world. The Democratic Republic of the Congo (DRC), in turn, has imposed an exclusion and suspended all flights to the country – the main way of conducting business.
A number of countries have also developed impressive testing programs. One was Senegal, whose Institut Pasteur in Dakar was one of the only two laboratories with COVID-19 testing capability when the pandemic began. Results are now available within hours. The country also trained health workers elsewhere on the continent, and developed the Institute home keys which would be available soon.
In South Africa, an army of health workers with experience in HIV and tuberculosis was used as contact detectives for COVID-19.
Another feature of the response in some countries was the acquisition of communities. Steve Mundeke Ahuka, the incident manager for the COVID-19 outbreak in the Democratic Republic of the Congo, said the country was using its previous experience in managing the Ebola response.
It involves the use of social scientists and epidemiologists to study perceptions of Ebola in the community due to the distrust of outsiders. These insights were used to create and adapt communications to combat fake news and to support vaccination and contact tracing. After two difficult years, the strategies paid off: more than 300,000 people vaccinated.
Similar strategies were used for COVID-19.
Research on COVID-19
Most research on COVID-19 takes place in North America and Europe. Large, well-organized clinical trials launched months ago save all lives.
This intensity of research is needed on the continent.
There are a number of reasons for this.
The first is that Africa has a different genetic profile. According to Helen Rees, executive director of the Wits Reproductive Health and HIV Institute in South Africa, which is leading the COVID-19 vaccine efforts in South Africa,
Populations have different genetic backgrounds and are exposed to different infections such as HIV and malaria. We need to know if future vaccines will be safe and effective in our population.
Another reason for more research on the continent is that it can help drive policy. As Borna Nyaoke Anoke, senior clinical project manager and medical manager at DNDi, argues:
We need large, well-executed, randomized clinical trials in Africa to support treatment policy change.
One of the most pressing priorities is the need for treatment for mild to moderate cases to avoid mass hospitals that would overwhelm already congested health systems. DNDi will soon begin a major clinical trial with a number of African and European partners to fill this gap. A number of treatments that can be given to patients with mild symptoms will be tested.
Lastly, African countries need to be active in the research arena to ensure that they are not last in line for life-saving treatments and vaccines.
African countries have proven that they have the skills and expertise to provide local solutions to this global pandemic. They must build together on this success to stop the pandemic.
Monique Wasunna, Director, Initiated Drugs for Neglected Diseases, Africa Regional Office and Researcher, Kenya Institute of Medical Research