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 on the mainland in mid-November are a huge loss. This is nevertheless far from the disastrous predictions made in March and April.
But the battle is not over yet: the Africa Center for Disease Control recently warned of a new wave of infections and reported nearly 9,000 cases a day.
With the closure and opening of the borders, this figure will definitely rise.
If good public health measures have helped Africa cope with its first Covid-19 wave, a response led by scientists and researchers should be central to any current and future threats.
This has been highlighted by several top scientists in Africa who met during a recent webinar to discuss the next steps to curb the pandemic.
The strong leadership shown by many African countries 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, especially not 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 for the general acquisition of diagnostic medical supplies. The initiative, called the ‘Partnership to Accelerate Covid-19 Testing in Africa (PACT)’, has been implemented for several countries and has resulted in 12 million tests being carried out.
Many countries have closed borders and implemented closures. South Africa has introduced one of the strictest in the world. The Democratic Republic of Congo (DRC), in turn, has imposed a lockout and suspended all flights to the country – the main way in which business has been set up.
A number of countries have also developed impressive testing programs. One was Senegal, whose Institute 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 has also trained health workers elsewhere on the continent, and the Institute is developing home test kits that will 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 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 have borne fruit: more than 300,000 people have been vaccinated.
Similar strategies were used for Covid-19.
Research on Covid-19
Most research that takes place for Covid-19 takes place in North America and Europe. Large, well-organized clinical trials launched months ago are already saving 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 launch 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.
Finally, African countries need to be active in the research arena to ensure that they do not stand 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, Medicines for Neglected Diseases Initiative, Africa Regional Office and Researcher, Kenyan Institute of Medical Research. The article was first published on The Conversation Africa.