As the AU Summit commences in Addis Ababa today (Sunday) there is one glaring omission from the official 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 that the risk of an outbreak of the Coronavirus on the continent was very, very high, and that there were significant concerns about the ability of Africa’s fragile health systems to cope.
So far there has not been any confirmed cases of Coronavirus 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 North America. But Africa is certainly not immune, and will need to brace itself for the inevitable.
The growing global concern about the dangers associated with the Coronavirus is due to the fact that it is airborne (spread by airborne droplets) so that it can rapidly spread among travellers, healthcare workers, and other patients, making it much more contagious than Ebola. Ebola, though more deadly, can only be spread 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 still be transmitted.
The unknowns of the virus 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 20,000 infected, suggests that any outbreak in Africa could easily overwhelm fragile and under resourced health systems. Already 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.
As Africa’s continental body, the AU should prioritise discussing the threat of the Coronavirus at the level of Heads of State, and this weekend’s Summit is an opportune moment to do so considering that the continent’s leaders will only reconvene mid-year.
That is not to say that 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 in the process of obtaining test kits, preparing lab facilities, and working with airlines on screening.
To date there are only six countries that are able to test for the virus which are South Africa, Senegal, Nigeria, Ghana, Sierra Leone and Madagascar. The WHO has said that an additional 29 African countries will receive materials to conduct testing by the end of the week.
The WHO announced it would be scaling up preparedness in Africa, particularly in 13 top priority countries: Algeria, Angola, Ivory Coast, the Democratic Republic of the Congo (DRC), Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda and Zambia. Authorities in most of these countries have set up active 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, Royal Air Maroc, EgyptAir, Air Madagascar 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 US$360 million 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 200 million people.
A number of countries, such as Mozambique, have suspended visas for visitors from China and blocked travel to the country. But with 1 million Chinese nationals living in Africa, and approximately 80,000 African students studying in China (4,000 of which are based 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 throughout African 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 widespread shortages of basic medicines such as painkillers, contraceptives, and antibiotics. Doctors have complained about not having adequate gloves and sometimes use their bare hands while masks and goggles are nonexistent. There have been reports of bare-handed surgeries, and plastic bread bags used to collect patients’ urine.
According to Prince Butau, the treasurer of the Zimbabwe Hospital Doctors Association, which represents 1,000 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 health system’s collapse. Zimbabwe’s Finance Minister allocated US$694 million for the health sector last year against an annual need of US$1.3 billion. Experts say that to return the sector to what it once was, the health ministry would need US$8 billion, which was the entire government budget for last year.
With a health system that is on 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 China’s top 10 hospitals located in Wuhan.
China has managed to construct three new hospitals in Hubei with over 1,000 beds each, all operational within 10 days of the plans for construction being made. China’s Ministry of Finance was able to commit approximately US$1.3 billion 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 of the Coronavirus in Zimbabwe, the immediate threat to South Africa would be the porous borders between the two countries and the high volume of irregular migration that takes place on a daily basis. Such a scenario needs to be considered and contingency plans put in place.
With the Coronavirus spreading at a speed even 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 whole nation into instant reaction and saved countless lives.
Shannon Ebrahim is the Foreign Editor for the Independent Media Group.