Addressing a pandemic on a continental level

What are the roles of the African Union and the African Center for Disease Control in responding to COVID-19?

Malaria Diagnostics and Control Center of Excellence microscopy training, Nigeria. Image credit Rick Scavetta via US Army Flickr CC.

When COVID-19 first hit western countries, health experts asked why it had not reached Africa despite its links to China and the continent’s fragile health systems. Reasons given included “weak travel connections, effective border screening and travel restrictions, local climate effects, a lack of screening or a lack of reporting.” However, the question that mattered was what will African countries do once the virus arrives considering their limited capacities to contain it?

Fast forward a few weeks, and there has been a spike in the number of cases in Africa. In response, major airlines like South African Airways have suspended all international flights and Ethiopian Airlines has canceled its flights to 80 international destinations. As African countries scramble to address the crisis by limiting the movement of their citizens through the closing of schools, cancelling of large gatherings, putting curfews in place, not allowing foreign nationals from certain high-risk countries to enter, among other protocols, the African Union (AU) and the Africa Center for Disease Control (Africa CDC) have stepped up to address the pandemic on a continental level.

The Africa CDC was established on April 13, 2015 and officially launched on January 31, 2017. The center has a number of strategic objectives which include the establishment of early warning and response surveillance platforms to address in a timely and effective manner health emergencies; support and/or conduct regional-and country-level hazard mapping and risk assessments for member states; and promote partnership and collaboration among member states to address emerging and endemic diseases and public health emergencies. As the AU continues to centralize its efforts, it was recently announced that Kenya has agreed to host the Africa CDC which, not surprisingly, will be funded by the Chinese government.

As an organization, the AU has highlighted the importance of partnerships for the Africa CDC. A central partnership is that with the World Health Organization (WHO). The AU and WHO signed an agreement in 2015, and building on previous pronouncements and commitments, have recently reaffirmed their shared mission to improve the health in Africa. The reaffirmation of their commitment comes after a high-level meeting of the AU Commission (AUC), the WHO, Africa CDC and its counterparts at the WHO Regional Office in Brazzaville, Congo. This relationship was further solidified with the signing of an agreement in 2019 that sought to “reinvigorate, expand, and deepen” the AU and WHO’s partnership in key areas. But, regardless of this support, the COVID-19 pandemic will serve as the Africa CDC’s ultimate test following the Ebola epidemic.

So far, a number of actions have been taken to address COVID-19. Starting in January, the Africa CDC called on member states to “enhance their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns of SARI or pneumonia cases” and shared that it was “working with laboratories in Member States to identify facilities that are able to receive and test specimens for novel coronavirus infection.” Since then, regular outbreak briefs have been issued by the Center as the situation escalates. Following the first case announced in Egypt, the African Ministers of Health called an emergency meeting where the need to scale up laboratory diagnosis; enhance screening at entry points and surveillance; and strengthen infection prevention and control measures were emphasized. Other high-level meetings included an emergency meeting of the Southern African Development Community (SADC) Ministers of Health which reiterated the Africa CDC’s key goals.

Handouts outlining what the virus is and associated risks along with a guideline on social distancing to limit the spread of the virus have been made publicly available. Most importantly, on March 20 the AU and Africa CDC published the Africa Joint Continental Strategy for COVID-19 Outbreak.

The AU and Africa CDC should be applauded for their transparency during this time. They have issued warnings to those who spread misinformation and are continuously tracking the number of countries affected, reported deaths, and recovery cases. Still, as the number of cases continue to rise and the global system remains in turmoil, the WHO’s Director General, Dr. Tedros Adhanom Ghebreyesus, has warned that “Africa should prepare for the worst and prepare today.” And, the question of whether the AU and the Africa CDC can tackle this crisis remains. Much attention has been placed on prevention but in this situation, as many countries have discovered, it is important to prepare for what happens when prevention is simply not enough.

Further Reading