Strong leadership fought Covid-19 in Africa: the next step is to harness research
The continent needs to gather information about the way its genetic profile may influence the efficacy of drugs and vaccines developed elsewhere
African countries are still reeling from the effect of measures such as lockdowns that were taken to contain the spread of Covid-19. Though painful, the measures were a vital part of the successful public health response mounted by many African leaders.
The quick responses by most African countries meant that they were able to avoid a larger number of fatalities. The 1.8-million infections and 44,000 deaths recorded on the continent by mid-November are a great loss. The numbers are, nevertheless, far from those featured in the catastrophic predictions made back in March and April.
But the fight is not yet over: the Africa Centres for Disease Control, a UN agency, has recently warned of a fresh wave of infections, reporting almost 9,000 cases a day. As lockdowns are eased and borders are opened this figure will certainly rise.
If good public health measures helped Africa tackle its first Covid-19 wave, a response led by scientists and researchers must be central to any current and future threats. This was emphasised by several top African scientists at a recent webinar that was convened to discuss next steps to contain the pandemic.
The strong leadership displayed by many African countries during the pandemic is certainly a lesson for others. But strong leadership needs good science. For Africa, this means that research for treatments and vaccines for Covid-19 must take place here, led by African scientists and tailored to this specific context.
Lessons from Africa
Global solidarity might be lacking in the fight against Covid-19 but regional co-operation, especially in Africa, is not. As the director of the Africa Centres for Disease Control John Nkengasong points out, “the continent came together very quickly”.
Under his leadership, 55 health ministers gathered in Addis Ababa in February to develop a joint African strategy for the Covid-19 outbreak.
The decisions taken include the development of a platform to train 100,000 health workers and the common procurement of diagnostic medical supplies. Called the “Partnership to Accelerate Covid-19 Testing in Africa”, the initiative was set up for multiple countries and has led to 12-million tests being conducted.
Many countries closed borders and implemented lockdowns. SA instituted one of the world’s strictest. For its part, the Democratic Republic of Congo (DRC) instituted a lockdown, and also suspended all flights into the country — the main way cases were being introduced.
A number of countries developed impressive testing programmes. One was Senegal, whose Institut Pasteur in Dakar was one of the only two laboratories with Covid-19 testing capacity when the pandemic began. Results are now available in hours. The country has also trained health workers elsewhere on the continent and the institute is developing home-test kits that should be available soon.
In SA an army of health workers with experience in dealing with HIV and tuberculosis was used as contact tracers for Covid-19.
Another feature of the response in some countries was getting the buy-in of communities. Steve Mundeke Ahuka, the incident manager for the Covid-19 outbreak in the DRC, says the country drew on its past experience in managing the Ebola response. This involved using social scientists and epidemiologists to study perceptions of Ebola in the community because of the distrust of outsiders. The insights derived from this were used to create and adapt communications to combat fake news and to support vaccination and contact tracing. After two difficult years, the approach paid off: over 300,000 people were vaccinated.
Similar strategies were used for Covid-19.
Research on Covid-19
Most of the research taking place for Covid-19 is happening in North America and Europe. Large, well-organised clinical trials that were 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 SA, who is leading Covid-19 vaccine efforts in the country, “populations have different genetic backgrounds, and they are exposed to different infections such as HIV and malaria. We need to know whether future vaccines will be safe and effective in our populations.”
Another reason more research needs to be done on the continent is that it can help drive policy. As Borna Nyaoke-Anoke, senior clinical project manager and medical manager at the Drugs for Neglected Diseases initiative (DNDi), argues: “We need large, well-conducted, randomised clinical trials in Africa to support policy change for treatments.”
One of the most urgent priorities is the need for treatment for mild to moderate cases to avoid mass hospitalisations that would overwhelm already overburdened health systems. DNDi will soon be launching a large 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.
Last, African countries need to be active in the research arena to ensure that they are not last in the queue for life-saving treatments and vaccines.
African countries have proved that they have the skills and expertise to provide local solutions for this global pandemic. They need to build on this success together to keep the pandemic at bay.
*Wasunna is director of Drugs for Neglected Diseases initiative Africa Regional Office and Researcher, Kenya Medical Research Institute. This article was first published on The Conversation.
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