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African countries are still reeling from the effect of measures, such as blockades, taken to contain the spread of COVID-19. Although painful, they were a vital part of the successful public health response organized by many African leaders.
The rapid responses of most African countries have enabled them to avoid the large-scale loss of life seen elsewhere. The 1.8 million infections and 44,000 deaths recorded on the continent in mid-November are a great loss. However, they are far from the catastrophic predictions made in March and April.
But the fight isn’t over yet: Africa Centers for Disease Control recently warned of a new wave of infections, reporting nearly 9,000 cases a day. With the loosening of the blockades and the opening of borders, this figure will certainly increase.
If good public health measures helped Africa deal with its first wave of COVID-19, a response led by scientists and researchers must be central to any current and future threats. This was highlighted by several leading African scientists gathered in a recent webinar convened to discuss the next steps to contain the pandemic.
The strong leadership shown by many African countries during the pandemic is certainly a lesson to others. But strong leadership needs good science. For Africa, this means that research into treatments and vaccines for COVID-19 must take place here, led by African scientists and adapted to this specific context.
Lessons from Africa
Global solidarity may be missing in the fight against COVID-19 but regional cooperation is not, especially in Africa. As Africa Centers for Disease Control director John Nkengasong pointed out, “the continent came together very quickly.”
Under his leadership, 55 health ministers gathered in Addis Ababa in February to develop a common African strategy for the COVID-19 outbreak.
One of the decisions made was to develop a platform to train 100,000 healthcare workers and to jointly procure medical supplies for diagnostics. Dubbed “Partnership to Accelerate COVID-19 Testing in Africa (PACT),” the initiative was established for multiple countries and resulted in 12 million tests conducted.
Many countries have closed their borders and implemented blockades. South Africa has established one of the strictest in the world. For its part, the Democratic Republic of the Congo (DRC) set up a blockade and suspended all flights into the country, the main way in which cases were presented.
A number of countries have also developed impressive testing programs. One was Senegal, whose Institut Pasteur in Dakar was one of only two labs with COVID-19 testing capabilities when the pandemic began. Results are now available in hours. The country has also trained healthcare workers in other parts of the continent, and the Institut is developing home test kits that are expected to be available soon.
In South Africa, an army of healthcare workers with experience in HIV and tuberculosis have been used as contact tracers for COVID-19.
Another feature of the response in some countries was getting community consensus. Steve Mundeke Ahuka, the incident responsible for the COVID-19 outbreak in the Democratic Republic of the Congo, said 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 due to the distrust of outsiders. This information was used to create and adapt communications to combat fake news and support vaccination and contact tracing. After two difficult years, the strategies have paid off: over 300,000 people have been vaccinated.
Similar strategies have been used for COVID-19.
Research on COVID-19
Most of the ongoing research for COVID-19 is happening in North America and Europe. Large, well-organized clinical trials that were launched months ago are already saving lives.
This research intensity is needed on the continent.
There are many 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 whether future vaccines will be safe and effective in our populations.
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Another reason for further research on the continent is that it can help guide policy. As Borna Nyaoke Anoke, senior clinical project manager and medical director at DNDi, argues:
We need large, well-conducted randomized clinical trials in Africa to support policy change for treatments.
One of the most pressing priorities is the need for care for mild to moderate cases to avoid mass hospitalizations that would overload already overloaded health systems. DNDi will soon launch a large clinical trial with a range of African and European partners to fill this gap. Numerous treatments will be tested that can be administered to patients with mild symptoms.
Finally, African countries need to be active in the research arena to ensure they are not the last in line for life-saving treatments and vaccines.
African countries have shown they have the skills and expertise to provide local solutions to this global pandemic. They must build on this success together to keep the pandemic at bay.
Monique Wasunna, Director, Drugs Initiative for Neglected Diseases Regional Office and Researcher of Africa, Medical Research Institute of Kenya
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