Ngozi Erondu is a senior research fellow at the Chatham House Center for Global Health Security (London, UK). She points out that there would always be a significant number of missed cases of COVID-19 in Africa. “Many African countries have weak surveillance systems,” Erondu said. “There are challenges in detecting known diseases such as meningitis; a new illness with non-specific febrile symptoms will be even harder to pick up.” At the beginning of 2020, Africa had two laboratories capable of performing RT-PCR tests. Capacity has since improved, but is almost entirely limited to the cities. More than half of sub-Saharan Africans live in rural areas.
Africa’s demographics have worked in its favor during the pandemic. The median age is 19.5 years. Of the 1.3 billion people who live on the continent, only 6 million are over 80 years old. There is no huge burden of diabetes or obesity. The WHO estimates that 65-85% of SARS-CoV-2 infections in Africa cause no symptoms. “We’re missing a lot of cases, but we don’t see a lot of people getting sick or seriously ill, and we don’t hear about a major impact on hospitals or cemeteries,” explained Thierno Balde, deputy incident manager for emergency response at the regional office of the WHO for Africa (Brazzaville, Republic of Congo). After the third wave peaked in July 2021, there has been a steady decline in new cases of COVID-19 across Africa, although a handful of countries are seeing an uptick.
Still, the pandemic has taken its toll. There is enormous economic damage. Millions of Africans have lost their jobs. In 2020, 32 million people in sub-Saharan Africa will fall into extreme poverty. School closures left more than 50 million children without free meals. The alpha, beta and delta variants have each been detected in more than 40 states on the continent. The longer SARS-CoV-2 remains in widespread circulation, the greater the chance that dangerous new variants will emerge.
The WHO predicts that only five African countries will succeed in fully vaccinating 40% of their population by the end of 2021. Only one of these countries, Mauritania, is located in sub-Saharan Africa. In addition, the misleading impression created by official figures on COVID-19 could lead to reduced vaccine uptake if people assume the virus is under control. Even when vaccines are available, their delivery is not always easy. Several countries are struggling to maintain cold chains. There have been issues with vaccine hesitancy and there have been reports of donated vaccines nearing expiration.
Africa has mostly limited testing to individuals who show symptoms. A new WHO program aims to initiate active case-finding. The plan is to reach more than 7 million Africans in eight countries by next year. Households within 100 m of a person who has tested positive for SARS-CoV-2 are offered rapid diagnostic tests. Those who have contracted COVID-19 will receive home care or in designated treatment centers, depending on the severity of the illness. Burundi, the Democratic Republic of the Congo and Senegal are among the participating countries. “We really need to bring testing to the community, and this program does just that,” Erondu noted. “It uses a ring strategy, which has been very effective for other infectious diseases, and should help us pick up many cases of COVID-19.” As high-income countries become aware of the true burden of disease in Africa, they may decide to ramp up vaccine donations. The COVAX facility, which aims to ensure equitable global access to the COVID-19 vaccines, has so far received less than a third of the 1.3 billion doses of the vaccines promised.
“African governments are beginning to come together to establish vaccine production capacity on the continent; if this does not happen, we will be in the same situation every time there is another pandemic,” added Erondu. She hopes that proposals to waive intellectual property protection for the COVID-19 vaccines, which have been supported by countries, including the US, will be adopted by the World Trade Organization. On October 26, 2021, BioNTech, which partnered with Pfizer to produce the first COVID-19 vaccine to be approved by UK and US regulatory authorities, announced plans to begin work on an mRNA production center sometime next year. vaccines in Africa.
Published: November 11, 2021
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