A New Public Health Order for Africa
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- Authors: JOHN NKENGASONG
- Published: December 2, 2021
Pandemic context and key statistics
- As of November 3, 2021, there were 8.5 million confirmed COVID-19 cases and over 218,000 COVID-19 fatalities across the continent.
- Less than 3 percent of the population in Africa is fully vaccinated.
- Africa has about 3 million health care workers.
- Health workforce density: 3 doctors per 10,000 people in Africa, compared with nearly 30 for the Americas and more than 40 for Europe.
- The G20 High Level Independent Panel estimates that it will cost at least $75 billion over the next five years to fill gaps in pandemic prevention and preparedness (global fund recommendation context).
Homegrown solutions and African Union–led initiatives
- Africa Centres for Disease Control and Prevention (Africa CDC) coordinated the African Union’s continental response strategy, released less than six weeks after the first confirmed case on the continent.
- Pan-African Partnership to Accelerate COVID-19 Testing (AUC and Africa CDC), launched April 2020:
- Number of countries with testing capacity increased from 2 to 43 in three months.
- More than 90 million test kits were procured.
- Thousands of lab workers trained.
- Medical supplies platform (AUC, Africa CDC, United Nations Economic Commission for Africa, African Export-Import Bank):
- Acts as a one-stop shop for procurement of personal protective equipment.
- Improves Africa’s bargaining power and supports African manufacturers.
- Trusted Travel Platform (AUC and Africa CDC):
- Simplifies verification of COVID-19 test results and public documentation for travelers.
- Potential use beyond COVID-19, including for the African Continental Free Trade Area.
- African Vaccine Acquisition Trust:
- Established to complement initiatives such as COVAX.
- Has secured enough vaccine doses to cover one-third of the African population.
Case for regionalization and the "new public health order"
- Regional institutions play roles beyond backstopping countries: innovation, adaptation to regional needs, and political engagement.
- Africa CDC’s five core focus areas for mid- to longer-term health security:
- Strong regional institutions to guide priorities, coordinate policies and programs, and drive standard-setting and disease surveillance.
- Local production of vaccines, therapeutics, and diagnostics to drive down procurement costs and increase response speed.
- Investment in the public health workforce and leadership programs.
- Strong, high-level partnerships, including between donors and governments and the public and private sectors and with public health institutions.
- A greater role for regional organizations in pandemic governance, by decentralizing institutions and through regional representatives in key agencies to ensure regional specificities are considered in planning central mechanisms such as surveillance systems.
Funding needs and financing considerations
- A starting budget of at least $20 million is required for national public health institutes (varies by size, function, and country).
- Tens of billions of dollars will be needed to train nurses, physicians, epidemiologists, and other health care workers.
- Continental manufacturing of vaccines, diagnostics, and therapeutics will require up-front investments in infrastructure, materials, and staff.
- These continental funding needs are in addition to global-level needs (support for WHO, access to vaccines/diagnostics/therapeutics, global surveillance and alert systems, rapid surge funding for early response).
- Domestic funding should increase but will not be sufficient for low- and many lower-middle-income countries; needs to be bolstered by:
- Favorable financing options.
- Strong partnerships and investments in pandemic preparedness and response.
- A backstop fund to pay for surge expenses as needed.
People-centered health systems and policy implications
- Call for a fundamental rethink toward people-centered, inclusive health systems.
- Equity begins with regionalizing health systems so regions have capacity and ability to respond when crises hit.
- Translating lessons from COVID-19 into a new public health order can lessen effects of future pandemics on lives and livelihoods.
John Nkengasong, "A New Public Health Order for Africa," F&D Magazine, December 2021
Content in this bundle
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