Emerging Lessons from the COVID-19 Pandemic
“The lesson of this current pandemic is that innovations are happening around the world. But the resources to fund and to scale innovations are not spread evenly. This must be addressed.”
The world is now in the process of re-opening after several months of global lockdown due to the COVID-19 pandemic. While some parts of the world are on the ascent in terms of new infections, some are just in the process of slowing the rate of new infections, and some have largely succeeded in bending the curve. The pandemic has affected countries differently. Though the impact is devastating for all, some countries will have bigger challenges and hurdles to overcome. The rallying cry globally now is how to reopen the economy without sowing the seeds for a more devastating return of the COVID-19.
Apocalyptic projections and the facts so far
One of the interesting developments in the ongoing pandemic is Africa, which was supposed to be the epicenter of COVID-19. The continent was feared to be defenseless against the inevitable spread of the coronavirus. Projections for the continent were apocalyptic in nature with estimates that almost one-quarter of a billion people could be infected with coronavirus in the first year of the pandemic while the U.N. Economic Commission for Africa (UNECA) estimated the deaths from COVID-19 could range from 300,000 to 3.3 million people. The good news to-date is that these are projections and there is no certainty on what the future holds.
For good measure, the health systems and infrastructure are not well developed and were already under stress. As per the World Health Organization, 4.5 medical professionals (physicians, nurses, and midwives) are needed per 1,000 people to achieve the globally agreed Sustainable Development Goals (SDGs). As of the last data available in 2017, it seems no country on the continent has met or surpassed this threshold. Based on projections, Africa is expected to account for 6.1 million out of the 14.5 million global shortage in health care professionals by 2030.
Still, in actual fact, Africa has done reasonably well to-date in the fight against COVID-19. From the early lockdowns around the continent starting at the beginning of March, there were low-tech solutions and innovations that emerged on the continent, as well as reasonably sound policies in many countries in Africa. The continent has surprised many observers with the speed in which it has acted and the leadership that it has shown in the response to COVID-19, while the pandemic has wreaked havoc on medical facilities in the U.S. and Western Europe. In the U.S., deaths from COVID-19 are now about 110,000 while about 2 million people have contracted the coronavirus. While, as of June 5, 2020, the total number of reported COVID-19 cases in Africa was less than 170,000 and the number of deaths stood at 4,568. Although some of this is partly due to under-testing and under-reporting, the reality to-date is far from the predictions. The bottom has not fallen out.
“Most observers will agree that what made the difference in Africa was the experience in dealing with the Ebola pandemic and the quick action of policymakers.”
Although, it is too early to declare victory, most observers will agree that what made the difference in Africa was the experience in dealing with the Ebola pandemic and the quick action of policymakers. If I may share a personal experience, I traveled to five of my constituency countries in Southern and Eastern Africa in late February to early March 2020. In Malawi, Zambia, Zimbabwe, Kenya and Uganda, we arrived at airports which, like clockwork, had already established COVID-19 protocols: we had to complete a health form; get interviewed by a health worker; our temperature checked; our local phone number provided; got information on what to do if one experienced symptoms; and airport personnel had masks adorned. This screening for COVID-19 was put in place in many countries some years earlier during the Ebola pandemic.
In addition, African countries began their lockdowns and social distancing efforts while some declared states of emergency rather quickly, even before COVID-19 arrived in any significant numbers on the continent. Simultaneously, international flights and travel bans were imposed early in many countries. Some countries took these important actions even before a single case was reported. For example, countries such as Uganda, Ethiopia, and Ghana aggressively embarked on contract tracing once they had their first few cases of COVID-19, including testing and isolating those that were positive. Uganda has undertaken randomized rapid-assessment surveys while Ethiopia completed a door-to-door survey of all households in Addis Ababa.
African innovations and regional collaboration
African countries also innovated on different levels. One of the major challenges which remains to-date is the access to testing. In fact, even with money it is not easy to get needed supplies from personal protective equipment (PPE) and ventilators to test kits. Countries like Ghana had to innovate in their approach to testing by using an innovative pool testing approach. With this process, rather than testing an individual, multiple blood samples are tested. Individualized follow-tests are then ordered if the pool test is positive. In Uganda, a team is developing several diagnostic tests; the goal is to build antigen based tests for which the reagents are readily available locally. The Institute Pasteur in Dakar, Senegal, has developed a low-cost test for COVID-19 expected to cost US$1 per person and take less than 10 minutes to reveal current or previous infection. The Institute Pasteur is now partnering to mass produce the test for distribution throughout Africa.
In recent months, PPE manufacturers have risen in many countries, including individuals making artisanal masks. In Kenya, for example, local production of PPE is on the rise while 3D printing companies have also started making COVID-19 equipment. Some are designing and making PPE while others are working collaboratively to develop a 3D-printed ventilator adaptor. This adaptor would allow physicians to use one ventilator to treat two or four patients at the same time. This is important given the scarcity and high cost of ventilators. On the other hand, a team of researchers in Senegal are working to develop a ventilator which will cost about US$160 each. Zimbabwe has turned a few technical colleges into COVID-19 response factories where some are now producing alcohol-based hand sanitizers.
While some countries are cooperating at the bilateral level, there are also regional activities aimed at ensuring that the continent is able to avoid the worst case scenario. The African Centers for Disease Control is helping to direct actions at the continental level including leading efforts to procure testing kits. The Africa Academy of Sciences is also supporting research and development through securing funding and providing grants for research and development. Science Granting Councils Initiative in Sub-Saharan Africa (SGCI), a multi-funder initiative which was established to strengthen the capacities of science granting councils in Sub-Saharan Africa, has launched the COVID-19 Africa Rapid Grant Fund. The aim is to use the grant to contribute to the continental response to COVID-19.
There are other regional projects designed to help countries strengthen cross border collaboration for detection and response. It is worth mentioning here the two regional projects funded by the World Bank Group. The Regional Disease Surveillance Systems Enhancement Program (REDISSE) is supporting 16 countries in West and Central Africa in such areas as entry-point surveillance, laboratory testing capacity, and access to essential medical equipment and materials. And the East Africa Public Health Laboratory Networking Project, which is supporting the countries of the East African Community in their response to COVID-19.
A global playbook for the next pandemic
Although, we cannot predict the future, to-date the apocalyptic scenario on Africa and COVID-19 has not materialized because the continent has done some things right. Largely the continent has been agile, invested in innovations, and benefitted from engaged leadership. The reality though is that the situation could change tomorrow. However, the only certainty is that there will be other pandemics in the future. The questions therefore are, how will the world respond to the next pandemic, and is the world ready to learn the lessons emerging from the current experience?
“The world needs a playbook. Pandemics such as COVID-19 cannot be left to each country to deal with on their own or in their own way.”
The COVID-19 pandemic shows clearly that the world is a global village. No nation can expect to be an island onto itself. COVID-19 spread across countries in record time, in a world that is highly interconnected and globalized. Given this reality, the world needs a playbook; pandemics such as COVID-19 cannot be left to each country to deal with on their own or in their own way, with their own strategies and within their own available resources. This crisis which has wreaked havoc on the world’s economy has shown that national health systems might be inadequate to deal with a pandemic of this nature. In short, events such as the coronavirus cannot be framed or viewed from the perspective of one country. They are global challenges that call for global responses.
Thus, there is a need for foresight and anticipatory planning using the world’s collective intelligence. Humanity’s ability to proactively respond to and deal with these issues calls for a global capacity to anticipate, model scenarios, and plan on how to rapidly react to these types of crises, before they become global pandemics.
Furthermore, countries and experts must share knowledge and work together collaboratively. The sharing of the collective intelligence is key to finding solutions and approaches to addressing global pandemics, whether it is reducing the ability of a virus to spread quickly, finding a cure or vaccine, or seeking solutions to quickly mitigate their impact.
“The lesson of this current pandemic is that innovations are happening around the world. But the resources to fund and to scale innovations are not spread evenly. This must be addressed.”
Linked to the issue of knowledge is the need to build the world’s capacity for innovation. Collaboration must be deepened in research and development, for training, as well as in scaling innovative ideas. The lesson of this current pandemic is that innovations are happening around the world. But the resources to fund and to scale innovations are not spread evenly. This must be addressed to enhance the world’s capacity to better manage future pandemics.
Also, there is a need for a global template on how to respond while at the same time empowering global organizations to lead. One lesson from the current coronavirus pandemic is that a do-it-alone national approach is not the most effective method. Importantly, there is a risk that some countries’ health systems might simply not be able to cope. The solution is to ensure a collective global response. This requires empowering existing organizations, including providing them with the necessary tools to lead and coordinate interventions with national governments across the globe.
“My call would be to build a global stimulus fund that can be quickly deployed to mitigate the effects of future pandemics.”
Finally, there is an urgent need for an overall increase in the funding of the preparedness, prevention, and containment as well as the related economic and social impacts of global pandemics. This calls for funding early warning and surveillance systems that all nations are plugged into and all can use to get real-time information.
Beyond early warning and surveillance there is a need for global resources to build strong health infrastructure globally, including human capital for the health sector. A global system of financing must be put in place to ensure that everyone has full access to basic primary care and that all countries have at least a robust primary care infrastructure.
While no one knows the full cost of the impact of the coronavirus, it is generally assumed that costs will be huge and will have a significant impact on the most vulnerable population. My call would be to build a global stimulus fund that can be quickly deployed to mitigate the effects of future pandemics. The world must be better prepared the next time. The alternative will be too costly.
About the author
Anne Kabagambe is the Executive Director at the World Bank Group for Africa Group I Constituency. Ms. Kabagambe took over the responsibility of Executive Director in November 2018. Prior to this appointment, she served as the Alternate Executive Director for the same Constituency for a period of two years. She serves as a Member of the Committee on Development Effectiveness (CODE); the Budget Committee (BC) and the Pension Benefits Administration Committee and Co-Chairs the Board’s Gender Working Group.
Ms. Kabagambe possess over 30 years of work experiences in the development field. Ms. Kabagambe holds two Masters’ Degrees from Columbia University in New York City, and the George Washington University, Washington DC in International Relations and Public Policy & Practice. She obtained her first degree from the University of California at San Diego (UCSD). In addition, Ms. Kabagambe holds post-graduate certificates from Harvard University’s JFK School of Government and the Cranfield School of Management in the United Kingdom.
COVID-19 Africa Watch tracks major developments and policy announcements from across the continent and also offers a curated selection of analysis on how the pandemic will impact African economies and development efforts. The site is a project of the Milken Institute’s Global Market Development Practice.
The views and opinions expressed in this publication are solely those of the author. They do not purport to reflect the opinions or views of COVID-19 Africa Watch or any affiliated organization.
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