How Southern Africa can get ahead of COVID-19
As August ended, Africa had reached about 1.3 million of the 25 million COVID-19 cases worldwide. As noted in a previous post about our Africa COVID-19 Community Vulnerability Index, COVID-19 hit less vulnerable communities in Africa first — densely populated urban centers like Cape Town in South Africa, for instance — but now it’s catching up in Africa’s most vulnerable regions. Southern Africa is a key area of concern, especially in light of this week’s announcement by the World Food Program that 45 million people in the region are food insecure due to COVID-19, climate change, and continuing economic turmoil.
Many experts are wondering whether Southern Africa can get ahead of COVID-19, in spite of these current challenges and the prevailing context of lagging economies, low resources, and weak health systems. To explore the issue further, Zimbabwean native and Surgo Foundation Program Manager Tichakunda Mangono recently facilitated an online discussion hosted by the Zimbabwe-based nonprofit Education Matters Africa, and featuring experts from the medical, public health, and technology fields.
The key takeaway from that discussion (which you can view here): Although Southern Africa may lose more people to HIV and TB than to COVID-19, it’s critical to mobilize now to respond to secondary consequences of COVID-19 — such as the region’s growing mental health crisis — and fix existing health system challenges. In other words, Southern Africa has a unique moment of opportunity in the face of a potential COVID-19 disaster.
Following, from that discussion, are seven ideas for making the most of it:
1. Destigmatize COVID-19, prioritize mental health
In southern African countries, lack of funding and human resources for psychosocial support dampens an improving but historically neglected mental health landscape. Thus, most are not ready for the avalanche of anxiety, fear, depression, and grief that come with COVID-19. For example, Zimbabwe only has 50 psychiatrists for its population of 16 million people. More prominent African influencers should follow the example of panelist Dr. S.M. Chirisa, Deputy Director at Zimbabwe’s Ministry of Health and Child Care and a COVID-19 survivor, who speaks out regularly to destigmatize COVID-19 and its consequences for mental health. Government leaders and others should also prioritize task-shifting to allow non-specialized personnel, including church leaders, to provide psychological first aid. Other approaches are worth exploring, as well — such as Friendship Bench, where grandmothers provide mental health counseling.
2. Learn from history, collaborate, and innovate
After a slow start, African countries have learned to collaboratively apply lessons from HIV, TB, and malaria to the COVID-19 response. The biggest challenges include human resource gaps and inadequate testing. For testing, the reported cases likely underestimate the extent of COVID-19 in Africa, and are likely the tip of the iceberg (see Three ways to estimate COVID-19’s real toll in Africa).
The pandemic has also spurred negative ripple effects on essential medical services at all types of care facilities — such as disruptions in maternal/child health and immunization programs. Collaborations between government agencies, NGOs, and other partners have been helpful in addressing these challenges. For example, organizations like CDC, UNICEF, and the Clinton Health Access Initiative have teamed up with Zimbabwe’s Ministry of Health and Child Care to conduct scenario planning to enable each province to develop tailored strategies based on disease burden and context. NGO partners are also supporting taking stock of existing lab infrastructure and equipment gaps to inform resource allocation; exploring new testing approaches like faster, easier antigen tests; and coordinating among regional governments in southern Africa. This coordination is critical, especially to better manage “imported” COVID-19 cases due to migration within the region.
3. Tap the private sector for unorthodox but effective solutions
The private sector offers opportunities for solutions, too. For example, in the same way that whiskey companies in the U.S. have shifted to making soap to address the need for sanitizing products, many governments in southern Africa are beginning to leverage private sector capacity to help address pandemic-related needs. In Zimbabwe, examples of this include business mogul Strive Masiyiwa’s initiative to create a marketplace for sourcing COVID-19 PPE and equipment across Africa, or even high school chemistry teachers helping to make hand sanitizer. More African institutions should host hackathons like this one hosted recently by MIT to enable technology, digital, and research companies to incubate tangible ideas
4. Integrate health service delivery
Currently, health programs are more siloed and disjointed, making them more prone to disruption than if they were integrated from a service delivery perspective. For example, experiences in field research in Zimbabwe showed that sexual and reproductive health services to young people were disrupted during lockdown, leading to an uptick in unintended pregnancies and STI rates. COVID-19 exposed underlying weaknesses in a disjointed health system, and for an important population group: young people. Since COVID-19 is likely here to stay, governments and stakeholders should begin consolidation of programmatic interventions to provide integrated care and comprehensive health services. This will enable patients to get the right type of care they need when they need it, making health systems more resilient to future pandemic disruptions.
5. With vaccine development, don’t sacrifice safety for speed
The global scientific research community has mobilized swiftly; consequently there are now more than 150 vaccine candidates in the pipeline for COVID-19. This acceleration means the first vaccine could be available as soon as December 2020. But normally, a vaccine takes anywhere from two to six years to develop — so we may be trading off safety in the long run for speed today. When it comes to the coronavirus pathophysiology, we need to take a thoughtful and deliberate approach. We need to explore and answer the right questions, especially given the volumes that may be needed for herd immunity — possibly billions — once a vaccine is available. And that’s even before we factor in the human element that the rise of vaccine hesitancy and anti-vaccination protests in African countries — especially in South Africa and Nigeria, where cases are high — will have adverse effects on potential vaccine uptake.
6. Fight misinformation using new and existing platforms
When it comes to combating misinformation about the pandemic, the southern African diaspora and locally based actors must take the fight to the source and provide new tools to empower citizens with knowledge. For example, the online platform COVID-19 Support Hub, developed by USAP students and young professionals, is a tool that can be used to distribute data, multilingual visuals, and infographics — empowering people with evidence-based health information. Another approach to fight COVID-19 online addresses misinformation and conspiracy theories through Twitter and Facebook groups. WhatsApp has also been an active platform for fighting misinformation, sharing accurate information with more than 900 Zimbabweans and holding “office hours” with doctors to answer key questions and clear doubts.
7. Be accountable and focus on solutions
Pandemics tend to expose underlying governance and leadership challenges, to which no country is immune — whether it’s Zimbabwe, Malawi, or even the United States. All leaders must stop politicking, be accountable, and adopt a solutions-oriented mindset to address the lack of human resources, low funding, and programmatic capacity gaps facing the region. Transparency when it comes to COVID-19 decisions and numbers is critical for public support. Politics must be deprioritized in order to save lives; all leaders should be solution-oriented and avoid dwelling on the problem or abusing the situation to gain political ground.
Thanks to the webinar panelists and planners: Sacrifice Chirisa, Phibeon Mangwendeza, Nancy Kasvosve, Constancia Mavodza, Glen Mpani, Itai Muzhingi, Clarety Kaseke, Farai Musariri, Tafadzwa Muguwe, and Rebecca Ziegler Mano.
This post was made possible by Tichakunda Mangono of Surgo Foundation. Note: The ideas discussed in this post do not reflect the official views of Surgo Foundation.