Revolutionise: Boosting Africa’s Infectious Disease Surveillance and Response Capabilities
By Dr. Esther Anyango, Project Manager, Africa Health Business
Infectious diseases, also known as communicable diseases, are diseases caused by pathogenic microorganisms such as bacteria, viruses, fungi, and parasites. Some of these diseases can easily be spread from one individual to another, directly or indirectly. The major infectious diseases causing morbidity and mortality in Africa include malaria, HIV/ AIDS, acute respiratory tract infections, diarrhea, and tuberculosis. Unlike other WHO regions, the disease burden of communicable diseases in Africa is much higher than that of non-communicable diseases, causing more than 6 million deaths every year[1]. The COVID-19 virus compounded this burden of endemic diseases, and while mortality rates in Africa were generally lower than the rest of the world regions, studies found that deaths directly or indirectly related to COVID 19 would result in between 1.8 and 5.3 million additional deaths in Africa by 2030. Indirect deaths would generally be due to a diversion of resources from basic healthcare prompted by the pandemic[2].
Africa has battled many disease outbreaks in the past including Ebola, yellow fever, cholera, and meningitis, among others. However, the effect of the COVID-19 pandemic and the resulting economic crisis surpasses all modern disease outbreaks in terms of scope, extent, and persistence of its effects, as alluded to earlier[3]. The control of COVID-19 and other previous outbreaks in Africa has faced many challenges including poor disease surveillance systems, poor governance systems, poor national pandemic management capacity and capability, low awareness, poor prevention, and inadequate treatment methods. The interconnectedness of the region, in as much as it offers a lot of opportunities for regional trade and economic productivity, heightens the risk, and spread of infectious/ communicable diseases. For this reason, local disease outbreaks can easily spread across borders and quickly morph into a global crisis, as was seen with the COVID-19 pandemic.
When the pandemic struck the world in 2020, WHO encouraged governments to leverage the private sector to provide continued non-COVID related care and to enhance national responses to the COVID-19 pandemic. There were multiple Public-Private Partnerships (PPPs) that were established within and without Africa, ranging across the health system elements. The development and implementation of applications for COVID-19 surveillance and monitoring was among the areas of Public-Private collaboration. Several countries, like South Africa, not only formed COVID-19 taskforce committees but also deployed digital healthcare tools and services for disease surveillance, monitoring, medication compliance, communication, and awareness[4]. Many of these innovations went a long way in determining the scope and extent of the disease which then influenced public health actions. On a continent scale, the Africa Centers for Disease and Control (Africa CDC), in a bid to live up to its mandate, played a critical role in the COVID-19 response. Together with the African Union Commission and WHO, the Africa Taskforce for Corona Virus (AFTCOR) was established. AFTCOR sought to implement a continent-wide response to the virus while working closely with the Africa CDC’s Regional Collaborating Centers (RCC’s) and National Public Health Institutions (NPHI) of African Union’s member states. This involved provision of technical guidance, policy recommendations, technical support, collaboration with stakeholders on exchange of ideas, alignment of strategies and sharing of best practices[3].
The Regional Integrated Surveillance and Laboratory Network (RISLINET), established by the Africa CDC was formed as a network of networks with the expectation that it would coordinate the continents response to public health challenges. However, the COVID 19 pandemic revealed several gaps within national and regional defense systems against infections in Africa. First, only the Central Africa RISLINET is actively running with the rest yet to be established. Second, member countries vary widely in terms of laboratory-specific strategic plans, implementation strategies, laboratory capabilities, human resources (technical know-how), surveillance, and reporting mechanisms. Further, many African countries have poor infrastructure, limited internet connectivity, poor policies, weak reporting systems, and paper- based reporting which has continued to hamper the progress of developing a continent-wide disease surveillance response system[3].
The progress that has been made by many African states to improve their disease response and surveillance systems, especially in addressing Antimicrobial Resistance (AMR), cannot be gainsaid. However, this progress has not been uniform, and much still needs to be done to boost the continent’s capabilities. Opportunities for enhanced regional collaboration must be identified, utilized, and maximized as was necessitated by the COVID-19 pandemic. In addition, establishment of effective and sustainable PPPs by fostering trust between the public and private sectors must be prioritized. With the ever-increasing global technological advancement, Africa must invest in digital solutions for disease surveillance to improve its surveillance and response capabilities. This must involve the utilization of available data from unutilized sources such as web-based activity including trends from web searches, social media postings, and participatory surveillance efforts[5], [6].
The new Public Health Order from CDC supports the need for Africa to invest in regional solutions to make it through future pandemics. Building strong regional institutions is a capital-intensive activity that will require millions of dollars. For this reason, strong partnerships, favorable financing options, and investments in pandemic preparedness must be a priority. Regionalized and Patient-Centered health systems will increase the capacity and ability for regions to respond to pandemics appropriately[7].
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