How COVID-19 Helped to Kickstart a New Public Health Order for Africa

“Will Africa survive the COVID-19 crisis?”

This question plagued traditional and social media at the start of the COVID-19 pandemic. Experts expressed concerns about the resilience of African health systems in the face of a public health emergency of international concern like COVID-19. Many believed that the pandemic would regress much of the health success after decades. I was one of the skeptics. I feared for my country and Africa at large. Fortunately, I was pleasantly surprised and encouraged by the robust response of national and continental public health agencies. I was inspired by the prompt implementation and coordination of measures to curb the spread of COVID-19 across the continent.

In spite of pessimistic narratives, limited access to vaccines, and funding, African public health institutions answered the call to action as they had done many times before.

Listening to Dr. Ebere Okereke and Sheila Mburu share nuanced insights about Africa’s COVID-19 pandemic response on the Global Health Unfiltered podcast, made me reevaluate my assessment of African Public Health Institutions. They believe that the pandemic emphasized the need for new rules of engagement and presented an opportunity to tackle Africa’s perennial challenges, that is, being under-resourced and overburdened.

Although the prior experience of the numerous public health institutions in Africa in responding to pandemics helped to mitigate the impact of COVID-19, in the end, it demonstrated the need for stronger institutions, better coordination between institutions, and increased country leadership and ownership. Okereke and Mburu emphasized regional solutions as being key to preparing for future public health crises.

To go fast, one can choose to walk alone but to go further, we need to walk together! The Africa Centres for Disease Control and Prevention (Africa CDC), a regionally coordinating public health institution of the African Union, served as proof of concept for the regionalization of financing and coordination during the pandemic. The Africa CDC pooled funds from African Union member states and partners and coordinated a continental response even before the first case of COVID-19 was recorded on the continent. This contributed significantly to the reduced burden of COVID-19 in Africa.

The Africa CDC has been spearheading the building of the New Public Health Order for Africa. The term is regularly attributed to Dr. John Nkengasong, former Director of Africa CDC and now U.S. global AIDS coordinator for PEPFAR (U.S. President’s Emergency Plan for AIDS Relief). Dr. Nkengasong described the New Public Health Order for Africa as focusing on the people, the workforce and institutions, partnerships, and healthcare products, needed to be resilient, adapt, and cope with emerging diseases of the 21st Century.

I learned several important things from this podcast episode. I gained a better appreciation for African public health institutions. Looking back, it seems ludicrous that the African Union did not have a Centre for Disease Control and Prevention up until 2017. I was flabbergasted to learn this considering the sheer number of public health emergencies Africa has managed in the past two decades: HIV/AIDS, malaria, tuberculosis, ebola, dengue, and yellow fever.

Moreover, as the continent seeks to increase transnational exchange via the African Continental Free Trade Agreement, one can expect that seemingly benign outbreaks will rapidly turn into epidemics in the absence of coordination. Public Health institutions play a major role in improving global, continental, and national surveillance strategies. However, these institutions require proper funding, infrastructure, and workforce.

Now is the time for Africa to invest in the future generation of public health leaders. I was pleased to learn about the Africa CDC’s capacity-building efforts. For example, the African Public Health Emergency Management Fellowship is a 24-week program that aims “to train highly skilled professionals to coordinate and lead preparedness and response in African public health emergency operations centers.”

Without a doubt, African governments, private companies, and civil society organizations should support the Africa CDC’s vision and do their part in building the New Public Health Order for Africa. Young African health professionals and students should be encouraged and aspire to work with or at the Africa CDC.

All these will only be possible once the narrative changes. The current dominant narratives about Africa being helpless must change. Key institutions like Africa CDC and the African Union must be paragons of good governance not only for them to achieve their visions but also so that African youth and civil society buy into a shared vision for the future.

Building the New Public Health Order for Africa should lead to a holistic health system strengthening across the continent. If anything, the COVID-19 pandemic highlighted that much like the human body, our health systems have interdependent components.

We all have a role to play in achieving the Africa We Want tomorrow if we choose to work together today.