"The virus does not need visa"

Countries across Africa coordinate their efforts in the fight against corona by the Centre for Disease Control (CDC) of the African Union in Addis Abeba. Until now, the curve of new infections has been successfully flattened – why? Dr. Ahmed Ouma, Deputy Director, explains the work of CDC in an interview with Tilman Wörtz.

 

Tests for the Corona virus: They are currently possible in 52 out of 55 African countries. Photo: GIZ / Ollivier Girard
Tests for the Corona virus: They are currently possible in 52 out of 55 African countries. Photo: GIZ / Ollivier Girard

Ahmed Ogwell Ouma

Dr. Ahmed Ogwell Ouma is Deputy Director at the Africa Centres for Disease Control and Prevention (Africa CDC). Before that, he worked many years for the WHO. Africa CDC is a specialized technical institution of the African Union established to support public health initiatives of Member States and strengthen the capacity of their public health institutions to detect, prevent, control and respond quickly and effectively to disease threats. Africa CDC supports African Union Member States in providing coordinated and integrated solutions to the inadequacies in their public health infrastructure, human resource capacity, disease surveillance, laboratory diagnostics, and preparedness and response to health emergencies and disasters. Established in January 2016 by the 26th Ordinary Assembly of Heads of State and Government and officially launched in January 2017, Africa CDC is guided by the principles of leadership, credibility, ownership, delegated authority, timely dissemination of information, and transparency in carrying out its day-to-day activities. The institution serves as a platform for Member States to share and exchange knowledge and lessons from public health interventions. Its headquarter is located in Addis Abeba, Ethiopia.

What is the situation like right now in Africa concerning the Corona-Pandemic?

I would say we are in the mid-morning, while in Europe and North America it is probably late-afternoon and China has reached dusk already. We are seeing numbers increasing at a rate that is probably doubling every five to six days. This gives us the motivation to work even harder to try and flatten the curve. As soon as we saw what was happening in China, we started to prepare by building up capacity, securing borders and encouraging social distancing. Those early measures have resulted in a delayed spread of the CORONA virus in Africa. In general, there is a lot more that needs to be done, but the numbers tell us that the measures we took are actually working.

 

To which degree was it possible for the CDC to coordinate the efforts of national governments?

 The first African case was diagnosed in Egypt on February 14th. One week later, we as Africa CDC convened a meeting of health ministers of all the 55 member states. The health ministers passed a continental strategy and we started to implement it. We are sharing the figures twice a day at nine o'clock in the morning and then at six o'clock in the afternoon with all member countries of the African Union. We have been coordinating for example procurement of personal protective equipment and laboratory supplies across the continent. Africa CDC is actually coordinating many aspects of their preparedness and response. At the same time individual countries are doing their work at country level.

 

The African Disease Control Center (CDC) is headquartered in Addis Ababa. Photo: GIZ / Thomas Imo / photothek.net
The African Disease Control Center (CDC) is headquartered in Addis Ababa. Photo: GIZ / Thomas Imo / photothek.net

Are you confident that the figures reflect accurately the real situation?

We are reasonably confident that governments are providing us with the correct picture, based on the testing that is going on at country level. Each country gives us figures of how many people they've tested in a day and how many have turned positive. There is testing going on across the vast majority of countries on the continent. The figures may not be 100 percent accurate because they are many asymptomatic people. But in terms of those that are being tested positively, it gives a relatively good picture of what is actually happening on the continent, both in terms of numbers and in terms of trends.

 

How much testing capacities is there across Africa?

Let me go back to January when this virus was reported to have entered the human population in China in January. We had no laboratory on the African continent that would be able to test for COVID-19. Two weeks later, in the beginning of February, we had two laboratories, one in Senegal and one in South Africa that were able to test for COVID-19. At that stage, we came in as Africa CDC and started to build the capacity of laboratories across the continent. As we speak today, 52 countries, out of the 55 countries can do laboratory testing and most of them can do it in more than one site. So we have build up capacity very rapidly. As of today we have conducted across Africa more than 1,2 million tests. And our plan is that over the next four weeks, we are going to test one more million. And over the next 24 weeks, we are going to test 10 more million. So our strategy is to expand testing and depending on the numbers that are turning out positive, to then isolate them and manage their cases depending on where they severe or whether it is mild. We do targeted testing. It is not testing of everyone.

 

Where do you get the test kits from?

This has been our biggest challenge because the test kits are manufactured outside of Africa and air travel has been banned except for cargo flights. But cargo flights are irregular. You don't fly to a place where you don't have cargo to take. The CDC has been using a bulk-buying protocol. We want to benefit from the large quantities that we order outside of Africa. Then we put all those materials into one plane, bring them to Addis Abeba from where it is distributed. There has been some delays, but we have been able to get lab reagents to all 55 member states. So the countries are able to continue doing tests. The capacity for testing has increased tremendously.

 

In Africa, people face many different infectious diseases every day. Photo: GIZ
In Africa, people face many different infectious diseases every day. Photo: GIZ

Did the Ebola crisis and the fight against tuberculosis and other diseases already provide the experience to be better prepared for Corona?

 The most famous of the outbreaks was the West Africa Ebola outbreak. There have been a few things that we have learned and we have used in addressing COVID-19. One is to start early if there is an outbreak. Don't delay measures! We have done that with the Corona outbreak, too. The second key lesson we have learnt is solidarity between countries, which means neighbours helping neighbours. The virus spreads across borders. It doesn't need a visa. If you try to act alone, your neighbours´ problem will quickly become your own. The third lesson is one of partnerships across the globe with individual countries, with intergovernmental organisations, private philanthropies and foundations. We have gone into a lot of these partnerships and all of them are designed to support our work in implementing the COVID-19 strategy of the African Union.

 

Was it helpful that normal population already had an understanding of what are infectious diseases by outbreaks like Ebola?

 Absolutely. The communities in Africa are faced with many different types of infectious disease on a daily basis, like Lassa fever, monkeypox, Ebola, measles. The population has already been developing better and healthier habits. As a result, we are even seeing cases of more simple infectious diseases dropping right now, because we are having better hygiene practices during this time of Coronavirus.

 

There have been doubts if the measures to limit Corona might increase the number of people infected by other diseases like tuberculosis and malaria. Do you see any danger there? 

It is a very big concern that we have and indeed it is a risk that is present in a number of countries. As Africa CDC, our message to governments and international organizations is very simple: don't treat Coronavirus only. Designate a few hospitals that are going to look into the Coronavirus cases and let all the other hospitals continue to do their usual work. We are encouraging governments to ensure that the investment in addressing a virus does not reduce the investment in the other areas of public health.

 

Do you think that the lockdown measures in other countries like Europe or the United States or China might affect economic growth rates so much that there are serious health effects on the population?

The lockdown measures everywhere do affect economic growth in Africa, not just the lockdown in Europe, China and the US. Any increase in the numbers of cases will have a very large negative effect on the economy and a very large negative effect on businesses. It is for this reason that we are about to launch a guidance document which is addressing the issue of how to progressively open up the lockdown for people to be able to go back to their normal economic activities. The guidance documents are going to be launched in the next few days as our contribution towards COVID-19 outbreak preparedness and response.

 

Bill Gates says that there might be the danger of 10 million people dying in Africa because of Corona. The WHO has predicted, according to estimates, 150000 deaths in Africa. Do you think that such predictions are helpful?

We must take predictions with a lot of care. Numbers can scare the population and result in panic. Panic is very bad when you have an infectious disease outbreak. People behave in manners that are not consistent with good public health science. On the other hand predictions are good for planning and allow us to react at an early stage. At Africa CDC we do modelling internally. We don't share with the public because the parameters we use for modelling change rapidly. What was the figure yesterday might change, depending on whether the measures that have been put in place by governments are working or not. So we avoid going into the numbers, but we definitely are building capacity across Africa.

 

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