Health experts to reform Africa’s health emergency response

With at least 100 health emergencies per year in Africa, ranging from disease outbreaks to natural or human-made disasters, health emergency partners are rallying to reform the continent’s current crisis response architecture.

Member States and health emergency partners meeting in May during the Seventy-fifth World Health Assembly called for comprehensive reforms of the World Health Organization (WHO) global health emergencies programme to address gaps such as the need for a dedicated global emergency health workforce, equitable access to vaccines, medical oxygen and other essential drugs, in addition to more investment in health-related infrastructure.

Although significant progress has been made in responding to health emergencies, with the average response time decreasing from 131 days in 2017 to 45 in 2019, protracted and emerging conflicts are driving humanitarian crises in 13 countries in the African region, with Sahel countries being the worst affected.

Currently, the Horn of Africa is experiencing one of its worst droughts in recent history, with an estimated 15 to 20 million people severely affected in Kenya, Somalia and Ethiopia. These humanitarian emergencies exacerbate the risks of outbreaks and nutritional crises, further stretching the already burdened health systems.

“Africa experiences more outbreaks and health emergencies than any other continent in the world, many of which are preventable or controllable with proven public health interventions,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.

The COVID-19 crisis has reaffirmed the importance of resilient health systems – with the required workforce, tools and technologies, and supplies. A January 2022 study in 18 in East, West, Central and southern Africa countries revealed that the most resilient to COVID-19 were those whose health systems centred on primary health care services.

Effective emergency response is partly hampered by the lack of sufficient health workers and physicians in most countries on the continent. For example, while 10 000 physicians graduate each year from sub-Saharan Africa’s 147 medical schools, the continent remains short of qualified medical personnel with a patient to doctor ratio as low as one doctor to 50 000 patients in some countries, against the WHO standard of one doctor to 600.

Building Africa’s defences against future shocks to the health system starts with recognizing preparedness as a priority in national development and national security agendas.

“This starts with shifting the narrative to what matters: our common humanity and the right of each and every person to equitable health care, regardless of where in the world they live,” said Dr Moeti.

“The growing complementarity of Africa CDC with organizations such as WHO and the Bill & Melinda Gates Foundation, is a promising development that will pave the way for a health secure Africa,” said Dr Ahmed Ouma Ogwell, Deputy Director, of the Africa Centre for Disease Control and Prevention (Africa CDC).

Global health security implies a collective action and cooperation among scientific institutions, policy makers, governments, industry and the civil society among others.

“These decisions are very important in the context of disease and other outbreaks that possess a spill-over effect; we are all on the same page,” said Dr Salam Gueye, Director for Health Emergencies and Preparedness at WHO Regional Office for Africa. “But because they require a global consensus, they can take two or three more years to mature, which is time we cannot afford to lose in Africa.”

In Africa, some of the inequities witnessed during the COVID-19 pandemic are already being addressed through improved overall surveillance for the international sharing of pathogen data and samples.

Africa’s health emergency response community has taken a more pragmatic approach to reforming the continent’s emergency architecture. A plan to establish a comprehensive programme with centres of excellence to promote aspects of health workforce training, surveillance and response has been developed.

To kickstart this programme, training is scheduled to begin in mid-June for one thousand – of a total three thousand – dedicated emergency health professionals, who will be on call to respond to various emergencies on the continent. Entitled SURGE (Strengthening and Utilizing Response Groups for Emergencies), it is the first of a group of three flagships programmes dedicated to health emergency preparedness and response, designed to equip countries and plan for health emergencies.

Core to all the flagship plans is combining Geographic Information Systems and community-based surveillance, in addition to investigative laboratory networks, risk communication and community engagement platforms to boost country capacity to respond to crises. Partners are investing in establishing a ‘one-health’ ethos, which incorporates environment, human and animal health and socio-economic aspects for health security, as the underlying principle in crisis resilience.