Thabiso Scotch Mufambi
Harare – With over 3,7 million COVID-19 cases recorded in Africa since the outbreak began last February, Africa’s already weak healthcare systems have been stretched to their limits.
According to a 2019 United Nations Economic Commission for Africa report on Healthcare and Economic Growth in Africa, the continent accounted for less than two percent of global healthcare expenditure despite bearing 36 percent of the global disease burden.
This is also despite the fact that African Union member states are signatory to the 2001 Abuja Declaration, in which nations pledged to allocate 15 percent of their annual national budgets to healthcare.
To date only a handful of African countries have met the Abuja targets, with average health expenditure hovering between five and six percent.
In Africa, public hospitals and clinics operating without running water and electricity is a common occurrence, while medicines and medical equipment are also often in short supply.
On top of that, service delivery is often affected by industrial actions by healthcare workers, while many qualified personnel leave for other continents in droves.
COVID-19 highlighted the imperative of well-equipped healthcare facilities – and some African countries have used the crisis as an opportunity to improve their overall systems.
Not Business as Usual
For example Wilkins Hospital – Zimbabwe’s largest infectious diseases facility – was speedily renovated to ensure readiness to handle COVID-19 patients, even though some argued that this was akin to sticking a Band-Aid on a bullet wound.
According to African Union Commission Chairperson Mr Moussa Faki Mahamat, the pandemic has presented Africa with an opportunity to emerge stronger.
“The COVID-19 crisis is an opportunity to reflect and also revisit some of our development strategies. We must therefore draw lessons from this pandemic to re-adapt in order to build more diversified and endogenous economies that will be more resilient to possible future exogenous shocks,” he said this week.
African Development Bank (AfDB) manager for the Public Health, Security and Nutrition division Babatunde Omilola summed up what needed to be done: “There is no time to waste, while finding ways to battle the current pandemic may be daunting, it also presents an opportunity to focus on the strengthening of Africa’s health systems by adopting a comprehensive and integrated approach based on each country’s individual needs. Let us not go back to business as usual after this pandemic.”
The poor state of healthcare systems on the continent has seen Africa largely being a bystander while global efforts to develop COVID-19 vaccines were on-going.
“It is unfortunate that we are yet to have a COVID-19 vaccine or cure developed from SADC or Africa as such, we are on the mercy of other countries to access vaccines. This is a wake-up call for enhanced regional research, pharmaceutical and manufacturing capacities,” SADC executive secretary Dr Stergomena Lawrence Tax tweeted recently.
Innovating Through Disaster
But there is hope.
A critical aspect to a better healthcare system in Africa is to improve affordable access to medical supplies by extending tax rebates on medical supplies and boosting local manufacturing capacity of drugs and equipment.
Countries across the continent have commissioned universities and colleges to manufacture personal protective equipment, sanitisers and other medical sundries.
Others, like Africa University in eastern Zimbabwe, have gone even further and developed throat lozenges from the zumbani plant, a African herb widely in use as a home remedy against COVID1-9.
“The cough drops are expected to add to an array of herbal products that are on the market with a view to boost immunity of the people in Zimbabwe and beyond as universities in the country continue to drive transformation through indigenous knowledge systems,” a university official said recently.
Building on such innovations could usher in a new era for African self-reliance beyond the pandemic.
Before the pandemic, African economies were on the rise.
Increased internet access and mobile phone penetration, declining poverty and infant mortality rates, among other advances, all pointed to a continent that was making all the right moves towards achieving its development priorities as espoused in the AU’s Agenda 2063.
Most of that came to a screeching halt when the pandemic started.
Early predictions were that Africa could see economic contraction of up to 2.6 percent in 2020 – the first continent-wide recession in 25 years – while the AfDB said COVID-19 could cause a GDP loss of up to US$88.3bn in the worst-case scenario, with public debt reaching US$2.1 trillion.
But, again there is hope.
Analysts contend that the pandemic is only a temporary setback and that Africa will rise again, leveraging on its demographic dividend, increasing innovation and win-win partnerships.
AfDB president Dr Akinwumi Adesina is confident of accelerated recovery post COVID-19, but cautioned that this was dependent on several factors, including debt relief.
“There is light at the end of the tunnel – it just happens to be a very long tunnel. I am very positive that African economies will bounce back over the next two years, but the speed of recovery will depend on ensuring that Africa gets enough vaccines for its population,” Dr Adesina said.
“To recover faster, Africa will need significant debt forgiveness from bilateral and official creditors. While developed countries have been spending trillions of dollars for fiscal stimulus, Africa does not have such resources. The payment for vaccines is already adding to the already high debt burden.”
Professor Kevin Chika Urama, a senior director at the African Development Institute of the AfDB, said full implementation of the African Continental Free Trade Area would help fast-track industrialisation and position economies to better withstand future shocks.
“The sudden closure of borders and the protectionist policies implemented by countries to contain the COVID-19 virus is a stark reminder of the risk exposures associated with over-reliance on global value chains,” he wrote in report for the AfDB titled “Building back better, policies for building resilient economies in post COVID-19 Africa”.
“The ACFTA presents a unique opportunity for Africa to build one of the world’s largest free trade zone with immense potential for future growth. While Africa participates in global value chains development and integration, it is mostly through upstream production which embodies production of raw materials that are then beneficiated in the importing countries.
“With a few exceptions, the degree of processing (value addition) in Africa’s commodity exports remains generally low and the share of local labour in their value is relatively small. Building national and regional value chains is crucial as they can bring about new forms of production, technological transfer and development, logistical development, labour skills up-grade, long-term industrial upgrade, job creation.”
Small is Big
To build back better, African governments will also have to commit more funding to research and development, and to protection and promotion of small and medium-sized businesses.
The informal sector and agriculture are mainstays of many African households, and as such demand attention in terms of investment, skills and technology support and in building resilience to climate change shocks.
“To be resilient, Africa’s health and economic systems need strengthened absorptive, adaptive, and transformative capacity in times of both endogenous and exogenous shocks such as COVID-19. COVID-19 is a pandemic among pandemics in Africa and it is likely not going to be the last.
“It has demonstrated that reliance on external institutional capacities and aid for development is risky. Countries and regions need to strengthen own capacity for early warning systems, policy research, governance and risk mitigation to secure the welfare of citizens today and tomorrow. Future economic headwinds and new health pandemics will come when it will,” Prof Urama said.
UN Secretary-General Dr António Guterres also emphasised what needs to be done.
“Everything we do during and after this crisis must be with a strong focus on building more equal, inclusive and sustainable economies and societies that are more resilient in the face of pandemics, climate change, and the many other global challenges we face – recovery from the COVID-19 crisis must lead to a different economy,” he said.