Pacing Forward in the Face of Fragility: Lessons From African Institutions and Governments' Response to Public Health Emergencies.

Byron Bitanihirwe,Derrick Ssewanyana,Ismael Ddumba-Nyanzi

doi:10.3389/fpubh.2021.714812

Byron Bitanihirwe, Derrick Ssewanyana + Show 1 more

Open Access

https://doi.org/10.3389/fpubh.2021.714812

Copy DOI

Abstract

Africa is home to 54 United Nation member states, each possessing a wealth of ethno-cultural, physiographic, and economic diversity. While Africa is credited as having the youngest population in the world, it also exhibits a unique set of “unfortunate realties” ranging from famine and poverty to volatile politics, conflicts, and diseases. These unfortunate realities all converge around social inequalities in health, that are compounded by fragile healthcare systems and a lack of political will by the continent's leaders to improve smart investment and infrastructure planning for the benefit of its people. Noteworthy are the disparities in responsive approaches to crises and emergencies that exist across African governments and institutions. In this context, the present article draws attention to 3 distinct public health emergencies (PHEs) that have occurred in Africa since 2010. We focus on the 2013–2016 Ebola outbreak in Western Africa, the ongoing COVID-19 pandemic which continues to spread throughout the continent, and the destructive locust swarms that ravaged crops across East Africa in 2020. Our aim is to provide an integrated perspective on how governments and institutions handled these PHEs and how scientific and technological innovation, along with educational response played a role in the decision-making process. We conclude by touching on public health policies and strategies to address the development of sustainable health care systems with the potential to improve the health and well-being of the African people.

Highlights

The evidence is clear that public health emergencies (PHEs) can dramatically impact the substantial gains made in primary health care initiatives [1], with estimates suggesting that each year one out of five World Health Organization (WHO) member states experiences a PHE [2]
Public health emergencies in the African region continue to exert an enormous toll on people’s livelihoods—with some PHEs characterized by excessive mortality and morbidity rates—often testing collective resilience
In light of the PHEs discussed in this paper, namely Ebola, COVID-19 and locust swarms, initiatives to strengthen preplanned and coordinated response have included: containment measures; building local and international collaborations to leverage expertise, international aid, and other resources; scaling-up surveillance and monitoring activities; leveraging initiatives like COVAX to ensure vaccine roll-out and supply; management and treatment of survivors; social protection programs against shocks to livelihoods; and community engagement

Summary

INTRODUCTION

The evidence is clear that public health emergencies (PHEs) can dramatically impact the substantial gains made in primary health care initiatives [1], with estimates suggesting that each year one out of five World Health Organization (WHO) member states experiences a PHE [2]. Rapid assessment tools have been applied successfully around the world to generate evidence for decision-making in the management of a variety of PHEs, including HIV/AIDS [92], forced displacement due to conflict [93], natural disasters [90] and more recently COVID-19 [94] Such tools are vital for identifying and addressing context specific issues, in acting as a guide for resource allocation and providing key information in relation to response planning and implementation as evidenced during the 2013–2016 Ebola epidemic in West Africa [95].

CONCLUSIONS

Findings

DATA AVAILABILITY STATEMENT