The measures taken so far in Uganda and many other African countries to respond to the Covid-19 pandemic appear to be quite tentative and don’t provide a pathway back to normal functioning within and between countries.
Measures that have been universally undertaken for curtailing the spread and effectively managing the infected persons are important for two main reasons:
First, to buy time for vaccines and effective medicines to be developed, the reality being that sooner or later nearly everybody will get the infection, just like we get flu, its cousin.
Second, to avoid overwhelming the healthcare capacity, which would lead to a high rate of deaths.
The next steps to take following the general behavioural changes being adopted by the public such as social distancing, washing hands with soap, safe coughing and sneezing, must be driven by scientific information and knowledge.
That information and knowledge will be provided by investigation and research. The first and obvious starting point is to determine those infected by the virus and, hence, capable of passing it on to others.
Similarly, to determine those who have been infected, overcome the infection and developed immunity against the virus.
The second area of scientific investigation and research is one that creates capacity to immunise the population and to have effective drugs to cure the infection.
Majority of those who get infected either don’t get any symptoms at all or get mild symptoms that don’t alarm them to get tested.
These infected, but untested, people will remain interacting freely with the public and potentially spreading the virus.
Those who have been infected, overcome the disease and have immunity are also unknown. Such people would no longer, generally, be under threat of getting infected, due to their immunity.
It means that such people could go back to their businesses without fear of getting sick and/or infecting others.
In order to know such people, a different type of test is needed; one that tests for antibodies against the virus in the blood.
It’s important and urgent that we develop the capacity to test widely, both for the virus and for the antibodies (immunity). All our major health facilities should be checking for Covid-19.
The real end of Covid-19 threat will come from developing effective and safe vaccines and curative drugs.
Once the infective agent is clearly understood, as the Covid-19 now is, the processes for developing vaccines are well known, it takes competent human resource, funding to develop the necessary facilities and time.
This is an area in which our African or sub-regional countries would be pooling, both human and material resources, and working 24/7 to develop remedies. This goes to the heart of the existential challenge that Africans face.
Health Research institutions all around the world are busy studying the genetic material (genome sequencing) of SARS-CoV-2, the virus that causes Covid-19.
Due to the mutations taking place as the virus spreads, it’s important that countries study the genome sequencing of local strains. This information would then be pooled into databases from which widely effective vaccines are developed.
So far, different countries have done more than 7,700 genome sequences of SARS-CoV-2. Of this, the contribution from Africa is only 90, about one per cent. Europe has contributed 52 per cent, North America 23 per cent, Asia 15 per cent, Oceania eight per cent and South America one per cent.
The 90 genome sequencing from Africa are from only six countries: DRC (42), Senegal (23), Ghana (15), South Africa (six), Algeria (three) and Nigeria (one).
Again, DRC’s work has been driven and funded by donors following the Ebola epidemic.
Covid-19 should jolt us up to the fact that it can’t be business as usual. Our health research effort must be urgently, institutionally rationalised, prioritised and adequately funded.
Our institutions must be at the forefront of developing vaccines, rather than being used to test what others have developed. Covid-19 may quickly get vaccines because it’s a priority for those who have money and institutions to respond.
Africa can, and often has, different challenges from those who’re currently funding health research.
Similarly, our research institutions should be at the forefront of developing and/or testing medicines to combat Covid-19 and other diseases.
Uganda, East Africa and Africa at large, have very highly trained and competent scientists, able to do amazing things in all these fields. What they need is organisational clarity and leadership on the one hand, and prioritisation in funding on the other.
African countries made an important commitment in 2001, known as the Abuja Declaration, where a target of 15 per cent of annual budgets would be allocated to the health sector. After 10 years, only one country had made the target and now, 20 years later, only six have ever reached the target!
Africa’s Health Research Organisations should be rationalised, streamlined, coordinated and their funding urgently and heavily scaled up. National, sub-regional and Africa’s Health research capacity should be focused on the areas of antibody testing, genome sequencing and development of vaccines.
Pharmaceutical research to develop remedies for new diseases and affordable medicines (especially anti-viral drugs) should be given special priority and funding.
This will be especially urgent in anticipation of heavy cuts or discontinuation of donor funds.
Dr Kizza Besigye is a medical doctor and former Ugandan presidential candidate.
