The challenges posed by the coronavirus crisis are an opportunity for African health systems to go beyond their current limitations.
Many countries have been forced to develop more innovative approaches.
African countries rapidly expanded diagnostic and genomics capabilities and increased use of digital health records.
Nations and sectors (public and private) pooled resources in response to the logistical challenges of providing a coordinated adult vaccination program.
Scientific resources from across the continent, though limited, were pooled into effective partnerships.
These experiences, learnings and solutions, if sustained with the support of political leadership and long-term financial investment, can be useful for the development of health systems fit for the 21st century and beyond.
African public health and political leaders must identify and invest in what works.
As a public health professional who has been working to strengthen health systems across the African continent for many years, I would like to offer some thoughts about emerging opportunities.
Helpful context for these reflections comes from the director of the Africa Centers for Disease Control and Prevention (CDC), Dr. John Nkengasong, who outlined four essential elements for a new public health order in Africa: stronger institutions, local production , public health personnel and respectful associations.
I would add a fifth: empowered citizens.
1. Strengthened public health institutions
Sharing knowledge and skills has proven to be an effective way to employ scarce resources across the continent during the pandemic.
The African CDC has taken the lead, as the continental coordinating institution, in promoting this approach.
The strengths of African scientific and health institutions have come together to develop new ones.
For example, the Pasteur Dakar Institute in Senegal offered training across the continent on PCR tests for covid-19.
This initiative increased diagnostic capacity from two countries (Senegal and South Africa) in January 2020 to 48 African Union Member States by the end of April 2020.
The African Center of Excellence for Infectious Disease Genomics, based in Nigeria, has worked with the African CDC's African Pathogen Genomics Initiative to bring knowledge to the entire continent.
The national public health institutes have increased their monitoring and response capacity.
They have built on experience based on previous epidemics and incorporated new technology for faster electronic eventual information management systems.
In Africa, the shortage of supplies during the pandemic has led to the emergence of solutions to acquire resources, from medical equipment to vaccines.
The Africa Vaccine Procurement Task Force could be a game changer by improving value for money through joint procurement and the support of a domestic manufacturing market.
2. Local production
Africa has the highest incidence of HIV in the world, yet is dependent on other regions for the production of diagnostic tests.
Only 1% of Africa's need for vaccines is produced locally, and the same goes for medicines for the treatment of high-morbidity diseases on the continent.
The lack of diagnostic capacity persists and the history of vaccination inequity is well reflected.
African leaders have recognized the importance of a self-produced ecosystem for the health sector.
There is a renewed commitment to developing a system that provides 60% of the continent's vaccine needs by 2040. This initiative has fostered support for the African Medicines Agency, a body that regulates the manufacture of pharmaceuticals.
A pharmaceutical production ecosystem on the continent will promote the focus of research and development towards African health needs.
3. Strengthened health personnel
Africa has far fewer health professionals than it needs.
The pandemic has shed light not only on the number and type of specialists in the health workforce needed, but also on their quality.
At the beginning of the pandemic, when the only control measures depended on community engagement (isolation, personal hygiene, and contact tracing), community health workers were essential.
Now they support the vaccination program against covid-19 and there is an opportunity for them to be absorbed by health systems to support general health services.
The joint training allowed the development of standardized quality medical care for patients with covid-19.
This strategy lends itself to the development of quality protocols for other priority diseases throughout the continent.
4. Trusted associations
The pandemic has fueled unprecedented collaboration between the public and private sectors.
It is worth noting the growth in diagnostic capacity of private sector laboratories.
The COVID-19 response is the first time private sector resources have contributed so much to a public health response.
The development of the African Vaccine Procurement Trust as a centralized purchasing agent on behalf of the African Union Member States, as well as the Africa Medical Supplies Platform, are a first on the continent.
They demonstrate what is possible through strong and reliable partnerships.
Collaborations like these can be applied to other challenges on the path to universal health coverage.
5. Citizen support and empowerment
The covid-19 pandemic has engaged ordinary citizens in a way that can only be positive for the future of African healthcare.
The entire planet and the continent have focused on the same questions.
The weak and under-resourced state of Africa's health systems – and aid dependency for health services – have been laid bare.
Citizens are beginning to question his political leadership.
Now there is an opportunity to use your demands for a broader debate on investment in health.
As election cycles progress, investment in the healthcare system must be put on the table.
African heads of state must be held to the commitments of the April 2001 Abuja declaration: allocate at least 15% of annual national budgets to improving the health sector.
The pandemic has shown that progress is possible even with limited resources.
Leaders must harness this momentum to establish a new public health order in Africa.
Ebere Okereke
is Senior Technical Advisor at the Tony BIair Institute;
She is the Africa CDC Honorary Senior Public Health Advisor and an Associate Fellow of the Global Health Program at Chatham House.
This article was originally published on The Conversation.
This article has been translated with the collaboration of Casa Africa.
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