Dr Iqbal Survé: For Africa to survive Covid-19, we need to be prepared

South Africa - Cape Town - Tents have been erected at the Culemborg Safe Space for Cape Town's homeless people during the Lockdown due to the Coronavirus pandemic. Photographer: Armand Hough/African News Agency(ANA)

South Africa - Cape Town - Tents have been erected at the Culemborg Safe Space for Cape Town's homeless people during the Lockdown due to the Coronavirus pandemic. Photographer: Armand Hough/African News Agency(ANA)

Published Apr 1, 2020

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CAPE TOWN - “Be prepared,” the motto of the Scouts movement since 1907, speaks to being in readiness for anything that might happen.

In scenario planning for crises, we also try to anticipate what the worst and best case would be for a given issue and prepare accordingly. I doubt many of us anticipated this moment, but that said, Africa is in a position to learn from international best practices so that to its best ability, it can “be prepared”.

It needs to be. Africa is recognised by the World Health Organisation (WHO) as being particularly vulnerable to the impact of Covid-19. Tedros Ghebreyesus, director-general of the WHO, recently stated that Africa should “prepare for the worst and prepare today”.

The continent comprises roughly 1.35 billion people across 54 separate countries. The majority of South Africans and those living on the continent also reside in high-density areas with limited access to running water and electricity, and de facto, health care.

This makes containing the spread of Covid-19 especially difficult. Add to this the fact that there is a high prevalence of people with compromised immune systems who would be most vulnerable, and our need as a country and as a continent to be prepared is imperative.

The full impact of the disease on the world cannot as yet be fathomed, but as of March 31, South Africa had 1353 confirmed cases of Covid-19 and five deaths.

One infection has also been recorded in Khayelitsha, the first “township” in the country to do so, and one of the Western Cape’s most densified human settlements.

Rwanda and South Africa have taken the lead on the continent in combating the spread, instituting national lockdowns ahead of the predicted infection curve.

This is much earlier than Western countries like the US, UK and Italy, which has been particularly hard hit by the virus. The aim is to interrupt the transmission flow to give health-care systems the chance to cope.

While lockdown is anticipated to be lifted in South Africa at midnight on April 16, it could well be longer if citizens do not behave. Sadly, there are thousands unconvinced of the serious nature of this pandemic, and who are not adhering to the rules, jeopardising everyone’s life in the process.

In Kenya, not yet in full lockdown, violent clashes between law enforcement and citizens are already happening. Anarchy across the continent is as much a fear for governments as the virus itself, as they would be fighting battles on two fronts.

But Africa has also delivered some of the world’s key lessons in changing behaviours when it comes to infection control - how Ebola has been controlled, for example. This, though, depends entirely on education outreach and helping local communities to think differently.

Further possibly hampering efforts to contain Covid-19 on the continent and educate the populace is the inherent distrust Africans have of their governments.

Pervasive corruption and disinformation propaganda campaigns over years have done little to convince the populace of the veracity of the current narrative, as well as making it tough to restrict and control movements and public gatherings.

In South Africa, we have a population count of around 57 to 59 million. While the country has one of the best public health systems on the continent, the stark reality is that it has fewer than 1 000 intensive care unit (ICU) beds, of which 160 are to be found in the private sector.

This is still better than our neighbours, though, where Malawi has just 25 ICU beds in its public hospitals and a population size of 17 million people; or Uganda, with a population of 44 million and 1500 beds, which are mostly found in the Mulago National Referral Hospital, and whose ICU can accommodate just 60 patients. South Sudan, devastated by a five-year civil war, has just 24 ICU beds.

The real concern, therefore, is the invasion of Covid-19 into heavily densified areas. It is nigh-on impossible to self-isolate in these locations, such is the current WHO-recommended protocol. However, social distancing can be implemented. So, stay at home.

Why is this important? Global reports show that all health-care systems are strained - in developed as well as developing economies.

Ventilators are in short supply everywhere, with factories like Dyson in the UK now re-engineering assembly lines to produce this much-needed lifesaving equipment. Likewise, in the USA, where General Motors has been commissioned to produce it.

South Africa should follow suit and not wait. We have the capabilities here and this would also assist with the economic crisis we are facing.

And, what of the economy? The South African economy has not been in good shape for years. Covid-19 does not help, but then again, I believe it could well be the catalyst to ignite much needed reforms, new thinking, new ways of doing things.

We are already seeing signs of this with the level of government commitment, individual and corporate innovation, and ubuntu, as well as cross-continental collaboration.

On Friday last, ratings agency Moody’s downgraded South Africa to sub-investment status. The timing could not have been worse, but it has served to spark much-needed structural reforms, as conveyed by Finance Minister Tito Mboweni on Sunday night. What these are, we all wait to see.

In the meantime, Africans, who are resourceful by nature, are coming together to help one another, contributing to monetary resources such as the Solidarity Fund and local community initiatives, donating food and supporting local suppliers and retailers who are putting their lives on the line to remain open.

As global as we are, the locavore movement (which aims to connect producers and consumers in the same region) is in full swing; it may well define a new way of living, going forward, because let’s face it, our future will be forever different.

Right now, if we in Africa want to spread something, let us spread love, understanding and compassion. Let us adapt our behaviour so we can be as best prepared as we possibly can, for whatever will come.

* Dr Iqbal Survé is executive chairman of Sekunjalo and a trustee of the Global Influenza Surveillance Initiative (GISAID).

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