Africa looks to Ebola lessons in corona fight

Samir Tounsi - Their continent has so far only registered a few coronavirus cases, but Sub-Saharan African governments are looking to their experience with Ebola as they prepare their fragile public systems for outbreaks of the new virus.

In 2014, an Ebola outbreak stormed West Africa, leaving more than 11 000 dead mainly in Guinea, Liberia and Sierra Leone and also reaching Nigeria and Mali.

Then, the World Health Organisation (WHO) was criticised for what some saw as a delayed response to what became the worst Ebola epidemic ever recorded.

Now the WHO is holding two simultaneous regional meetings on the coronavirus in Dakar and Nairobi with the United Nations and international partners, said a source familiar with the meetings.

The objective: "share information", "support countries", "pool resources".

Only six cases have been recorded in Sub-Saharan Africa by Friday morning, according to the WHO: four in Senegal, one in Nigeria and one in South Africa.

Globally, there have been over 98 000 cases and more than 3 300 deaths, according to a Reuters tally on Friday morning. The coronavirus that emerged in China late last year has reached over 80 nations, with the outbreak now spreading rapidly in other parts of Asia, Europe and the United States, Reuters said.

Multiple diseases

"The Ebola epidemics have enabled [African] countries to have a base on which we can rely in preparation for Covid-19," said WHO's Michel Yao.

Yao, the agency's Africa director of emergency programmes, said countries would benefit from their experience in border detection systems for suspected cases and isolation and treatment structures at airports.

Health ministries are also obliged to apply the WHO's International Health Regulations (IHR), which require them to be able to report epidemics and cases early, said Pierre-Marie Girard at the Paris-based Pasteur Institute Foundation.

Confronted with multiple diseases - malaria, cholera, measles, as well as Ebola - most African countries are struggling with fragile public healthcare systems.

Parts of Africa also face conflict, crowded cities with inadequate sanitation, rickety governance and porous borders - all of which provide excellent opportunities for the virus to spread.

According to the World Bank, health spending amounted in 2016 to US$78 per inhabitant in Sub-Saharan Africa compared with a world average of US$1 026, with a peak of US$9 351 in North America and US$3 846 in the European Union.

Some guidance

But the lessons of Ebola offer some guidance.

"With the Ebola epidemic, we can assume that health systems, cooperation and communication platforms and 'monitoring' have developed more," said Dorian Job, a doctor and programme manager for MSF (Doctors Without Borders) in Burkina, Niger, Nigeria and Cameroon.

"There is better monitoring, better follow up and it will certainly help."

The Ebola epidemic is still ongoing in the eastern Democratic Republic of the Congo, where it has killed 2 264 people since August 2018.

But no new cases have been recorded for 13 days, a development welcomed by the WHO. The authorities however still have to wait a total of 42 days without new cases to declare the end of the epidemic.

To prevent the arrival of coronavirus, Congolese health authorities are already testing the temperature of travellers as soon as they get off the plane at Kinshasa airport, or when they cross the Congo river from Brazzaville.

"The measures we have taken to fight against Ebola are the same measures as those we have taken against the coronavirus, namely hygiene and hand washing," said Congolese professor Jean-Jacques Muyembe, head of the anti-Ebola response team.

Preparedness

With financial assistance from Japan, Kinshasa has also just launched a "diagnostic and research centre" within its National Institute for Biological Research (INRB).

In early February, only South Africa and Senegal had laboratories able to test suspected cases of coronavirus. WHO has since supplied equipment to around 40 countries to help them prepare.

More than 300 000 people have been vaccinated in response to the Ebola epidemic in eastern DR Congo, another illustration of the country's response.

"WHO says we're going to take advantage of the Ebola experience to speed up the Covid-19 vaccine and drugs," said Muyembe.

Several companies and institutes in Australia, China, France, Germany and the United States are racing to develop a vaccine - a process that usual takes years.

In West Africa, health systems are still marked by the most serious Ebola epidemic in history and what they learned in the process.

"Our preparedness is better because of the lessons learned from the Ebola crisis," said Mosoka P. Fallah, the director general of the National Institute of Public Health in Liberia.

Liberia has put in place "nine strategic pillars" to prepare its response to the coronavirus, Fallah said.

"All the people at the head of each of the pillars derive their experience from Ebola." – Nampa/Reuters