Johannesburg — As COVID-19 swept across the globe, one thing became clear: a well-functioning, well-resourced, agile and resilient health system can mean the difference between life and death.
For Africa, the economic costs of the health pandemic were high. The prescription was often worse than the illness as Africa’s poor found themselves without work, food and even access to health care as economies were locked down across the continent in a bid to contain the virus.
The World Bank predicts that a pandemic-fuelled depression could lead to as much as 3.3 percent drop in growth this year – pushing the region into its first recession in 25 years.
We will not defeat COVID-19 without Africa in the global response. Africa cannot be muted in the global conversations and its leadership must play a role not only in identifying the problems but also in seeking the solutions
This health pandemic has serious socio-economic consequences. What COVID-19 has taught us is that the state has a critical role to play. It was the state, not the private sector, to which citizens looked to and which rose to the occasion when the pandemic struck.
This was true in Africa as much as it was in Europe and other developed countries and calls for a rethinking of the importance of state capacities and capabilities in sectors of public significance.
Now, rather than see the pandemic as the end, we could view this crisis as an opportunity for a collective effort to forge our own path at the global table for health.
We need to ask ourselves what global solidarity and shared responsibility would look like for the continent. We know that Africa has many lessons to share.
The Africa Centres for Disease Control and Prevention (Africa CDC) has taken a strong lead in the response to the COVID-19 pandemic. Right from the start organizations leading the AIDS response were mobilized with the Global Fund to Fight AIDS, Tuberculosis and Malaria allocating up to US$ 1 billion to help countries fight COVID-19.
The Africa CDC requires more resources if it is to play an even bigger role.
Where will those resources come from? African countries need to rethink development and how they can build local capacity if the continent is to play its part in the global strategy.
UNAIDS has been clear that we will not defeat COVID-19 without Africa in the global response. Africa cannot be muted in the global conversations and its leadership must play a role not only in identifying the problems but also in seeking the solutions.
To this end, UNAIDS was among the first to join the African CDC’s newly created Partnership to Accelerate COVID-19 Testing (PACT) as part of the Africa Joint Continental Strategy for the COVID-19 response.
The partnership aims to close the gap in testing by supporting the efforts of African countries to rapidly scale up their capacity to test and trace – a crucial step in reducing infections and deaths. PACT also calls for the rapid establishment of an Africa CDC-led system for pool procurement of diagnostics and other COVID-19-related response commodities.
COVID-19 does not discriminate in who it targets but economic and social determinants of ill-health are strong predictors of who might die from the virus. We cannot allow Africa’s poor to bear the greatest risk without support.
COVID-19 and AIDS are colliding epidemics, and, in many countries in the eastern and southern African region, sexual and gender-based violence is a third and silent triplet.
The UNAIDS “World Aids Day Report, Prevailing Against Pandemics by Putting People at the centre”, has noted that the global commitment to fast-track the HIV response and end AIDS by 2030 is now off track.
Indeed, agreed milestones for 2020 have been missed. But Africa can take comfort that the architecture, human resources and lessons learned from the AIDS response hold invaluable lessons.
We now know that the evidence points to people-centred 2025 targets around comprehensive HIV services, context specific integration of services and the removal of societal and legal impediments to an enabling environment for HIV services. Together these three elements form a powerful whole with people living with HIV and people at greatest risk of HIV infection at its core.
Shrinking budgets mean less investments in the HIV response. Our report shows clearly that the collective failure to invest sufficiently in comprehensive, rights-based, person-centred HIV responses comes at a high price: from 2015 to 2020, there were 3.5 million more HIV infections and 820 000 more AIDS-related deaths than if the world were on track to achieve the 2020 targets.
We must have a global response for both HIV and COVID-19. While recent vaccine announcements have brought some hope, UNAIDS calls for vaccines and treatments which are available for all and is active in the global movement for a People’s Vaccine.
But this will not be an easy task. The COVAX initiative coordinated by WHO, Gavi and the Coalition for Epidemic Preparedness needs our vigilance to ensure access for the world’s poor.
The decline in AIDS-related deaths–a 39% drop from 2010 to 2019–demonstrates what can be done. We have made important progress towards zero new infections, zero AIDS-related deaths and zero discrimination.
But we are far from our goal.
We must now double our efforts for both HIV and COVID-19.
Our goal for HIV is clear: we want people-centred and context specific integrated approaches that lead to at least 90% of people living with HIV or at heightened risk of HIV infection to be linked to services needed for their overall health and wellbeing. And we need a global COVID-19 strategy that works for everyone.
We cannot do the necessary without Africa at the table. And our experience of such phenomenon is that if Africa is not on the table, it will be on the menu–and that would be disastrous.
Aeneas Chapinga Chuma is currently the interim Director for the UNAIDS Regional Support Team for Eastern and Southern Africa based in Johannesburg, South Africa.