Testing and quarantine are largely considered the best methods for preventing, identifying, and controlling pandemic outbreaks. However, the nuances around how such strategies are carried out need to be extremely context-sensitive and planned with respect to local social, cultural, and behavioural norms[i].
In the African context, strategies around isolating and quarantining also need to be balanced against the socio-economic realities of urban and rural areas in LMICs, as, in vulnerable areas, lockdowns that inhibit economic activity can, do more harm than good, and at worst result in even greater poverty, or even mass starvation[ii].
Cynthia Makarutse, content lead for the much-anticipated Africa Health 2022 Exhibition, set to take place in Johannesburg at the end of the month says that experts are looking to the success stories from Covid-19 for lessons in public health system pandemic resilience, to ensure that Africa is prepared to weather any future outbreaks of Covid, or other epidemics (both known and unknown).
“Countries like Germany and South Korea are considered ‘best case scenarios’ as they fared far better than their neighbours during the recent pandemic and managed to keep Covid-related death rates remarkably low,” she says.
They are thought to have achieved this with strategies like extending mass testing campaigns to asymptomatic carriers, and concerted efforts to safely isolate all infected individuals[iii].
“While public health strategy from developed nations cannot simply be copy-pasted into LMICs, certain aspects of these nations’ strategies may be relevant in guiding Africa’s public health strategy policy, and future pandemic resilience,” says Makarutse.
“Other strategies to strengthen Africa’s health systems and pandemic-preparedness that the continent’s experts are discussing include strengthening local medical supply chains and pharmaceutical infrastructure; integrating local vaccine production; high-level partnerships between regional health institutions and government, the private sector, or civil society donor institutions; and extensive leadership and skills training[iv],” Makarutse adds.
Professor Jo Vearey is an Associate Professor and Director of the African Centre for Migration & Society, University of the Witwatersrand, where she coordinates MAHP (the Migration and Health Project Southern Africa).
Vearey is among the healthcare systems ethics specialists who will be presenting at the 11th Ethics, Human Rights & Medical Law Conference at this year’s Africa Health event.
Her session on ‘Public Health Strategies for Managing Covid-19 and Future Pandemics in Africa’ will form part of a larger conversation on global health, human migration, and ‘Ethics in Post-pandemic World’ – the theme of the conference, which will be opened by celebrated Professor Sylvester C. Chima, Associate Professor and Programme Head of Bio & Research Ethics and Medical Law, at the University of KwaZulu-Natal’s College of Health Sciences.
Vearey and Chima are joined by the likes of Matthew J. Gibney, Professor of Politics and Forced Migration at Oxford University, and Nigeria-based Professor, Sampson Ihesiene Erugo, who will discuss the complementary theme of ‘Cultural Values and Ethics: Human Rights and Migration in Africa’.
As well as delivering talks summarising the latest developments in their respective areas of expertise, these renowned authorities will also engage in a cross-disciplinary panel discussion on ‘The Ethics of Refugees and Human Migration in Africa’ – an open-ended conversation that promises to facilitate rigorous debate and a healthy flow of knowledge and ideas.
With a particular focus on knowledge production and dissemination; human migration; urban public health in Africa; urban vulnerabilities and social determinants of healthcare outcomes, Vearey’s work places her at the forefront of social justice in healthcare and the development of pro-poor pandemic response policies[v].
Her latest publication, which appeared in the medical journal Global Health Action, explores human migration patterns, maternal health, and PMTCT (prevention of mother-to-child transmission) services[vi].
She also recently published extensive research based on a manuscript she co-authored with fellow experts Thea de Gruchy, Thulie Zikhali, and Johanna Hanefield on how human migration in SA was famed in the media during the Covid-19 pandemic. The research notes an increase in xenophobia associated with the pandemic. This was attributed not only to the fact that human mobility facilitated the viral spread but also to the additional pressure that pandemic emergency measures put on SA’s communities[vii].
SA has a mixed migration flow, and approximately 7% of the population are non-citizens, a figure which includes documented immigrants, refugees, asylum seekers, students, as well undocumented migrant workers, the study notes.
“For vaccine campaigns to be effective we can’t leave anyone behind. Citizens, non-citizens, as well as South Africans without ID books all need to be able to safely register and receive a vaccine.” Vearey says.
She points out that, while the rights of undocumented migrants to basic healthcare services are constitutionally enshrined in SA, applications of these rights are inconsistent in practice, and some immigrant groups are currently unable to access healthcare services[viii].
A major lesson from this pandemic is that “healthcare system inclusivity is about achieving population immunity. Without achieving immunity, we run the risk of new outbreaks and new variants emerging,[ix]” Vearey says.
“Getting our public healthcare systems to a point where we can manage pandemics, will allow us to avoid economically disruptive lookdowns, and avoid loss of life in future pandemics. If we leave anyone behind, we leave everyone behind,” she concludes.