The World Health Organisation (WHO) regional director for Africa, Matshidiso Moeti, said she hoped the US government would rethink President Donald Trump’s decision to halt funding to the organisation, because the loss will be bigger than just money. 

“The United States government is an important partner, not only in financial terms,” she told a Zoom media briefing from Brazzaville on Thursday 16 April. 

“It is an important strategic partner. We work with many of the technical institutions in the United States. They are important players in the WHO’s policy-making [and] strategy-making, and we value the relationship with the United States.”

She said some of the money contributed by the US is used for the eradication of polio, a goal the organisation is close to achieving. It’s also used to fight other communicable diseases, such as HIV and malaria, and to strengthen health systems.

She said the WHO’s budget for Covid-19 response support in 47 sub-Saharan African countries is around $300-million for the next six months. This comes from different partners and sources, but the US has always been the top contributor to the WHO budget. 

“For example, we have had voluntary contributions of about $151-million from the US, and we have already received for this biennium, starting this year, almost $50-million from the US,” she said. 

“So, the impact potentially of this decision will be quite significant in areas such as polio eradication.” 

The US is the WHO’s biggest donor and contributes over $400-million a year. Trump announced earlier this week that his country would pull funding from the WHO because he believes the organisation had covered up key details about the coronavirus on behalf of the Chinese government.

Meanwhile, the WHO is grappling with how to adapt guidelines on fighting the spread of the disease in Africa’s unique circumstances. 

WHO emergency operations programme manager Michel Yao said the organisation feared that “10 million severe cases could happen” in Africa over the next six months if there’s no intervention, but added it was “difficult to make a long-term estimation because the context changes too much”. 

He said the organisation’s Ebola projections had ended up being an overestimate because of timely interventions, but that difficulties in reaching remote areas could make it difficult to combat Covid-19

So far there have been more than 17,000 cases in Africa with over 900 deaths. Moeti said the most likely reasons for the apparent slow spread of the virus on the continent could be the early alerts and screenings that Africa put into place, learning from the experience of other regions hit by the virus earlier on. 

“The challenge now confronting us is the shortage of test kits and other key items that are needed to scale up and decentralise these interventions,” she said. 

South Africa, Algeria and Cameroon are among the worst affected currently, but the rapid increase in Niger, Guinea, Ivory Coast and Cameroon is a cause for concern, Moeti said. The organisation was also concerned with the high death rate in the Democratic Republic of Congo.

“We understand that the impact in Africa will be very severe. We still have 14 African countries that have reported fewer than 20 cases and I would like to very much encourage that we seize this opportunity to contain and limit this spread and learn from other countries with a more advanced form of the pandemic,” she said.

The weakness of some health systems, endemic disease and the fragility of certain states are among the concerns should the coronavirus become widespread across the continent.

Internationally recommended measures to combat the spread, such as physical distancing, are difficult in some places, and getting people to stay indoors when it’s hot and their spaces are small, was also difficult, Moeti said. 

“It’s important that this be applied in a way that’s contextualised to the reality of the people. 

“If we go to the places where we go shopping in African settings, the markets where we buy our food, it’s very difficult there to keep people apart. These are informal settings. If you are the person running the stall, you are not going to remind your potential clients to stay away from each other because in this way you might disadvantage yourself in terms of what you’re going to earn on that particular day.”

Additional protection such as face masks, hand sanitisers and running water and soap are emphasised in these environments. 

Moeti said the WHO would release guidelines soon with advice on deciding when to impose and how to lift lockdowns and analyse their impact. 

“There are a number of parameters: the evolution, in terms of new cases and how the virus is spreading, and if measures are having an impact.” 

In the case of South Africa, where lockdown measures had been progressively introduced, “it might be that when there are observations that in some localities the situation is starting to show an impact, some of the measures can be reduced while others are sustained in order to make sure that you don’t have an upsurge of cases if we do this abruptly,” she said. 

Mitigating factors, to help make up for a loss of income and damage to the economy were important.

Moeti added that the creativity and resilience of Africans to cope with difficult situations shouldn’t be underestimated. During the Ebola outbreak “people adopt very extraordinary measures that are completely against how they would normally behave, and this has been achieved by people understanding and internalising and finding their own way, [and] feeling a sense of agency how to deal with these difficulties. 

“I have a lot of faith in African people and communities. Our duty is to help people understand in the simplest way possible, in an idiom that they can understand, in non-technical language.” DM