Between last Thursday, April 23 and the previous Thursday, April 16, the number of coronavirus infections in Africa jumped 43% to 26,144, with 1,247 deaths. Dr John Nkengasong, director of the Africa Centre for Disease Control (Africa CDC), said this increase was “remarkable”.

Africa’s total numbers are still relatively low, but the fear is that it is just because the coronavirus arrived on the continent comparatively late and may take off fast and soon. Between Thursday, when Nkengasong briefed journalists, and Monday this week, the total number of infections rose another 22% to 31,933, with 1,423 deaths.

Nkengasong noted then that while Egypt was still just ahead of South Africa with the most cases, followed by Algeria, Morocco and Cameroon, a different ranking emerged if one looked at infections relative to population. Then, tiny Djibouti had the highest per capita infections, followed by Mauritius, Cape Verde, Seychelles, Morocco, Tunisia, and Algeria, with South Africa eighth.

Nkengasong noted that Africa, a continent of 1.2 billion, had only tested about 415,000 people. 

“That comes to about 325 tests per million which is very, very limited.”

He compared that to Italy, which has tested about 16,600 per million, according to latest reports. 

“So we need to do something to scale up. That’s why AU Commission chairperson Moussa Faki Mahamat launched this initiative and actually presented it to the AU Bureau of nine heads of state yesterday,” he said, referring to PACT, the Partnership to Accelerate Covid-19 Testing, with the tagline Trace, Test and Track.  

A press release on the official launch of PACT said its aim was to conduct at least one million tests in 10 weeks, but Nkengasong gave a more ambitious target, one million tests in four weeks. Likewise, the press release gave the aim of 10 million or more tests in six months while Nkengasong set the deadline for that number two months earlier. Ten million tests would improve the testing ratio from 325/million to about 8,000/million, he said. He added that his centre aimed to carry out 20 million tests over the next nine months to a year. 

PACT is focusing its help on the African countries with the least capacity for testing. 

“If you don’t test, you don’t find,” Nkengasong said. “And if you don’t test, you are blinded. You are like pilots on a plane without a radio system. If you don’t test you are not ahead of the curve. You need to be ahead of the pandemic, not chasing the pandemic. 

“If we don’t test, we don’t know how to open our economies. They are now locked down and… one of the indicators that will allow us to open the economies from the lockdown is the testing. To know who is infected and isolate them and then trace their contacts. That’s the importance of doing the testing as quickly as we can.”

Nkengasong said the rolling out of the one million new tests from the Africa CDC’s depot in Senegal had already begun, with 73,000 test kits going out over the last week. Another 500,000 new test kits would be arriving soon as part of the third consignment of medical equipment donated by the Chinese philanthropist Jack Ma. They arrived in Addis Ababa, Ethiopia, on Monday this week. 

Another one million tests had been ordered from Germany. 

“So we are on track towards our target of rolling out one million tests in the next four weeks on the continent.”

PACT is implementing the AU’s Africa Joint Continental Strategy for COVID-19 by coordinating national efforts including the allocation of scarce equipment, such as test kits and ventilators bought or given by donors. 

It is establishing warehousing and distribution hubs across Africa, in partnership with organisations including the World Food Programme and Ethiopian Airlines. 

And it is supporting the deployment of one million community healthcare workers across Africa to help trace the contacts of those who have been infected with the coronavirus.

“It is also standardising and deploying common technology platforms to boost public trust in testing data, epidemiological models and critical health forecasting techniques as part of the economic recovery and reopening agenda,” the AU and the Africa Centre for Disease Control said in a statement. 

“Accelerated Covid-19 tracing, testing and outcomes tracking in Africa is key to the achievement of the first pillar of the continental strategy, which aims to limit transmission and slow the spread of the pandemic, whilst laying the foundation for accelerated socio-economic recovery that should bring the Africa integration agenda back on track,” it added.

Dr James Mwangi, group chief executive officer of Pan-African Bank, Equity Group Holdings, and a member of AfroChampions, said businesses were nothing without a healthy and productive workforce and so were very grateful for the AU/Africa CDC’s programme of accelerated testing.

The World Health Organisation (WHO) has cautioned nonetheless that Africa could become the next epicentre of the coronavirus. But Nkengasong said any country or region could become the next epicentre of the virus, depending on how one responded.

“Are you testing, are you finding the cases, isolating and tracing their contacts? That’s what it takes to be ahead of the curve. So it’s not a prediction that says it must happen.”

The Africa CDC’s priority was to manage the supply chain of diagnostic equipment. “That’s why we have so much focus on pushing out the diagnostics,” said Nkengasong.

It was also encouraging countries to expand their use of community workers to help the government track and trace the contacts of those who tested positive. “The government alone cannot do that.” 

Nkengasong said the Africa CDC was already helping Cameroon to deploy community workers and would expand that help in the next couple of weeks to reach the target of one million community workers tracking and tracing. 

It was necessary for Africa to pool its resources to succeed in the “very competitive” market for Covid-19 fighting equipment with one voice.

He praised South Africa for its “aggressive testing and aggressive tracing, using community workers and mobile laboratories. We don’t need to be the next epicentre if we do the things that I’m encouraging countries to do,” he concluded.

The week before, Nkengasong had described the dire shortage of ventilators on the continent, an essential apparatus for treating critically ill coronavirus patients. On Thursday he said that some of the 300 new ventilators coming from the Jack Ma Foundation would go to those countries.

Nkengasong also said Africa CDC intended to ask China – which produces most of the medical equipment for fighting Covid-19 – if it would set aside quotas of such equipment for Africa as a whole to buy.

It was necessary for Africa to pool its resources to succeed in the “very competitive” market for Covid-19 fighting equipment with one voice. He noted that orders for some equipment were taking three or more months to be met. 

“We have to recognise that we as a continent are competing for the same supplies from the same places as everyone else in the world, If we do not pool ourselves and have volume, it will be difficult to engage suppliers.”

Just a week after Africa had reported its first reported infection, in Egypt on February 15, Moussa Faki had mobilised all the continent’s health ministers in an emergency meeting to draft a joint strategy of cooperation, coordination and collaboration.

The longer lesson of the pandemic was that Africa was too reliant on foreign countries for its diagnostic equipment and needed to produce its own. 

“It’s an uphill battle to build your health systems when you need them. You always build your health systems before you need them. So that’s what we are doing now, we’re playing catch-up. And that’s very difficult.”

Though Africa had itself already bought one million test kits which it was distributing, in the middle of the pandemic it had had to rely also on whatever partnerships it could to accelerate its testing to reach its targets of 10 million tests in the next four months and 20 million in the next nine months to one year.

Nkengasong was asked if the AU’s response to the pandemic had met expectations. Only member states could make that judgment, he said, but added that he was “positive” about how the AU was handling the crisis. 

Just a week after Africa had reported its first reported infection, in Egypt on February 15, Moussa Faki had mobilised all the continent’s health ministers in an emergency meeting to draft a joint strategy of cooperation, coordination and collaboration. 

“That showed leadership and an appreciation of the dangers.”

He noted that Africa was the only continent with a joint strategy for fighting the pandemic. This joint strategy was being implemented by the AU’s coronavirus task force which had, for example, been able to scale up diagnostics from almost no country being able to diagnose in January, to 48 countries now. 

“We have also trained over 4,000 clinicians on our online platform. That is a contribution in terms of preparing our continent. We have also trained 39 countries on infection prevention, partnering with the country and the WHO and other partners. There’s a whole range of things we are targeting.”

He was proud of the AU’s efforts, though they weren’t enough.

“But we don’t intend to replace countries. It’s the responsibility of each country to protect the health and security of its citizens. And African countries had done remarkably well in terms of awareness of the pandemic, mobilising their health systems. This was very challenging because of the weak health systems Africa has.” 

Nkengasong declined to comment on growing calls for China to compensate the rest of the world for the harm caused by the coronavirus, because of its alleged delay in informing other countries about the outbreak which began in Wuhan, China, late last year.

He said now was the time to focus everyone’s energies on fighting Covid-19. Afterwards would be the time to analyse the pandemic, to examine the role played by everyone – including Africa – and then to apportion blame.

Given the importance of China to Africa in providing critical medical equipment to fight the virus, either by donation or sale, it is hardly surprising that Nkengasong chose to refrain from comment on the controversy. DM