Defend Truth

Opinionista

Of epidemics, artificial intelligence and responsive public policy

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Busani Ngcaweni is Principal of the National School of Government.

South Africa is well endowed with ideas, experiences and human resources to contain Covid-19. A well-coordinated, multi-sectoral and adequately funded response will confront and stop the virus from spreading.

In December 2019, a deadly coronavirus (Covid-19) starts out in Wuhan City, in the Hubei Province of central China and spreads to different parts of the world. Within four months of its discovery (or at least of its public reportage by official news agencies), it has gone viral worldwide. At last count, no region of the world had been spared, which is a clear demonstration of the interconnectedness of the world.

Astonishingly though, in Africa, the virus came via Europe while flights from the epicentre in Asia continued to land in our capitals. As we argue below, the Asian countries’ public policy interventions were quicker, with stringent controls of movement and public life. 

Epidemiologists – the specialist medical practitioners who have expertise in the study of incidence (infection rates and patterns), how diseases spread as well as knowledge of how diseases are controlled (biomedically and otherwise) – have been hard at work trying to figure out how this global outbreak can be controlled and cured.

Given the speed at which it’s spreading, like the recent fires of the Amazon and Australia, the pandemic has been scaremongering across continents and in its wake, leaving scores of people dead – even among the rich nations.

Eventually, the stubborn virus that has been sending the whole world into a frenzy landed in South Africa too. Markets are in free-fall, confidence levels touching rock bottom (no correlation with Covid-19), and hand sanitisers are leaving store shelves faster than milk. 

Black Twitter is breaking the internet with memes, perhaps providing palliative therapy to an otherwise depressing national development. That is the phenomenology of humans, who deploy hilarity even in the shadow of death. 

A closer look at its global distribution shows how this pandemic has generated unprecedented developments across the globe. From it we observe, with sheer curiosity and awe, the global travel patterns, especially the linkages between the hinterlands of China with the rest of the world in terms of trade, tourism or just touristic sojourn. In other words, the regional and global distribution of the epidemic tells us who goes in and out of Hubei Province, Wuhan City and mainland China in general. 

Much is being said and written about the state of healthcare systems of various countries, most of which seem to have failed dismally to detect and control the early manifestation of the virus on their doorstep. Such cynicism downplays the gravity of the situation.

However, we also observe the resilience of the healthcare systems in countries like South Korea, Japan, Singapore, Canada and indeed China itself. Most of these countries have universal health coverage. Consequently, the spread of the virus to the United States, and some countries in Africa and other regions that lack either national healthcare systems that guarantee universal coverage or have limited resources, has been devastating, to say the least.

On the other hand, the global economy is now coming to terms with the epidemic, which is running deep in the veins of markets, trade arrangements and in some parts of the world, supply chains are being rudely interrupted. In England, where authorities are encountering their third black swan in a dozen years (the 2008 global economic crisis and Brexit vote), the daytime movement of essential supplies to retailers has been relaxed as the rush for toilet paper, face masks and hand sanitisers escalates.

More importantly, the viral displays of technological advancements are also creating panic in many parts of the world and I dare say here in South Africa too. The citizens’ perceptions of whether or not their countries are ready and capable of responding to the pandemic – which could easily reach epidemic proportions in some poor communities if not timeously stopped in its deadly tracks – are largely also shaped by viral videos of machines and robots that use artificial intelligence.

These machines and robots are disinfecting cities, buildings, public transport, markets, the shop floor and education. Some of these robots have been serving food in hospitals, with drones delivering supplies and smart devices scanning people’s temperatures in public spaces. New technologies are helping with rapid tests that otherwise would have taken days to give results. 

When people hear that close to about 20 people have contracted the virus and some of those infected have had contact with over 100 other people, their minds visualise a human catastrophe of unimaginable proportions.

However, these technological gizmos should be an inspiration to the citizens who may question the capabilities of their own healthcare systems to deal effectively with Covid-19. Beyond this immediate crisis, such technology can be used to provide solutions to persistent system challenges facing developing countries. Some countries in Africa are already using drones to deliver medicines and healthcare commodities to communities in far-flung rural areas. Beyond this period of panic and despair, there seems to be some light at the end of the treacherous tunnel.

Fundamentally, technology is transferable. Already, China is exporting theirs to highly affected countries in Europe and should bring the same to Africa as well. 

Suddenly, even the most cynical of western observers are commenting about the efficacy of China’s political system, given the rapid response capabilities we have been fed by global news networks and social media.

Nevertheless, being under lockdown in a foreign country like Italy or China is not the spoof that Black twitter has made it to be. Planned holidays have been ruined, people’s savings lost and educational dreams deferred. Normal daily life has been disrupted. These are extraordinary times which necessitate extraordinary interventions. 

Historically, events that threaten human survival are usually those characterised by marauding gangs with guns, fighter jets and missiles, and in central and east Africa, the machete – the local weapon of mass destruction. This time around, the threat is invisible, often asymptomatic and is spread daily through social practices such as hugging, kissing and touching. Powerful missile defence systems and bunkers will not defeat it.

On the cultural front, Covid-19 has left a trail of disruption, with people no longer able to shake hands or hug each other, especially at public gatherings such as funerals and at mass-based churches (with Easter only weeks away). Imagine dwindling crowds at sporting events and shisa nyama outlets; as coughing and sneezing immediately makes you a prime suspect at such public gatherings.

Dealing with the spread of Covid-19 is a Himalayan mountain that policymakers must climb. They are expected to unleash a massive public awareness campaign that counteracts perceptions of armageddon while simultaneously demonstrating rapid response capabilities driven by suitably skilled people and state-of-the-art technology.

In fact, Covid-19 could not have come at a worse time for South Africa and other countries around the world. Amid the reported low levels of trust across the board and in particular, the lack of confidence in public institutions, clubs of rich nations like the G20 have also admitted that growing inequality is driving the trust deficit.

Collectively, as South Africans, we have lessons to learn from our own immediate experience of dealing with an epidemic. Two decades ago, we all thought that HIV had come to annihilate the population. Death was our immediate destiny. At the time, mortuary businesses were booming and orphanages expanding. No other cause in post-apartheid South Africa mobilised civil society than the threat presented by HIV/Aids.

Thanks to a multi-sectoral response driven by biomedical and social sciences, we have almost outlived Aids. Millions have voluntarily tested and thousands enrolled into treatment. Thousands continue to be productive in the labour market due to life-saving treatment. 

Significantly, the multi-sectoral and multi-dimensional national response restored women’s reproductive rights – all because of openness to counselling and testing, and the availability of antiretroviral (ARV) treatment in the public healthcare sector. HIV-positive mothers are giving birth to healthy babies because of the rollout of ARV treatment. This is a clear example of public policy responding and adapting to national priorities.

Today, we have successful medical male circumcisions (MMC) in most parts of the country. The increased uptake even in areas perceived to be conservative (rural areas), has largely been the result of policymaking processes that brought on board all critical stakeholders, including traditional leaders. Take KwaZulu-Natal for example, MMC is driven successfully by the government working with traditional leaders who promote it as a reproductive health intervention – thus avoiding sensitive cultural debates. 

South Africa’s well-considered, reasonably funded and all-inclusive comprehensive healthcare campaign drove the impactful HIV/Aids prevention and treatment messages. Social mobilisation also brought on board all social partners in the fight against the Aids pandemic. I once postulated that the fight against Aids saw the second largest wave of international solidarity in favour of South Africa, second to the fight against apartheid.

South Africa is well endowed with ideas, experiences and human resources to contain Covid-19. A well-coordinated, multi-sectoral and adequately funded response will confront and stop the virus from spreading. Behold, there are solutions to this near-existential threat to humanity.

No single event has tested human civilisation since the turn of the 20th century as this virus, apart from America’s use of nuclear weapons in Hiroshima and Nagasaki. I dare say, no other event will unite nations to find common solutions as Covid-19 is doing. The fact that rich nations are also affected means that they will accelerate vaccine development and treatment arrangements faster than would have been the case had Covid-19 been confined within the borders of the global south.

Even with the equally devastating Ebola, we witnessed the doubling of effort once it reached western capitals. For its part, South Africa is acknowledged for deploying its centres of excellence and expertise to keep Ebola at bay.

While Covid-19 is a public policy concern, the private sector and other social partners need to come to the party. All human and technological capabilities of the country need to be mobilised for South Africa and the region to outlive this pandemic.

In central and west African countries, epidemics like Ebola also impacted on cultural practices such as diets and on burial rites. China too is confronting cultural changes – some animal products are exiting lunch and dinner menus.

This “thing” is big, no matter how short it may last, and it has seen the ritualistic cleaning of hands like never before. Our claims to building a capable developmental state that effectively implements responsive public policy are under the microscope. As alluded to earlier, what South Africa needs – hands in gloves, masks on noses, large doses of compassion learnt from the national Aids response and our staple tradition of Ubuntu – is to confront Covid-19 collaboratively and stop it from becoming a community epidemic.

Despite the relative nascency of our AI capabilities compared to China, we have no reason to believe that we are not ready to manage and outlive the virus, given the expertise in our institutions like the National Institute for Communicable Diseases and the medical fraternity in general. Plus, as the situation would dictate, technology can quickly be exported to address an emergency.

Like polio and many other epidemics, we will outlive Covid-19. DM

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