The COVID-19 pandemic, distinct in its global impact, presented significant public health-related challenges to Africa like the rest of the world. Peculiar to Africa however, is that it is still battling high levels of communicable diseases and rising non-communicable diseases. A pandemic therefore present a burden to its health system and population in general. With nearly fractured public health systems, deprived health sectors and a few specialised hospitals, experts forecasted high mortality rates in Africa arising from COVID-19. Nonetheless, Africa experienced lower-than-expected death rates. Several reasons have been put forth to explain this occurrence: Africa’s young demographic; climatic factors; early interventions such as lockdowns and travel restrictions and its prior experience handling public health emergencies. Africa’s wealth of experience with previous health crises (such as Ebola) has provided it with valuable lessons that in some measures prepared the continent with handling of COVID-19. One noteworthy strategy is the significance of community engagement, education, and obilisation in promoting behavioural change, such as adopting preventive measures, combating disinformation, and providing accurate information during COVID-19 to counter vaccine hesitancy. In spite of lower reported mortality rates and demonstrated resilience, the continent's response to outbreaks has been characterised by a pattern of “crisis response followed by neglect and complacency.” Many African states perceive Infection Prevention and Control (IPC) as a reactionary action to epidemics rather than pivotal to pandemic preparedness, health system strengthening, health worker protection, and patient safety. The COVID-19 pandemic exposed critical weakness in Africa’s public health system. The public health infrastructure was severely overstretched and under-resourced, evidenced by insufficient facilities, health personnel and equipment such as personal protective. This made providing adequate care and handling the upsurge of cases difficult. While testing capacity varied across the continent, testing capabilities made the true immensity of the pandemic's impact difficult to determine due to underreporting. Vaccination campaigns were impeded due to inadequate access to vaccines caused by COVID-19 vaccine inequity globally. When vaccines were available, logistical challenges persisted in its distribution. Limited cold chain infrastructure in some areas presented a logistical challenge in meeting specific storage requirements for vaccines such as mRNA. A potent communication strategy was necessary to overcome the widespread misinformation about COVID-19 and vaccine hesitancy. In light of these challenges, Africa must begin to prepare and build resilience towards such a health crisis. Africa’s financial resource capacity for public health emergencies including COVID-19 pales against its structural demands. As such, public health action should focus on preventive strategies such as promotion of hygiene, sanitation and proper waste management. Concurrently, it needs to build its predictive, responsive and adaptive capacity. Investments should also be made in the expansion of health-related surveillance and early warning systems by National Public Health Institutes (NPHIs) at the country level with the capability to detect health threats and support public health systems. Enhanced laboratory systems and a coordinated laboratory network can abate shortfalls in testing capacity demonstrated during the COVID-19 pandemic. The ability to test for pathogens and coordinate testing efforts are critical to containing an epidemic. Concerted efforts should be made to guidelines, protocol and development of public-health workforce specifically for field epidemiologists, frontline responders and Community Health Workers (CHW). Supply chain disruption during COVID-19 left Africa with an “acute” shortage of Personal Protective Equipment (PPE) such as face masks and shields. This is due to Africa’s high import dependency and low purchasing power. In order to build the region’s resilience against public health emergencies, Africa needs to strengthen regional value chains and local value addition to manufacture scale up its supplies of these products and create a stockpile for emergencies. The adaptive capacity of community engagement and mobilisation in countering misinformation, encouraging adherence to pandemic guidelines and behavioural change towards preventive behaviour need to be strengthened. Disease outbreaks threaten Africa’s health, prosperity and security. The timing, scale, and unpredictability of outbreaks overwhelm the routine capabilities of our regional healthcare systems, which are already facing competing priorities. Prevention and control mechanisms cannot be put together instantaneously or function optimally when prompted in the midst of a crisis. African countries' capacities for preparedness and response need to be strengthened to minimise the impact of unexpected public health emergencies. In order to sustain the optimum functioning of our healthcare system and the continuation of donor-funded programmes, African countries need to look to domestic and regional funding mechanisms to meet their needs. African states must fulfil the 15% public health funding expenditure provision according to the 2001 Abuja Declaration. The Africa Centres for Disease Control and Prevention (Africa CDC); the technical agency mandated with continental health security needs to build long-term capacity to manage future pandemics and outbreaks by among other things, ensuring communication and coordination at the regional level; strengthening surveillance; training of public health workforce to states; ensuring stockpile of products and equipment for prevention, control and treatment and local production of vaccines. With the support from the Africa Development Bank, Africa CDC, envisages to manufacture meet 60% of the continent’s vaccine demand by 2040. In June 2022, construction of a manufacturing facility began in Rwanda for the production of mRNA-based drugs. Plans are under way for a vaccine production facility in South Africa and Senegal. Using the mRNA technology, malaria and TB vaccines can be developed, bolstering the continents chances to fight endemic diseases. Africa CDC bargaining power for Africa’s own continental health response needs to be strengthened. By extension, building a safe, healthy and prosperous Africa.
