NOW OR NEVER

What can we learn from the pandemic?

We can either be jolted into action or sleepwalk into the next disaster

In Summary

• Now's the time to tackle bed-sharing, drug shortages and medics straining

A Covid-19 ward at the Coast General Teaching and Referral Hospital.
A Covid-19 ward at the Coast General Teaching and Referral Hospital.
Image: JOHN CHESOLI

The ongoing Covid-19 pandemic has jolted the world out of a global public health slumber. We have been woken up to the fact that emerging infectious diseases pose a serious threat to our daily lives, even with our modern sophistication and aspirations for disease eradication — or have we?

The world is opening its eyes to the reality of our interconnectedness in an age of nationalism and partisanship. Although there have been many pandemics before, the current one has arisen in an era of viral information spread and a background of East-West geopolitical quarrel. Indeed, these factors contributed to the initial notion that Covid-19 was a Chinese problem rather than a global one.

Covid-19 has exposed weaknesses in world-famous health care systems and poses an even more menacing test for the weaker systems of most developing nations. The pandemic now calls for innovation on all fronts of society and global health for optimal mitigation.

Importantly, how best do we learn from this pandemic and prepare for the next or even similar threats? Closely, how do we balance between addressing existing health challenges, while being ready for future threats?

Four years ago, in a now-viral Ted Talk titled ‘The next outbreak? We are not ready’, Bill Gates predicted the next global threat would not be a nuclear bomb but a virus for which the world was not at all prepared.

While this prophetic assessment may have come to pass with the current outbreak, if we do not learn from it, it will be a prophesy fulfilled over and over again.

Actually, emerging and re-emerging infectious diseases are here to stay, and with ongoing climate change crisis, assault on biodiversity, antimicrobial agents abuse, changing lifestyles and globalisation, the wheels are in motion for other pandemics.

In fact, even diseases that have long been with humanity are re-emerging as either drug-resistant, such as multi-drug resistant tuberculosis, or as more virulent forms, such as cholera and malaria. The constant evolution of pathogens will ensure we have to think, innovate and act better and faster to survive and pre-empt their threats.

So, for African countries, what are the key takeaways from the pandemic even at this point? Firstly, we have to be prepared. We must ensure our health care systems can meet existing needs and have sufficient capacity to handle the unexpected.

This has starkly been demonstrated in China and Italy, where healthcare resources and personnel have been stretched to the limit. Bearing in mind China has the capacity to put up entire hospitals in 10 days and Italy boasts one of the world’s best health systems.

So, how can weaker systems that do not meet routine needs cope? On the other hand, Cuba has once again demonstrated that long-term investment in healthcare, in terms of the workforce and infrastructure, can accumulate resilience, preparedness and even confidence to support others who may be overwhelmed.

Healthcare systems, similar to human body systems, need critical reserves to cushion in extraordinary circumstances. In short, greater long-term investments to build strong healthcare systems is now an urgent imperative.

Secondly, we need to invest in research and development. Traditionally, African countries have looked for solutions elsewhere for medical and technological products, a situation that has seen neglect and underinvestment in homegrown solutions. This has to stop.

The news of the African Centre for Disease Control unit coming to Nairobi is heart-warming. But again, Africans need to have more skin in the game, otherwise the agenda will be donor-driven and maybe unresponsive to the continent’s critical needs.

To achieve cutting-edge research outcomes that are translatable interventions, such as medicines, vaccines and diagnostics, we need to invest in enabling environments and value chains. Medical research should be handled as a strategic developmental goal. Policies that incentivise innovation should be enacted with the understanding that innovation is the only insurance to sustainable development.

Thirdly, our philosophy and perspectives as a society should be live to our interconnectedness. That we have to think globally and act locally. That our simple actions can have outsized consequences for the rest of the world and that pathogens know no borders.

The above three lessons are certainly not exhaustive, and before the pandemic is over, we shall have picked more. Importantly, are we woke enough to start learning from this pandemic.

Will the pandemic shake us sufficiently to act and build our hospitals' capacities to eliminate situations where patients share beds, most essential drugs are out of stock most days of the year and our healthcare workers are stretched to the seams? Or will we luckily sleepwalk through the pandemic barely scathed, and be jolted by the next?

Dr Jesse Gitaka is a Physician Scientist at Mount Kenya University (MKU), Thika and an Affiliate and grantee of the African Academy of Sciences. Dr Francis Kobia is a Postdoctoral fellow at Gitaka Lab and Vaccari Lab, University of Milan - Italy