• The fact that countries were not prepared for coronavirus is no reason to avoid preparedness for the next infectious outbreak.
• Mounting infectious disease research hospital, with mobile units, would help in realising the health pillar of Uhuru’s Big Four.
Coronavirus has discomforted the entire world and forced intensified thinking about global preparedness for health unknowns.
It has relegated other diseases to the periphery of national and global pre-occupations. Yet, there are numerous other challenges that need serious attention, among them being the creation of infectious diseases research hospitals. The decision to do this, however, depends on geography and sociopolitical dispositions of the leaders.
Politics determines policy everywhere. All other human activities operate at the mercy of politics. While science, technology, economics, the military, engineering, and the state of health do influence and affect policy, they are essentially instruments or tools that political players use to determine action. They advise and try to persuade policymakers in a country on likely options, but they do not decide what is to be done.
Policymakers are not beholden to or prisoners of selected advisers. In a 1963 meeting in Nakuru with white settlers, for instance, Jomo Kenyatta listened to his “revolutionary” advisers and then did the opposite. In subsequent self-defence, remembered Njoroge Mungai, he reminded the advisers that their job was to give advice but the decision was his. He took into account security ramifications of his decision. It was a political decision.
Politics is the reason countries took varied positions on coronavirus. With ideologies guiding sociocultural beliefs, presidential attitude determines decisions. While Uhuru Kenyatta adopted stringent WHO measures in Kenya, Tanzania’s John Pombe Magufuli did the opposite.
In Kenya, Uhuru is in the dilemma of what he calls “two rights” compounded by desire to secure a legacy. In his Jamhuri Day address in 2017, he outlined his Big Four agenda, comprising four pillars of health, food, jobs, and housing. The health pillar was shaky and was not ready for coronavirus; no country was prepared.
The fact that countries were not prepared for coronavirus is no reason to avoid preparedness for the next infectious outbreak. Kenya should have an infectious disease research hospital. It, however, does not, although it has small units of spinal injuries and is grappling with cancer centres. Mounting infectious disease research hospital, with mobile units, would help in realising the health pillar of Uhuru’s Big Four.
To accomplish this needs much strategic thinking on the part of Uhuru’s members of the National Security Council. Each of them has a lot of what Lt Gen (rtd) Humphrey Njoroge calls “staffers” to help think through long-term strategies and options.
There are two types of “staffers”: Those who think and take initiative and those who are efficient in paper pushing or delaying. While “staffers” with initiative can suggest to their bosses, however, they cannot decide. The actual decision would be political, based on members of the NSC capacity to absorb the challenges and taking many things into account. It is not technical.
Uhuru, poorly prepared for coronavirus, is careful in easing up restrictions by balancing what he calls “two rights”, what “experts” tell him and the people demand for “freedom”. He tried giving each side just a little by prolonging movement restrictions on Nairobi and Mombasa, while removing them in Kilifi and Kwale and also relaxed curfew hours to logical times. It also implied preparing the public for additional easing while getting the governments – national and counties — to increase healthcare capacity. More important, is for government to think of the future.
To be included in that future thinking is the political decision on the handling of new and old types of infectious diseases. It cannot be left to medical technicians or assorted scientists since they have no capacity to decide. The purpose would be for the country to be better prepared than it was for coronavirus and one way of that preparation would be to set up two-pronged Infectious Disease Research Hospital.
First would be the hospital research centre itself and second would be a series of mobile units. The challenge to the country is grand thinking in futuristic ways where infectious diseases are concerned. This would be primarily a political decision guiding health science in national interests, not an externally engineered “scientific” one that ends up confusing policy making.
Prof Macharia Munene teaches history and international relations at USIU-Africa. He holds a a Doctor of Philosophy in Diplomatic History from Ohio University.