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The biggest investment for African public health is its healthcare workers

In 2020, the World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus asked African Union states “to come together to be more aggressive in attacking” the virus.

“Our biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems,” said Tedros.

A year later, we must ask ourselves what lessons we have learned from the African response to the pandemic. My country, Angola, serves as an example of a best-practice Sub-Saharan African vaccine roll-out. Having vaccinated over half a million people, Angola has a higher rate of inoculations than its neighbours, including South Africa. However, Angola now hosts the world’s ‘most mutated’ strain of COVID-19, including a so-called ‘escape mutation’ from pre-existing immunity according to recent findings. These two facts illustrate the complex nature of a public response to a challenge that is always evolving in real-time.

Sub-Saharan Africa struggles with conflicts, poor health infrastructure, crowded cities with inadequate sanitation, limited governance, and porous borders — all of which provide excellent opportunities for variants to grow and spread. According to the World Bank, per-capita health expenditure in the region in 2018 was just US$83, compared to $1,110 on average in the rest of the world. The highest was $10,050 in North America, followed by $3,524 in the European Union.

The COVID-19 pandemic has highlighted not only the vulnerability of the world’s poorest continent to outbreaks of contagious diseases, but the ardent need for the private sector to step up to fill the healthcare gap in Africa, especially human capital. Prioritising a ‘Whole-of-Society’ approach, as the WHO has called for, will involve calling upon stakeholders, entrepreneurs, scholars, and both continental and community leaders to share a common aim of building a more resilient and risk-ready healthcare system. Because it’s not a question of if, but when the next global health crisis will arrive. And we need a future generation of leaders ready to stand at the helm.

In a report released by the WHO last month, they pointed to the risk in relying solely on state health systems in Africa citing unpredictable financial flow, lack of political will, and limited human and technological resources. These gaps support opportunities for the private sector to accelerate fair access to new COVID-19 technologies and materials and strengthen the existing regional coordination mechanisms.

Considering both the global and regional pandemic fatigue and increased circulation of more contagious variants, immediate, strong and decisive public health interventions are clearly essential to control transmission. However, to safeguard future healthcare workers’ ability, a long-term investment in human resources and education must be implemented. This will demand an inclusive multisectoral coordination aimed at maximising all the available resources and reversing the tide of brain drain in the region.

Strong community structures in Africa are well-positioned to be leveraged for critical public health measures, as we learned during the Ebola outbreak. To do so, support training for innovation and leadership must be prioritised on a human level. As I was directly inspired by my years of higher education overseas, the cornerstone of the Fundaçao Kuculá mission is the creation of a community of transformative leaders who work together across borders and sectors.

The Fundaçao Kuculá’s Community Development scheme encourages awareness of public health preventive measures, including physical distancing, frequent hand hygiene, respiratory etiquette, proper mask use and awareness of the role of ventilation. Its secondary aim is to inspire a responsibility towards the environment while promoting access to safely managed water, sanitation, and hygiene (WASH). Education and public health go hand-in-hand, particularly for vulnerable communities and those populations affected by humanitarian crisis.

Philanthropy fills gaps. In an age where philanthropy is not just a moral good, but a moral necessity, COVID-19 presents an opportunity to radically transform Africa’s approach to public health. The theory of change that Fundaçao Kuculá is founded upon is that the world needs leadership from ethical, creative and courageous people who can bridge cultures and disciplines.

The pandemic has proven the interconnectedness of all nations and peoples in tackling some of the hardest questions we have faced yet. Yet, it has also shown that at the core of any system are its people, who need access to good schooling, stable resources, and bright prospects. We must give our youth a strong and healthy future that they can believe in.  

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