With almost 750,000 cases of COVID 19 and millions of people in quarantine around the world, this new pandemic has stopped the world in its tracks. People’s health is now centre stage everywhere, and it has become ever so clear that diseases do not stop at national borders. Now, more than ever, regional institutions’ effectiveness in ensuring health and safety should be considered a matter of priority. How these institutions act and react, may, in the long term, prove of significant importance on the way nations tackle future epidemics.
As I write this, many countries in West Africa are grappling with new confirmed cases of the coronavirus. After decades of under-funding the health sector, policymakers need to recognise that if the Economic Community of West African State (ECOWAS) does not rise to face this challenge, the coronavirus pandemic could mark yet another, worse “Ebola crisis.” As of 30 March 2020, ECOWAS, an economic region of about 380 million people, had almost 1,300 confirmed cases of Covid-19. They were reported in 15 Member States with 33 deaths reported in Cote D’Ivoire, Ghana, Cameroun, Nigeria, Togo, Mali, Niger, Gambia, Burkina Faso and Cabo Verde. Given its weak health infrastructure, poverty, conflicts, poor sanitation and urban crowding, it is now clear that the regional apparatus must better prepare to wrestle such pandemics successfully.
The mandate of the West African Health Organisation
The West African Health Organisation (WAHO) was created in 1987 as a specialised institution of ECOWAS. According to its founding protocol, the WAHO is entrusted with a political mandate by the Heads of State and Government. Its task is to ensure the coordination of regional health interventions within the ECOWAS region. With this mandate, the WAHO has the ability to promote health interventions that specifically address the needs of West African countries. In this time of recurring epidemics and scarcity of resources, WAHO is primarily focusing on critical areas, such as Pharmaceuticals (medicines & vaccines); Prevention & Control of Communicable and non-Communicable Diseases; and Health Information. These issues are under review in the context of achieving the UN Sustainable Development Goals 3 (good health and well-being) and 17 (partnerships for the goals). The idea is to strengthen the means of implementation and revitalise the global partnership for sustainable development. Multi-stakeholder organisations, such as the WAHO, would help mobilise and share knowledge, expertise, technology and financial resources.
Even after the Ebola crisis, some West African countries face the recurrence of other epidemic-prone diseases, like Lassa fever, cholera and measles. All the countries in the ECOWAS, except Cabo Verde, have recently undertaken the Joint External Evaluation (JEE) of the International Health Regulations (IHR)’s capacities. For many of these countries, the recommendations have been to build capacity for preparedness and response to health emergencies to ensure a comprehensive, rapid and effective public health response. WAHO has supported countries such as Liberia and Mali in this regard. So far, both countries have very low case numbers (25 and 3 respectively). But it is early days, and we are yet to see if preparedness will help keep the numbers low permanently. The WAHO also participated in an emergency meeting of the Ministers of Health of ECOWAS on regional readiness and response to the ongoing Covid-19 (Coronavirus) epidemic on the 14th of February, 2020.
Lack of regional coordination
The extraordinary burdens from the outbreaks of Ebola led to the creation of an Agency of WAHO called Regional Centre for Surveillance and Disease Control (RCSDC). This Agency’s task is to improve preparedness and response efforts against future public health emergencies across all ECOWAS member states. As of now, it is still unclear how effective WAHO is as this pandemic continues in Africa. It is not entirely clear if WAHO has been at the frontline of managing decision-making and coordination regarding the prevention of the coronavirus across the ECOWAS region. If it has been, then it has failed to communicate it. So far, it seems that individual member states are taking their own precautionary measures at different times. Actions range from stopping flights from nations struggling to control the virus, closing land border passing, banning larger gatherings of people, prohibiting religious and cultural festivals and shutting down schools. It is very similar to what happened in the European Union, where member states developed their own mechanisms to deal with the pandemic. Only on the 18th of March, 2020, did the EU block declare a unified shutdown. Indeed, many pointed out the lack of solidarity between EU countries, as Italy struggled with increasing cases and death tolls.
The opportunity this crisis offers
The current coronavirus pandemic provides an opportunity to put the WAHO at the forefront of a joint regional response into action. ECOWAS cannot simply ignore the need for a coordinated local response. Only strong leadership from WAHO can solve the regional coordination problems related to travel restrictions and the guaranteed flow of critical goods across borders. So far, only 6 out of the 15 countries (Nigeria, Burkina Faso, Ivory Coast, Ghana, Sierra Leone and Senegal) have national reference laboratories with the capacity to diagnose. The WAHO must help coordinate the process of equipping countries with laboratories to enhance surveillance in the region and also coordinate vaccine research and clinical trials in the ECOWAS region. It would be directly in line with SDG Goal 3B, which calls for a “support of research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries”.
The capacities of countries in the ECOWAS region in epidemic disease surveillance, prevention, response and resilience need to be strengthened. The WAHO must play a strong leadership role in this. It is a central organisation that can improve communication and coordination among member states, preparing the region for future epidemics and other emergencies. The WAHO must help countries in the area to harmonise policies, scale-up best practices and establish standards of preparedness. Political will in this regard from all governments in the region is needed more than ever.
This blog was originally published on the Southern Voice Website, in March 2020
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