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The pandemic’s impact on healthcare services in Africa

The pandemic has undermined the progress made when it comes to fighting deadly diseases that have plagued Africa over the year

The Covid-19 pandemic has proven to be a defining moment in the 21st century. As of November 2nd, 2021, around 5,023,000 deaths have been reported worldwide as a result of the virus. Pandemics or epidemics are not new, but it was the first time that a health crisis has brought the entire world to a standstill. The pandemic clearly demonstrated that our healthcare systems were not designed to deal with a crisis like this. It proved the healthcare sector was ill-equipped to deal with an unpredictable and large-scale health challenge like the Covid-19 pandemic. To put things into perspective, no healthcare systems across the world, including the ones in developed nations, were prepared for something like this.

Covid-19 has further exposed the cracks that exist in the healthcare sectors in countries like Africa. According to the World Bank, Africa requires around $100 billion to successfully tackle Covid-19 impact across all verticals. The World Bank said, “Since the start of the Covid-19 crisis, the Bank Group has committed over $157 billion to fight the impacts of the pandemic. Provided from April 2020 to June 2021, it includes over $50 billion of IDA resources on grant and highly concessional terms. Our support is tailored to the health, economic, and social shocks that countries are facing.”

The impact of Covid-19 is not just limited to healthcare. African nations such as Kenya and Nigeria have been also impacted. The lockdowns and stay-home orders issued to curb the spread of the virus has had implications on food security. The Covid-19 pandemic has also taken a toll on the mental health of many Africans. Many cases of healthcare workers, Covid-19 patients, youth, or even the elderly suffering anxiety and depression have been recorded. It has become of utmost importance to integrate mental health education and counselling with psychosocial support during these testing times.

The World Health Organisation said, “This unprecedented public health emergency has demonstrated that health facilities, medical transport, patients as well as health care workers and their families can – and do – become targets everywhere. This alarming trend reinforces the need for improved measures to protect health care from acts of violence. During the Covid-19 pandemic more than ever, protecting the health and lives of health care providers on the frontline is critical to enabling a better global response.”

Vaccination drives in Africa were slow to start with. Most of the African nations rely on the COVAX programme, whereas some have managed to get vaccines as donations or through bilateral trades. Africa’s aim is to vaccinate at least 40 percent of its population by the end of this year, however, most of the nations will fail to hit the target, unless the vaccination drives pick up rapidly in the remaining days of this year.

Covid-19 in Africa
Around 8.5 million cases of Covid-19 were reported in African countries till since the beginning of the outbreak, as per official data. The World Health Organisation found that less than 15 percent of the Covid-19 cases in Africa were reported correctly. It is estimated that nearly 60 million people contracted the virus in Africa. Dr Matshidiso Moeti, WHO Regional Director for Africa said, “With limited testing, we’re still flying blind in far too many communities in Africa. Most tests are carried out on people with symptoms, but much of the transmission is driven by asymptomatic people, so what we see could just be the tip of the iceberg.” She said that test numbers have been rising in Africa, but this community-based initiative is a radically new approach that should help significantly raise detection rates. “More testing means rapid isolation, less transmission and more lives saved through targeted action,” she added.

Besides infecting people, the Covid-19 pandemic is also disrupting health services in Africa. The pandemic has undermined the progress made when it comes to fighting deadly diseases that have plagued Africa for years. The fight against diseases such as human immunodeficiency virus (HIV), tuberculosis (TB), and malaria, which continue to be the leading causes of death in the region have taken a back seat.

A study revealed that the mortality rate has increased too. It was reported that there has been an increase of up to 10 percent, 20 percent, and 36 percent due to HIV, tuberculosis (TB), and malaria respectively during the pandemic. The pandemic has also disrupted the fight against HIV in Sub-Saharan Africa. During the pandemic, adding to the HIV death burden. An analysis on HIV treatment forecasted that a disruption in treatment as a result of the pandemic could lead to an additional 500,000 HIV deaths in Africa.

In 2020, access to healthcare services declined significantly not only in Africa but throughout the world as a result of the pandemic. This is because people were afraid of contracting Covid-19 from their visits to hospitals. Other factors such as patients’ inability to reach healthcare facilities due to lockdown measures, disruptions in public transportation, and stay-at-home orders also played a part.

Africa’s healthcare system over the years has faced multiple challenges be it lack of funds, poor infrastructure, inadequate healthcare workforce, or its high burden of disease. The pandemic has only made matters worse by adding to the existing double burden of communicable and non-communicable diseases. Other factors contributing to this are the higher poverty rate in African countries and poor health literacy.

Like many other regions across the globe, Africa too saw an aggressive second wave. Far more cases were registered by the end of 2020 as compared to the first wave. One of the long-term impacts of Covid-19 will be that the gains made when it comes to increasing child mortality and poverty in Africa 2025 and 2030 will be lost.

Hospitals and healthcare facilities across are facing financial challenges as a result of the Covid-19 pandemic. This is attributed to unexpected changes in demand for health services. Due to the pandemic, many people have stopped visiting hospitals and many surgeries have been postponed. Significant declines in demand for routine services have impacted revenue. Also, the virus has increased demand for specialised acute care that has imposed unexpected or have taken a financial toll on the healthcare service providers.

Covid-19’s impact goes beyond healthcare
Women and children across the globe have been affected by the pandemic, especially in the African continent. It is estimated that Covid-19 has pushed around 150 million people around the world into poverty. African nations such as Kenya and Nigeria have been also impacted. The lockdowns and stay-home orders issued to curb the spread of the virus has had implications on food security.

In Africa, many children are provided with food in their respective schools. Such programmes are designed to provide children from marginalised communities with nutrition. The closure of schools due to the pandemic has impacted these children’s nutrition. The pandemic has also impacted many daily wage earners, thus leading to the loss of human capital. The pandemic has also affected the mental health of many Africans, be it a daily wage earner, a mother, or a healthcare worker.

Many cases of healthcare workers, Covid-19 patients, youth, or even the elderly suffering anxiety and depression have been recorded. It has become of utmost importance to integrate mental health education and counselling with psychosocial support during these testing times. A survey by WHO revealed that the Covid-19 pandemic has disrupted or halted critical mental health services in 93 percent of countries worldwide while the demand for mental health is increasing. “The survey of 130 countries provides the first global data showing the devastating impact of Covid-19 on access to mental health services and underscores the urgent need for increased funding,” the World Health Organisation said.

In many African nations, the indirect health effects of Covid-19 showed disruptions in essential health services. Even though the pandemic has negatively impacted the healthcare sector like the economy across the globe, it also presents an opportunity to reshape healthcare systems. The pandemic highlighted the shortcomings of the African healthcare system. Now, the government in these African nations can plan accordingly and direct funds to bolster their respective healthcare systems.

“Doctors’ associations across the world have also initiated talks with authorities to make their work environment safe from infections and to better protect health care providers outside the hospital. Through its Health Care in Danger initiative, the International Committee of the Red Cross published a checklist for a safer Covid-19 response addressed to managers of healthcare services, individual practitioners and health policymakers. WHO and partners are also conducting communication and outreach campaigns at country-level to support governments in addressing attacks on health care,” the WHO said.

Vaccination in Africa
The Covid-19 vaccination drive has been slow in Africa since it began on March 1st,2021. According to WHO, just five African countries, less than 10 percent of Africa’s 54 nations, are projected to hit the year-end target of fully vaccinating 40 percent of their population. African nations struggled to get their hands on vaccines initially, but the situation slightly improved since September as vaccine production was ramped up everywhere. Wealthier countries or vaccine-making nations pledged to make donations to the COVAX programme or even directly to African nations during the G7 summit held in the month of June in the UK.

WHO said, “This comes as the region grapples to meet the rising demand for essential vaccination commodities, such as syringes. It also said that three African countries- Seychelles, Mauritius and Morocco have already met the goal that was set in May by the World Health Assembly, the world’s highest health policy-setting body. At the current pace just two more countries, Tunisia and Cabo Verde, will also hit the target.

The vaccination rollout has been uneven across Africa because of the unsteady supply of vaccines and financial crunch. Most of the African nations are relying on the COVAX programme by WHO and on donations and bilateral deals. According to a World Bank report published in early October, “Of the 6.4 billion vaccine doses administered globally, only 2.5 percent have been administered in Africa – even though the continent accounts for a little over 17 percent of the world’s population.”

G20 countries have received 15 times more Covid-19 vaccine doses per capita than countries in sub-Saharan Africa, according to an analysis conducted by science analytics company Airfinity. With most of Africa relying on the COVAX programme, a delay in shipment or a supply chain crisis further adds to Africa’s woes. Another reason for the slow rate of vaccination is vaccine hesitancy or skepticism.

WHO has further revealed that more than 50 nations have missed their target of vaccinating around 10 percent of their population by the end of September. Most are these countries are in fact in Africa. According to WHO, only 4.4 percent of Africa was fully vaccinated in October. Comparatively, nearly 66 percent of the whole population has been fully vaccinated. In the EU, 62 percent of the population has been fully vaccinated and 55 percent of the population in the US.

“The looming threat of a vaccine commodities crisis hangs over the continent. Early next year Covid-19 vaccines will start pouring into Africa, but a scarcity of syringes could paralyze progress. Drastic measures must be taken to boost syringe production, fast. Countless African lives depend on it,” Dr. Matshidiso Moeti said.

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