Similar discussions are being held in the framework of the Global Fund (GF) post-2022 strategy, whereby a consensus was reached on the need to integrate PPR into HIV, TB and Malaria, as a way to build resilience into disease programming, with a view to strengthen health and community systems in readiness for any future pandemics. In this context, funding for PPR has also stirred debate as most constituencies in the GF are against the idea of PPR as a parallel competing workstream from HIV, TB and Malaria programming.
Regardless of where PPR will fit in the strategic framework, and cognizant of the fact that African countries are already burdened by a weak health system and yawning funding gaps for health, there however ought to be exchange of views to identify current gaps and focus areas on strategies related to epidemic and PPR mechanisms. Against this background, the African Constituency Bureau for the Global Fund convened a virtual coffee session on PPR.
This interactive session held on 27 July 2021, saw subject experts, including participants from African Risk Capacity (ARC), WHO/AFRO, Ministry of Health of Kenya and ACB board members sharing their insights on priority areas to strengthen PPR in the continent. Key lessons learnt in the implementation of the COVID-19 Strategic Preparedness and Response in African Constituencies as well as policy recommendations for the Global Fund were discussed.
The discussion noted that preparedness through improving disease surveillance, investing in health systems and human capacity in areas such as emergency operation centres, improved laboratories, frontline health facilities, and interoperable data systems could play a key role. Additionally, coordination across all sectors with adequately trained and properly resourced response teams, improving the supply management systems to ensure commodities are available at the very time of need as well as exploring innovative ways to fund outbreak response such as risk transfers and insurance for epidemics could better help to respond to outbreaks.
A call for governments to invest in infrastructure and human capacity for disease modelling, epidemic forecasts, reducing the continent’s reliance on external help by supporting local manufacturing of products were also suggested as means of managing risks.
One cannot discuss PPR or health security without mentioning the International Health Regulations (IHR) of 2005 in which the international community agreed to improve the detection and reporting of potential public health emergencies worldwide. In fact, the regulations require that all countries have the ability to detect, assess, report and respond to public health events.
It is for this reason that experts in the PPR coffee session recalled that over 40 countries in the WHO AFRO conducted a joint external evaluation to determine the extent to which countries could implement the various technical recommendations from the IHR. Accordingly, Kenya with a few other countries developed an action plan for health security. While most African countries are still far from reaching the IHG goals, Dr Kadondi Kasera, Head of National C19 Response Mechanism pointed out that ”COVID-19 raised the interest of governments in an area which has not so much been looked into but rather neglected”.
Despite the underinvestment and lack of political interest in PPR, it is noteworthy that the African continent’s prompt response to COVID-19 has defied the gloomy prediction that Africa could be the epicentre of fatalities from the pandemic. The rates of infections, fatalities and recoveries do show that Africa is the second least affected region of the world mainly due to a coordinated regional response as well as swift adoption of public health measures, in some instances drawing on lessons learnt from the Ebola response.
African countries should thus build on this strength to fully meet the IHR goals (can detect, assess, report, respond) and for global partners such as the Global Fund to assist countries to shiftly move away from a reactive mindset to a pro-active one that matches national government investment in Health Systems Strengthening (HSS) to better contribute towards HIV, TB and Malaria control.
To further invest in robust surveillance systems, it is important that countries invest in real-time digital data, detection capacity, capacitate front-line workers to detect and rapidly respondd to the epidemics. In addition, integration of community systems for detection and response, including strengthening laboratory systems and diagnostics capacity is key.
By expediating the domestication of IHG goals, allocating sufficient resources for a resilient health system in the midst of adequate support from partners such as the Global Fund, African constituencies will most likely withstand the pressure should future pandemics occur.