Global Health Diplomacy Failures in the COVID-19 Era: Surviving Denialism and Corruption in Sub-Saharan Africa

 

Africa is currently bordering close to four million Coronavirus cases, with over 100 000 deaths, the rate of recovery is close to 90%. Northern and Southern Africa remain the hardest hit with the COVID-19 pandemic, 1.5 million cases are recorded in South Africa.  There have been a range of health responses, from strong responses to the outright denial of the global pandemic. Countries such as Kenya, Uganda and South Africa have instituted lockdown measures with phased re-opening of economies in line with the spike or decline in cases, while the Government of Botswana extended the state of emergency and kept its borders closed for longer than six months in 2020.  However, it is important to note that under the premise of public health, curfews and restricted movements there has been increased militarisation in multiple settings. Police brutality and human rights violations have been reported in multiple settings including Uganda, Kenya, and South Africa.

At the other end of the spectrum, fighting COVID-19 has been intertwined with political rhetoric and denialism on this continent, detrimental to human lives. Madagascar proclaimed its miracle herbal cure, and the debate was wide-open in terms of western medicine, versus traditional medicine and decolonisation. Although, at the heart of the ‘cure’ was political rhetoric and a poor pandemic response as cases continued to rise in the country. The first point of call for some patients on this continent is to use traditional medicine. It is a crucial debate we must have, but when it is driven by false promises any future belief, trust and investment is undermined.

Despite reports that there was no transparent reporting of Ebola in the country, Ebola screening took place in Tanzania. While in terms of COVID-19 there has been strong denialism in Tanzania, there are reports on the ground that people are told not to even wear masks. The parallels are quite interesting in that both Tanzania and the United States held elections during the pandemic, political leaders did not wear masks and the economic and health consequences of the virus was ignored. There has been a recent turnaround in Tanzania, but over a year later into the pandemic, how many lives have been lost? International organisations tend to stay mum and diplomatic and often state the obvious after a problem has been allowed to fester.

There has been a lack of decisive and strong leadership especially at a continental and regional level. With cross border movements of people and goods, denial of COVID-19 in one country has the potential to increase infection rates in neighbouring countries. The nationalisation of COVID-19 control efforts has largely downplayed continental and regional strength in management of the pandemic. Continental and regional bodies are reduced to playing advisory roles to national governments and hosting talk shops on manufacturing a vaccine or personal protective equipment (PPE). Instead of any manufacturing happening, we have instead seen the scramble and acceptance of donations and international aid or loans; the latter (COVID-19 funds from donors and through loans) are nearly impossible to track. Moreover, there has been silence by both continental and regional bodies on the human rights violations and denialism of COVID-19.

Almost all African countries have COVID-19 funds which have disappeared or been misused. Inflated prices for COVID-19 relief items such as food and PPE have been reported in countries such as Uganda and South Africa – this is unacceptable. We need a huge-scale outcry and non-acceptance of the misuse of COVID-19 funds, civil society and citizens have a key role to play in recovering money as best possible. In comparison to countries in Europe, who were planning and engaging in COVID-19 vaccine procurement discussions, African countries were reluctant to engage or put in place processes to procure the vaccine and now, there are cries around vaccine inequities and lack of equitable distribution. While there are definite inequities, developed countries are not solely to be blamed. Corruption, denialism, poor budgets, lack of procurement prioritisation and dependency on the COVID-19 Vaccine Global Access (COVAX) has led to the situation we find ourselves in as a continent.

Moving forward in this pandemic, there is a need to track and recover the COVID-19 trillions. Leaders in power need to account for their poor decisions and laissez-faire attitude, continental and regional bodies need to move beyond talk shops on enhancing manufacturing capacity for vaccines to implementing necessary mechanisms. In future pandemic or emergency situations, international bodies need to act faster against denialism instead of playing politics and the diplomatic game at the cost of human lives.

About the authors:

Charles Ssemugabo is a Research Associate at Makerere University School of Public Health, Kampala Uganda and an Emerging Voices for Global Health Alumni, tweet @cssemugabo8

Dr Shakira Choonara is an Award-winning Independent Public Health Practitioner, Emerging Voices for Global Health Alumni and Bold Health Activist, South Africa, tweet @ChoonaraShakira

Competing interests: None.

Handling Editor: Neha Faruqui

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