THE world grappled with the Covid-19 pandemic for over two years, witnessing ebbs and flows in infection rates and experiencing various degrees of impact across nations. Just when hopes are rising about that era being in the past, the emergence of a new wave of infections has cast a shadow of doubt over our collective progress.
As of August 2023, the Nigerian Centre for Disease Control and Prevention (NCDC) stated that the new subvariants (descendants) of the Omicron variant of the SARS-CoV-2 virus named EG.5 and BA.2.86 have been reported in fifty-one (51) countries including China, the United States of America, the Republic of Korea, Japan, Canada, Australia and the United Kingdom among others, etc. So far, only one instance of the EG.5 has been identified in Africa, and none in Nigeria.
This new variant carries numerous mutations, particularly in its spike protein region. The characteristic that raises concerns is that it may be able to evade the immunity conferred by previous infections and vaccinations. The existing vaccines, primarily designated to target the original strain, might be less effective against this new variant. This scenario deepens the questions about the vulnerability of populations, particularly in regions where access to vaccines and healthcare is limited.
Lessons from previous waves: Africa’s response
Africa’s response to the earlier waves of Covid-19 offers valuable insights into its preparedness for a potential resurgence of infections caused by the BA.2.86 variant. During the initial stages of the pandemic, many African countries acted swiftly, implementing stringent measures such as lockdowns, travel restrictions, and widespread testing. These efforts and the relatively youthful population in many African nations contributed to lower infection rates than in other regions.
However, this success came at a cost. The economic impact of lockdowns disproportionately affected vulnerable populations who rely on daily wages to meet their basic needs. Furthermore, healthcare systems in Africa faced significant challenges, including limited hospital capacities, inadequate medical supplies, and a shortage of healthcare professionals.
Vaccine distribution and access
The emergence of the BA.2.86 variant underscores the urgency of global vaccination efforts. While several developed countries have made substantial progress in vaccinating their populations, Africa continues to struggle with vaccine supply challenges. This is despite the support of well-meaning organisations like the Mastercard Foundation, which partnered with the Africa CDC to the tune of $1.5bn. This support birthed the Saving Lives and Livelihoods Initiative which has delivered over 32 million doses of Covid-19 vaccines and trained up to 37,609 health workers, created about 22,520 jobs in its wake.
Healthcare infrastructure and capacity
The readiness of Africa’s healthcare infrastructure to handle a potential new wave of infections is a critical concern. Many African nations have limited hospital capacity and resources. The influx of patients during previous waves strained healthcare systems to their limits. The emergence of a more transmissible variant like BA.2.86 could exacerbate these challenges, potentially overwhelming hospitals and leading to higher mortality rates.
Investments in healthcare infrastructure, including expanding hospital facilities, training medical personnel, and stockpiling essential medical supplies, are crucial to enhancing Africa’s preparedness for a potential resurgence of Covid-19 cases. These investments bolster the response to the current pandemic and lay the groundwork for a more resilient healthcare system.
Surveillance and data collection
Effective monitoring and surveillance systems are pivotal in detecting and responding to emerging variants. While some African countries have enhanced their surveillance capabilities, gaps remain. Limited testing capacities, particularly in remote and rural areas, hinder the early detection of outbreaks. The lack of comprehensive and real-time data can impede decision-making and resource allocation.
Investments in surveillance infrastructure, laboratory capabilities, and data collection mechanisms are crucial for Africa’s preparedness. Timely and accurate data can inform evidence-based responses, allowing governments and health agencies to implement targeted measures to contain outbreaks and mitigate the spread of variants.
Community engagement and vaccine hesitancy
Addressing vaccine hesitancy through targeted risk communication and community engagement (RCCE) is vital to Africa’s preparedness strategy. Misinformation, cultural beliefs, and historical mistrust of healthcare systems can contribute to reluctance around vaccination. Effective RCCE campaigns that provide accurate information, address concerns, and engage local communities can play a pivotal role in encouraging vaccine uptake.
Collaboration with community leaders, healthcare workers, and local influencers can help build trust and ensure that accurate information reaches every corner of the continent. African nations should strengthen their resilience against prospective waves of infections, particularly those caused by new variants, by addressing vaccination reluctance.
The way forward: Collaborative action
In the wake of the BA.2.86 variant and its potential to trigger a new wave of infections, Africa’s readiness requires a multi-faceted approach. Collaboration is key among governments, international organizations, healthcare institutions, and pharmaceutical companies.
Key areas of action include:
- Accelerated vaccine distribution/ delivery: Ensuring equitable access to vaccines through the Mastercard Foundation’s Saving Lives and Livelihoods, and other initiatives, and addressing supply chain challenges to expedite the vaccination process.
- Strengthening healthcare infrastructure: Investing in healthcare facilities, medical supplies, and workforce training to enhance the capacity to handle a surge in infections.
- Improving safety surveillance and data: Improving testing capacities, laboratory infrastructure, and real-time data collection to facilitate early detection and response.
- Risk communications and community engagement: Implementing effective risk communication campaigns to address vaccine hesitancy and disseminate accurate information.
- Research and monitoring: Supporting efforts to understand the BA.2.86 variant’s impact on vaccine efficacy and disease severity.
The emergence of the BA.2.86 variant underscores the interconnectedness of global health security. No country or region is immune to the threat posed by the new variants. By working together, sharing knowledge, and providing support where needed, the international community can enhance Africa’s readiness and contribute to a collective response that mitigates the impact of Covid-19 variants.
The challenges Africa squared up to during the Covid-19 pandemic make it pertinent that the continent’s preparedness against the emergence of BA.2.86 variant should be of critical concern. While challenges persist, the lessons learned from previous waves and collaborative efforts and investments that encouraged vaccine distribution and access, improved healthcare infrastructure and capacity, enhanced surveillance, and adoption of data collection which resulted into community engagement can help build resilience and enable African nations to navigate the evolving pandemic landscape effectively. Also, the global community’s commitment to equitable vaccine distribution and collective action is essential to ensure no region is left behind in the fight against emerging variants.
In conclusion, this is the time for African governments to take the health of the continent as top priority by designing and implementing well-informed policies on the back of key collaborations with international organisations, healthcare institutions, and pharmaceutical companies.
Dr Aloni Alali is a Consultant Public Health Physician and Lecturer, Department of Community Medicine at the Rivers State University Teaching Hospital in Nigeria
