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“Silence the Guns”: Africa’s CDC Head on Delayed Pandemic, Health Equity & Dangers of War

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The African continent has mostly escaped the worst of the pandemic, but the World Health Organization is now warning of an impending acceleration of its spread. “We have always been very clear that the pandemic in Africa was a delayed pandemic, that the continent wasn’t spared,” says Dr. John Nkengasong, director for Africa Centers for Disease Control and Prevention.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now! The Quarantine Report. I’m Amy Goodman, with Juan González. As COVID-19 cases skyrocket in South Africa, the World Health Organization warned this week the spike in infections could signal an impending acceleration of the coronavirus across Africa. This is Mike Ryan, executive director of health emergencies, speaking Monday.

DR. MIKE RYAN: I think what we’re starting to see is a continued acceleration of transmission in a number of countries in sub-Saharan Africa. And I think that has to be taken very, very seriously. South Africa may unfortunately be a precursor. It may be a warning for what will happen in the rest of Africa. … Many of those countries exist in the midst of fragility and conflict. Many of them need external help and support.

AMY GOODMAN: As South Africa’s case numbers rise, countries across Africa also are seeing a spike in numbers. Al Jazeera reports cases in Kenya increased by more than 30% in the past week. Numbers are up by 50% in Madagascar. 69% in Namibia. This comes after Africa had so far escaped the worst of the coronavirus pandemic, with countries such as Rwanda implementing stringent public health policies to prevent the spread. The death rate in Africa has also been low.

For more on COVID-19 in Africa, we go to Addis Ababa, Ethiopia, where we’re joined by Dr. John Nkengasong, the director of the Africa Centers for Disease Control and Prevention, formerly with the Centers for Disease Control and Prevention in the United States.

Dr. Nkengasong, it’s great to have you with us. Thanks so much for taking the time, in this time of crisis and pandemic, to speak to us. Explain the issue in Africa right now. We have seen it as so far being spared from the — well, what the United States is going through. But is that a matter of lack of testing, or are the numbers, do you believe, truly low on infections and deaths?

DR. JOHN NKENGASONG: Thank you for having me on your show, first of all.

And we have always been very clear that the pandemic in Africa was a delayed pandemic, that the continent wasn’t spared, but rather that because of the aggressive measures that were put in place very early on due to strong leadership from the different countries and a strong, coordinated approach from the African Union and the president of South Africa, in his capacity as the chair of the African Union, that helped to blunt the pandemic. And I think it was always clear in our mind as the Africa CDC that this pandemic was going to gather momentum.

And here we are with the situation, that is — I’ll call it the second phase of that, where countries are beginning to see dramatic increases in the number of cases. An example is the South Africa you just mentioned. So, a pandemic is heterogeneous. We should be very careful the way we look at the numbers. We still have over 40 countries with less than 10,000 cases, and then South Africa is constituting more than half of our 750,000 cases on the continent. But the general trend is in the upward swing mode.

JUAN GONZÁLEZ: And, Dr. Nkengasong, in terms of the prior experience of public health officials in Africa in combating other health threats and pandemics or epidemics, like Ebola and HIV/AIDS, what — has the public health infrastructure, as a result, been more prepared this time around for COVID?

DR. JOHN NKENGASONG: Somehow, yes. If you look at the countries like Sierra Leone, Liberia and Guinea, where they were heavily hit by the Ebola outbreak in 2014, you see that, I mean, they have, after that period, developed their national public health institutes. They strengthened their community health workers program, that is extremely important for contact tracing. And that has helped those countries, especially in what I call the phase one of the response. I mean, absolutely no doubt about that.

The overall awareness of the threat of diseases has also heightened because of Ebola and HIV there. If you look at South Africa, I mean, I know that the situation in South Africa is changing dramatically, but we should always remember that their initial response was very critical. Otherwise, we would probably be at a million or more than a million cases in South Africa.

So, that experience that Africa is used to fighting HIV, tuberculosis, malaria, Ebola is very important. But we should also remember that this is a different virus. This is different from Ebola. The transmission patterns is different. It’s affecting everybody at the same time. It’s not restricted like Ebola was in DRC or in West Africa. And it’s very different from HIV. So, I think we are learning. The continent is adopting new strategies. We are learning that this is a very different enemy we have to fight.

JUAN GONZÁLEZ: And, Doctor, what about the whole issue of testing accessibility for COVID-19? What’s it been like? Are there particular countries that are more ahead in this area? And what do you see as what needs to be done?

DR. JOHN NKENGASONG: That’s a very good question. I mean, the continent has come a long way. Let’s be very clear. We are extremely challenged with the issues of testing, not because the continent doesn’t know how to test, but just because we didn’t have the reagents specific for COVID. If you all recall, in February, just two countries had the capacity to test for COVID on the continent. Again, we ramped that up very quickly, the capacity, by training a large number of countries in Senegal and South Africa. And within three weeks, starting the end of February to March, we were able to ramp that up very quickly to about 43 countries.

Today, as a continent, we have tested about 7 million, or conducted about 7 million COVID tests. And if you compare that with just two to three months ago, we were still under half a million tests. So I think the testing has picked up. But we are not yet there. I mean, as a continent of 1.3 billion people, we should be testing about 12 million COVID — conducting about 12 million COVID tests a month. So I think we still have a long way to go in order to catch up and be where we have to be. So, testing still remains a challenge.

The appropriate testing, though, is also important. The so-called polymerase chain reaction-based testing is good, but it’s very tedious. It requires a long turnaround time. The type of tests that we need are those point-of-care tests, that we can easily decentralize into the communities and do the testing, followed by the contact tracing, isolation of patients and then taking care of them, for those that are infected. And that is why we’ve launched the initiative called the Partnership to Accelerate COVID Testing on the continent, that is underpinned by the ability to test, to trace and to treat. I think we are slowly catching up on the goal of testing 10 million people. As I indicated, we’ve conducted about 7 million tests. The Africa CDC continues to roll out testing reagents to many countries. So I think we are slowly catching up on testing, but, again, it has been a serious challenge for us.

AMY GOODMAN: Dr. Nkengasong, I wanted to ask you about the importance of the World Health Organization and President Trump pulling the United States out of it. And that leads to my second question about global cooperation and how important that is. Right now we have had the United States joining with Britain and Canada saying Russian hackers are stealing vaccine information, and now you have the indictment of two Chinese people in the United States who President Trump says has also hacked vaccine information. But why are we talking about this? What about global cooperation on this critical issue, where this is really open-source, so we come up with a vaccine that works for everyone? Both of those issues, WHO and vaccine global cooperation?

DR. JOHN NKENGASONG: So, let me start with the cooperation piece. If you look at the Joint Continental Strategy that Africa has put forward, it is underpinned by the need for strong cooperation, the need for strong collaboration, the need for strong coordination and communication. Those are the four Cs that guide our continental strategies, which was in those at the highest level of the continent since February. So I think the continent recognizes that the victory, the global victory, against COVID has to be guided by global solidarity, because this is a global crisis. And no country will be considered free of COVID if any country in the world is considered — still has COVID infections there. And again, the continent of Africa of 1.3 billion cannot be excluded in the equation in this whole discussion of eliminating COVID in the world. So, I think, again, we strongly adhere to the principles of coordination, cooperation and collaboration to seek solutions that will help us move [inaudible]. This is a war of survival for the world. I think we’ve seen how — the damage that COVID has imposed on our economies, on our lifestyles, and the number of deaths that COVID has cost us. So, again, this is not a fight that any single individual or region of the world will win without a global coordination and solidarity.

With respect to WHO, I think our position is very clear, that the world has always been a safer place, global health problems have always been solved adequately, only with the leadership and strong leadership of the United States and of the World Health Organization. Absolutely no doubt about that. The HIV/AIDS crisis, we begin to turn the fight against HIV/AIDS only when the United States launched the president’s initiative against HIV, called PEPFAR, in 2002, 2003. And the continent of Africa has benefited from that effort. I think the United States has invested over $70 billion to $80 billion in fighting HIV/AIDS on the continent, which the continent is extremely appreciative. Through solidarity and cooperation, the global fund was established in 2001, 2002, and it has been a game changer. It’s probably a good example of how we should coordinate efforts to fight against COVID-19, which is the greatest challenge the world is having in the last 100 years. So, I think a strong WHO and a strong United States leadership is the key ingredient for us to come out of this extremely devastating crisis, Earth crisis.

JUAN GONZÁLEZ: And, Dr. Nkengasong, in terms of this issue of global solidarity, for years now we’ve seen a key feature of international trade agreements, where the pharmaceutical companies and other corporations push the importance of intellectual property protections, obviously for patents, especially of medicines. Do you believe, given this crisis, that there should be a suspension of this race to control a particular vaccine, and, in essence, make it available generically from the start, to at least stem this epidemic, with possibly five or 10 years down the line companies then trying to benefit, once the world situation has stabilized?

DR. JOHN NKENGASONG: That’s a very important question. I think we as the Africa Centers for Disease Control and the African Union Commission issued a statement in that regard just a few weeks ago — to be very specific, on the 25th of June — where we convened a continental international conference on COVID vaccine. And that meeting was chaired by president of South Africa, His Excellency President Ramaphosa, and the chair of the African Union Commission, His Excellency Moussa Faki. The essence of that meeting was clear, that we have to discuss the issues related to intellectual property. We have to discuss issues related to access to vaccines, almost in a timely fashion, variable for a continent of 1.2, 1.3 billion. And exactly what we — in that communiqué, we touch on the Doha Declaration, which speaks to this intellectual property you just mentioned.

I think we are always reminded, always reminded of what happened in 1996, when the HIV drugs were available and it took us about seven years, up to 2002, before it became accessible to the continent of Africa. I think if that situation plays out now, you can see that the future of the continent will be completely underbalanced. You see that the development of the continent will be underbalanced.

So, I think, again, we are calling for a global solidarity to make sure that just speaking about access to vaccines in developing world, and in Africa, in particular, is just not a nice word to say. It’s not just a feel-good word to say, but it’s a reality. And we are developing our own strategy called African access vaccine strategy, underpinned by access and development of the vaccines for the continent.

AMY GOODMAN: Dr. Nkengasong, we just have a minute, but I wanted to ask you about the connection between COVID transmission and war. In our headlines, we just read about U.S. soldiers around the world, and particularly in Japan. There’s an outbreak of COVID-19 — what this means for local populations. You have talked about that connection, going back to the Spanish flu, and how this can be dealt with — war, conflict and pandemic.

DR. JOHN NKENGASONG: I think there is always that strong interrelation between war or crisis and disease outbreak or pandemic, our ability to control that. It is not chance that the Spanish flu in 1918 happened just after the Second World War — sorry, after the First World War. So I think it’s very clear that these two are very, very interrelated.

And I am very concerned that a continent of us, with so many hot spots, where you have conflicts going on, will sooner or later be affected by the COVID-19 pandemic, and it will become extremely challenging to fight the war against COVID in those regions. So, I think you begin to face a double war in a single country or in an entire region. We must put that into our continental strategy to be able to make sure that we’re prepared to root out COVID when they finally get into these conflict regions. But, very importantly, to end, it will be that this is the time for us to silence the guns, silence all the guns everywhere in Africa, so that we can fight this common enemy.

AMY GOODMAN: Dr. John Nkengasong, thank you so much for joining us, director for Africa’s Centers for Disease Control and Prevention, trained as a virologist who used to work at the Centers for Disease Control.

When we come back, as the pandemic surges throughout the United States, we look at the impact on Latinx workers, apparel workers, meatpackers, farmworkers, so hard hit. Stay with us.


AMY GOODMAN: Music by the mbira musician and teacher Cosmas Magaya of Zimbabwe, who died earlier this month of COVID-19.

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