Q&A: Africa’s new order for achieving health security

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Africa has a roadmap to help the continent achieve health security for sustainable development.

Known as the new public health order for Africa, the roadmap created by the Africa Centres for Disease Control and Prevention (Africa CDC) could make the continent emerge successfully from the bitter pain of the Covid-19 pandemic and respond adequately to continuing and future health threats.  

SciDev.Net spoke to Africa CDC’s acting director, Ahmed Ogwell Ouma, who told us more about the new public health order.

What is the new public health order?

The new public health order is guided by local ownership and leadership principles, equity, sustainable investment in health systems, innovation, and self-reliance to position the continent to address its health security challenges effectively. Five pillars define it: strong African public health institutions that represent African priorities in global health governance and that drive progress on key health indicators; expanded manufacturing of vaccines, diagnostics, and therapeutics to democratise access to life-saving medicines and equipment; investment in the public health workforce;  increased domestic investment in health; and action-oriented partnerships to advance vaccine manufacturing, health workforce development, and strong public health institutions.

Why does Africa need the new public health order?  

Africa is at a pivotal moment regarding its health and development. As a continent of more than 1.2 billion people, Africa has a disproportionately high disease burden and continues to experience the highest incidence of public health emergencies annually. However, there need to be more health funding and emergency response models in Africa. For too long, Africa’s health priorities, policies, funding sources and access to medicines have been shaped by forces outside the continent, and this system is failing us.

For example, during the early days of the Covid-19 pandemic, African countries struggled to get critical infection prevention and control measures and diagnostics. Later, when Covid-19 vaccines became available, African countries were the last to get global vaccine supplies. This reinforced an uncomfortable truth that, without a new public health order prioritising local ownership, regional solutions, equity, and self-reliance, Africa will remain at the end of the queue for access to resources and medicines during global health emergencies.

How will the new order affect public health institutions in Africa? 

Regional institutions — such as Africa CDC and the African Medicines Agency — will be strengthened as well as national public health institutes, local universities, research centres and emergency operations centres. The new order focuses on equipping these institutions with adequate infrastructure and systems to enable us to respond rapidly to disease outbreaks.

The new public health order is focused on building the capacity of African public health institutions to coordinate policies and programmes, drive disease surveillance, and harmonise public health responses.

To what extent will the order improve the health and livelihoods of people as a whole? 

Disease outbreaks have health, social and economic consequences. Therefore, if we can strengthen public health institutions to be better prepared to respond to disease outbreaks, more lives could be saved when the next pandemic comes.

If we can develop local manufacturing capacity for vaccines, diagnostics and therapeutics, we can make life-saving medicines and equipment more accessible to African patients.

If we invest in the public health workforce, we’re ensuring that patients receive quality care and that health workers have the training, support and remuneration they need to do their jobs. Such investments will lead to better health outcomes in Africa.

What are the possible challenges in implementing this new public health order? 

Each of the five pillars in the new public health order addresses a particular problem or limitation of the status quo. The greatest possible challenge is not advancing the new public health order and not doing everything in our power to ensure its vision is realised.

What will happen if there is no support for implementing the new public health order?

In September last year, during the 77th Session of the United Nations General Assembly in Ethiopia, heads of state and governments in Africa called for the full implementation of the new public health order.

However, suppose African governments, public health institutions and other vital parties don’t support the full implementation of the new public health order. In that case, the status quo remains unchanged and we will continue living through the challenges we see today.

The experience we’ve had through the Covid-19 pandemic, Ebola and other diseases is a consequence of this lack of investment in public health in the health workforce, health institutions, vaccines, therapeutics, and diagnostics and in the existing health system itself. We are living through the consequences of a failure to invest in and prioritise public health, which is the impetus for the new public health order.

Improving Africans’ health, livelihoods, and security is always the end goal, so I hope the new public health order will be fully implemented in Africa.

This interview has been edited for clarity and brevity. SciDev.Net’s Sub-Saharan Africa English desk produced this piece. This article was done in partnership with Africa CDC 2nd International Conference on Public Health in Africa.