How Africa has tackled covid-19BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2830 (Published 16 July 2020) Cite this as: BMJ 2020;370:m2830
All rapid responses
As described by Wadvalla (1), robust health systems and adequate staffing are vital for Africa to be able to effectively implement case detection, contact tracing, and scale-up hospital capacity to tackle COVID-19. While many unknowns remain about the direct and indirect impacts of COVID-19 on the African continent, the accelerating trajectory of the pandemic highlights the importance of early, decisive, and long-lasting action. Alongside current efforts to “flatten the epidemic curve” through strong public health measures we suggest the implementation of urgent public health interventions to lower the baseline number of avoidable hospital admissions (2), particularly those requiring critical care beds and oxygen which are in extremely short supply (3).
One such example is road traffic injuries, which cause 1.35 million deaths per year – as well as several times more severe injuries - and are a significant problem in the Africa region (4). In Ethiopia alone, the estimate is around 22,000 injuries and fatalities per 100,000 motor vehicles per year (5). Implementing what we know works – such as decreasing and enforcing speed limits, drink- and drug- driving and mobile phone use while driving - can further reduce accidents and save lives while minimising pressure on acute hospital services and the toll on clinicians (6,7). These measures can be implemented at little or no extra cost and help meet Sustainable Development Goal 3.6 (‘halve global deaths from road traffic accidents by 2030’) (8).
We encourage policymakers to explore such interventions that are effective, quick to implement, and tailored to their national context. Well-designed interventions can support health systems in Africa while helping overcome the global pandemic. As Ethiopian Prime Minister Abiy Ahmed said in March: “Momentary victory by a rich country in controlling the virus at a national level, coupled with travel bans and border closures, may give a semblance of accomplishment. But we all know this is a stopgap. Only global victory can bring this pandemic to an end.” (9).
1. Wadvalla, BA. How Africa has tackled covid-19. BMJ. 2020;370:m2830
2. Bhopal S, Bola GK, Hughes R, Gopfert A, Bhopal A. B (2020). Can we improve the NHS’s ability to tackle covid-19 through emergency public health interventions? BMJ Opinion. (Available: https://bit.ly/2UCWQ7E)
3. Murthy S, Leligdowicz A, Adhikari NKJ (2015). Intensive Care Unit Capacity in Low-Income Countries: A Systematic Review. PLOS ONE 10(1): e0116949.
4. Abegaz T, Gebremedhin S. Magnitude of road traffic accident related injuries and fatalities in Ethiopia. PLoS One. 2019;14(1):e0202240.
5. WHO. (2018), Global status report on road safety 2018. Geneva: World Health Organization.
6. WHO. (2017), Save lives: a road safety technical package. Geneva: World Health Organization.
7. Miljeteig, I., Defaye, F., Desalegn, D., et al (2019). Clinical ethics dilemmas in a low-income setting - a national survey among physicians in Ethiopia. BMC Med Ethics 20, 63.
8. Sustainable Development Solutions Network (SDSN). SDG 3.6: Road traffic deaths. Available: https://indicators.report/targets/3-6/
9. Ahmed A. If Covid-19 is not beaten in Africa it will return to haunt us all. Financial Times, 25 March 2020. Available: https://www.ft.com/content/c12a09c8-6db6-11ea-89df-41bea055720b
Competing interests: No competing interests