Why Africa needs ownership of its health security agenda

By Dr. Githinji Gitahi, Group CEO Amref Health Africa, Commissioner Africa Union COVID 19 commission, Governing Board member Africa CDC

The Monkeypox outbreak, like Ebola before it, is the best signal yet that the Global Health Security Agenda, it’s instruments, it’s framework of implementation and it’s governance needs urgent review.

Despite recording over 10,000 suspected monkeypox cases and 600 deaths in the  two years (2020 and 2021), WHO stockpiled smallpox vaccines which were only mobilised when monkeypox was identified in far fewer cases and no deaths in high income countries in 2022.

The continent has been containing Monkeypox outbreaks since 1970.

In 2022 alone, Africa has recorded over 1,400 suspected cases 66 deaths. During this period, with adequate science to support Small Pox vaccine effectiveness against the Monkeypox virus, there has not been a trigger to use the vaccines even in the frontlines or protecting contacts.

It’s only after going beyond Africa, that stockpiled vaccines are being released & a Public Health Emergency under International Health Regulations is being considered. No preventable death should be acceptable anywhere!

The tools to slow the Monkeypox spread have long been available, the policies and systems haven’t been available to protect the African people who have dealt with it since 1970.

This is not isolated. It’s true that many diseases only attract significant money and interest after infecting people from High Income Countries.

We witnessed decade long delays in affordable access to lifesaving Anti-retrovirals on the African continent, of one year delay to declare the 2018 Democratic Republic of Congo Ebola outbreak as a public health emergency of International concern (PHEIC) and more recently we witnessed severe inequities in access to COVID-19 medical countermeasures, which has seen Africa unable to meet its COVID-19 vaccination targets and to this day unable to access oral therapeutics.

WHO has 31m doses of smallpox vaccines (effective against Monkeypox), mostly kept in donor countries & intended as rapid response to any re-emergence of the disease, which was declared eradicated in 1980. Doses have never been released for any monkeypox outbreaks in Africa

This situation is similar to stockpiles of Ebola doses which are held while Ebola continues to threaten unvaccinated health workers and volunteers in African countries like Uganda & DR Congo – These countries are begging for their release to vaccinate frontline Ebola responders

It is this situation that informs Africa Unions position to seek more control of the health security of its people while at the same time protecting the world by managing continental health threats while coordinating with existing health security regional and global architecture including WHO. In February 2022, President Cyril Ramaphosa, Africa Union COVID 19 Champion and Chair of the Africa Union Commission proposed the autonomy of Africa CDC and the creation of the Africa Pandemic Preparedness and Response Authority (APPRA) and which were both adopted by the Assembly of Heads of State and Government.

If Africa, a continent that hosts 27% of all countries of the world, has the means to react, respond and control disease threats, the world will be safer.

A strong Africa-led independent mandated and resourced Africa CDC working in concert with others including WHO won’t be for the benefit of Africa alone but of the world at large.

The clock on strengthening its independence cannot turn back and those of us who deeply care about our unique circumstances know this.

Our African Member State health ministers meeting at the Strategic Health Committee of the African Union know this best and it’s their duty to protect future generations from the embarrassment our generation has faced by leaving our fate completely in the hands of others. They can demonstrate this by supporting the new Public Health Order under an autonomous mandated Africa CDC.

Let me close with a quote from President Kagame, ‘Because we (Africa) do things ourselves, doesn’t mean that we do them alone’

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