Health Emergencies in sub-Saharan Africa: Response, Challenges, and Strategies for the Future
Main Article Content
Abstract
Health emergencies pose significant threats to countries all over the world. They arise from various hazards, such as infectious disease outbreaks, natural disasters, food contamination, humanitarian crises, and threats associated with climate change and deforestation. Risk factors for these emergencies include poverty, social determinants, weak health system infrastructure, and poor health financing. Sub-Saharan Africa has experienced numerous health emergencies over the last few decades. Events like the Ebola outbreaks and the COVID-19 pandemic resulted in large-scale health emergencies, suffering, significant social, economic, and political disruption. These events also tested the resilience, preparedness, and capabilities of sub-Saharan Africa countries to respond to health emergencies. To better handle future health emergencies, countries in sub-Saharan Africa need to be prepared, learn from previous emergencies they have experienced, and put in place strategies to respond rapidly and effectively to risks, in order to preserve life and their economies. This paper discusses two health emergencies that have occurred in sub-Saharan Africa, their risk factors, strategies employed to address them, challenges experienced, lessons learned, and strategies to handle future health emergencies in the region.
Keywords:
Health emergencies, sub-Saharan Africa, Ebola, COVID-19, emergency response
Article Details
How to Cite
ARMSTRONG-MENSAH, Elizabeth et al.
Health Emergencies in sub-Saharan Africa: Response, Challenges, and Strategies for the Future.
Medical Research Archives, [S.l.], v. 13, n. 1, jan. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6271>. Date accessed: 10 feb. 2025.
doi: https://doi.org/10.18103/mra.v13i1.6271.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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40. Davén J, Thokoa R, Gaarekwe O, Blecher M. Public finance management mechanisms and practices used in South Africa’s health response to COVID-19. Unpublished communication for the 5th WHO Montreux Collaborative meeting on fiscal space, public financial management and health financing; 2021.
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2. Yimer B, Wassachew A, Awraris W, Muluken T. COVID-19 and global health security: Overview of the global health security alliance, COVID-19 response, African countries’ approaches, and ethics. Disaster Med Public Health Prep. Disaster Medicine and Public Health Prep.2020;6(2):426-430. doi:10.1017/dmp.2020.360
3. Chen Q, Rodewald L, Lai S, Gao GF. Rapid and sustained containment of COVID-19 is achievable and worthwhile: Implications for pandemic response. BMJ. 2021;375:e066169. https://doi.org/10.1136/bmj-2021-066169
4. Gavi.org. How African Countries Coordinated the Response to COVID-19: Lessons for Public Health. Gavi.org. Accessed August 19, 2024. https://www.gavi.org/vaccineswork/how-african-countries-coordinated-response-covid-19-lessons-public-health
5. Bell BP, Damon IK, Jernigan DB., et al. Overview, control strategies, and lessons learned in the CDC response to the 2014–2016 Ebola epidemic. MMWR Suppl. 2016;65(3):4–11. doi:10.15585/mm wr.su6503a2
6. Okware S, Bosa HK, Muyembe TamFum JJ, Omaswa FG. Ebola outbreaks in Uganda and Central Africa: Challenges and lessons learned. African Forum for Research and Education in Health (AFREhealth) webinar. November 25, 2022. Accessed October 14, 2024
7. World Health Organization. Coronavirus Disease (COVID-19) Situation Report -128. WHO.int. Updated May 27, 2020. Accessed September 8, 2024. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200527-covid-19-sitrep-128.pdf?sfvrsn=11720c0a_2
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9. Statista. Number of Coronavirus (COVID-19) Cases in Africa as of November 18, 2022 by Country. Statista. Updated 2024. Accessed September 8, 2024. https://www.statista.com/statistics/1170463/coronavirus-cases-in-africa/
10. Statista. Number of Novel Coronavirus (COVID-19) Deaths Worldwide as of May 2023 by Country and Territory. Statista. Updated 2024. Accessed October 14, 2024. https://www.statista.com/statistics/1093256/novel-coronavirus-2019ncov-deaths-worldwide-by-country/
11. Okoroafor SC, Asamani JA, Kabego L, et al. Preparing the health workforce for future public health emergencies in Africa. BMJ Glob Health (2022);7(Suppl 1):e008327. https://doi.org/10.1136/bmjgh-2021-008327
12. Doumbia S, Jalloh A, Diouf A. Review of Research and Policy For Climate Change Adaptation in the Health Sector in West Africa. ResearchGate. Updated 2014. Accessed October 16, 2024. https://www.researchgate.net/publication/264766437_Review_of_research_and_policy_for_climate_change_adaptation_in_the_health_sector_in_West_Africa
13. Rebaudet S, Sudre B, Faucher B, Piarroux R. Environmental determinants of cholera outbreaks in inland Africa: A systematic review of main transmission foci and propagation routes. J Infect Dis. 2013;208 Suppl 1:S46-S54. doi:10.1093/ infdis/jit195
14. Schmidt JP, Park AW, Kramer AM, Han BA, Alexander LW, Drake JM. Spatiotemporal fluctuations and triggers of Ebola virus spillover. Emerg Infect Dis. 2017;23(3):415-422. doi:10.3201 /eid2303.160101
15. Pinzon JE, Wilson JM, Tucker CJ, Arthur R, Jahrling PB, Formenty P. Trigger events: enviroclimatic coupling of Ebola hemorrhagic fever outbreaks. Am J Trop Med Hyg. (2004);71(5):664-674.
16. World Health Organization. One Year into the Ebola Epidemic January 2015. Updated 2024. Accessed October 16, 2024. https://www.who.int/news-room/feature-stories/detail/one-year-into-the-ebola-epidemic
17. Olu O, Wamala J, Chamla D. Management of Complex Emergencies in Global Health. In: Haring R, ed. Handbook of Global Health. Springer; (2020). doi:10.1007/978-3-030-05325-3_104-1.
18. World Health Organization. New Report Shows that 400 Million do not have Access to Essential Health Services. Who.int. Updated June 2015. Accessed October 14. www.who.int. https://www.who.int/news/item/12-06-2015-new-report-shows-that-400-million-do-not-have-access-to-essential-health-services
19. Oleribe OO, Momoh J, Uzochukwu BS, et al. Identifying key challenges facing healthcare systems in Africa and potential solutions. Int J Gen Med. (2019);12:395-403. doi:10.2147/IJGM.S223882
20. World Bank. A Situational Assessment and Five-Year Action Plan for the Africa CDC Strengthening Regional Public Health Institutions and Capacity for Surveillance and Response Program. ReliefWeb. Updated March 18, 2021. Accessed September 8, 2024. https://reliefweb.int/report/world/disease-surveillance-emergency-preparedness-and-response-eastern-and-southern-africa
21. Demissie B, Okebukola P, Holt T, Sun YS, Kimeu M. Strengthening Africa’s Health Systems: Five Big Ideas for High-Impact Interventions. McKinsey & Company. Updated May 2020. Accessed October 14, 2024. https://www.mckinsey.com/~/media/McKinsey/Featured%20Insights/Middle%20East%20and%20Africa/Acting%20now%20to%20strengthen%20Africas%20health%20systems/Acting-now-to-strengthen-Africas-health-systems-vF3.pdf
22. Boozary AS, Farmer PE, Jha AK. The Ebola outbreak, fragile health systems, and quality as a cure. JAMA. (2014);312(18):1859-1860. doi:10.100 1/jama.2014.14387
23. Pathmanathan I, O'Connor KA, Adams ML, et al. Rapid assessment of Ebola infection prevention and control needs--six districts, Sierra Leone, October 2014. MMWR Morb Mortal Wkly Rep. 2014;63(49):1172-1174.
24. Nyenswah TG, Kateh F, Bawo L, et al. Ebola and its control in Liberia, 2014-2015. Emerg Infect Dis. 2016;22(2):169-177. doi:10.3201/eid2202.151456
25. Gigova, R. DRC’s Health System is ‘on Life Support’ As It Fights Several Killer Diseases, Including Coronavirus. CNN. Updated April 22, 2020. Accessed May 26, 2021. https://www.cnn.com/2020/04/22/africa/drc-coronavirus-killer-diseases-intl/index.html
26. Asante A, Wasike WSK, Ataguba JE. Health Financing in Sub-Saharan Africa: From Analytical Frameworks to Empirical Evaluation. Appl Health Econ Health Policy. 2020;18(6):743-746. doi:10.10 07/s40258-020-00618-0
27. World Health Organization, Geneva. Public Financial Management for Effective Response to Health Emergencies: Key Lessons from COVID-19 for Balancing Flexibility and Accountability. Who.int Updated 2022. Accessed September 9, 2024. https://iris.who.int/bitstream/handle/10665/359143/9789240052574-eng.pdf?sequence=1.
28. Centers for Disease Control and Prevention. Strengthening Public Health Systems in Guinea. CDC. Updated 2024. Accessed September 9, 2024. https://www.cdc.gov/globalhealth/stories/strengthening-public-health-systems-in guinea.html.
29. Arwady MA, Bawo L, Hunter JC, et al. Evolution of Ebola virus disease from exotic infection to global health priority, Liberia, mid-2014. Emerg Infect Dis. 2015;21(4):578-584. doi:10 .3201/eid2104.141940
30. Jalloh MF, Sengeh P, Bunnell RE, et al. Evidence of behaviour change during an Ebola virus disease outbreak, Sierra Leone. Bull World Health Organ. 2020;98(5):330-340B. doi:10.2471/ BLT.19.245803
31. Pedi D, Gillespie A, Bedson J, et al. The development of standard operating procedures for social mobilization and community engagement in Sierra Leone during the West Africa Ebola outbreak of 2014-2015. J Health Commun. 2017;22(sup1) :39-50. doi:10.1080/10810730.2016.1212130
32. Bedson J, Jalloh MF, Pedi D, et al. Community engagement in outbreak response: lessons from the 2014-2016 Ebola outbreak in Sierra Leone. BMJ Glob Health. 2020;5(8):e002145. doi:10.1136 /bmjgh-2019-002145
33. World Health Organization. Vaccination Boosts Sierra Leone’s Ebola Prevention. WHO | Regional Office for Africa. Updated 2021. Accessed October 14, 2024. https://www.afro.who.int/news/vaccination-boosts-sierra-leones-ebola-prevention
34. World Health Organization. Africa’s Response to the COVID-19 Pandemic: A Summary of Country Reports - January 2020 to December 2021. WHO Regional Office for Africa. Updated 2022. Accessed October 16, 2024. https://iris.who.int/bitstream/handle/10665/363757/9789290234807-eng.pdf?sequence=1&isAllowed=y
35. McNamara LA, Schafer IJ, Nolen LD, et al. Ebola surveillance - Guinea, Liberia, and Sierra Leone. MMWR Suppl. (2016);65(3):35-43. http://dx.doi.org/10.15585/mmwr.su6503a6 United States Agency for International Development. West Africa - Ebola Outbreak - Fact Sheet #1. USAID. Updated 2021. Accessed September 8, 2024. https://www.usaid.gov/fact-sheet/west-africa-ebola-outbreak-fact-sheet-1
36. Organization for Economic Co-operation and Development (OECD). The Face Mask Global Value Chain in the COVID-19 Outbreak: Evidence and Policy Lessons. OECD Publishing; 2020.
37. World Health Organization. The World Health Report 2006—Working Together for Health. World Health Organization. Updated 2006. Accessed October 16, 2024. https://iris.who.int/bitstream/handle/10665/43432/9241563176_eng.pdf?sequence=1
38. World Health Organization. Road Map for Scaling up the Human Resources for Health for Improved Health Service Delivery in the African Region 2012-2025. Brazzaville, Republic of Congo. WHO Regional Office for Africa. Updated 2013. Accessed October 16, 2024. https://www.afro.who.int/sites/default/files/2017-06/road-map-hr.pdf
39. World Bank. Africa Centers for Disease Control Receives a $100 Million Boost from the World Bank to Strengthen Continental Public Health Preparedness. World Bank. Updated 2022. Accessed September 8, 2024. https://www.worldbank.org/en/news/press-release/2022/07/21/africa-centres-for-disease-control-receives-a-100-million-boost-from-the-world-bank-to-strengthen-continental-public-hea
40. Davén J, Thokoa R, Gaarekwe O, Blecher M. Public finance management mechanisms and practices used in South Africa’s health response to COVID-19. Unpublished communication for the 5th WHO Montreux Collaborative meeting on fiscal space, public financial management and health financing; 2021.
41. International Monetary Fund. Fiscal Monitor, October 2021: Strengthening the Credibility of Public Finances. Washington, DC: International Monetary Fund. Updated 2021. Accessed October 16, 2024. https://www.imf.org/en/Publications/FM/Issues/2021/10/12/Fiscal-Monitor-October-2021-460455
42. Moonasar D, Pillay A, Leonard E, et al. COVID-19: lessons and experiences from South Africa's first surge. BMJ Glob Health. (2021);6(2):e004393. doi:10.1136/bmjgh-2020-004393
43. United Nations Development Programme. Africa’s Pandemic and Emergency Preparedness Under Spotlight at TICAD 8. UNDP. Updated September 12, 2022. Accessed October 14, 2024. https://www.undp.org/africa/news/africas-pandemic-and-emergency-preparedness-under-spotlight-ticad-8
44. Social Security Administration. Effect of COVID-19 Related Financial Assistance on SSI Income and Resources. Secure.ssa.gov. Updated April 19, 2021. Accessed September 9, 2024. https://secure.ssa.gov/apps10/reference.nsf/links/06042021092805AM/$file/EM-20014+SEN+REV+2+Issued+4-19-2021_Redacted.pdf
45. World Health Organization Regional Office for Africa. Ensuring Health Security in the African Region: Emergency Preparedness and Response Flagship Programmes. #1 Quarterly Report. World Health Organization Africa Region. Updated May 2022. Accessed September 9, 2024. https://www.afro.who.int/sites/default/files/2022-05/QUARTERLY%20REPORT%20%231_WHO%20AFRO%20EPR_v6_WEB.pdf
46. Munodawafa D, Onya H, Amuyunzu-Nyamongo M, Mweemba O, Phori P, Kobie AG. Achieving SDGs and addressing health emergencies in Africa: Strengthening health promotion. Glob Health Promot. (2021);28(4):97-103. doi:10.1177/17579759211064296
47. Zaitchik BF. Climate and Health Across Africa. Oxford University Press; 2016.
48. Braman LM, van Aalst MK, Mason SJ, Suarez P, Ait-Chellouche Y, Tall A. Climate forecasts in disaster management: Red Cross flood operations in West Africa, 2008. Disasters. 2013;37(1):144-164. doi:10.1111/j.1467-7717.2012.01297.x