As COVID-19 grips developing countries, the number of new cases per day is higher than ever, and the total caseload is approaching 5 million. If the virus is to be defeated, U.S. global leadership is indispensable. But the U.S. is retreating from it, threatening to reconsider its funding and participation in the World Health Organization (WHO), and skipping a high-level meeting of the European Union and other U.S. allies to secure funding for the global fight against the pandemic.
The U.S. needs to play a larger international role, especially in Africa, where many countries are inadequately equipped to fight an infectious threat of this character and magnitude. COVID-19 has been relatively slow to spread to Africa, but the WHO now warns that up to 190,000 people in Africa could die in the first 12 months if containment fails, and that the pandemic could become an enduring threat to the continent.
As a U.S. ambassador to two African countries that successfully defeated Ebola outbreaks, I have witnessed firsthand the difference that U.S. assistance and expertise can make in fighting a deadly virus. In Africa's fight—and the world's fight—against the coronavirus, it is all hands on deck. That includes the U.S. and, just as importantly, WHO.
Six years ago the world was threatened by an Ebola outbreak in West Africa. At the time, I was the U.S. Ambassador to Liberia, one of three countries that were at the epicenter of the outbreak. Experts warned that the outbreak, if not contained, could kill hundreds of thousands of people in West Africa and ultimately become a global threat. Thankfully, it did not, but it did take a gruesome toll. In Liberia, a country of just 4 million people, there were 10,678 confirmed cases and nearly 5,000 people died from the virus.
Last year, while serving as the U.S. Ambassador, I saw how Uganda, with support from the U.S., WHO and other international players, successfully defeated another Ebola outbreak and prevented the spread of the disease from neighboring Democratic Republic of the Congo.
Over the past decade U.S. assistance and expertise have played a vital role in the fight to eradicate Ebola. COVID-19, thankfully, is not as lethal, but because of the ease of transmission, it could infect millions of Africans and kill far more people in Africa than the Ebola virus ever did. As we gear up for this fight there are at least three vital lessons that we can draw from Africa's prior experience in fighting Ebola and other epidemics.
The first is that medical expertise, diagnostic capability, and data collection are mission-critical. While many African countries have gained valuable experience in fighting viral threats like HIV/AIDS and Ebola, too many countries still lack the required epidemiological expertise, the testing capacity, and the laboratory facilities needed to detect, contain and track epidemics.
The second is that the fight against epidemics ultimately depends on the doctors, nurses, technicians, and other health care personnel who treat and prevent infectious diseases. Unfortunately, most African countries, on a per capita basis, have just a small fraction of the number of health care providers found in economically advanced countries.
Finally, there must be a sustained international commitment to preventing future outbreaks in Africa. The past four decades have amply demonstrated that Africa is highly susceptible to public health threats. East and Southern Africa remain the epicenter of the HIV/AIDS epidemic, and in the past decade Africa has suffered through several outbreaks of the deadly Ebola virus.
President George W. Bush's President's Emergency Plan for AIDS Relief (PEPFAR) did much to build the epidemic fighting capacity of countries in East and Southern Africa, but other parts of the continent have lagged far behind.
In response to the 2013 outbreak of Ebola in West Africa, the Obama administration instituted the Global Health Security Agenda (GHSA), which has boosted the epidemic-fighting capacity of many countries in Africa, but U.S. support for GHSA has been reduced in recent years. Combined with cuts in funding for the CDC's overseas work, America's commitment to fighting infectious disease in Africa has been shrinking.
Now, at the worst possible time, the Trump administration has suspended aid to WHO, a step that will inevitably hinder its work in Africa. I was one of the first to criticize WHO for its weak response to the West African Ebola epidemic in 2014. Since then, however, WHO has upped its game and, if given adequate funding, is in a good position to aid Africa in its fight against COVID-19.
Working together, we can do much to :"flatten the curve" of COVID-19 in Africa, but without international support Africa will lose the fight against this pandemic. If so, COVID-19 will remain a global threat, and we will all be losers.
There is an old African adage worth heeding: If you want to go far, go together. That applies with special urgency to the global fight against COVID-19.
Deborah Malac served as the U.S. Ambassador to Liberia (2012-15) and as U.S. Ambassador to Uganda (2016-January 2020). She is currently a senior fellow at the Population Institute.
The views expressed in this article are the author's own.
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