Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics

• Published in: The Lancet 2020-05, Vol.395 (10238), p.1735-1738
• Main Authors: Kavanagh, Matthew M, Erondu, Ngozi A, Tomori, Oyewale, Dzau, Victor J, Okiro, Emelda A, Maleche, Allan, Aniebo, Ifeyinwa C, Rugege, Umunya, Holmes, Charles B, Gostin, Lawrence O
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Africa; AIDS; Betacoronavirus; Clinical Laboratory Techniques - ethics; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronaviruses; COVID-19; COVID-19 diagnostic tests; COVID-19 Testing; Disease control; Emergency medical services; Epidemics; Free flow; Gloves; Health Resources - supply & distribution; Health Services Accessibility - ethics; Human Rights; Humans; Masks; Medical ethics; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Politics; Protective equipment; Public health; Reagent Kits, Diagnostic - supply & distribution; SARS-CoV-2; Treaties; Vaccines; Viewpoint; Viral diseases
• ISSN: 0140-6736; 1474-547X; 1474-547X
• DOI: 10.1016/S0140-6736(20)31093-X

The African Centers for Disease Control and Prevention (CDC) has announced a plan for 1 million tests and a promising partnership aiming to produce 10 million tests, but this will not solve the immediate need.6 National contexts and responses are diverse—which will continue in the short term and longer term. In Veneto, Italy, home-based care was combined with widespread testing and early diagnosis, resulting in a mortality rate four-times lower than that reported in Lombardy.10 Such home-based care could be a model for African contexts, building on community-level response experiences from the west African Ebola outbreak.11 Africa competes for testing kits and a future vaccine Rolling out testing, tracing, and care across Africa will not be easy. On vaccines and therapies, the current situation of inequitable access will repeat without action, as leaders highlighted at the launch of a new international effort to accelerate COVID-19 tools.20 Rich countries monopolising vaccine markets would mirror past actions.21 Meanwhile, demand for masks, gloves, and other personal protective equipment face similar dynamics. Binding human rights treaties are not specific on distributing scarce goods in health emergencies.23 World Trade Organization rules require free flow of medical goods in the market, with little provision for crises when markets inequitably distribute goods in ways that undermine public health.