Brocher Symposium 2021

Covid-19 and the human right to health: what's really at stake for Africa?

Co-Organized by the Competence Center for African Research, University of St.Gallen, Switzerland and the Ethics and Public Policy Laboratory of the Catholic University of Central Africa, Cameroon

Description of the topic:

Our scientific knowledge of COVID-19, which continues to affect a significant portion of the world's population, still has gray areas. However, the acute effects are clear. The risk of infection and death is highest in disadvantaged and vulnerable populations in high-income countries. In lower-income countries, infection and mortality rates are not clear. It is possible that mortality rates are lower because there may be cross-reacting protective antibodies or because the overall average age of the population is younger. The economic impact is felt worldwide, again with the greatest impact in countries without a social safety net. However, the medium- and long-term impacts of the pandemic will most likely be felt disproportionately in countries with fewer resources, especially in terms of health and the consequences of job loss, loss of education, and disruption of many other health programs (such as vaccination, tuberculosis, treatment of noncommunicable diseases, etc.).

After several months of hindsight, the expected health catastrophe in Africa has not yet occurred, although some prominent figures have died from COVID-19 and countries such as South Africa, Kenya, and Ethiopia are struggling with high numbers of infections. The corruption in the most affected countries, such as South Africa and Kenya, exposes the ruthlessness of decision makers and their indifference to the health of the general population. Similar corruption may occur elsewhere, but in more stable societies, the effects may be less obvious. The current disease outbreak is therefore still of great concern for Africa, although not for the same reasons as in higher-income countries. The African CDC responded early, lockdowns were initiated early, and therefore Africa can even be considered to have acted more responsibly and in a more timely manner than other countries. However, the weakness of economies, health systems, and government structures makes people extremely vulnerable. African countries have also been unable to compete on the global market for fair prices for personal protective equipment and medicines, and are likely to be at the back of the queue when it comes to access to vaccines.

As the virus began to spread around the world, there was the "paternalistic" assertion, mostly reflecting a broader Western view, unfortunately passed on by some in Africa, that African countries would not be able to recover from this pandemic because it would doubly punish already very broken African health systems and weak economies. Based on this "paternalistic" analysis, a "paternalistic" solution was also quickly proposed: rich countries should do something quickly to help the very poor African countries that would never be able to handle a pandemic of this magnitude on their own; and many African countries did not fail to ask for help immediately.

However, if we focus on what we observe rather than what we think we know about the African context, we could have anticipated more realistic scenarios that explain why the situation is less harrowing than expected, as well as that we should focus on the real health challenges that this pandemic poses for Africa, two of which stand out:

The first challenge is the fact that this pandemic is diverting attention from more widespread and deadly diseases than COVID-19, such as malaria, HIV-AIDS, tuberculosis, maternal health, and noncommunicable diseases, which together result in many millions of deaths per year. It is not about competition between diseases, but simply about being aware of local health challenges so that public health policy measures are appropriately adjusted. African countries should be responsible for not exacerbating the spread of the virus within and outside their borders, but this cannot be the only priority (imposed by the global community) when other health problems that are more or equally urgent also require urgent attention to avoid losing previous gains (e.g., malaria, HIV, tuberculosis) or worsening already suboptimal baselines (e.g., NCDs).

The second challenge is the extent to which local African governments take seriously the human right to health of their own citizens and develop sound and coherent national health policies that make this human right effective. This pandemic, which has forced many countries to close their borders, has forced us to face the obvious and sometimes forgotten fact that the fate of every citizen's health depends first and foremost on his/her state, and that the national framework remains the place par excellence to make human rights such as the right to health effective. The human right to health of every African should also be seen in the context of the human right to health of all citizens of all countries. Global responsibility and solidarity are also necessary for governments to protect the human right to health of their citizens.

Knowing the real challenges that this pandemic poses to Africa would discourage African states and governments from copying outward-looking health strategies as usual, and would force them to finally develop sound public health policies that are adapted to African demographics and context, meet local needs, and truly protect the human right to health of African populations.

This symposium aims to address these and other challenges related to protecting health as a human right in Africa.