Africa’s public health leaders believe tools such as testing and viral gene sequencing will help track the spread of COVID-19 and blunt the impact of future waves.
The World Health Organization’s (WHO) Africa regional office and the Africa Centres for Disease Control and Prevention (Africa CDC) each has launched projects to expand the continent’s ability to find and fight COVID-19 outbreaks before they spread.
The WHO is working with the South Africa National Bioinformatics Institute to set up a regional laboratory to study virus samples from across Southern Africa to identify new variants before they can overwhelm communities like beta and delta did.
The regional center will expand the genetic testing capacity the WHO and Africa CDC created in 2020 by linking labs across the continent that allowed them to share research and sequence the genetic material of more than 43,000 samples.
Africa produces about 1% percent of the world’s COVID-19 genetic data.
“Genomic sequencing paves a clear path for us to track the COVID-19 virus, monitor mutations that can lead to new variants and respond effectively and in a timely manner to more infectious variants,” said Dr. Nicksy Gumede-Moeletsi, the regional virologist for WHO Africa. “The regional center will allow countries to be a step ahead of the virus.”
At the same time, the WHO and Africa CDC plan to increase COVID-19 testing across the continent by distributing easy-to-use rapid diagnostic test kits to local health agencies. Similar tests have been available for many years for at-home HIV testing.
Using a sample taken with a nasal swab, the rapid tests quickly identify a COVID-19 infection, even if the person shows no symptoms. The WHO estimates that 65% to 85% of Africa’s COVID-19 cases show no symptoms.
The broad-based testing plan departs from previous testing, which has focused primarily on people who turn up at medical centers showing symptoms. The WHO estimates that Africa’s current testing strategy captures only about 1 in 7 cases of COVID-19.
“Much of the transmission is driven by asymptomatic people,” said WHO Africa Director Dr. Matshidiso Moeti. “The reported cases we see, therefore, could be just the tip of the iceberg.”
Since the pandemic began in early 2020, African countries have conducted more than 79.5 million tests but lag well behind other parts of the world. European countries, for example, have conducted nearly 12 times that number in the same period, according to data from the European Centre for Disease Prevention and Control.
During the most recent wave driven by the delta variant, Africa’s case positivity rates averaged more than 11%, which is double the rate at which the WHO recommends lockdowns and other drastic measures to interrupt the spread of a disease.
The economic costs of national lockdowns have made political leaders wary of using them.
“We, as Africa CDC, are saying the way we managed the pandemic with a series of severe lockdowns is over,” Africa CDC Director Dr. John Nkengasong said recently.
Public health officials are trying a more focused approach using methods similar to the ring vaccination strategy that helped break the 2014-16 Ebola outbreak in West Africa.
Under that strategy, someone testing positive will be asked to isolate themselves. Anyone living within 100 meters of the positive case also will be tested. Everyone will receive masks and other material to prevent further spread of the virus.
Between broader testing and expanded laboratory capacity, Africa’s public health leaders hope the continent can make strides in controlling the pandemic.
“It is clear in my mind that the continent has a huge human capacity for public health,” Nkengasong said.