COVID-19 and Global Health Security: Overview of the Global Health Security Alliance, COVID-19 Response, African Countries’ Approaches, and Ethics (original) (raw)
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Africa is currently in the grip of a global pandemic caused by SARS-CoV-2 infection. The resulting condition, COVID-19, has spread rapidly and infected over 4 million people globally. [1] The pandemic has ravaged many nations on a global level, and African countries are no exception. The World Health Organization (WHO) country and technical guideline for COVID-19 is subdivided into 16 different topics to inform countries about their preparedness for and response to the global pandemic. While these are important public health measures to contain an outbreak in more egalitarian contexts, some of the topics addressed in the guideline are tailored to a response in resource-rich settings. [2] In Africa, given substantial inequities in health systems and socioeconomic conditions, our challenges vary, as underprivileged and vulnerable people are differently affected by the pandemic compared with those in resource-rich settings. In low-to middle-income countries (LMICs), some of the recommended critical measures for COVID-19 prevention and control could potentially and paradoxically be harmful, as they threaten survival. Fragile healthcare and public health systems render capacities for testing, isolating, quarantining, treating and contact tracing particularly difficult. In a pandemic, public health containment strategies must be balanced against realities such as lack of income, access to basic services and food security in different contexts. Some African countries have implemented national lockdowns with stringent measures as a containment strategy. During the national lockdowns, temporary bans have been placed on both international and local travel, and citizens are encouraged to selfisolate and quarantine at their residences. South Africa (SA) has enforced compulsory wearing of face masks in public, and the country initially scaled up mass testing, community testing and contact tracing, at the centre of its multifaceted response. In public health emergencies, both isolation and quarantine are ethically justifiable. [3,4] An intrusion on the autonomy and privacy of individuals through contact tracing requires explicit ethical justification. The standard ethical justification is that the public health measures will reduce transmission and mortality and preserve healthcare capacity. Zambia This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.