Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti
Good morning, good afternoon, bonjour and I’d like to thank all our colleagues from the press for having joined us for this press conference today indeed to discuss how COVID-19 has impacted on the provision and on access to essential health services in Africa.
I am really pleased to be joined for this conversation today by Professor Ifedayo Adetifa, of the KEMRI-Wellcome Trust Research Programme and the London School of Hygiene and Tropical Medicine, and Ms Regina Kamoga, who is the Executive Director of the Community Health and Information Network and also chairs an Alliance of Patients Organisations in Uganda. I’m also joined by my colleague Dr Ngoy Nsenga who will answer some of the questions of a more technical nature in French.
While so far, many African countries have been spared the worst of the COVID-19 pandemic, with 1.8 million cases and 43,700 deaths on the continent, our concerns are the pandemic’s knock on effects for health in Africa, more broadly.
Many countries have been spared the worst of the pandemic, and I just gave the number of cases we’ve seen and we have had many conversations about why Africa hasn’t been as devastated as had been predicted, but we are very concerned about the fact that there is a knock in effect for health in Africa and even in as countries respond the pandemic, it is really important that other life-saving services continue to be available to communities.
A preliminary analysis by WHO indicates COVID-19 is hitting other health services really hard. We have looked at indicators in 14 African countries, like outpatient consultation, skilled birth attendance, malaria treatment and we see a sharp decline in the uptake of these services in 2020 compared with 2018 and 2019. The biggest gaps were in May, June and July when many countries enforced restrictions on movement as well as other social and public health measures, the so-called lockdowns.
In these three months, we witnessed a drop of more than 50% on average in the services we monitored.
An extra 1.32 million children aged under one year missed their first dose of the measles vaccine from January to August 2020, compared to the same period in 2019.
And in Nigeria, for example, more than 362,000 pregnant women missed antenatal care between March and August, and in August alone there were 310 maternal deaths in health facilities, almost double the number recorded in August 2019.
So, while COVID-19 is not overwhelming African health facilities in the way that many including ourselves first predicted from some models, it is really stretching already resource-limited health systems. Staff and resources have been diverted to the response, and barriers to service access have increased, with the pausing of immunization campaigns, with financial hardship on the part of families, we know that in most African countries a lot of the financing for health comes directly out of the pockets of families and individuals, and also people are afraid of coming to health facilities and there are other fears that are triggered by misinformation around COVID-19.
Together, authorities, partners and communities really need to do more to protect the hard-fought gains made over many years in improving access to care and health outcomes in African countries.
The good news is that some delays reported earlier in the year are being overcome. In many countries, immunization campaigns have restarted, protecting tens of millions of children from diseases like measles and polio.
At WHO we are advising countries on ways to provide essential services safely, with protections for health-care workers and community members, and we are assisting countries to address stock outs of essential medical products. We have also set-up monitoring systems with 22 African countries to track data on service delivery in around 4800 health facilities in real-time, so that any drops in access can be investigated.
The continent has been experiencing a plateau in COVID-19 cases since mid-September but in the past few weeks we are seeing a concerning uptick in some countries.
It’s too early to say if this is the start of a so-called second wave as we are seeing in Europe and elsewhere. But with COVID-19 already crushing economies and disrupting key health services, we mustn’t leave the door open for the virus to resurge.
In line with further re-opening of economies, individual protective behaviours need to be reinforced. This is imperative to continue easing the restrictions safely.
I have to say communities have shown great fortitude in this response, and a huge effort is still needed by individuals to keep wearing masks, keep a distance when it’s possible and practice frequent hand hygiene, and by authorities to scale-up smartly targeted public health interventions to localize the response.
Together we can save lives by ensuring access to essential health services and getting livelihoods back on track.
I look forward to our conversation today and thank you once again for having joined us.