A scientist with a PhD in chemistry, President Magufuli abandoned Covid-19 testing after his own trials allegedly showed fruit juice tested positive for the virus. Yet despite being widely ridiculed at the time, many are asking whether the late Tanzanian president was right, with European courts declaring tests unreliable – while the inventor of the Covid-19 PCR test is facing a multi-million-dollar law suit for ‘misleading’ world governments. By Sonia Elijah.

 

In May 2020, the former chemistry teacher and late-Tanzanian president John Magufuli made a speech that has since been removed from much of the internet. In it, he revealed that he secretly sent samples of goat meat and fruit juice to the country’s official PCR testing lab – and the samples came back as 'positive' for the novel coronavirus.

Magufuli’s simple stunt threw into question the claim that PCR tests were the ‘gold standard’ for diagnosing Covid-19, as the SARS-CoV-2 virus is commonly known in the media.

The statement unleashed ridicule and condemnation against the president from the rest of the world and led to him being smeared as a ‘Covid-denier’ in Western media. The BBC, for instance, incorrectly reported that Magufuli ‘used the results to justify his denial of the virus’.

However, President Magufuli never denied the existence of the Covid-19 – he simply questioned the accuracy of the PCR test used to diagnose the virus.

Now, almost a year later, and questions surrounding the reliability of the PCR tests are growing louder. Christian Drosten and the other scientists who created the PCR testing protocol used to ‘diagnose’ Covid-19 are being sued by the top trial lawyer Dr Reiner Fuellmich in a historic class-action law suit in Germany and the US.

If successful, it could lead to national governments being sued by businesses and individuals over lockdowns, mask mandates and other restrictions imposed on the basis of ‘positive’ Covid-19 tests.

The law suit against Drosten and his colleagues was spurred by an independent review of their ‘gold standard’ Covid-19 tests by 22 international scientists, which claims to have exposed 10 major flaws of the way the PCR tests were being used to detect the virus.

The alleged flaws and conflicts on interests of the scientists behind the tests, led Fuellmich to declare that ‘those responsible for it must be criminally prosecuted, and sued for civil damages'.

Dr Mike Yeadon, former vice president and chief scientist of Pfizer, who co-authored the review, highlighted another major flaw with the PCR test in ‘its propensity to suffer from contamination’.

He said that the ‘integrity of a PCR is very easily destroyed by invisible levels of contamination even in the hands of an expert, working alone and on a small handful of samples’.

A health worker prepares in a mobile NHLS testing lab at a Diepsloot COVID-19 screening and testing site at Diepsloot Sarafina Park (1).jpg

The Nobel-prize winning inventor of the original PCR method, Kary Mullis, famously said in 1993 that his technology was never meant to diagnose a virus, adding: ‘It doesn’t tell you that you are sick. These tests cannot detect free, infectious viruses at all.’

This crucial fact was completely ignored many years later by countries around the world that bought millions of PCR tests to conduct mass Covid-19 testing on their citizens, many of whom were ‘asymptomatic’ – showing no symptoms of being sick with the virus.

There is mounting evidence that shows the PCR test is unreliable, resulting in false-positives and was never designed to test for a live virus. Dr Pieter Borger described the PCR test as having ‘no relevance for the diagnosis whatsoever’.

While Dolores Cahill, Professor of Translational Science at the University College Dublin, warned early on in the pandemic that ‘a positive PCR coronavirus test may testify to the presence of the common cold’.

Concerns about the use of PCR tests are growing around the world. The pathologist Dr Clare Craig explained, for instance, how one Spanish study showed that ‘87 per cent of people in hospital who tested positive for Covid on PCR had not been infected according to antibody testing’.

‘Even for those with Covid on intensive care, 53 per cent did not have antibodies.

‘Every test can go wrong and we can check how well they are working by comparing with other tests.’

Her concerns about the reliance on PCR testing is shared by the public health scientist Abir Ballan, who told NewsAfrica that it is possible that the test could have ‘picked up some other viruses that are closely related to SARS-CoV-2’, adding: ‘The E gene used in the PCR test, as described in the Corman-Drosten paper, is not specific to SARS-CoV-2.’

Interestingly, while Thailand, a country applauded for extremely ‘low’ Covid levels, screens for up to six genes, many of the countries hardest hit by Covid-19, like the UK and the Netherlands, are known to have run a high percentage of their tests using this flawed single-gene approach.

In the UK, for instance, 38 per cent of all positive test results in the first week of February 2021 had been screened for just one gene, raising serious questions about the true extent of the number of Covid-19 cases and deaths as a result.

But it’s not just the tests’ inability to distinguish between different viruses that concerns Ballan. She fears that the samples are being amplified to such an extent – known as ‘cycles’ – that they are picking up traces of dead virus in patients who were previously infected and have since recovered.

Nick Hudson, the South African who co-founded the international research group Pandemics Data & Analytics, told NewsAfrica that PCR testing was ‘being deployed in the wrong way.’

He doesn’t doubt President Magufuli’s claims that engine oil, fruit and meat tested positive for Covid-19, adding that ‘its sensitivity is being ramped up to an absurd level’ that everyday items like tap water have been returning false positives for Covid-19.

‘Cycling these tests up to such an extreme sensitivity has given rise to this notion of the ‘asymptomatic’ case – another medical absurdity.’

Hudson, like most independent scientists, scoffs at the notion of asymptomatic spreaders of the virus, questioning how someone can spread a respiratory disease ‘if you don’t have symptoms’.

It’s a position supported by several studies around the world, which found little or no evidence of asymptomatic or pre-symptomatic spread.

Kenyans walk past a mural about the coronavirus, Haile Selassie Avenue, Nairobi. Press Association.jpg

This hasn’t stopped labs running tests on people without symptoms, though. In Canada, for example, not a single province has run tests below the suggested 30 cycles. While one province, Quebec, has run tests as high as 45 cycles.

This has led to inflated ‘cases of Covid-19’, according to the scientist.

It’s a problem Hudson thinks may be common in South Africa too.

He revealed that one lab he had contacted had been running tests at up to 42 cycles – something he described as ‘utter madness’.

Hudson fears the mis-use of PCR in this way may have led to thousands of healthy people being incorrectly misdiagnosed as infectious, and, in turn, contributed to the government’s decisions to impose draconian lockdowns that have impoverished millions and led to economic stagnation in the African powerhouse.

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Such examples led Dr David Bell, a former World Health Organization (WHO) programme head, to praise President Magufuli’s response to the virus.

He told NewsAfrica that the late-Tanzanian leader was one of the few world leaders to correctly follow the WHO’s guidelines for dealing with a respiratory illness.

‘There is not compelling evidence elsewhere that mass PCR testing has averted significant Covid-19 mortality, once community transmission is well established,’ explained Bell.

‘Magufuli had a science background and would have understood that PCR tests are appropriate for detecting sequences of genetic material, not as a sole way of defining ‘cases’ as is used, against WHO advice, in many other countries.’

The WHO has repeatedly warned against mass-testing of asymptomatic people.

This apparent misuse of PCR testing by countries like South Africa and Canada hasn’t gone unnoticed beyond the scientific community.

In November, 2020, an appeals court in Portugal made a landmark ruling stating that ‘the PCR process is not a reliable test for SARS-CoV-2, and therefore any enforced quarantine based on those test results is unlawful’.

The judges, Margarida Ramos de Almeida and Ana Paramés, referred to several scientific papers on the PCR tests, including a study by Jaafar et al, which found that when running PCR tests with 35 cycles or more the accuracy dropped to three per cent, meaning up to 97 per cent of positive results could be false positives.

With evidence mounting against PCR accuracy, the WHO issued a warning statement on December 14, that using a high CT value will result in false positives and advised labs to use the ‘positivity threshold’ recommended by the manufacturer.

Meanwhile, just two days after President Magufuli was laid to rest in March, an Austrian administrative court acknowledged the limitations of PCR and antigen testing, declaring ‘PCR tests have no diagnostic value’. This view was echoed in April by one of Germany’s lower courts, which described PCR tests as not ‘suitable for determining an ‘infection’ with the SARS-CoV-2 virus’ and ordered the lifting of various restrictions in the region in question, Weimar.

Yet despite growing legal and scientific support for his warnings about PCR misuse, Western coverage of the Tanzanian president’s funeral repeated many of the earlier slurs against him, deploying dog-whistle terms like ‘African leader’, ‘Catholic’ and ‘Covid denier’, while omitting his scientific credentials.

The use of such phraseology smacks of ‘prejudice’, according to ex-WHO scientist Dr David Bell, who thinks the Tanzanian should be applauded for his approach to the pandemic. Magufuli rejected the Chinese-inspired lockdowns embraced in the West and Western-leaning African countries like Nigeria, South Africa and Kenya, and encouraged Tanzanians to go about their everyday lives instead.

‘Magufuli followed the evidence-based pandemic guidelines released by WHO in 2019, and those of the US CDC,’ explained the American.

‘These did not envision mass business closures and restrictions on religious freedom. Most Tanzanians are of relatively young age, are not obese, and so are at very low risk from SARS-CoV-2 infection. He acted as you would expect a well-trained scientist.’

With yet more court cases slated over the use of PCR testing and the lockdowns they triggered, Bell thinks there will be a major re-assessment of Magufuli’s legacy.

Even the BBC, whose coverage of President Magufuli’s response to the pandemic has been particularly scathing, has been forced to acknowledge major flaws with the PCR tests recently, after its flagship Panorama programme sent an undercover reporter to work at a UK lab earlier this year.

The journalist discovered a series of bio-security breaches, leading to cross-contamination of samples and potential misdiagnoses of Covid-19 during its so-called ‘second wave’.

Whether such breaches led to over-inflated death figures will be difficult to prove.

But with the test branded ‘not fit for purpose’ by an increasing number of scientists, perhaps world leaders should have taken heed rather than ridicule the former scientist in their ranks.

He may have been ridiculed in the West for rejecting lockdowns and encouraging prayer-a-thons. But as ex-World Health Organization scientist Dr David Bell explains, Tanzania's late president John Magufuli is not seen as a pariah by many in the scientific community – he’s seen as a life-saver.

If you read the BBC website, you probably think Tanzania’s late president was either a rebel, a ‘Covid denier’ or just plain stupid.

In reality, he was none of these.

President Magufuli was actually a highly educated scientist with a PhD in chemistry, who probably saved thousands of lives by refusing to embrace lockdowns and other knee-jerk reactions foisted on the people in much of Africa and the West. 

Magufuli’s decision not to lock down was consistent with the evidence-based pandemic guidelines released by the World Health Organization (WHO) in 2019.

He rightly predicted that Covid-19 mortality in Africa would be very low compared to other major killers like malaria, tuberculous (TB) and HIV-Aids, and followed good public health principles in prioritising these higher burden diseases that particularly afflict the young, while telling Tanzanians not to panic.

He also prioritised keeping the economy growing, which is in the long term the most effective way of improving life-expectancy and health. In short, he acted as you would expect a well-trained scientist and rational public health expert to act in the Tanzanian context. 

Throughout the Covid-19 pandemic, the media has demanded longer and harder lockdowns, as if they were normal – or helpful.

But they rarely point out that no pandemic plan recommended mass business closures and restrictions on religious freedom, travel, or normal societal function before 2020, because removing these is expected to cause greater harm, and impinges greatly on fundamental human rights.

We never implemented any of these measures during the SARS, MERS or swine flu outbreaks of recent years. People attended places of worship, caught packed buses and trains, the young went clubbing and danced and sang and kissed.

The same was true for Tanzanians during this pandemic too.

And rightly so. 

Most Tanzanians are young and not obese, and so are at very low risk from Covid-19.

President Magufuli received a lot of bad press for telling his countrymen to go to church at the start of the pandemic to ‘pray’ Covid away.

But mass gatherings would not be expected to put the vast majority of the Tanzanian population at significant risk.

Tens of thousands of sports fans went to stadiums in Florida and Texas recently, and there was no noted uptick in cases afterwards.

Of course, protecting the vulnerable from harm is important in any epidemic, and it’s difficult to say whether the mass prayer-a-thons were a good idea from a purely transmission standpoint, as they may have increased risk to older people early on in Tanzania’s outbreak.

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Building so-called ‘herd immunity’ in young people rapidly through such gatherings would however be expected to exert a protective effect, if the vulnerable are well protected until such transmission-suppressing immunity is achieved.

The policy overall was probably far better for public health than strict lockdowns, which led to the first recessions in a quarter of a century in many African countries, as well as a reduction in treatment for major killers like malaria, tuberculous (TB) and HIV-Aids.  

The virus that leads to Covid-19, SARS-CoV-2, is likely to become endemic, and as herd immunity is reached through natural infection or through vaccination, severe disease and death will become increasingly uncommon.

Multiple studies have shown very limited impact of stricter lockdowns on Covid-19 mortality.

Therefore, one would expect Tanzania, like Sweden, Croatia, Belarus and other ‘non-lockdown’ countries, to have similar overall Covid-19 deaths and epidemic trajectories as comparable lockdown countries in the end. 

The vehement criticism of President Magufuli in the media is therefore disappointing and highly ignorant. It does appear that Western journalists find it easier to smear leaders in African countries than European leaders. Sweden's leaders, for instance, have never been labelled 'Covid deniers'.

This is not new, but perhaps shows how much hypocrisy and prejudice persist in Western society.

Tanzania appears to have done better from a health point of view than most other low-income countries through this last year. While millions of Africans have been thrown into hunger and poverty, Tanzania has seen GDP rise throughout 2020.

Falls in GDP and general impoverishment are associated with increases in all-cause mortality.

This is particularly the case in sub-Saharan Africa, where food security is often a real problem and control of endemic diseases such as malaria, tuberculosis and HIV-Aids is fragile.

It is therefore highly likely that, in maintaining a well-functioning economy, he and his government were responsible for greatly reducing mortality. UNICEF estimate almost a quarter of a million additional child deaths in South Asia in 2020 due to the responses to Covid-19 there.

It is likely that similar tolls will be seen in sub-Saharan Africa but we would expect that Tanzania will now be relatively protected from this. 

Let us hope, for Tanzanians’ sake, that this continues with his successor.

Western media may have had a good laugh at President Magufuli – and Tanzanians in general – for thinking they could ‘pray’ away a virus.

But, rhetoric aside, by refusing to lockdown, and by refusing to divert health resources away from malaria and TB to test people with no symptoms for a virus with a very low fatality rate, Magufuli was following an orthodox pandemic response. 

He was also orthodox in his approach to human rights. Religious freedom was considered an important human right by most Western journalists only 18 months ago, and fear should not change fundamental human rights. 

Honest journalists should acknowledge the benefits of Magufuli’s approach, however much it may contradict their current preferred world view.

Ridiculing religious observances that fall outside their experience, and denigrating public health science that they clearly don’t understand, is not good journalism.

It just highlights how ignorant they are. 

Guinea, Liberia and Sierra Leone on edge over fears of Ebola return. By Jonathan Paye-Layleh in Monrovia.

It has been five years since the deadly Ebola virus was beaten out of the Mano River Union countries.

The countries, which have suffered countless wars and political unrests over the past three decades, still bear the psychological scars from the pandemic, which claimed more than 11,000 lives and caused widespread fear throughout Guinea, Liberia and Sierra Leone.

The return in February of the much-feared disease to Guinea, which is where the 2014-2016 outbreak started, has sent a wave of panic across the sisterly countries that have a lot in common, including poor healthcare delivery and poor infrastructure.

Re-emerging from the same Guinean Forest Region where the last pandemic began in 2014, the disease has already claimed five victims with hundreds more under surveillance within the first two weeks.

Swift international intervention included the dispatch of anti-Ebola vaccines.

The World Health Organization’s representative in Guinea, Alfred Kizerbo, emphasized the importance and efficacy of the vaccines in saving people of dying from Ebola.

And the global vaccine alliance, Gavi, revealed it had half a million doses ready to deploy if needed.

But this was not without resistance from people who, despite the devastation of 2014 – 2016, still doubt the existence of the disease.

Guinea’s minister of health, Remay Lamah, who hails from the Ebola-affected area, has lashed out at people who promote ‘fake’ ideas about the vaccine.

He told the BBC: ‘This vaccine is not a poison. This is why we are administering it in public so that you yourselves can see the reality.’

Despite Guinea’s porous borders, Sierra Leone and Liberia have not reported any case at the time of going to press.

Sierra Leone’s president, Julius Maada Bio, however, was not leaving anything to chance.

On hearing the Guinea re-emergence, he instructed his new health minister, Dr Austin Demby – who was in country with the US Center for Disease Control and Prevention during the last Ebola outbreak – to take immediate action and ensure the country’s emergency response system was increased to Level 2. This would ensure enhanced surveillance, active case finding and robust community engagement.

Liberia’s President George Weah reacted to the new Guinea outbreak by ordering health authorities ‘to heighten the country's epi-surveillance and preventative activities’.

Coincidentally, the 54-year-old footballer-turned-politician was in the region that borders Guinea, as part of his three-year anniversary tour of Liberia, when news of the resurgence broke.

A senatorial aspirant at the time of the 2014 Liberia outbreak, Weah had teamed up with the Ghanaian singing sensation, Sidney, to create an Ebola awareness song during the last outbreak.

Now president, he has instructed health officials to ‘immediately engage communities in towns and villages bordering Guinea and increase anti-Ebola measures.’

Amid the panic, Liberian health authorities reported one suspected case of Ebola in a woman with malaria-like symptoms who had been to the Guinean town of Nzerekore on February 12. The country’s minister of health, Wilhelmina Jallah, later confirmed that the woman had tested negative for the disease.

The outbreak of Ebola in Liberia in March 2014 exposed the weakness of the health sector of Africa’s oldest independent republic.

A lack of personal protective equipment (PPE) caused healthcare workers to succumb to the disease in that outbreak, and led to hospitals and clinics turning their back on potential Ebola patients out of fear.

The 2014-16 outbreak overwhelmed Liberia.

Burial teams were unable to cope with the number of dead, and a large Indian-owned crematorium in a township southeast of Monrovia had to be opened. Meanwhile, thousands of non-Ebola patients died of curable diseases for fear of being diagnosed with Ebola if they reported to hospital.

Since the defeat of Ebola, the Liberian government has not said what it intends to do with the ashes and remains of victims of the 2014-16 outbreak.

There are suggestions that those who had been buried hurriedly in shallow graves prior to the introduction of cremation could be exhumed and reburied in a more dignified way.

Before the February return of Ebola to the sub-region, people from the Mano River Union countries nervously monitored news from the Democratic Republic of Congo (DRC), which was combating its own Ebola outbreak.

The outbreak is the DRC’s 12th since Ebola was first discovered in 1976 in isolated villages on the banks of the river after which it is named.

The latest DRC outbreak comes less than three months after a separate outbreak in the western province of Equateur officially ended in November 2020. 

It’s the airborne delivery service that’s transformed healthcare provision in Ghana and Rwanda.

While many people might think companies like Amazon will be the first to start with drone delivery services, few realize the technology has already been in use in Africa for several years - and for a far greater purpose.

Medical start-up Zipline has been using drones to deliver life-saving medicineand blood transfusions in Rwanda for four years and in Ghana for nearly two years.

And the US company is set to expand its drone-delivery service to Kaduna in Nigeria. 

The service will operate 24 hours a day, seven days a week, from three distribution centres – each equipped with 30 drones – and will deliver to more than 1,000 health facilities serving millions of people across the populous Nigerian state. 

The Silicon Valley-based logistics company has also started to play a growing role in the fight against the Covid-19 pandemic.

In Ghana, Zipline began delivering Covid-19 test samples collected from patients in more than 1,000 rural health facilities to labs in the country’s two largest cities, Accra and Kumasi.

The service allowed the government to monitor and respond to the spread of the disease in some of the country’s most remote and difficult-to-reach areas, and reduced testing time from days to hours in some cases. 

In Rwanda, Zipline worked with global health non-profit organisation Partners In Health to ensure that quarantined cancer patients, who were unable to travel to the hospital for care and consultation, could continue to receive their chemotherapy treatments during the height of lockdown. 

Meanwhile, in the US, Zipline launched the first long-distance emergency drone logistics operation for hospital pandemic response, transporting deliveries of personal protective equipment to frontline medical teams in Charlotte, North Carolina. 

Recently, the start-up announced a partnership with a major manufacturer of Covid-19 vaccines to build an end-to-end distribution system that will see the company distribute the vaccines in the countries where it operates.

‘Where you live shouldn’t determine whether or not you get a Covid-19 vaccine,’ said Zipline CEO Keller Rinaudo.

The drone company wants to help rural areas that have been hard hit by the coronavirus.

‘We can help health systems bypass infrastructure and supply chain challenges through instant delivery.’ 

The Covid-19 vaccine delivery service should help health facilities avoid the need for ultra-low-temperature freezers by receiving on-demand deliveries of the precise number of vaccines they require at any time, safely and compliantly within the required temperature profile.

‘We will build ultra-low freezers at all of our distribution centres. And we are developing special packaging that will help maintain safe temperatures in flight to allow the vaccine to be used within five hours,’ Justin Hamilton, Head of Global Communications and Public Affairs at Zipline, told NewsAfrica.

Zipline declined to specify its vaccine partner but said it has built a system that can deliver ‘all leading Covid-19 vaccines.’ 

It was initially thought that the vaccine developed by Pfizer and BioNTech must be stored in extreme cold temperatures of -70C, requiring special freezers. 

But recently, both companies announced that tests have shown that their coronavirus vaccine can withstand warmer temperatures, between -25C to -15C, which are at levels commonly found in pharmaceutical freezers and refrigerators. 

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‘This is good news for the world,’ Zipline’s Head of Communications said.

‘But we want to be in a position to deliver all vaccines at any temperature. They will still be a scarce commodity that needs to be distributed efficiently and effectively.’ 

A Pfizer spokeswoman said it supports Zipline’s efforts to expand access to vaccines and medicines to those in hard-to-reach geographies.

‘We share Zipline’s commitment to innovative solutions to ensure equity in the distribution of vaccines and medicines, she said, though she declined to specifically confirm a deal had been signed with Zipline.

Zipline expects to be ready to deliver Covid-19 vaccines in all the markets where it operates from next month.

The company’s fixed-wing, battery-powered drones navigate by GPS.

The unmanned aircrafts are able to carry 1.6 kg of medical supplies – about the weight of three pints of blood.

Through a very cleverly designed catapult-type system, the drone plane is accelerated to a 100km per hour (60mph) cruising speed in only 0.3 seconds. 

As take-off and landing are the most difficult stages of a flight, the drones don’t land on the designation but simply drop the supplies in an insulated cardboard box with a simple parachute, which afterwards can be thrown away.

Thanks to this system, clinics don’t need any infrastructure to sign up as a client or a distribution centre. 

Each aircraft can fly 160km (100 mile) roundtrip, in strong winds and rain, day or night, to make on-demand deliveries in 30 to 45 minutes on average.

A single distribution site can operate dozens of drones and supply an area of up to 20,000 square kilometres – or just under 8,000 square miles

Zipline says its drones have flown more than six million kilometres(3.5 million miles) and made nearly 400,000 deliveries in the last five years.

In Rwanda, the company’s drones transported a staggering 20 per cent of all the blood used in transfusions outside of Kigali, leading Zipline’s CEO, Keller Rinaudo, to describe the East African nation as a ‘role model’ for how the rest of the world’s health care systems may one day work.

EXPERT OPINION: Global public health experts Dr David Bell and Muhammad Usman Khan ask whether millions of young Africans need to be vaccinated – and for whose benefit?

Child mortality will almost certainly rise across sub-Saharan Africa this year.

The singular focus on Covid-19 has resulted in an interruption to all other healthcare – as well as growing levels of malnutrition, thanks to lockdown-induced job losses and poverty. 

The World Health Organization (WHO) was at pains to reassure children in developed countries of Father Christmas's immunity to the virus in December, so as not to ruin their year.

Meanwhile, little focus has been given to African children, increasing numbers of whom have been orphaned by HIV/Aids and tuberculosis during the pandemic. 

Sadly, the global health community that, in the past, prioritised HIV/Aids, tuberculosis (TB) and the big child killer, malaria, appears to consider avoidable deaths from such illnesses an acceptable cost in their attempt to reduce transmission of SARS-COV-2.

This paradox is especially true in Africa, where more than 50 per cent of the population is under the age of 19, and additional factors such as the climate, low levels of obesity and other comorbidities, may have left most Africans effectively protected from Covid-19.  

In spite of this, influential organisations in global health are calling for restrictive measures to continue until a Covid-19 vaccine is available and all are vaccinated – sometime in the coming years.  

With wealthy countries and private philanthropy planning to divert large donations to this cause, and a global alliance under the COVAX umbrella gearing up to lead it, there is an urgent need to examine whether this is of benefit to Africa.  

The virus, SARS-COV-2, was initially feared to be highly lethal and capable of killing up to one in 20 infected people.

The initial mortality rates for northern Italy’s elderly looked frightening when transferred to the entire population of the African continent.  

Governments, corralled by the WHO, narrowed their focus on dealing with what was initially presented as an existential threat to medical infrastructure around the world.

But as more data poured in, it became clear that the challenge the virus presented, although serious, was not the global catastrophe previously feared.

Yet seemingly undeterred by emerging data – the infection fatality rate is now estimated at 0.23 per cent, and far lower for those under 65 years of age – global health institutions and governments continue to allocate hefty resources and a blinkered focus on the pandemic with undiminished urgency.  

Half of the billion-plus people in sub-Saharan Africa are under 19 years of age, and we know that most infections in children are barely symptomatic.

Regardless, a climate of fear is being sustained with the media still whipping up fear of a looming ‘catastrophe’ for African countries.  

When most European nations locked down their populations, copying the highly restrictive measures employed in China, the WHO advocated similar measures across Africa.  

This ran contrary to its own prior evidence-based pandemic guidance and with seemingly little regard for the high vulnerabilities to pre-existing epidemics, such as malaria, TB and HIV/Aids, as well as the limited capacity of these populations to absorb income loss.  

The catastrophe currently unfolding in Africa is not due to the coronavirus.

Despite months of community spread in crowded cities, recorded Covid-19 mortality was under 70,000 across the entire continent by January 1, 2021.

If we exclude the Mediterranean countries and South Africa with their differing demographics and high comorbidities, just 13,031 people died of Covid-19 in the rest of the continent in 2020 – that’s approximately one death for every 80,000 people.  

As the figure shows, Covid-19 would likely have gone unnoticed in Africa if we had not been testing for it.

The virus has dominated the policies of donors and international organisations on an unprecedented scale, and while African countries may be easing internally, the focus externally remains on Covid-19, and a vaccine whose roll-out in these populations would defy all previous public health norms.  

This catastrophe goes far beyond health alone.

A generation of children’s schooling has been interrupted. Children from poor and rural families will likely never recover.

Even more alarmingly, girls and young women have been pushed back into the trap of early marriage and poverty.   

Without any serious pushback from its staff, the World Health Organization and wealthy philanthropic foundations have advocated for policies that impoverish, restrict and reduce healthcare access, abandoning previous recommendations advising against such measures.

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In a new form of post-colonial oppression, the rich world, via video meetings on Zoom, have introduced policies that are leading to impoverishment in Africa. 

The rise of large private philanthropies, who arguably dominate the current global public health agenda, has undoubtedly brought great benefits in terms of almost unlimited funding, new ideas and enthusiasm, though this may not always be fully aligned with local priorities.  

Vaccines are a perfect example of this.  

In recent months, the world has been focused on the development and trials of vaccines for SARS-COV-2, in the hope that they will allow a return to normality.  

This had led to a poorly considered campaign of mass immunization being promoted, despite the current lack of evidence that the vaccines have a transmission-blocking effect.

If vaccines don’t stop onward transmission, and just lessen symptoms, it essentially means we will not be vaccinating children for their own health, but in order to protect a small cohort of elderly citizens. 

And given the very low impact of Covid-19 on younger people, and thus on the vast majority of Africans, one has to question why a vaccine for Covid-19 should take precedent over investment in mosquito nets for malaria, for instance.

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A Covid-19 vaccination programme will inevitably reduce the amount of money and manpower to prevent far worse diseases that African children face.

Foreign aid from increasingly cash-strapped donor countries is already being sought for the COVAX mechanism in the name of global equity, while local health staff, logistics and expertise will be drawn from other pressing areas to help vaccinate against Covid-19. 

To justify this approach, some pressure groups are claiming that people in sub-Saharan Africa need to be vaccinated in order to reduce the risks for those living elsewhere.

If we believe the SARS-COV-2 virus can and should be eradicated globally, but we recognise that diverting resources for this programme will cost lives, then we need to acknowledge that the children who are no longer benefiting from other health interventions, are dying for the benefit of mostly elderly and chronically sick people in far wealthier nations, who wish to reduce their own Covid-19 risk.  

This may not be ‘wrong’, if the benefit to Africans can be shown to outweigh the costs.

But clearly, if this is not demonstrated, then the equity argument behind COVAX and the universal Covid-19 vaccination programme becomes unsustainable.

Those of us in the global health community need to pause, question and think for ourselves.

By any normal measure, we are catastrophically failing the people we were entrusted to serve.

The current approach appears to be causing net harm, and African health is at risk of being crushed under a model designed by and for others.  

Covid-19 is a chance to reset, but not through the deaths of children and the impoverishment of tens of millions.

Fixing this will take humility and self-awareness.  

To build a better future, we first need to avoid doing more harm. Let’s hope, collectively, we have the courage and moral decency to undo the mess we have created.

Then we must support the people of these countries in continuing the broad improvements in health care upon which they, with admirable support from both public and private sectors, had previously embarked.  

 

Dr David Bell is a clinical and public health physician with a PhD in population health. He was Director of the Global Health Technologies at Intellectual Ventures Global Good Fund in the USA, Programme Head for Malaria and Acute Febrile Disease at FIND in Geneva, Switzerland, and coordinating malaria diagnostics strategy with the World Health Organization. 

Muhammad Usman Khan is a health policy analyst. Usman has consulted and worked in advisory roles for multiple governments and NGOs.