1 Introduction
This chapter examines major activities of the African Union (AU) in the health sector, particularly in 2020. The year 2020 proved to be eventful in global public health history, with significant impact on the global economy. It has been recognised for centuries that human capital is necessary for the development and sustenance of a vibrant economy, and this includes a healthy and educated workforce, making health an important economic variable (see UNECA 2004). Fortunately, health has always been an important sector of the AU’s programmes and activities, and has been part of the bedrock of continental cooperation and integration throughout its history. The preamble of the 1963 Charter of the Organisation of African Unity (OAU) states the desire of all African states to come together and unite in order to improve the welfare and well-being of their peoples. The issue of health is thus, among the prominent factors defining African regionalism. As outlined in Article II of the OAU charter, one of the purposes of establishing the organisation was to ‘coordinate and intensify … cooperation and efforts to achieve a better life for the peoples of Africa’ (OAU 1963, § II[1]b). To this end, member states of the organisation were encouraged to coordinate and harmonise their general policies in different fields, including health, sanitation, and nutrition cooperation (ibid., §II[2]d). Similarly, one of the specific objectives of the 2000 Constitutive Act of the African Union is ‘the eradication of preventable diseases and the promotion of good health on the continent’ (OAU 2000a, §3[n]). Health is therefore an important aspect of the aspiration and agenda of the continental organisation.
In recent times, the importance of health to development has been increasingly recognised, especially considering the health challenges and crises that have befallen countries and regions across the globe. The Covid-19 pandemic, which the World Health Organisation (WHO) declared a public health emergency of international concern in February 2020, shut down the global economy in a way that has continued to devastate communities the world over. While the health effects of the pandemic have not been as devastating as anticipated in Africa, the social, political, and economic effects are quite telling and the region’s existing health challenges are compounded by the global
In Africa, there are several major issues of concern regarding development in the health sector, including the quantity and quality of health systems, endemic diseases, nutrition deficiencies, and health-related challenges in humanitarian contexts. For instance, the Ebola epidemic of 2014, which was also declared a public health emergency of international concern, revealed critical fractures in the health systems of the countries most affected by the epidemic and exposed their vulnerabilities (see Abdullah and Rashid 2017; Ojomo 2017). Similarly, global health indicators have consistently put the continent among the low-performing regions when measuring important health benchmarks.1 Diseases like malaria, tuberculosis (TB), and HIV/Aids have placed a heavy burden on the health systems of African countries for decades and have led to significant fatalities in countries across the region. The continent has the lowest average in life expectancy, relative to the global average and to the record of other regions, and it has high mortality rates for infants and adults. These circumstances reveal a health sector facing widespread challenges that impact human productivity and limit the enjoyment of life. Thus, the AU has an important role to play in promoting the individual and collective development of the health sector of member states.
To give effect to the AU agenda on health, the AU Commission (AUC) is endowed with different structures. At the AUC, there are two divisions responsible for health both of which are located within the AUC’s Department of Social Affairs. These are (1) the Health and Humanitarian Affairs Division – which responds to vital generic health issues related to health policy and delivery systems, nutrition, and other related public health issues and challenges that require a concerted and coordinated approach at a continental level – and (2) the Health Systems, Diseases and Nutrition Division – which plays a leading role in policy development, advocacy, coordination, monitoring, and evaluation on AIDS, TB, and malaria, as well as other infectious diseases.
Moreover, in 2016 the 26th AU Assembly (Addis Ababa, Ethiopia, 30–31 January 2016) established the Africa Centres for Disease Control and Prevention (Africa CDC), which was officially launched in January 2017 (AU Assembly 2016). As a specialised technical institution of the AU, it was established
Furthermore, in 2019 the treaty for the establishment of the African Medicines Agency (AMA) was adopted by the 32nd AU Assembly (Addis Ababa, Ethiopia, 10–11 February 2019) (AU Assembly 2019). The AMA is described as ‘the second continental health agency after the Africa Centres for Disease Control and Prevention (Africa CDC), that will enhance the capacity of States Parties and Regional Economic Communities (RECs) to regulate medical products in order to improve access to quality, safe and efficacious medical products on the continent’ (AUC AMA). The AMA is also expected to promote the harmonisation of standards and coordination of efforts within and among recognised RECs and the Regional Health Organisations (RHOs).
As the AU continues to build its policy and institutional capacity, the year 2020 found it oscillating between attending to long-standing health challenges and confronting the Covid-19 pandemic. This chapter examines how the AU has been able to balance its activities by ensuring that the fight against the Covid-19 pandemic did not occur at the expense of other critical health programmes.
1.1 Facts and Figures about Health in Africa
The major areas of focus of the AU in health matters are malaria, HIV/AIDS, TB, and other infectious diseases, as well as nutrition and the strengthening of health systems. This is rightly so in view of the stark statistics on these issues. The disproportionate global share of Africa in the disease burden, mortalities, and impact on children and communities justifies the placement of high priority by the AU on programmes and activities aimed at strengthening the health systems in member states.
According to the latest World Malaria Report (WHO 2020) released on 30 November 2020, there were approximately one million fewer malaria cases in 2019 (229 million) than in 2018 (228 million) and about 2,000 fewer deaths in 2019 (approximately 409,000) than in 2018 (approximately 411,000). In 2019, children under five years of age accounted for 67 per cent of global malaria deaths, making them the most vulnerable group affected by the disease. The report further records that Africa continues to carry a disproportionately high share of the global malaria burden, with 94 per cent of all malaria cases and deaths in 2019 coming from Africa. In 2019, the following six African countries
Similarly, according to the WHO, HIV continues to be a major global public health issue and has claimed more than 35 million lives so far (WHO RO Africa 2021). In 2018, some 470,000 people died from HIV-related causes, approximately 37.9 million people were living with HIV, and 1.7 million people became newly infected globally. Of these figures, Africa was the most affected region, with 25.7 million people in Africa living with HIV in 2018. The African region also accounts for almost two-thirds of the global total of new HIV infections, and in 2018, about 1.1 million people were infected with HIV in the region.
According to Africa CDC (2021b), in 2016, approximately one-quarter of the 10.4 million people who fell ill with TB were from Africa, and more than a quarter of the 1.7 million people who died from TB globally were from Africa. Nevertheless, the WHO Regional Office for Africa (ROA) reports that there was a yearly decline in TB incidence on the continent from 2011 to 2014, which was expected to continue in subsequent years, while treatment success rate was high and increasing and mortality rate low and declining (WHO ROA 2018, 60, 62).
In terms of nutrition, the 2020 Global Nutrition Report shows that among children under 5 years of age in Africa, the malnutrition burden is noteworthy, although the Africa averages are lower than global averages in some instances. For example, while the regional average prevalence of overweight (4.7%) and wasting (6.4%) is lower than the global average (5.6% and 6.9%, respectively), the regional prevalence of stunting (29.1%) is higher than the global average (21.3%). Among adults in the region, 16.9 per cent of the population live with diabetes while 25.9 per cent are obese.
Available literature on health systems in Africa has shown that there is a gap in the capacity of the health systems to confront these challenges. In particular, it also shows persistent inequities in access to quality and affordable health care between countries and within countries (WHO 2019, 21). The Covid-19 pandemic exposed the grim reality of basic hygiene inequalities in Africa, with data from the WHO/the United Nations Children’s Emergency Fund (UNICEF) revealing that hundreds of millions of Africans lacked access to basic hygiene facilities for handwashing, which is critical for preventing the spread of the virus (Okoi and Bwawab 2020).
These statistics and facts show that Africa has a complex health crisis that has to be addressed in order to have a healthy society that can supply productive labour and build a vibrant market for economic growth while reducing
2 AU Response to Health Challenges
The AU has over the years developed broad policy frameworks for defining its health goals and generating strategies for their achievement. It has also adopted specific programmes targeted at addressing immediate health challenges, including efforts to tackle some of the most pressing health challenges in the region, such as HIV/AIDS, malaria, and TB. In this section, we discuss the comprehensive health agenda of the AU defined in the Africa Health Strategy, then we look at some of the specific policies and programmes developed to address particular health challenges over the past few decades.
2.1 Efforts at Health Integration: Towards a Pan-African Health Project
The AU Executive Council is empowered to coordinate and take decisions on policies related to ‘[e]ducation, culture, health and human resources development’, among other things (OAU 2000a, §13[1]h). As noted above, there are also departments within the AUC that are charged with functions that cover health matters (ibid., §14[1]f). These institutions are charged with a general task that flows from the statutory justification for health cooperation among African states, demonstrating the recognition of health as an important tool for enhancing social and economic development and integration on the continent.
2.1.1 Africa Health Strategy (2007–2015)
As part of its efforts towards strengthening health cooperation and development, the AU, through the AU Executive Council, adopted a health strategy in June 2007 based on the instrument adopted by the 3rd Session of the AU Conference of Ministers of Health (CAMH) (Johannesburg, South Africa, 9–13 April 2007), with the theme ‘Strengthening of Health Systems for Equity and Development in Africa’ (AU Council 2007). The strategy emphasised the role of the AU, member states and the RECs in the ‘strengthening of health systems with the goal of reducing disease burden through improved resources, systems, policies and management’ (CAMH 2007a, 2). This was an attempt to articulate the continent’s health challenges in one instrument and propose broad plans
The strategy identified the following challenges affecting the development of health sectors in member states and across the region (CAMH 2007a, 4–5):
Insufficient sustainable financial resources and the efficient allocation and use thereof;
Lack of social protection for the vulnerable groups especially those in catastrophic situations;
A shortage of appropriately trained and motivated health workers;
Poor commodity security and supply systems and unfair trade practices favouring the rich countries;
Weak health systems operations;
Marginalisation of African Traditional Medicine in national health systems;
Inadequate community involvement and empowerment;
Capacity of the private sector, including NGOs [non-governmental organisations] is not fully mobilised;
Paucity and inadequate use of available evidence and information to guide action including use of ICT [information and communications technology];
Effective co-ordination with other sectors and harmony with partners not yet attained;
Lack of optimal intersectoral action and coordination;
Restrictive and disruptive global policies (e.g. structural adjustment programmes and unfair terms of trade), conditionalities and actions that adversely impact on Africa’s health systems; and
Gaps in governance and effective leadership of the health sector.
In addition to this, the strategy identifies central guiding principles to govern the implementation of the strategy, including the recognition of health as a human right, health as a productive sector, and the requirement for cross-border cooperation in the management of diseases, among others. The role of regional and subregional institutions in advancing the health agenda is core to the Africa Health Strategy. Consequently, the AU instructs the RECs and member states to build their capacity for implementation of the strategy. This reveals the importance of subregional programmes – through the RECs – for the implementation of the continental strategy.
2.1.2 Africa Health Strategy (2016–2030)
seeks to provide strategic direction to Africa’s efforts in creating better performing health sectors, recognizes existing continental commitments and addresses key challenges to reducing the continent’s burden of disease, while also drawing on lessons learned and existing opportunities. (AUC DSA 2016, 8)
The strategy relies on the following policy frameworks to identify and advance approaches for the implementation of health programmes for development (AUC DSA 2016, 13):
- –Agenda 2063: The Africa We Want
- –Sustainable Development Goals
- –2015 Addis Ababa Action Agenda on the 3rd High-Level Conference on Financing for Development
- –Global Strategy for Women’s, Children’s and Adolescent Health (2016–2030)
- –AU Roadmap
- –2016 Catalytic Framework to end AIDS, TB and eliminate Malaria by 2030
- –2006 Continental Policy Framework for Sexual and Reproductive Health and Rights and its Maputo Plan of Action (2016–2030)
- –2007 Pharmaceutical Manufacturing Plan for Africa
- –African Regional Nutrition Strategy (2015–2025) and
- –AU Decade on Traditional Medicines (2001–2010).
Relying on the same guiding principles adopted under the 2007 strategy, the 2016 strategy identifies the following two strategic objectives: achieving universal health coverage by 2030; and reducing morbidity and ending preventable mortality from communicable and non-communicable diseases and other health conditions. To achieve these objectives, the strategy identifies thirteen strategic approaches, including, among others, surveillance, emergency preparedness and response; expanding social protection; health financing; health research and innovation; leadership and good governance; and multi-country collaboration. As with the 2007 strategy, the 2016 strategy particularly recognises the importance of the RECs in facilitating its implementation, noting that the RECs play a special role in providing technical assistance to member states; advocating increased resources; harmonising standards and their implementation; monitoring and reporting progress; and identifying and sharing best
The RECs, like the Economic Community of West African States (ECOWAS) and the Southern African Development Community (SADC), have adopted comprehensive legal and institutional mechanisms for health cooperation within their spheres of operation. The RECs act as a forum for closer cooperation among states with tighter geographical and historical ties, and this cooperation feeds into the broader cooperation at the continental level.
In the case of ECOWAS, the 1975 treaty establishing the community makes no mention of health, neither as a policy focus nor as a broad objective. There is a mention of cooperation in social and cultural matters but there is no specific mention of health (ECOWAS 1975, §60[2]). In the 1993 Revised Treaty of ECOWAS, health is recognised as an important objective of the integration project. Among the aims and objectives of the community is ‘the harmonization and coordination of national policies and the promotion of integration programmes, projects and activities, particularly in … health’ (ECOWAS 1993, §3); member states also undertake efforts to ‘encourage and strengthen cooperation among themselves in health matters’ (ibid., §61). Health is also recognised as an important objective of cooperation in science and technology (ibid., §27[1]b), while trade restrictions are permitted for the protection of human health, among other things (ibid., §41[3]c). In addition to these statutory endorsements of health cooperation, the West African Health Organisation (WAHO) was established on 9 July 1987 for the purpose of promoting the attainment of the highest standards of health in member states (WAHO 2021). WAHO acts a platform for cooperation among ECOWAS member states on all health matters. It is headquartered in Bobo-Dioulasso, Burkina Faso.
While the WAHO protocol presents a broad framework for health cooperation in all relevant matters, the 1999 Protocol on Health in SADC provides both general and specific provisions for health cooperation, identifying areas such as mental health, trauma, environmental health, reproductive health, and occupational health, among others. The SADC protocol also places a particular focus on combatting HIV/AIDS/ sexually transmitted diseases (STDs) through regional policies and cooperation (SADC 1999, §9).
The AU’s Africa Health Strategy provides the most comprehensive articulation of a regional plan on health, including the relevant policy frameworks, vision, and mission for health development in the region; the objectives and operational approaches; and the institutional components and functions. Although the AU does not have a specialised health agency like the WHO or WAHO, its organisational structure provides for a health component in its
2.1.3 Agenda 2063: The Africa We Want
On 25 May 2013, 50 years after the establishment of the OAU, African leaders adopted the 50th Anniversary Solemn Declaration to celebrate past successes of integration and commit to greater efforts towards achieving their sustained goals. Agenda 2063 represents a ‘shared framework for inclusive growth and sustainable development for Africa’ that is meant ‘to translate the ideals [of the Solemn Declaration] into concrete objectives, milestones, goals, targets and actions/measures’ (AUC 2021). The agenda lies at the core of all development initiatives on the continent, and the RECs are expected to adopt it and apply it to the implementation of their development programmes. Aspiration 1 of the agenda is a ‘prosperous Africa based on inclusive growth and sustainable development’, and this covers the promotion of health and social development on the continent. As noted above, the agenda is one of the key instruments that offer the underlying policy guidance for the Africa Health Strategy (2016–2030).
2.2 Regional Responses to Critical Health Challenges
In addition to the above-mentioned general initiatives that underlie the health policies and programmes of the AU, there have been specific programmes aimed at targeting particular health challenges, especially diseases that are endemic to the region, like malaria, or diseases with a high prevalence like HIV/AIDS. These specific policies and programmes have formed the core of the regional health initiative that drives subregional and national health plans and their implementation as well as the focus of international development partnership in health. Below are some of the most prominent health policies and programmes that have shaped the regional landscape in this regard.
2.2.1 1997 Harare Declaration on Malaria Prevention and Control in the Context of African Economic Recovery and Development
Noting that more than 4,200 lives and $5 million were lost daily to malaria, member states at the 33rd OAU Assembly (Harare, Zimbabwe, 2–4 June 1997) declared their commitment to make malaria eradication a priority and commit to partnerships at all levels and across sectors for the purpose of ending malaria on the continent (OAU 1997). The Harare Declaration contained a proposed plan of action with the following eight priority areas: health systems; disease management; provision of anti-malarial drugs; disease prevention; disease surveillance and epidemic detection and control; sustainable control; human resources development; and interdisciplinary operational research.
In response to the WHO’s Roll Back Malaria initiative, introduced in 1998, an Extraordinary Summit of the OAU Assembly (Abuja, Nigeria, 24–25 April 2000) adopted the Abuja Declaration to show their commitment to the initiative and pledge their support to its implementation by making specific undertakings to that effect (see OAU 2000b). The declaration noted that malaria was the cause of more than a million deaths and more than $12 billion was lost to malaria in the region annually, with about 90 per cent of malaria cases happening in sub-Saharan Africa. The declaration contains a pledge to halve malaria mortality by 2010 and make correct, affordable, and appropriate treatment available to 60 per cent of the population, among other things. Member states and development partners are also called upon to commit specific resources to the implementation of the Initiative. The declaration also makes 25 April World Malaria Day.
2.2.3 2000 Lomé Declaration on HIV/Aids in Africa
This declaration was adopted in July 2000 at the 36th Ordinary Session of the OAU Assembly (Lomé, Togo, 10–12 July 2000), which noted, among other things, their grave concern over ‘the widespread incidence of HIV/AIDS and the ravages caused by other pandemics such as malaria, which seriously undermine Africa’s development efforts’ (OAU 2000d, preamble). The accompanying Lomé Declaration (OAU 2000d) presents a more detailed elaboration of the plan of African leaders to intensify the fight against HIV/AIDS, including their endorsement of several instruments for that purpose: the Algiers Common Position and Plan of Action on Strategies to support HIV/AIDS Orphans, Vulnerable Children and Children Infected by HIV/AIDS adopted by the OAU Labour and Social Affairs Commission; the Algiers Appeal by the OAU Labour and Social Affairs Commission for the Intensification of the Fight against AIDS in Africa; the Ouagadougou Commitment for Action for the Implementation of the Declarations, Decisions and Recommendations of the Heads of State and Government of the OAU aimed at strengthening HIV/AIDS control in Africa; and the Framework of the International Partnership on AIDS in Africa in order to intensify the health sector response to the HIV/AIDS epidemic.
AIDS Watch Africa (AWA) is an advocacy platform of the AU created at the Abuja Special Summit (Abuja, Nigeria, 24–27 April 2001) (OAU 2001a, 2001b), in line with the perspectives promoted in the Lomé Declaration and other related regional and global strategies, including the Africa Health Strategy and the UN Sustainable Development Goals. Its main objective is to ‘lead advocacy, resource mobilization and accountability efforts to advance a robust African response to end AIDS, TB and malaria by 2030’ (AIDS Watch Africa 2021). Its governance structure comprises the AWA Heads of State and Government
2.2.4 2006 Continental Policy Framework for Sexual and Reproductive Health and Rights
This continental policy framework was adopted by the 2nd Session of the AU CAMH (Gaborone, Botswana, 10–14 October 2005), and it was subsequently endorsed by the 8th Ordinary Session of the AU Executive Council (Khartoum, Sudan, 16–21 January 2006) (see AUC 2006). It seeks to prioritise sexual and reproductive health and to improve access to services and financing for health challenges. The framework formed the basis for the subsequent plan for its implementation, the Maputo Plan of Action for the Operationalisation of the Sexual and Reproductive Health and Rights Continental Policy Framework (2016–2030), which was adopted during a Special Session of the AU CAMH (Maputo, Mozambique, 18–22 September 2006) (CAMH 2006). The plan is ‘a short-term plan for the period up to 2010 built on nine action areas: Integration of sexual and reproductive health (SRH) services into PHC, repositioning family planning, developing and promoting youth-friendly services, unsafe abortion, quality safe motherhood, resource mobilization, commodity security and monitoring and evaluation’ (ibid., 2).
2.2.5 2006 Abuja Call for Accelerated Action towards Universal Access to HIV/AIDS, Tuberculosis and Malaria Services in Africa
This is a plan of action adopted by the AU Assembly to intensify action by governments and their partners in the fight against HIV/AIDS, malaria, and TB in Africa (AU Assembly 2006). The call stipulates particular action points to be taken through engaged partnership between states, the RECs, civil society, the private sector, and international development partners and sets timelines for monitoring and implementation. In 2010, a five-year review of the call was undertaken, leading to the extension of the call to 2015, when it was again extended to 2030.
2.2.6 2007 Pharmaceutical Manufacturing Plan for Africa
This plan was developed by the AUC within the framework of the New Partnership for Africa’s Development (NEPAD), pursuant to instructions from the AU Assembly and the AU CAMH in 2005. It was adopted in 2007, with the main objective to promote the local manufacturing of drugs in Africa (CAMH 2007b). To this end, it highlights the technical and political challenges exacerbating
2.2.7 2013 Abuja Declaration of the Special Summit of African Union on HIV/AIDS, Tuberculosis and Malaria
At a special summit themed ‘Ownership, Accountability and Sustainability of HIV/AIDS, Tuberculosis (TB) and Malaria Response in Africa: Past, Present and the Future’, the AU Assembly adopted a declaration on HIV/AIDS, TB, and malaria. The declaration was themed ‘Abuja Actions Toward the Elimination of HIV and AIDS, Tuberculosis and Malaria by 2030’ (AU Assembly 2013). The declaration set out specific proposals for tackling the health issues identified and called on national authorities and the RECs to adopt and implement strategies towards implementation while also setting up a monitoring timeline for its proposals.
2.2.8 Abuja +12: Shaping the Future of Health in Africa
This is a set of commitments by African leaders to continue more fervently to tackle the health challenges in the region, particularly to address the scourge of HIV/AIDS, TB, and malaria (UNAIDS 2013). It provides an overview of the progress made and the persistent challenges encountered since the adoption and implementation of the Abuja Declaration. The recommendations put forward are:
- –Unite leadership for a healthy Africa
- –Generate innovative financing solutions
- –Make smart investments for greater health returns
- –Strengthen Africa’s human health resources
- –Leave no one behind.
2.2.9 African Union Support to Ebola Outbreak in West Africa (ASEOWA)
Shortly after the Ebola outbreak in West Africa in 2014, AU leaders, under the auspices of the Peace and Security Council, adopted a communiqué to provide much-needed support to the countries affected by the outbreak (AU PSC 2014). The decision endorsed the deployment of an AU-led military and civilian humanitarian mission, with the first deployment arriving in Liberia on 15 September 2014, less than a month after the establishment of ASEOWA on 20 August 2014. By November, ASEOWA teams had been deployed to Guinea, Liberia, and Sierra Leone, as the AU continued to engage citizens across the
2.2.10 2016 Catalytic Framework to end AIDS, TB and eliminate Malaria by 2030
In 2016, African leaders endorsed the framework, which was adopted by African ministers of health during the Working Group of the Specialised Technical Committee on Health, Population and Drug Control (African Union 2016, 4). The main aim of the framework is to ‘intensify the implementation of the Abuja +12 commitments by building Africa-wide consensus on the key strategic actions within the context of the existing targets and milestones’ (ibid., 8).
2.2.11 African Regional Nutrition Strategy (2015–2025)
The regional nutrition strategy is a multi-year blueprint of ideas and programmes for promoting nutrition and food security in Africa (African Union 2015). The first strategy was presented by the OAU and adopted by the International Conference on Nutrition (Rome, Italy, 5–11 December 1992). The 1993–2003 strategy was revised by a 2005–2015 strategy. The current strategy is the 2015–2025 instrument, which highlights the challenges of malnutrition on the continent and proposes a clear institutional path towards the implementation of existing plans and programmes. The 2015–2025 strategy situates ‘the AUC as an implementing institution focusing on promoting the execution of existing policies and frameworks’ (ibid., 5). It presents the following clear targets (ibid., 13):
- –40 per cent reduction of the number of African children under 5 years who are stunted by 2025
- –50 per cent reduction of anemia in women of child-bearing age in Africa by 2025
- –30 per cent reduction of low birth weight in Africa by 2025
- –no increase of overweight in African children under 5 years of age by 2025
- –increase exclusive breast-feeding rates during the first six months in Africa to at least 50 per cent by 2025 and
- –reduce and maintain childhood wasting in Africa to less than 5 per cent by 2025.
3 AU Health Activities in 2020: The Covid-19 Response
The major health issue that dominated the attention of the AU in 2020 was the Covid-19 response (see the interview, this Yearbook, chapter 2). While the Covid-19 pandemic has resulted in a global crisis of multiple dimensions,
As noted above, the Covid-19 pandemic dominated the global health landscape in 2020, and in Africa, the pandemic took centre stage. Although there were other health initiatives, particularly those based on the existing strategies and programmes, its effect on other sectors also impacted other health concerns and plans given the critical impact of the pandemic. For instance, the AUC’s Department of Rural Economy and Agriculture produced a White Paper on the COVID-19 Crisis and the Seed Sector in Africa: Impact, Options for Actions and Recommendations (AUC DREA 2020). This revealed the impact of the pandemic on agricultural activities, which led to concerns about food and nutrition security on the continent. Some of the identified impacts include increased transaction costs; delays in distribution; reduced imports and exports; reduction in availability of quality seeds; delays in service delivery; and limited legislative and regulatory framework (ibid., 3–5). The white paper contains recommendations for governments to prioritise agricultural production, being essential to the health conditions and challenges created or worsened by the pandemic.
While the current focus on health for the past year has been on fighting the global pandemic, the role of cooperation in strengthening health systems and tackling health crises is not new, and the AU made available an important collective platform for African states to tackle the pandemic. The AU’s response was primarily driven by Africa CDC, which developed the following six initiatives with regard to the regional Covid-19 response: the 2020 Africa Joint Continental Strategy for COVID-19 Outbreak; Africa Task Force for Coronavirus (AFTCOR); Partnership to Accelerate COVID-19 Testing in Africa (PACT); Africa Medical Supplies Platform (AFSP); Consortium for COVID-19 Clinical Vaccine Trials (CONCVACT); and Africa against COVID-19: Saving Lives, Economies
Below are some of the additional programmes, activities and reports issued by the AU in response to the Covid-19 pandemic. On 13 April 2020, the AU Executive Council requested that the AUC chairperson establish a Covid-19 response fund ‘with the objective to fight the socio, economic and humanitarian aspects arising from COVID-19 and to further boost the capacity of Africa CDC’ (AU Council 2020, §6). On 24–25 June 2020, the AUC and Africa CDC held a conference on ‘Africa’s Leadership in Covid-19 Vaccine Development and Access’, involving ‘African leaders, pharmaceutical industry experts, and partners to discuss a roadmap for the development of safe, efficacious, affordable, equitable and accessible COVID-19 vaccine in Africa, with the involvement of Africans’ (Africa CDC 2020). And in November 2020, Africa CDC published a Q&A sheet on the Covid-19 vaccine to provide basic information drawn from common speculations and frequently asked questions about the Covid-19 vaccine (Africa CDC 2020b). Furthermore, Africa CDC, in collaboration with the South African Medical Research Council (SAMRC) held a conference on ‘Framework for Fair, Equitable and Timely Allocation of Covid-19 Vaccines in Africa’ (December 2020), where leading public and private sector personalities – including the UN under-secretary-general and executive secretary of the UN Economic Commission for Africa, the president of the Africa Export-Import Bank (Afreximbank), and the director-general of WAHO – discussed strategies for making vaccines available and accessible in Africa. The regional response to the pandemic by the AU primarily through Africa CDC displays a multifaceted engagement with various stakeholders.
4 The AU and Health: An Appraisal
The African Union has been active for decades in developing health policy and strategy to guide national and regional health programmes and activities. The OAU, prioritised health as an important ingredient for development, and the AU pursued this approach to integration and development by sustaining and further developing some of the OAU programmes while also devising new programmes to address health challenges. There has been an aggressive regional approach to addressing the most pressing health challenges on the continent, including endemic diseases such as HIV/AIDS, TB, and malaria;
References
Sources
Africa CDC 2020a. ‘Africa’s Leadership Role in COVID-19 Vaccine Development and Access’. Virtual Conference, Addis Ababa, 24–25 June 2020. URL: <https://africacdc.org/event/africas-leadership-role-in-covid-19-vaccine-development-and-access/> (accessed: 30 June 2020).
Africa CDC 2020b. ‘Questions and answers on COVID-19 Vaccine’. Addis Ababa: Africa CDC, 4 December. URL: <https://africacdc.org/download/questions-and-answers-on-covid-19-vaccine/> (accessed: 30 June 2020).
Africa CDC 2021a. ‘Our History’. Addis Ababa: Africa CDC. URL: <https://africacdc.org/about-us/our-history/> (accessed: 30 June 2021).
Africa CDC 2021b. ‘Tuberculosis’. Addis Ababa: Africa CDC. URL: <https://africacdc.org/disease/tuberculosis/#:~:text=In%20the%20same%20year%201.7,of%20the%20Sustainable%20Development%20Goals> (accessed: 30 June 2021).
African Union 2015. African Regional Nutrition Strategy 2015–2025. Addis Ababa: African Union. URL: <https://au.int/sites/default/files/pages/32895-file-arns_english.pdf> (accessed: 30 June 2021).
African Union 2016. ‘Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030’. Adopted by the Working Group of the Specialised Technical Committee on Health, Population and Drug Control, Experts Meeting, 25–26 April, Addis Ababa, Ethiopia, and the Ministers of Health Meeting, Geneva, Switzerland, 21 May. URL: <https://au.int/sites/default/files/newsevents/workingdocuments/27513-wd-sa16949_e_catalytic_framework.pdf> (accessed: 30 June 2021).
AIDS Watch Africa 2021. ‘About Us’. Addis Ababa: African Union. URL: <https://aidswatchafrica.net/about-us/> (accessed: 30 June 2021).
AU Commission 2021. ‘Agenda 2063: The Africa We Want. Background Note. Addis Ababa: AU Commission. URL: <https://au.int/sites/default/files/documents/33126-doc-01_background_note.pdf> (accessed: 30 June 2021).
AU PSC 2014. ‘Press Statement issued after the 450th PSC meeting held in Addis Ababa, Ethiopia, on 14 August’. PSC/PR/BR. (CDL).
AUC AMA 2021. ‘Infographic’. Addis Ababa: AU African Medicines Agency (AMA)’. Addis Ababa: AUC Department of Health, Humanitarian Affairs and Social Development. URL: <https://au.int/sites/default/files/documents/40313-doc-ama_infographic_eng.pdf> (accessed: 30 June 2021).
AUC DREA 2020. ‘White Paper on the COVID-19 Crisis and the Seed Sector in Africa: Impact, Options for Actions and Recommendations’. Addis Ababa: AUC Department of Rural Economy and Agriculture. URL: <https://au.int/sites/default/files/documents/39568-doc-white_paper_on_covid_rev1.pdf> (accessed: 30 June 2021).
Global Nutrition Report 2020. ‘Country Nutrition Profiles: Africa’. ULR: <https://globalnutritionreport.org/resources/nutrition-profiles/africa> (accessed: 30 June 2021).
WAHO 2021. ‘Who We Are’. Bobo-Dioulasso: West African Health Organization. URL: <https://www.wahooas.org/web-ooas/en/who-we-are> (accessed: 30 June 2021).
WHO ROA 2021. ‘HIV: Overview’. Brazzaville: WHO Regional Office for Africa. URL: <https://www.afro.who.int/health-topics/hivaids> (accessed: 30 June 2021).
Literature
Websites
AUC Department of Social Affairs. URL: <https://au.int/en/sa>.
WHO Regional Office for Africa. URL: <https://www.afro.who.int>.
Most of the data used in this paper comes from WHO records, which rely on the regional data coming from the WHO Regional Office for Africa (WHO ROA). This does not cover the entire membership of the African Union or all states within the continent, but is limited to 47 countries, thus excluding Djibouti, Egypt, Libya, Morocco, Somalia, Sudan, and Tunisia from the records of the ROA.