Africa cannot afford a Zika outbreak

If the latest mosquito-borne Zika virus breaks out in Africa the continent would be less prepared than any other to deal with the outbreak.

Zika fever is a mosquito-borne viral disease caused by the Zika virus which is suspected of leading to the birth of deformed babies. The virus is transmitted to humans when an infected Aedes mosquito stings a person. Direct human to human transmission through sex has also been reported.

The virus has spread to 23 countries in the South American region. Brazil has been the hardest hit with over 3700 cases. Although the outbreak in Brazil has received the most attention, the virus has also since spread beyond the region to the Cape Verde Islands, which are off the coast of Senegal but are not part of the African mainland, Samoa and Tonga.

Global attempts are underway to stop the spread of the virus which has been declared an international emergency by the World Health Organisation (WHO) and the US’s Centre for Disease Control has put out six travel alerts so far.

There are several reasons Africa is least prepared to deal with an outbreak of the Zika virus. This includes the limited laboratory capacity and a lack of experts and funding.

Firstly, the laboratory capacity to test for the virus is limited. Although the clinical features of the Zika virus are known, these are non-specific. This means other known diseases, such as malaria, have some—though of course not all—of the same signs and symptoms.

That Zika may appear like several other diseases makes laboratory testing for the virus imperative. But there are no widely available tests. This is unlike diseases or infections such as malaria and HIV and Aids that have clinically tested and approved commercial laboratory tests or reagents.

Although South Africa has the National Institute for Communicable Diseases, which could manage these tests in a standardised manner, several other countries do not have this capacity. Examples of the few comparable laboratories outside of South Africa are the Uganda Virus Research Institute and the Centre of Excellence for Genomics of Infectious Diseases at Redeemers University in Nigeria. But much of the continent does not have the infrastructural and human capacity to diagnose Zika.

Facilities are not the only challenge. There is also a lack of proactive national and regional health experts to guide the response in case of any outbreak. This is a gap that needs urgent attention, not only for the Zika virus but also to deal with emerging and re-emerging infections.

There is much to learn from the Ebola epidemic which swept through several countries in West Africa in 2014 and 2015.

To effectively deal with the Ebola outbreak, international cooperation and collaboration was vital. Affected national governments, neighbouring nations and both local and international funders all came together to stem the spread of disease.

The international collaboration continues in terms of searching for a vaccine as well as the treatment and care of Ebola patients. We have learned that fragile health systems are more susceptible to infectious diseases epidemics.

Furthermore, unlike in the US, there is not a unified body of health experts on the continent. The available regional bodies such as the West African College of Physicians and the soon to be launched College of Physicians of East, Central and Southern Africa have their jobs cut out already to lead in the health sector.

WHO’s African Regional Office, unlike its Pan American Health Organisation (PAHO), does not proclaim advisories and guidelines apart from those decided at headquarters in Geneva.

As early as July 2013, the African Union Summit identified the need for an African centre for disease control modelled on the on the in the US. Among its responsibilities would be surveillance and response, which would include an emergency operations centre. Although the centre has been launched, it has yet to handle its first epidemic. Until the African centre for disease control is fully active, there is no comparable entity for Africa.

The re-emergence of diseases such as Zika calls for African states and experts, as well as the international community, to join forces to build the continent’s disease response capacities. n