Prof Stanley Okolo, WAHO DG Speaks on COVID-19: "We remain optimistic"
Less impacted than the rest of the world, Africa is also suffering from the coronavirus pandemic. There are some who predict several million deaths in Africa. In the Economic Community of West African States (ECOWAS), each country has its own response plan, but the West African Health Organization (WAHO), a specialized ECOWAS institution with headquarters in Bobo-Dioulasso, is responsible for coordinating the fight against the virus. Professor Stanley Okolo, Director General of WAHO, says ECOWAS "remains optimistic" while working to have "context-specific mitigation strategies and measures to minimize the potential impact of shortages of health products and commodities".
Question: At what level is WAHO in the fight against the covid-19 pandemic?
Prof Stanley Okolo: The West African Health Organization (WAHO), has been designated as the lead agency to coordinate the COVID-19 ECOWAS regional response. By its founding protocol and in line with the political mandate by the Heads of State and Government of ECOWAS countries, WAHO works collaboratively with country governments, through the Ministries of Health and other key ministries, departments and agencies, to safeguard the health of the population.
WAHO has been given the mandate to coordinate this fight within the ECOWAS region. What are the specific missions of your organization in this coordination role?
Within the framework of the fight against the COVID-19 pandemic, the Heads of State and Government of the ECOWAS countries have instructed WAHO to continue their efforts of regional coordination, collaboration and communication, particularly through the strengthening of the networks of National Public Health Institutes and laboratories and to focus support to the ECOWAS Member States on:
- The overall evolution of COVID-19 in the region using all available epidemiological and laboratory data to inform decisions, forecast regional demand for diagnostic and critical medical equipment (e.g. PPE) and determine the relevance of surveillance, testing, isolation protocols and approaches to case management.
- Provision of reagents for biological diagnostic kits, sampling and transport; personal protective equipment to avoid stock-outs; and
- Multi-level training of health workers.
WAHO is also mandated by the Heads of State and Government to coordinate the interventions carried out by our technical and financial partners with the aim of creating maximum synergy, avoiding duplication and increasing the impact of interventions.
Is this coordination easy given that countries are not at the same level and that each country has its own response plan?
Each ECOWAS member country has its own action plan based on its epidemiological and organizational context, among other things. WAHO collaborates with each member country in the implementation of its plan.
Facilitation of communication between countries is an important tool for harmonization of implementation procedures, capacity building.
WAHO, and moreover ECOWAS countries do not pretend to have equal plans.
What difficulties are you facing in the fight against the pandemic and what can be the solutions?
ECOWAS countries are generally applying the "test-track-treat" strategy, although at different levels of implementation.
This implies a large capacity to carry out tests, in particular reagents, human and material resources in quality and quantity to ensure contact tracing and the management of cases including intensive care if necessary.
The sustainability of this strategy is the major challenge for ECOWAS and its member countries. To meet this challenge, ECOWAS supports the local production of diagnostic tests, personal protective equipment, bulk purchase of the most essential health supplies, and establishment of a security stock and the strengthening of training programs.
What do you expect from ECOWAS member countries at a time when the worst is predicted for Africa?
While we acknowledge the predictions of exponential increases in COVID-19 cases and the socioeconomic impact of the pandemic across member countries, Africa and specifically the ECOWAS region can be said to be at an advantage with its large young population which constitutes about 19% of the global youth population. This is especially important based on the available COVID-19 data which shows that the severity of cases are with the older population, persons with comorbidities and persons with compromised immunity.
We remain optimistic as we continue to work collaboratively as a region, to get context specific strategies and mitigation measures to minimize potential impact of shortages of health commodities and supplies such as Personal Protective Equipment (PPEs) and test kits as well as human resources and limited access to essential health services. WAHO remains convinced that through building the resilience of member countries and strengthened regional integration, we will find sustainable solutions to the challenges we face because we believe that ECOWAS is stronger together!
On 30 April, the WHO-AFRO held a press conference during which it expressed its concern about the evolution of the disease in Africa, more specifically in West Africa, in ECOWAS member countries. What actions are being taken to contain the disease in this part of Africa?
WHO-AFRO has expressed its concern about the evolution of this pandemic in Africa. Certainly, countries with more health problems in general are of particular concern.
We know that there are countries in West Africa whose health systems are already very fragile (or very weakened by social and/or political instability) as indeed in other parts of our continent.
All ECOWAS countries have developed action plans to combat Covid-19 and are carrying out specific actions in terms of national coordination, risk communication and community engagement strategy, surveillance, strengthening of rapid response teams and contact tracing, surveillance of entry points, laboratory diagnosis, infection prevention and control, case management and operational and logistical support.
As mentioned earlier, WAHO and other partners, particularly WHO, are supporting the implementation of these plans.
What is the specificity of the ECOWAS countries in the fight against the pandemic of the novel coronavirus?
Each country has its own context and its social, economic and political dynamics. Moreover, the same epidemic evolves in different ways according to these different contexts. From this point of view all countries are different from each other.
However, West Africa has the additional advantage of being the only region in Africa with a regional health institution with the political mandate for regional coordination and promotion of integration. Leveraging on this mandate, WAHO is able to ensure the efficiency and effectives of coordinating the regional COVID-19 response.
In West Africa, some countries are in the process of lifting measures that have been established to contain the spread of the virus, while there has been no improvement in the health crisis. What do you think of these relief measures and what might be the consequences?
As previously mentioned, COVID-19 pandemic has significantly impacted on the global economy. The impact varies depending on the region and context with low and middle income countries (LMIC), being predicted to be the worst hit.
With that in mind, it is important to recognize that importance of adhering to infection prevention and control measures and guidelines put in place to reduce the scale of spread. These measures include social and physical distancing which requires using non-contact greetings, maintaining a distance of at least 1.5 meters between you and other people, and staying at home when ill and other isolation and quarantine measures. These public health and social measures have been known to significantly reduce community transmission, however, considering regional context where there is a lack of or limited access to basic amenities of water to support sanitation and hygiene practices such as handwashing for instance or where we have large household sizes and dense populations, this acceptable strategy becomes additionally challenging to implement without a heightened risk of losing the health gains made over the years.
For member countries, it is a delicate balance of choice as they grappling with the question of the proven benefits of social distancing restrictions against the disruption of the livelihoods of populations within the region, most of which live below the poverty line, thereby exposing them to acute financial shock. These restrictions has also triggered increased cases of gender based violence, civil unrest and violence, increased shortage of food and inflation which can exacerbate the spread of the coronavirus.
The restrictions also impacted on trade and travel with significant economic implications especially for economies with little or no safety nets and where semi-formal and informal enterprises constitute the bulk of the economy.
However, WAHO, working closely with member states, continue to develop, adapt and provide context specific and evidence based advisories and guidelines for ECOWAS countries who have decided to relax these measures. Some of these measures include reviewing workplace and business continuity guidelines, travel restrictions with specific considerations for port of entry screening, school closures and ban on large gatherings while prioritizing the protection of the most vulnerable. These guidelines also include prioritization of social and behavior change communication as a catalyst for promoting positive health practices. Access to running water, soap and other hygiene supplies and communication equipment - including radios and mobile phones - can enable or hinder the adoption of safe public health behaviors.
WHO encouraged countries to test as much as possible. Is this possible in West Africa? If not, what contribution can WAHO make to the success of such a project?
Yes! Certainly testing is one of the most important strategies. However, there is currently a global shortage of tests and high demand. This has also contributed the cost of tests thereby limiting the targeted number of testing that is required to identify cases per population within the region as compared to countries in Europe and now, America, which has the highest number of confirmed cases and currently has tested 32,594 per 1 million population.
In the West Africa region, member countries are using varying testing strategies. Some of the strategies used by countries include massive testing, testing of active cases and contacts of confirmed cases as well as testing of possible contacts within a geographic locations – hot spots and among certain populations.
Interview by Françoise DEMBELE