This article is written by Samuel Sheku Kargbo, Consultant Epidemiologist, Consultant at World Health Organisation; Aspen New Voices Senior Fellow.

  • The problem: African countries are prone to frequent epidemics, but the response capabilities remain suboptimal.
  • Why it matters: Some of these epidemics have the potential to negatively impact global health and the economy.
  • The solution: The improvement in the state of preparedness of the African countries will serve to nip things in the bud and forestall major public health disasters.

11 March marks four years since the World Health Organization (WHO) declared covid-19 a pandemic. The recent upsurge of communicable diseases in epidemic and even pandemic proportions like covid-19 exposes the weaknesses of the health systems of many African countries. To mitigate the effects of pandemics, the WHO and African Centres for Disease Control (Africa CDC) embarked on a new initiative in 2022 that is proving effective and should be supported and expanded.  

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The Strengthening and Utilising Response Groups for Emergencies (SURGE) is one of the initiatives of the Emergency Preparedness and Response (EPR) flagships that have been rolled out in the African continent for emergencies. These flagships were launched by the WHO African Regional Office (AFRO) to improve the capacity of all member states to prepare for, detect and respond to public health emergencies.

The purpose of SURGE**

The implementation of the SURGE initiative will entail training at least 3,000 emergency responders into multi-sectoral and multi-disciplinary teams. These volunteer government workers from different sectors, each qualified in their respective fields, are ready and willing to be deployed to nearby countries at short notice in the event of a disaster. They help reduce the burden on the local health systems, which, in times of disaster, become overwhelmed, with staff ill prepared and often exhausted from the workload. SURGE also looks at enhancing coordination of response through the strengthening of Public Health Emergency Operation Centres (PHEOC), preposition of logistics support and ensuring public awareness.

The support of other global bodies is critically essential to developing and sustaining this novel idea to prevent future epidemics from escalating to more considerable proportions.

As a medical doctor in Sierra Leone during the West Africa Ebola crisis, I saw what happens when responses are only in-country and are not quickly coordinated. Ebola was not quickly contained because the national health systems of the affected countries were ill equipped and grossly under-resourced. The international community's support was unprecedented and crucial to halt the spread of the disease and reverse the trend. But this support came late when the disease had spiralled out of control and there were already hundreds of deaths. Many could have been prevented if only better help was available locally or quickly mobilised from within the region. 

Often, locally designed approaches are more effective in ensuring that a country's most disadvantaged and vulnerable receive high-quality health care. But this is only possible when the health systems of these countries are sufficiently strong and capable of delivering the required services. Unfortunately, most countries' health budgets barely meet the recommended minimum of $86 for providing the minimum package of essential health services. By comparison, Norway spends about $7,704 on health for each citizen.

It has been long argued that international funding and increased global cooperation are needed to build pandemic preparedness and response (PPR) capabilities. The World Bank launched the first mechanism focused on providing sustained financing to help countries develop their capacity to prevent epidemics, prepare for them and respond to them in November 2022. The Pandemic Fund was established to provide additional, long-term funding for pandemic PPR functions as a support to and reinforcement of existing capacity-building efforts as Africa disproportionately bears the global disease burden.

This idea is entirely plausible and the realities at the implementation level need to adequately reflect the spirit behind global ideas. Much has been done, but much more is required as we prepare for the next pandemic.

Rolling out SURGE across Africa

The SURGE initiative is promising. It already has around 1,300 people trained and there are positive early results. SURGE members have been deployed to assist with health emergencies like cholera, yellow fever, diphtheria, flooding and other humanitarian crises. In the same vein, the WHO regional office for Africa was also able to deploy, through the Global Outbreak and Response (GOAR) network, trained AVoHC-SURGE members from Botswana and Rwanda to support the cholera response in Malawi and Kenya. 

The rollout to the entire continent could be done within the next two years as countries’ acceptance of the initiative is so high. Indeed, a fast roll-out process is necessary as the next epidemic may be approaching.

In addition to WHO and Africa CDC, the support of other global bodies is critically essential to developing and sustaining this novel idea to prevent future epidemics from escalating to more considerable proportions and inflicting heavy human and material losses. 

SURGE is providing a face-lift using a contextualised methodology to the African region’s health system and observers acknowledge the benefits associated with ensuring government ownership and leadership of the entire process and that other partners' roles are more technical guidance. This is why SURGE is needed so badly now.

Indeed, this new impetus guarantees countries and regions the resilience and ability to respond to outbreaks as soon as possible and should thus be on the agenda of multi-national corporations and the developed world, who would be eager to see the containment of potential epidemics to avoid catastrophes like ebola and covid-19.

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(Image credit: Unsplash)