During the pandemic, the UK and other wealthy countries have relied on African doctors and nurses to bolster their health services.
Now the continent’s health chief hopes to reverse the brain drain with a plan to persuade African expats to return.
Dr. John Nkengasong, director of the Africa Centers for Disease Control and Prevention (Africa CDC), said they are planning a program to attract scientists, doctors and nurses from the diaspora.
“Leaders on the continent must invest in strengthening health systems,” Nkengasong said, in an interview with the Observer. “We need a very deliberate program that helps Africans in the diaspora to come back to the continent and rotate. A Ghanaian or a Nigerian in London doesn’t just wake up in the morning thinking, “I’m going to Nigeria for a year. This person needs housing, basic transportation. They have responsibilities, a job.
He said the Africa CDC would soon propose a set of measures to the African Union commission to create a regional health treaty to govern the response to the pandemic, which would include support for expatriates.
Research by the House of Commons Library last year showed that 2.5% of NHS England’s 1.35 million staff were African. The largest proportion was 10,494 from Nigeria, with another 4,780 from Zimbabwe, 3,395 from Ghana and 2,895 from Egypt.
Nigeria has about 72,000 registered doctors, but only 35,000 were practicing in the country in 2021, according to Abba Moro, a Nigerian senator.
The Africa CDC has set up seven working groups allowing doctors and scientists working in rich countries to give regular advice remotely.
“They have been extremely helpful during this pandemic,” Nkengasong said. “We need to formalize it and facilitate the return to the continent to meet the public’s need.”
Africa seems to have suffered less from Covid and its variants than other continents. Around 10 million people are estimated to have been infected, but this is likely an undercount, Dr Nkengasong said, and around 220,000 people have died.
“That’s relatively little for a continent of 1.3 billion people,” he said. “We saw India was overwhelmed by Covid in May, you couldn’t hide it. We haven’t seen a scenario in Africa where people are dying on the streets.
“I think there is a puzzle as to why so many more people have been infected in Africa, but it hasn’t translated into many deaths. That’s a research question that we need to study, and also how many deaths we miss.
“We have to prepare for the emergence of variants that will be more difficult than what we are dealing with.”
Africa CDC was instrumental in establishing the Sentinel network of laboratories to track the virus using genomic sequencing which led to the detection of the Omicron variant in Botswana in November.
“We have the infrastructure in place to detect early, prevent and respond,” he said. “Take West Africa – there are a lot of public health assets there. The Noguchi [Medical Research] Institute in Nigeria is a state of the art facility. The Institut Pasteur in Côte d’Ivoire, the Institut Pasteur in Senegal, the Medical Research Council in Gambia – but they didn’t talk to each other. The whole concept of this new order of public health is to use as many as possible in the region. »
He added that in 2018 he was contacted by public health officials in Sierra Leone about a suspected case of monkeypox, asking for help finding someone at the US CDC to test for the disease. “I said no, if you send that to Ivory Coast, I know they have the basics to help you do that.”
This mindset of Africans always needing help from wealthier Western countries is far too prevalent, he said.
“People see the continent as a place to go, do some projects, put the data together, publish it, do some clinical trials and get out. It’s not global health. This should be an equal partnership, recognizing that principal investigators should come from developing countries.
The pandemic provided an example of the limits of Western aid, he said, with the WHO’s Covax programme. The Gavi alliance, which leads the programme, had promised 2 billion doses of vaccines to 144 poorest countries in 2021, but has managed around 900 million. Earlier this month, poorer countries threw away 100 million doses that were about to expire. There have been heated debates over whether Western countries are stockpiling the vaccines.
“Covax represents the best mechanisms for global cooperation,” Nkengasong said. “But look what happened. This is a good example where good intention does not match reality. The promissory note that African countries would receive vaccines at the same time did not happen.
“And what we did, under the leadership of President Ramaphosa, we created the Africa Vaccine Acquisition Task Force and we were able to acquire 400 million doses of the Johnson & Johnson vaccine.”
So far, Africa CDC has launched 12 pandemic initiatives, he said. In addition to genomic surveillance and vaccines, there are plans to secure diagnostic and test kits, as well as medical supplies.