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African National Public Health Institutes Responses to COVID-19: Innovations, Systems Changes, and Challenges
Sue Binder1, Alex Riolexus Ario1, Hervé Hien1
1Sue Binder, MD, is Senior Advisor for Public Health Practice; Amandine Zoonekyndt, MPH, is a Program Coordinator; Callie McLean is a Graduate Research Assistant; Katherine Seib, MSPH, is Director of Programs; and Ellen A. Spotts Whitney, MPH, is Director; all at the International Association of National Public Health Institutes, Global Health Institute, Emory University, Atlanta, GA. Callie McLean is also a Graduate Research Assistant, Rollins School of Public Health; Emory University; Atlanta, GA. Alex Riolexus Ario, MD, is Director, Uganda National Institute of Public Health, Kampala, Uganda. Hervé Hien, MD, PhD, MPH, is Director General, National Public Health Institute, Ouagadougou, Burkina Faso. Natalie Mayet, MD, MPhil, is Deputy Director, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa. Ilesh V. Jani, MD, PhD, is Director General, Instituto Nacional de Saúde, Maputo, Mozambique. Chikwe Ihekweazu, FFPH, MPH, is Director General and Elsie Ilori, MSc, is Director, Surveillance and Epidemiology Department; both at the Nigeria Centre for Disease Control, Abuja, Nigeria. Ebba Abate, PhD, MSc, is Director General, Ethiopian Public Health Institute, Addis Ababa, Ethiopia. Sabin Nsanzimana, MD, PhD, MSc, is Director General, Rwanda Biomedical Centre, Kigali, Rwanda. William Yavo, PharmD, PhD, is Deputy Director, Training and Research, Institut National de Santé Publique, Abidjan, Côte d'Ivoire. Wemboo Afiwa Halatoko, MD, MPH, MSc, is Director, Institut National d'Hygiène, Lomé, Togo. Shiva Murugasampillay, MD, is Director, Global Public Health, Geneva, Switzerland. Claude Millogo, MD, is a Consultant, International Association of National Public Health Institutes, Global Health Institute, Emory University, Ouagadougou, Burkina Faso. Edris Nikjooy, MS, is a Project Manager and Anne-Catherine Viso, PhD, is Director, International Association of National Public Health Institutes; Edris Nikjooy is also a Project Manager and Anne-Catherine Viso is Deputy to the Secretary-General, Science and International Office, Santé publique France; all in Saint-Maurice, France.
Abstract:
National public health institutes (NPHIs)-science-based governmental agencies typically part of, or closely aligned with, ministries of health-have played a critical part in many countries' responses to the COVID-19 pandemic. Through listening sessions with NPHI leadership, we captured the experiences of NPHIs in Africa. Our research was further supplemented by a review of the literature. To address issues related to COVID-19, NPHIs in Africa developed a variety of innovative approaches, such as working with the private sector to procure and manage vital supplies and address key information needs. Creative uses of technology, including virtual training and messaging from drones, contributed to sharing information and battling misinformation. Positive impacts of the pandemic response include increased laboratory capacity in many countries, modernized surveillance systems, and strengthened public-private partnerships; much of this enhanced capacity is expected to persist beyond the pandemic. However, several challenges remain, including the lack of staff trained in areas like bioinformatics (essential for genomic analysis) and the need for sustained relationships and data sharing between NPHIs and agencies not traditionally considered public health (eg, those related to border crossings), as well as the impact of the pandemic on prevention and control of non-COVID-19 conditions-both infectious and noncommunicable. Participants in the listening sessions also highlighted concerns about inequities in access to, and quality of, the public health services and clinical care with resultant disproportionate impact of the pandemic on certain populations. COVID-19 responses and challenges highlight the need for continued investment to strengthen NPHIs and public health infrastructure to address longstanding deficiencies and ensure preparedness for the next public health crisis.