Porous borders place Africa at risk from coronavirus

Author(s): Inga Vesper, Source: SciDev.net , Date: 30 January 2020

Fears were growing over Africa’s ability to protect its citizens from the rapidly spreading coronavirus epidemic as the World Health Organization (WHO) declared the outbreak a public health emergency of international concern.

The new virus has so far claimed 170 lives in China and infected almost 8,000 people across 19 countries said the WHO after convening its emergency committee in Switzerland today (30 January) for a second time. 

Speaking at a press conference in Geneva, WHO director-general Tedros Adhanom Ghebreyesus said: "We don’t know what sort of damage this virus could do if it were to spread in a country with a weaker health system. We must act now to help countries prepare for that possibility."

Ifeanyi Nsofor, an epidemiologist and director of policy and advocacy for Nigeria Health Watch, told SciDev.Net that one suspected case of the virus had been identified in Côte d’Ivoire. The WHO said there had so far been cases in 18 countries outside China.

Egypt has started screening all air passengers arriving from countries where the infection has occurred, while Kenya, which receives at least three flights a day from China, issued a directive to start screening at all ports of entry on 22 January. Nigeria followed suit the same day.

However, Africa’s porous land borders remain a cause for concern among policymakers and health professionals, who fear that unchecked migration and transport between countries could spread the virus quickly.

“These land borders are ignored in all the noise about the coronavirus outbreak and could be possible sources of the infection coming to the continent,” says Nsofor. “Generally, there is no country in Africa fully prepared to detect, prevent and respond to infectious disease outbreak.”

His fears are confirmed by data from the Prevent Epidemics website, which uses information from the WHO to measure a country’s ability to deal with and prevent infectious disease outbreaks. Countries need to score at least 80 points to be considered prepared, but even the most experienced African nations, such as Kenya, South Africa and Sierra Leone, only score between 50 and 60 points.

Poor landlocked nations, such as the Central African Republic or Chad, score in the 20s. These countries are subject to significant amounts of goods transits along roads and have largely uncontrolled land borders.

The problem is compounded by the fact that passengers are not screened when changing flights.

Inas Hamam, a spokeswoman for the WHO’s Middle Eastern regional office, said: “Countries of arrival take responsibility for all screening of passengers, not regional transit hubs. These hubs do, however, have the capacity to detect and respond to suspected cases. Detection of suspected cases and enhancing surveillance systems should be in place in all countries, including countries of arrival.”

Coronavirus is a group of viruses that cause several types of respiratory disease, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). The current outbreak, which began in the Chinese province of Wuhan in December, is a novel strain, dubbed 2019-nCoV.

As of 30 January, 7,834 cases of the virus have been confirmed, out of which 98 were found outside China. A total of 170 people have died of the disease — all of them in China — and 1,370 have been classed with “severe” infection, according to the WHO.

The development of vaccines, therapeutics and diagnostics must be accelerated said Tedros, calling for a review of preparedness plans to assess resources needed to identify, isolate and treat new cases. He warned against the spread of misinformation, saying: "This is the time for science, not rumours."

The latest cases outside China to be confirmed were four in the United Arab Emirates — all of whom had travelled from Wuhan City.

Middle Eastern countries forming the biggest transit ports for African travel are better equipped to deal with the virus, however. The Gulf countries, which host large, international airports such as Doha and Dubai, have previously tackled MERS, a strain of coronavirus transmitted to humans via camels.

Islam Hussein, senior researcher at Microbiotix Inc., a company specialising in antibiotics, said: “The Middle East countries have benefited from previous experiences in dealing with similar epidemics in the past few years, the last of which, MERS, is the most virulent of the emerging coronavirus. What we need now is to raise public awareness and anticipation to identify any infected cases as soon as possible, and then isolate and treat them in equipped hospitals.”

Africa has seen an uptick of visitors from China in the past decade, both through tourism and because of China’s increasing investments in the continent. According to the China Global Investment Tracker, Sub-Saharan Africa received around US$270 billion in Chinese funding in the past decade.

However, Nsofor says that this does not have a significant influence on if and how the virus could spread in Africa. “Considering the ease of travels and how interconnected countries are today, every nation on earth is equally at risk from coronavirus,” he said.