Lusaka, Zambia — The battle against infectious diseases neglected tropical diseases (NTDs), and antimicrobial resistance (AMR) in Africa is a critical and complex issue that requires urgent attention. While the continent has made significant strides in combating these threats, formidable challenges remain, demanding a unified and strategic response.
During a high-level session on Combating Infectious Diseases, NTDs, and Antimicrobial Resistance in Africa, the urgent call to action reverberates through the discussions - a call that transcends boundaries, sectors, and disciplines. The gathering marks a pivotal step in this direction, bringing together experts, policymakers, and stakeholders to address cross-sector issues that lie at the heart of our collective fight against infectious diseases, NTDs, and AMR, said Professor Rose Leke, an Emeritus Professor at the University of Yaounde in Cameroon.
Breaking down these barriers becomes our collective mandate, carving a path toward holistic healthcare delivery and a rightful place on the world stage. At the forefront of the discussions lies the question of what Africa needs to change the trajectory of our infectious diseases.
Professor Marc Mendelson, Head of the Division of Infectious Diseases at the University of Cape Town, South Africa, called for a comprehensive strategy to address infectious diseases in Africa. He said there’s an urgent need to bridge the communication gap between global organizations and African communities, prioritize preventive measures over interventions, and enhance Africa's capacity for disease detection and surveillance.
"As we strive to interrupt the trajectory of infectious diseases, we must address several critical issues," he said.
Mendelson argues that the current trajectory of infectious diseases in Africa is unsustainable and demands a fundamental shift in approach. He highlights the disconnect between global disease prevention messages and the realities faced by African communities. This disconnect, he contends, hinders effective interventions and perpetuates disparities in health outcomes.
To bridge this gap, Mendelson advocates for a more localized and context-specific approach to disease prevention. He stresses the importance of understanding the unique needs and challenges of different African regions and tailoring strategies accordingly. This approach, he believes, will lead to more effective and sustainable interventions.
"The Global North has had the privilege of addressing infectious diseases more proactively, while other regions have struggled to catch up. Therefore, adopting a one-size-fits-all approach is ineffective," added Mendelson.
"Reducing the burden of infectious diseases demands a focus on preventative measures. The notion of "watch and wait" is no longer tenable. Ensuring food security is paramount, as malnutrition is a key factor exacerbating the impact of infections. Moreover, addressing the climate crisis is crucial, as climatic factors significantly impact the transmission and spread of bacteria and viruses. We are only beginning to unravel the complex interplay between climate, environment, and infectious diseases," he said.
Mendelson added that the Ebola virus outbreak in 2014 highlighted the increasing risk of spillover effects from our environment. Protecting our environment is not a luxury; it is a necessity. We are fundamentally interconnected with bacteria, viruses, and other organisms, and our environment serves as the matrix for Africa.
"In the wake of the COVID-19 pandemic, we witnessed the devastating consequences of the Global South's limited access to vaccines. This inequity not only hampered disease control efforts but also exacerbated the disparities in health outcomes. Similarly, the lack of affordable and accessible diagnostics poses a significant threat to eradicating infectious diseases," he added.
Drug-resistant infections pose top 10 global threat, expert warns
Carol Ruffel, the Southern Africa Director of Drugs for Neglected Diseases initiative (DNDi) and the Global Antibiotic Research and Development Partnership (GARDP), called drug-resistant infections one of the top 10 global threats.
"I've witnessed firsthand the evolution of antimicrobial resistance (AMR) throughout the years, from the early days of antibiotics to the emergence of superbugs and the impact of the environment," Ruffel said. "I've seen how misuse and overuse of antibiotics, coupled with environmental factors, have contributed to the rise of resistant pathogens."
"The COVID-19 pandemic highlighted the critical role of AMR in global health," Ruffel added. "We've seen how the spread of infections can be exacerbated by antibiotic resistance, making it more challenging to treat diseases. This underscores the need for a coordinated global response to AMR."
In the fight against AMR, a multifaceted approach is essential, according to Ruffel. Effective strategies must span a wide range of areas, with education as a cornerstone. She emphasized the need for comprehensive awareness campaigns to promote the judicious and responsible use of antibiotics. Alongside education, investing in research and development is crucial to uncovering new, powerful antibiotics capable of combating resilient pathogens. Additionally, strengthening healthcare systems and implementing robust infection control measures are essential to curb the spread of infections and impede the emergence of resistance.
Ruffel also underscores the importance of addressing environmental factors, advocating for pollution reduction, and sustainable agricultural practices to mitigate the environment's influence on AMR.
Empowering frontline healthcare workers is also essential, said Ruffel.
"This includes providing them with access to effective diagnostics, treatment options, and guidance on antibiotic stewardship," Ruffel said.
The eradication of smallpox is a testament to its power
Professor Charles Charles Wiysonge, the Regional Adviser for Immunisation and Team Lead for the Vaccine-Preventable Diseases Programme, WHO AFRO, spoke on the prevention of vaccines. He traced the history of immunization, highlighting the eradication of smallpox as a testament to its power.
"I'd like to begin by underscoring the remarkable strides made in immunizations since the eradication of smallpox," he said. "This achievement, a beacon of global collaboration, paved the way for the establishment of immunization programs in 1974," he added.
Dr. Wiysonge further emphasized that "vaccines have undeniably transformed our lives, dramatically reducing the burden of infectious diseases. Vaccination campaigns have resulted in substantial declines in morbidity and mortality. This progress has become an integral part of our culture and healthcare systems," he asserted.
"Despite these advancements, there remain notable gaps in immunization coverage, particularly in parts of Africa. These disparities can trigger outbreaks and impede overall progress," he cautioned. "To address these challenges, we must bolster primary healthcare systems and expand access to new vaccines. This entails investing in research and development, refining vaccine delivery strategies, and tackling vaccine hesitancy," he elaborated.
He additionally remarked that the introduction of new vaccines holds the potential to further revolutionize global health. These groundbreaking technologies offer promising solutions to combat emerging and existing infectious diseases. To effectively harness these new vaccines, we must strengthen our research infrastructure and ensure their affordability and accessibility. This necessitates collaboration among governments, healthcare organizations, and the pharmaceutical industry," he emphasized.
As we move forward, we must remain committed to expanding immunization coverage and ensuring that everyone has access to these life-saving interventions. By doing so, we can continue to protect the health of our communities and make the world a safer place," concluded Dr. Wiysonge.
Africa CDC calls for action to combat Neglected Tropical Diseases
The Africa CDC's acting head of surveillance and disease intelligence, Dr Yenew Kebede Tebeje, advocated for broader adoption of robust diagnostic and quality assurance practices," the statement said.
"'The World Health Organization (WHO) has set a goal of reducing NTD transmission by 90% by 2030. To achieve this goal, we need to ensure that individuals have access to effective treatments and preventive measures. This includes early diagnosis of NTDs, which is crucial for timely intervention and to prevent the spread of disease,'" Dr. Tebeje said.
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Dr. Tebeje added: "'Globally, over a million people are infected with neglected tropical diseases, and Africa accounts for 40% of those cases. These diseases can cause serious disabilities and even death. While mass drug administration is effective for some neglected tropical diseases, others require intensive patient monitoring and individualized treatment.'"
"'To address these challenges, we need ideal diagnostic tools that are self-contained, multiplex, portable, battery-operated, and affordable. Unfortunately, there are few commercial incentives for developing these tools, and many countries lack the resources to invest in research and development. We need to work together to overcome these barriers and develop the diagnostics that are urgently needed to combat neglected tropical diseases,'" he concluded.
In closing remarks, Francesca Mutapi, a Professor of Global Health Infection and Immunity at the University of Edinburgh, highlighted the strides made against neglected tropical diseases (NTDs). While celebrating the 50 countries that have eliminated at least one NTD, she stressed the persistent challenges. Africa faces a grave threat from NTDs, impacting public health and socioeconomic progress. The lack of investment in surveillance and diagnostics is a glaring obstacle, hindering accurate assessment and effective intervention. Francesca said the unacceptable toll of NTDs, causing blindness, disfigurement, and death, urging global action against these preventable afflictions.
She advocated for innovation in prevention and treatment strategies, stressing the importance of antibiotic stewardship, improved sanitation, and acknowledging the interconnectedness of NTDs and non-communicable diseases.
"Let us unite in our resolve to eliminate these debilitating diseases and pave the way towards a healthier future for all," she said.
AllAfrica's reporting from CPHIA2023 is supported by the African Union and Africa CDC.
