Dr. Chris van Straten, Global Health Advisor Clinical Governance, International SOS
With April marking a focus on World Health, is not just the time to celebrate the recent decrease in mortality rates from the COVID-19 pandemic, but a time to urge the world and especially African countries to refocus on health issues neglected during the pandemic. These include non-communicable diseases (NCDs) like diabetes, hypertension and cancer, and infectious diseases such as malaria and tuberculosis (TB).
Our observation is that the pandemic has negatively impacted many aspects of Africa’s healthcare systems including disruptions to routine health screening, treatment and prevention programmes. Reduced visits to healthcare professionals due to lockdowns, an overwhelmed healthcare system or fears of contracting the virus have led to a surge of cases in other disease categories.
In fact, the World Health Organisation (WHO) has noted the highest incidence of malaria cases in 20 years during the pandemic. Sub-Saharan Africa continues to carry the heaviest malaria burden, accounting for about 95% of all malaria cases and 96% of all deaths in 2020. TB control and progress was also severely disrupted; according to the European Respiratory Journal, an additional 200 000 TB deaths are expected between 2020 and 2024 across South Africa, India and China. Over the past two years for the first time since 2015, the annual numbers of TB deaths have started increasing with more than 1.5 million people dying of TB in 2020.
NCDs have also been impacted; in a WHO survey of 41 countries in sub-Saharan Africa, hypertension management has been disrupted in 59% of the countries, while diabetic complication management has been disrupted in 56% of the countries. New data even shows that COVID-19 can increase the risk of type 2 diabetes beyond the first 30 days of infection, making it even more important to renew efforts in the fight against diabetes and other NCDs.
Another important healthcare aspect that is overlooked due to its taboo nature in parts of Africa, but of critical importance, is mental health. When the pandemic struck, it significantly worsened people’s mental health through the impact of longer work hours, the blurring of work-life balance, and the pressures of working from home. Research reported by The British Medical Journal finds that the mental health impact of the pandemic has been severe and will be long lasting. For instance, International SOS’ Risk Outlook 2022 survey shows that mental health will be among the top 5 causes affecting productivity at work this year.
These are all concerning statistics that clearly demonstrate the health threats lurking in COVID-19’s shadow, and that require a multifaceted approach if we are to tackle Africa’s health threats now and for future generations.
One such approach is innovation. As a pioneer and leader in international health and security risk management, International SOS has been at the forefront of great advances in the application healthcare technology. Through a process of guiding leading organisations in Africa to redouble their duty of care to employees, we believe that innovative solutions such as telehealth, business intelligence and mobile device applications will likely continue to play a pivotal role in the continent’s health sector. Leveraging technology will facilitate expanding the reach of healthcare and health promotion across Africa. This can be life-saving – especially in remote and offshore sites.
Prevention remains critical in ensuring health and wellbeing of workforces and communities at large. Such strategies include education, chronic conditions monitoring and prophylaxis as well as testing, screening, vaccination, isolation and prevention strategies – not limited to COVID – are aimed at identifying all cases of infectious diseases before staff deployment to sites. Such detection is done by means of pre-employment health screening and stabilisation of chronic conditions and NCDs and can make a substantial difference to the teams and broader communities at these remote sites.
A recent case study at International SOS is testament to the difference such prevention strategies can make. Challenged by the rugged circumstances of a client that had several offshore sites in Africa employing rotational workers, a well thought out prevention strategy resulted in zero incidence of malaria cases, markedly lower COVID-19 cases than other operators in the region and the sites remained fully operational, as the previous rate of 23 medical evacuations related to chronic conditions and NCDs fell to just two cases.
This is just one example of what can be achieved.
It has been two years since WHO announced the pandemic outbreak. Two years that have tested to the limit the resilience of the global population, business continuity and especially healthcare workers, but the work is not over. We need to be prepared against other health risks and we need to work together to build a resilient health system in Africa.