The social determinants of health (employment, education, place of residence and other similar factors) shape health outcomes, determine life expectancy and ultimately shape health inequities among countries. With the outbreak of the coronavirus pandemic (COVID-19) and as the world surpasses one million positive cases, we are also seeing how health is one of the greatest social determinants of our times and how investment in better healthcare is non-negotiable for our overall development.
The pandemic marks a turning point in the 21st century in changing the way we live, work and interact. As the world’s largest emerging trading bloc, the African Continental Free Trade Agreement (AfCFTA), is meant to unlock Africa’s immense economic potential. If the political commitment behind the agreement is firm and genuine, then the AfCFTA should be adaptable and resilient to any further shocks. Disruptions are certain but, under the extenuating economic circumstances this continent will face immediately and long into the future, there is no choice but for the planned operationalization of the AfCFTA to go full steam ahead.
Wamkele Mene, recently appointed as Secretary General of the AfCFTA, stated: “I don’t think anybody would have anticipated that the virus would be so disruptive to the entire global economy.” If it wasn’t for the virus, discussions would have been concluded in May when South Africa was scheduled to host an extraordinary African Union summit to finalize the modalities of the agreement. According to Mene, “the rules of engagement are 90% ready.”
The vision of the AfCFTA is already in line with the virtual world, with the strengthening of an online tool meant to be accessible for negotiations, and a collaborative platform to exchange products with set tariff conditions. Other operational elements that can be implemented are the Pan-African Payments and Settlement System (PAPSS) for centralized and intra-trade payments and the African Trade Observatory portal to immediately improve trade data.
Experts from Johns Hopkins University and the World Health Organization (WHO) state that it has taken weeks to see the effects of a lockdown in curbing the pandemic. South Africa is yet to enter the height of the pandemic and it is still too early to see if the planned lockdown will be adequate in the absence of a vaccine and the risk of a second wave of infection.
This May AfCFTA Summit and further gatherings mentioned by Secretary General Wamkele Mene are likely to take place virtually. In light of the fact that the African Centres for Disease Control and Prevention (Africa CDC) reports that there are 32 full border closures and 9 international air traffic closures on the continent, a face-to-face meeting at least in the immediate future would not be possible.
The fact is, we need to be realistic. Different countries on the continent are at different stages of the pandemic and even as we hope to move towards tackling the crisis, there is going to be massive devastation.
The after-effects are not being planned for at the moment, but in all likelihood it will take time for borders to re-open, for travel to take place smoothly, for individuals to be emotionally and physically ready to travel.
Resuming any in person contact is also dependent on how quickly the airline and travel industries recover. The International Air Transport Association (IATA) predicts the COVID-19 outbreak could cost airlines $113 billion in lost revenue. The Single African Air Transport Market (SAATM), which the AfCFTA planned to capitalize on, is already affected. Furthermore, underperforming airlines such as South African Airways may not weather the present global health and economic storm.
These are just some of the factors that will affect the operationalization of the AfCFTA. On the health front, trade is also affected with reports stating that the pharmaceutical industry is bracing for disruption to global production. There are also fears of drug shortages as a result of India being affected by the pandemic; in turn affecting the supply of generic drugs worldwide.
It’s set to be a tough year. But, within these times, there is also an opportunity for political commitment to deliver and maximize on the AfCFTA-anchored Pharmaceutical Project. Commissioned in Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Mauritius, Rwanda, Seychelles and the Sudan, the project could be expanded throughout the continent. The Business and Sustainable Development Commission (2017) and the UN Economic Commission for Africa report on Health Care and Economic Growth in Africa states that Africa’s health and wellness markets are valued at an estimated $259 billion.
How can we have a transformative COVID-19 response that spurs the AfCFTA into action, especially in the trade of medical supplies and equipment? Not only do African countries face a shortage of medical equipment and medicines, the WHO has also warned of a severe and mounting disruption to the global supply of personal protective equipment (PPE). Crucial to our COVID-19 response is to have PPE for health workers to protect themselves and their patients from being infected and infecting others. However, since the outbreak, WHO reports that prices have surged, surgical masks have seen a six-fold increase, N95 respirators have trebled and gowns have doubled.
The time to deliver on the AfCFTA is now. We need to immediately get into gear for vaccine development and research on COVID-19, and mass production and trade for equipment and PPE for our health workers. The other immediate consideration would be how, in the short-term, to direct any resources realized as a result of the AfCFTA to relief efforts for COVID-19 which are going to be needed on the continent at least for a 5-year period.
On a separate but important note to our leaders, while some have the privilege of working virtually, 44% of the world’s uncovered population (without internet coverage) reside on this continent. As we adapt to these new ways of working and living, the AfCFTA must also ensure that the continent is connected or there will be continued exclusion and only those who can afford to reap the benefits of the AfCFTA will be reached. Others will be pushed into even deeper and more abject poverty without the virtual means or access of participating in this rapidly changing world.
Dr. Shakira Choonara is an Independent Public Health Practitioner and the 2017 Woman of the Year in Health, South Africa.
Suggested additional resource (short video): Africa’s Pharmaceutical industry under the AfCFTA https://www.youtube.com/watch?v=RVFKvm9aMXE