Influenza: Reinforced Diagnostic and Surveillance Capacity Planned For Africa Outbreaks
A scientist at Ethiopia’s National Influenza and Arbovirus Laboratory, in February, equipped to test for COVID-19.

Africa is set to establish a plan of preparedness and to compile influenza data sets with the World Health Organisation (WHO), to expand its surveillance of potential flu outbreaks.

The African region has also called for the integration of influenza surveillance into an all-inclusive infectious disease surveillance system, and for the creation of a necessary mechanism for contributory finance that can make vaccines and control measures affordable and equitable.

Dr Chikwe Ihekweazu, Director General of the Nigeria Center for Disease Control (NCDC), told the World Health Assembly (WHA): “We notice the challenges with influenza preparedness as well as the consequences that recurring pandemics have on health, economies and society – particularly on vulnerable countries with weak health systems, now exacerbated by the COVID-19 pandemic.”

Establishing a plan of preparedness with the Secretariat would “help expand and reinforce the surveillance and diagnostic capacity of the African region in case of influenza outbreaks,” he said.

He also asked WHO to continue to stockpile vaccines in anticipation of influenza outbreaks, so as to support the region’s ongoing plan to expand sentinel sites next year.

Could the Northern Hemisphere Avoid Flu Season?

In the early weeks of the COVID-19 pandemic, WHO and health stakeholders noted that COVID-19 could worsen the seasonal influenza outbreaks around the world.

“Every year, there are up to 3.5 million severe cases of seasonal influenza worldwide, and up to 650,000 respiratory-related deaths,” WHO stated. “Every hospital bed occupied by a patient with COVID-19 is a bed that is unavailable for someone else with another condition or disease, such as influenza.”

As of November, however, trends are less clear.

On the one hand, over the spring and summer, the southern hemisphere registered a sharp drop in flu cases compared to previous years – attributed to COVID-19 restrictions and guidance like social distancing and hand washing.

At the same time, given the unpredictable course of the pandemic, public health officials have warned countries in the north not to let up their guard.

“We cannot assume the same will be true in the northern hemisphere flu season,” WHO stated. “The co-circulation of influenza and COVID-19 may present challenges for health systems and health facilities, since both diseases present with many similar symptoms.”

WHO said it is working with countries to take a holistic approach to the preparedness, prevention, control and treatment of all respiratory diseases, including influenza and COVID-19.

“Many of the same measures that are effective in preventing COVID-19 are also effective for preventing influenza, including physical distancing, hand hygiene, covering coughs, ventilation and masks,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus.

WHO Must Make Sure Africa’s Record-Low Cholera Cases Are Not Undone by COVID-19

African countries, including Zambia, Nigeria and South Sudan, reported an average 59% decrease in the number of cholera cases between 2017 and 2018, as the broader African region experienced its lowest number of cases in the 21st Century. COVID-19’s impact on vaccination campaigns, however, threatens to drive cases back up.

Dr Chikwe Ihekweazu says influenza outbreaks in Africa require improved surveillance
Dr Chikwe Ihekweazu, DG of Nigeria’s NCDC, spoke on behalf of the African region at the WHA on Wednesday.

Despite the successes so far earned by global initiatives – like the Global Task Force on Cholera Control’s 2030 roadmap which aims to reduce cholera deaths by 90% using evidence-based best practices – Ihekweazu noted the urgent need for additional work to ensure these milestones are consolidated.

“We emphasize that despite a significant downward trend in cholera transmission, more effort is needed to sustain the results achieved, especially during this period of the COVID-19 pandemic,” Ihekweazu said.

He also called for support for a privatization of epidemiological and laboratory surveillance, and a multi sectoral approach to strengthening health systems: a sentiment mirrored by a separate committee at the WHA.

Dr Ibrahima Socé Fall, WHO’s Assistant Director-General for Emergencies Response, noted that there was a 64% reduction in cholera deaths between 2019 and 2018 in the African region, and he drew attention to Nigeria and Sudan’s requests for continued investment in laboratory capacity and community engagement.

He said: “We are continuing to work on this with our partners. There are still a number of challenges despite this progress that we’ve made.”

Dr Socé Fall noted that many African countries, including Cameroon, Uganda and Mozambique, are now resuming their vaccination campaigns following COVID closures, with others resuming preventive campaigns. In 2019, the region distributed 23 million oral cholera vaccines.

“We are also seeing preventive campaigns in Zambia, Tanzania and other countries,” he said. “We would encourage countries not to cancel these campaigns.

“COVID-19 measures have been implemented and it is important that we continue to do this to save lives.”

Image Credits: WHO AFRO/Otto B., WHO / WH.

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.