Pandemic preparations are unhealthy

At midnight on 26 March 2020, the government locked down South Africa. As part of the Covid‑19 pandemic response, all South Africans were to stay home unless acquiring food or essential goods or seeking medical attention. 

The country struggled through various levels of lockdown for more than two years until the National State of Disaster was finally terminated in April 2022. 

Similar lockdowns were imposed across Africa. 

According to a 2022 article in Tropical Medicine and Health, lockdowns caused collateral damage to the health systems and economies of many African countries. According to another study in BMJ Global Health, there is evidence that lockdowns harmed public health across Africa “by affecting the functioning of the health system and causing social and economic disruption”.

For the privileged few who could work from home, lockdowns did not pose a major problem to securing a livelihood. However, for the vast majority of the continent, working in the informal sector, lockdowns were catastrophic. 

According to the scientists and scholars of the Pan-Africa Epidemic and Pandemic Working Group, lockdown regulations across the continent were a “class-based and unscientific instrument, harmful to lower-income people” across Africa. 

The disruption to economies and education entrenched and deepened inequality and massively expanded national debt, worsening the debt crisis facing the continent.

According to Professor Fernandes Wanda, of The Centre for Social and Economic Research at Agostinho Neto University in Angola, the militarisation of lockdowns in Angola led to the loss of civilian autonomy and human lives and livelihoods. 

The lockdowns also had devastating effects on Angola’s economy. In 2020 and 2021, Western countries raised interest rates to manage the economic effect of the pandemic. This curtailed the ability of African countries to finance and repay their debt arrangements and has resulted in ballooning interest rates and weakening local currencies.

In the wake of the pandemic, people in Nigeria are facing “an economic crisis unequalled in its modern history”, according to Toby Green of King’s College London and author of The Covid Consensus. 

Basic food items are now a luxury and people are resorting to drastic measures to secure sustenance, including eating low-grade rice usually reserved for use as fish food. 

Green has described the Covid pandemic response on the continent as neocolonial. It suppressed indigenous medical systems, disregarded the perspectives of public health officials in Africa and frontlined Covid vaccinations at the expense of treating other serious medical conditions such as malaria and tuberculosis. 

On the other hand, the pandemic produced a new billionaire almost every day, inflating inequality across the globe. 

According to Oxfam International, the world’s 10 richest men more than doubled their fortunes, while the incomes of 99% of the world’s population fell, and over 160 million people were forced into poverty.

Furthermore, the pandemic and current pandemic-preparedness initiatives are centralising control over global public health, undermining the national and health sovereignty of nations across the Global South.

The World Health Organisation (WHO) is negotiating two instruments to furnish it with far-reaching powers in case of another pandemic. 

The first constitutes amendments to the International Health Regulations and the second is a new pandemic-preparedness treaty. The draft agreements are scheduled for signing by member states of the WHO in May. 

The treaty would pour funds into pandemic preparedness, taking away precious resources for diseases of higher priority in Africa, including malaria and tuberculosis. 

If the treaty and amendments are passed, the WHO, and the private corporations and wealthy individuals who fund it, would be able to impose border closures, lockdowns and forced medical treatments over nation-states. This would lead to a loss of health sovereignty, particularly in underdeveloped countries across Africa. 

Even though the treaty would be legally binding if ratified, there is little public awareness of, or debate about, it in South Africa. 

The Pan-Africa Epidemic and Pandemic Working Group is organising and raising awareness about the potential dangers of the treaty for national and health sovereignty in Africa. The group is led by scholars from across the continent such as Pedrito Cambrão of UniZambeze in Mozambique; Wellington Oyibo from the University of Lagos in Nigeria and Reginald Oduor from the University of Nairobi in Kenya.

At a press conference held in Accra and online on Friday 15 March, the working group addressed various Ghanaian TV and radio stations, as well as academics and university students in Ghana, to discuss the proposed treaty and amendments. 

Oduor was concerned that the pandemic agreement would secure the use of emergency authorisation of pharmaceutical products, which would save Western pharmaceutical companies substantial funds in getting unregulated medicine to African markets, making big pharma massive profits. 

Public health physician and leading global health expert David Bell argues that public health initiatives across Africa and the Global South are increasingly driven by Western corporatist funding and imperial agendas looking to make profit.

According to Bell, an expanding bureaucracy and conglomerate of international agencies “implements the centrist agenda, removing remaining vestiges of local ownership and control”.

Bell says what is needed is a decentralised and contextualised approach to managing new infectious diseases. 

Residents and local health officials have the best understanding of their needs and priorities, as well as the different local health burdens. 

Public health proposals need to be tailored to the risk in different countries and different communities, rather than imposed from above and by centralised institutions ascribing to a Western biomedical framework and which are increasingly shaped by authoritarian modes of capitalism. 

Scholars and concerned citizens are mobilising against the proposed WHO pandemic-preparedness treaty and amendments to the International Health Regulations across Africa. 

Unfortunately there is little debate about the proposed treaty in South Africa. Where is the concern over the threat to national and health sovereignty posed by the interests of Western imperial and neo-colonial agendas?

Anjuli Webster is a PhD candidate in African History at Emory University, a Mellon Sawyer dissertation fellow and editorial assistant at African Economic History.