The Intergovernmental Committee of UNESCO’s 2005 Convention on the Protection and Promotion of the Diversity of Cultural Expressions has approved funding for initiatives that will boost the cultural and creative industries in developing countries around the world, during its annual meeting, held online from 1 to 6 February.
During the Committee session, a high-level ResiliArt debate took place, celebrating the International Year of Creative Economy for Sustainable Development, Building Back Better through the Creative Economy. Participants discussed how artists and creators are adapting in response to the pandemic, and stressed that they need greater support from governments, and regional and international organizations.
The debate brought together Jean-Michel Jarre (musician and UNESCO Goodwill Ambassador), Adberrahmane Sissako (film director) Thomas Steffens, (CEO of Primephonic), Vanja Kaludjercic (Director, International Film Festival Rotterdam), Victoria Contreras (founder and General Director of the Association Conecta Cultura de México) and Alvaro Osmar Narvaez (Secretary of Culture, City of Medelln, Colombia, UNESCO Creative City of Music).
Each project will receive more than $70,000 from the International Fund for Cultural Diversity (IFCD). With this year’s attribution, the IFCD will have supported 120 projects in 60 developing countries with over $8.7 million since 2010.
The projects will include, evaluating Jamaica’s Cultural and Creative Industries, proposed by the Jamaica Business Development Corporation (JBDC); Cultural Nests, supporting indigenous cultural start-ups, proposed by Mexico’s Centro de Investigación en Comunicación Comunitaria A.C,; and Strengthening the contemporary dance scene in East Africa, proposed by Tanzania’s Muda Africa Organization.
While the race to find safe and effective COVID-19 vaccines continues, African countries are signing up to a ground-breaking initiative, which aims to secure at least 220 million doses of the vaccine for the continent, once licensed and approved.
All 54 countries on the continent have expressed interest in COVAX, a global initiative which is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance (Gavi) and the World Health Organization (WHO). The partners are working with governments and manufacturers to procure enough vaccine doses to protect the most vulnerable populations on the continent. Through the Gavi-coordinated COVAX Facility, the initiative seeks to ensure access for all: both higher and middle-income countries which will self-finance their own participation, and lower-middle income and low-income countries which will have their participation supported by the COVAX Advance Market Commitment (AMC).
There are eight countries in Africa that have agreed to self-finance their vaccine doses through the COVAX Facility. This expression of interest will turn into binding commitments to join the initiative by 18 September, with upfront payments to follow no later than 9 October 2020.
“Equatorial Guinea has signed up to COVAX as it’s the most effective way to ensure that our people can access COVID-19 vaccines,” said Hon Mitoha Ondo’O Ayekaba, Vice Minister for Health and Social Welfare, Equatorial Guinea. “We are concerned as some wealthier countries have made moves to secure their own interests. We believe that through this initiative we can access successfully tested vaccines in a timely manner and at lower cost.”
In addition, 46 countries in Africa are eligible for support from the financing instrument, the COVAX AMC which has raised approximately US$ 700 million against an initial target of securing US$ 2 billion seed funding from high-income donor countries, as well as private sector and philanthropists by the end of 2020.
“COVAX is a ground-breaking global initiative which will include African countries and ensure they are not left at the back of the queue for COVID-19 vaccines,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “By reaching beyond the continent to work together with other governments and manufacturers on a global scale and pooling buying power, countries can protect the people most vulnerable to the disease in Africa.”
CEPI is leading COVAX vaccine research and aims to develop up to three safe and effective vaccines which will be made available to countries participating in the COVAX Facility. Nine candidate vaccines are currently being supported by CEPI; two are currently being tested in South Africa, in addition to other regions around the world.
“It’s critical that countries in Africa participate in vaccine trials, in addition to the clinical trials taking place in other regions of the world,” said Dr Richard Hatchett, Chief Executive Officer, CEPI. “Testing vaccines on the continent ensures that sufficient data is generated on the safety and efficacy of the most promising vaccine candidates for the African population so they can be confidently rolled out in Africa once vaccines are approved. CEPI is investing in the research and development of a diverse range of vaccine candidates, with the aim of delivering safe and effective vaccines to those who need them most through COVAX.”
Through COVAX, vaccines that have passed regulatory approval or WHO prequalification will be delivered equally to all participating countries, proportional to their populations. Health workers and other vulnerable populations will be prioritized and then vaccine availability will expand to cover additional priority populations in participating countries.
African countries will need to have in place the right systems and infrastructure to define the regulatory and ethical pathways for a quick approval of a candidate vaccine. They will need to have logistics and supply chain systems which can reach not only the traditional target populations for routine immunizations and campaigns but be ready to vaccinate a much larger target population.
“To roll out a vaccine effectively across countries in Africa, it is critical that communities are engaged and understand the need for vaccination,” said Dr Richard Mihigo, Programme Area Manager, Immunization and Vaccine Development, Programme Area Manager, Immunization and Vaccine Development, WHO Regional Office for Africa. “It is important to already start working with communities to prepare the way for one of the largest vaccination campaigns Africa has ever experienced.”
Physician and public health consultant, Dr. Maryse Simonet said “not many African countries are without impact, but the full extent is not yet known. Most of the cases and the responses have remained in capital cities, yet rapid tests are now coming to rural settings.”
Dr. Maryse Simonet, MD, MPH ’93, MSc ’03
Dr. Maryse Simonet works with Expertise France, a technical assistance agency operator of the French Ministry of Foreign Affairs, to support coordinated and informed coronavirus responses in Guinea and other sub-Saharan nations.
“The onset of COVID-19 required us to adapt our technical assistance activities, in terms of preserving essential health services and responding to the additional needs arising out of this pandemic,” she said, adding that In a lot of African countries, teleworking is only available to an elite minority.
She said people need to maintain informal activities and businesses to survive.
“Like France, Guinea has used hotels to isolate asymptomatic people, but until recently only in the capital. Now Guinea is experimenting with mandated institutional confinement throughout the country, although this may cause objections to testing.”
She also noted that Ebola helped develop and strengthen health security in most countries and through regional and sub-regional organizations.
“This created an advantage in reacting to COVID-19. However, the transmission is much faster and invisible with COVID. A “copy-paste” response, from the Ebola experience or from Western world strategies, is inadequate,”
She also noted that efforts must go beyond finding cases and treating them; there’s a need to focus on anticipating and preventing the spread. “There’s a need to support African health authorities in documenting and implementing creative solutions, rooted in context—including gender sensitive approaches.”
A researcher holds a COVID-19 mRNA vaccine at the National Primate Research Center of Chulalongkorn University in Thailand. Chaiwat Subprasom/SOPA Images/LightRocket via Getty Images
The World Health Organisation (WHO) recently noted that “researchers are working at break-neck speed” to understand SARS-CoV-2, the virus that causes coronavirus disease (COVID-19). They are also working to develop potential vaccines, medicines and other technologies that are affordable and equitable. By June 2020 – six months since it was first identified – thousands of therapeutic trials and dozens of vaccine development studies were under way, including one vaccine study each in South Africa and Nigeria.
As a public health specialist and infectious diseases epidemiologist, I am very happy and impressed to see such massive research activity to relieve human suffering from this baffling disease. But then, as an African, I ask myself, when will these treatments or vaccines be available for Africans on African soil? Will the “break-neck speed”, “affordability” and “equity” work for the benefit of Africa?
It is true that African countries are making their own efforts to fight the pandemic. For example, the Democratic Republic of Congo (DRC) is building on its Ebola response to tackle COVID-19; Namibia is working hard on a “test-isolate-treat” strategy; and Nigeria is turning hospitals into COVID-19 treatment centres and calling on volunteer nurses to close the gap in health professionals. The WHO is also supporting the COVID-19 response in the African region, particularly in logistics and the capacity of health and multidisciplinary experts.
But the history of pandemic or epidemic diseases is not encouraging. It shows that treatments and vaccines have been accessible to African countries only after the loss of millions of lives and typically years – sometimes decades – after developed nations have benefited from them. This is mainly because the treatments and vaccines for most diseases are produced in Western countries and are too expensive for African countries. This largely remains in place as the chief barrier to accessibility of treatments and vaccines.
What history tells us
The timelines, affordability and equity of providing services to manage tuberculosis (TB) and HIV illustrate the above point.
The scientist Robert Koch discovered Mycobacterium tuberculosis, the bacteria that causes TB, in 1882. TB become an epidemic disease in Africa a decade later. And it is still a public health threat on the continent. By 2016, there were 2.5 million infections and 420,000 deaths.
TB treatment in the US and Europe was introduced in 1944. But Africa only started receiving the treatment in the early 1970s, nearly three decades later. The drugs were very expensive and African countries couldn’t afford to import them.
It was the same with the TB vaccine, BCG. European and American babies started receiving it in the 1920s. South Africans had to wait more than 50 years. The vaccine was too expensive and international donors needed several years to rally support for political and economic reasons.
Similarly, antiretroviral therapy (ART) for HIV came to Africa in the early 21st century, roughly a decade after it was available in the developed West. By then the problem was far worse in Africa, despite some fragmented prevention efforts. The death rate in the 1990s was 100-200 per 100,000 in Africa but only 5-10 per 100,000 in Europe. As of 2018, HIV infected 25.7 million and killed 0.47 million Africans.
The price of ART drugs eventually declined because of higher purchase volumes, more producers and the availability of generics.
A strategy of testing for and treating HIV was launched in the US in 2010, and only six years later in parts of Africa. Test-and-treat programmes are still not available in all African countries because of poor infrastructure, shortages of trained professionals and other reasons. ART is still expensive for African countries but has been supported by international donors. Some NGOs that were central to the treatment strategy are handing it over to local governments.
Generally, treatments and vaccines for almost all diseases are developed outside Africa and take years to arrive in low-income countries, which cannot initially afford them. When they do arrive there may be other problems, such as lack of infrastructure to distribute the treatments and deliver vaccines, and lack of skilled health workers to provide the care. The people in need may not take up the available services widely. Modern and traditional healthcare provision aren’t always integrated in ways that enhance health-seeking behaviour.
Remaining obstacles
In addition to the long and complex process of trial research, there are several factors that complicate access to future COVID-19 treatments and vaccines.
First, the traditional donors to African countries themselves are hard-hit by the virus and many are at the brink of deep economic recession, if not depression. Therefore they may not be able to contribute readily to directly supporting Africa’s health systems, subsidising drugs or strengthening existing partnerships between countries and institutions.
Second, the withdrawal of US financial support for the WHO, one of the major supporters of Africa, will most certainly be felt. US allies could also revise their contribution and thereby destabilise the institution. And there could be a disconnect between US scholars and the WHO, to the detriment of Africa.
Third, many African governments may not be able to afford the cost of a COVID-19 vaccine.
Fourth, there are ongoing conflicts and displacement of people in the region, which will challenge access.
Fifth, the region has poor infrastructure and a shortage of health workers to distribute treatments or vaccines.
So, to manage the COVID-19 crisis, Africa must learn from the history of HIV, TB and other outbreaks. A delayed introduction of treatments and vaccines should not be repeated. And countries should first do all they can to prevent the crisis.
In 2020, it was the only African country ranked in the top 10 of the World Economic Forum’s Global Gender Gap Report.
It ranked in the top four in the Report’s political empowerment category, in recognition of the high proportion of Rwandese women lawmakers and ministers.
The country therefore seemed a natural fit for a 2018 pilot program of the African Development Bank’s Coding for Employment initiative, with Nigeria, Kenya, Côte d’Ivoire and Senegal.
The Coding for Employment flagship program is establishing 130 ICT centers for excellence in Africa, training 234,000 youths for employability and entrepreneurship to create over 9 million jobs.
Hendrina C. Doroba, Manager in the Education, Human Capital and Employment Division at the Bank, explains how Rwanda is empowering women in technology.
How has the government of Rwanda enabled women to pursue careers in technology, and STEM in general?
The government of Rwanda has been a foremost champion of women in ICT and in the fields of science, technology, engineering and mathematics (also known as STEM), by driving initiatives like the establishment of the Carnegie Mellon University-Africa campus, for which the Bank provided funding. Students from 17 different countries pursue highly specialized ICT skills at the Africa campus.
The country also hosts the African Institute of Mathematics (AIMS) which is now recruiting balanced cohorts of women and men. Lastly, the Bank-funded University of Rwanda College of Science and Technology has for many years produced women leaders in the ICT sector in Rwanda and globally.
Rwanda’s government also supports initiatives such as the Miss Geek Rwanda competition, an initiative of Girls in ICT Rwanda, which aims to encourage school-age girls, even those in remote areas, to develop innovative tech or business ideas and to generally immerse themselves in ICT. The Miss Geek initiative has now been rolled out in other countries in the region.
What role has the Bank played in supporting Rwanda’s digital strategy, especially in relation to women?
The strategy of the Bank’s Coding for Employment center of excellence in Rwanda has been to join forces with the Rwanda Coding Academy through a grant agreement to support the school’s activities, like ICT equipment, teacher training and career orientation. The Rwanda Coding Academy started in January 2019 and has so far enrolled one cohort, which is now going into their second year.
Besides the Rwanda Coding Academy, the Bank’s Coding for Employment program held a two-day masterclass for girls and young women entrepreneurs at the 2018 Youth Conneckt summit, where over 200 beneficiaries were trained in using digital tools to amplify their businesses. The session was attended by women entrepreneurs as well as students from girl schools in Kigali, including those from White Dove School, which is an all-girl school fully dedicated to training in ICT. The masterclass culminated into a pitching exercises from various groups who presented their ideas to a panel of judges.
What lessons can other African countries learn from Rwanda’s approach to the 4IR, in particular the role of women?
The government of Rwanda has been a trailblazer in using innovation to improve public services across the country using the e-governance platform Irembo, to bring government services closer to citizens. In addition, the government is driving national digital skilling campaigns by championing digital ambassador programs and platforms such as Smart Africa, which has organized the annual Transform Africa summit since 2013.
Still, gender equality remains a concern, and gender gaps are evident even in schools. Rwanda’s ambitions extend to piloting the Kigali Innovation City, also Bank-funded, to serve as the country’s knowledge and innovation hub by attracting new businesses and incubating ideas. At the same time, the country has created a business environment which is pro-entrepreneurship and welcomes global inventors to test their ideas and concepts. Zipline, a company which uses drones to deliver medical supplies in remote areas, is one example.
Lastly, Rwanda promotes women leaders in the ICT and innovation sector. The country’s Minister of ICT and Innovation is a woman, as is the CEO of the Irembo platform. Appointments such as these are helping to dispel the myth that women are not as capable as men in ICT.
Africa faces a range of public health challenges, from infectious diseases such as cholera, malaria, Ebola, HIV, and more recently, coronavirus, to a growing burden of chronic diseases. Other problems in Africa, including poverty, armed conflicts, and government mismanagement, complicate efforts to address health issues.
Joseph Agyepong
But the founding director of the three-year-old Africa Centres for Disease Control and Prevention (Africa CDC), John Nkengasong, says African nations are making a concerted effort to develop a continent-wide strategy for improving public health.
Nkengasong, who formerly served in leadership roles at the U.S. Centers for Disease Control and Prevention’s Center for Global Health and the International Laboratory Branch of the Division of Global HIV and TB, spoke on March 5, 2020 at Harvard T.H. Chan School of Public Health’s inaugural Joseph S. Agyepong Distinguished Lecture on Public Health in Africa.
Agyepong, founder and executive chairman of the Ghana-based Jospong Group of Companies, spoke at the event and explained how his interest in public health led him to endow the lecture series. Harvard Chan School Dean Michelle Williams and Emmanuel Akyeampong, Oppenheimer Faculty Director for the Center for African Studies, offered opening remarks. Eugene Richardson, assistant professor of global health and social medicine at Harvard Medical School and a Brigham and Women’s Hospital physician, moderated a Q&A with Nkengasong after his presentation.
Nkengasong said that the Africa CDC’s overall goals are to improve disease surveillance, emergency preparedness and response, laboratory systems and networks, information systems, and national public health institutions.
He described some specific challenges, such as controlling Ebola. The virus used to crop up only in remote areas, but recent outbreaks in cities in West Africa “took us two years to beat back,” he said. Progress has been made in improving maternal and child health, but more needs to be done. And obesity in Africa is on the rise.
One important way to improve public health across Africa is to increase local manufacturing of medications and diagnostics, Nkengasong said. At present, Africa relies heavily on drugs imported from countries such as China and India, but locally manufactured drugs could cost far less. As for diagnostics, he said they’re badly needed for endemic diseases such as malaria, tuberculosis, and HIV.
Africa also needs to significantly boost its public health workforce, according to Nkengasong. For example, there are only 1,400 epidemiologists for the entire continent, but 6,000 are needed.
The Africa CDC has been spearheading numerous continent-wide meetings and trainings for public health professionals, Nkengasong said. In late February, to address the growing threat of coronavirus, the agency helped convene an emergency meeting for dozens of ministers of health from across Africa, and created a coronavirus task force to support member states with surveillance, clinical care and management, infection prevention and control, supply chain management, laboratory work, and risk communications.
“In December or January, if we’d been hit in Africa [with the coronavirus], we wouldn’t have had one single laboratory that was able to diagnose it,” he said. The Africa CDC kicked into action, organizing two massive training sessions for public health workers from across Africa. “As of today, we have more than 40 countries that have the ability to detect the virus,” he said. “Hopefully by the middle of this month, all countries will have the ability to detect it.”
He said the coronavirus response shows the power of “unity of purpose” in Africa—the ability of Africans “to come together rapidly … and act to solve a problem.”
A global coalition of development partners announced today their commitment to maintain momentum in the fight against extreme poverty, with $82 billion for the International Development Association (IDA), the World Bank’s fund for the poorest.
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The financing, which includes more than $53 billion for Africa, will help countries invest in the needs of their people, boost economic growth, and bolster resilience to climate shocks and natural disasters.
“Today’s commitment by our partners is a strong sign of their support for the urgent mission to end extreme poverty and promote shared prosperity in the poorest and most vulnerable countries,” said World Bank Group President David Malpass. “We are grateful for their continued trust in IDA and its ability to deliver good development outcomes for people most in need.”
Two thirds of the world’s poor—almost 500 million people—now live in countries supported by IDA. The funding will allow IDA to reinforce its support to job creation and economic transformation, good governance, and accountable institutions. It will also help countries deal with the challenges posed by climate change, gender inequality, and situations of fragility, conflict, and violence, including in the Sahel, the Lake Chad region, and the Horn of Africa.
IDA will renew its support to facilitate growth and regional integration, including investments in quality infrastructure. The IDA Private Sector Window will continue enabling the International Finance Corporation (IFC) and the Multilateral Investment Guarantee Agency (MIGA) to mobilize private sector investment in challenging environments, a critical component to meet the scale of financing needed in developing countries.
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