COVID-19 and NTDs: Implications for Sightsavers supported programmes

The world has been assaulted by COVID-19. Unpredictable changes in all sectors of economies and societies will manifest themselves over the coming months with impacts as yet unpredicted and unpredictable. There is no evidence that any country has been adequately prepared for the COVID-19 pandemic, so precisely predicted by Bill Gates in 2015 in his TED talk following the Ebola outbreak. The most robust health systems have become overwhelmed in countries which spend a higher proportion (around 2-3 per cent) of the GDP on health/medical care (Germany, France and Italy) compared with the UK. The impact of COVID-19 will be long term, initially from an acute medical emergency response via attempted mitigation, through to a phase of chronic acceptance of the situation as cases fall from a peak. The real impact of the societal costs will outweigh the initial medical costs of interventions (or preparedness that should have been done) but have major long-term impacts on the most vulnerable in society. The consequential mental health morbidity will place a huge burden on already overstretched services. Domestic violence and social stress will increase because of an economy in recession – if not depression – with high levels of unemployment. The likelihood of increased unemployment, particularly of the younger urban male population, could be a tinder box for violence. However, the situation in Africa could unfold in a different way and should be seen through a different lens.

It can be anticipated that the immediate and long-term consequences for Africa will, perhaps, be even more profound than elsewhere given the fragility of health systems and the unlikelihood that social distancing can be possible particularly in larger conurbations, where more than 40% of Africans live, or that social messaging imperatives can be expected in rural settings. The longer-term consequences could be felt for decades. At the time of writing urban Africa is probably four to six weeks behind Europe and the United States but has some limited time to initiate adequate mitigation policies such as social distancing and lockdown to stem the spread of this most infective and contagious virus. Such harsh enforced measures in South Africa have at the time of writing seemingly capped numbers of cases, albeit for the time being.