GRILA comments on the Coronavirus pandemic, THE CONDITION OF THE CONTINENT AND A PAN-AFRICAN RESPONSE

Apr. 20 2020

This observation and the views that follow, addressed primarily to Pan-Africanists, are intended to outline our present condition and inspire political will among decision-makers responsible for public policy decisions to come to a consensus amidst the looming COVID-19 pandemic. It urges Pan-Africanists to embark on required initiatives beyond solely meeting medical objectives and into systemic change for broader public health and wellbeing of African populations. With civic awareness, we must engage our populations and harness a self-reliant development moving beyond COVID-19 that brings our communities together to produce an effective Pan-African response.

The present exceptional combination of three realities confront us: 1) the challenge of the global capitalist order; 2) the unprecedented scale of the ongoing pandemic; 3) an impending ecological disaster. This offers us a historic opportunity to pull ourselves together. Reinforced by Pan-African solidarity, Africa’s resilience, despite centuries of oppression that we have endured, will give us the strength we need to overcome this temporary state of inertia. In addition, as the whole planet is forced to take an ecological pause, it also grants us time to radically reinvent our praxis and internationalism.

We offer our deepest condolences to those who have lost loved one. We offer solidarity to those who are either afflicted by this disease or burdened by caring for the sick, and those who are currently suffering the backlash of lockdowns in difficult conditions. That burden we know falls disproportionately upon African women, who, although on the front lines are denied the credit they are due, both in societal recognition and in equal pay for work of equal value due (i). Due to systemic discrimination against women rooted in capitalist systems and some patriarchal cultural traditions, African women on the continent and women of African descent in the Caribbean and abroad will continue to bear the brunt of caregiving responsibilities for children and elders. African women also face higher rates of gender-based violence and economic insecurity. They are disproportionately represented in the informal sectors which are comprised of lower-paid precarious jobs with no benefits, deprived of sick pay and no disability insurance. In the event they should fall sick, be quarantined or have family obligations to take care of a loved one, African women are likely to be disproportionately impacted by the economic disruption that COVID-19 has caused. Thus, COVID-19 could have a devastating impact on a group that though numerically in the majority continues to experience marginalization, gender-based violence and systemic oppression.

We extend our gratitude and thoughts of solidarity to health care workers who are exposed every day to the risks of this pandemic and forced to shoulder its highest costs. Nor have we forgotten all of the workers of the world, and we pay tribute to those in Africa as well as Afro-descendants globally, whose continuous productivity supplies our society.

Incidentally, during every one of the past four centuries, the world has experienced a catastrophe of a similar magnitude: the plague of 1720, the cholera epidemic of 1820, the ‘Spanish’ flu of 1918-1919 and now a coronavirus crisis in 2019-2020. We also note that pandemics have increased in intensity and frequency – H3N2 around 1968, HIV-AIDS 1981, Dengue 2000, SARS 2003, H1N1 2009, Ebola 2013, MERS 2014, and SARS-CoV-2 better known as CODVID-19 in 2019. This new pandemic has seemingly resulted from a human-animal contact. Most human diseases of zoonotic origin (SARS, H1N1, yellow fever, avian influenza H5N1 or H7N9 and probably CODVID-19) are the result of human incursion into or aggression against the animal world rather than the other way around. Viruses that have existed for millions of years are adapting and mutating more than ever before, especially since humans are irreversibly altering environmental spaces (ii). The transmission of Covid-19 between humans is attested at least as early as December 2019 in the area around a market in Huanan (southern China), when it also infected the city of Wuhan (central China) (iii). There was still no reason to believe that this epidemic would result in a pandemic (iv). It appears that the scientific community was ill-prepared for the outbreak. As of April 10 2020, there have been 1,521,252 confirmed cases of COVID-19, including 92,798 deaths, reported to WHO.

The virus has an RNA-type genome. Its mode of replication allows it to create new strains, mutate and makes this pandemic all the more complex. The disease spreads rapidly, mainly through droplets and physical contact. Within a few weeks, it had left China, rapidly taking advantage of the transnational connectivity of communication networks. Because the disease was underestimated, it was able to spread very quickly, and continues to do so in many social sites, exploding in the absence of minimal sanitation standards and also being transported by asymptomatic carriers (v)who may be super spreaders or carriers with mild or inconsistent symptoms. The use of symptom-relieving drugs has also undermined early intervention measures. The impact of the virus appears to differ according to the reliability of statistics; a) either within or between countries; b) mortality rates (the number of people who die in relation to a population in a given period), c) morbidity rates (the number of people with the same disease in a given population), d) lethality rates (deaths in the pool of infected people). WHO recommends that people avoid touching their eyes, nose and mouth and notes the following:
“The most common symptoms of COVID-19 are fever, tiredness, and dry cough (vi). Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don’t feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness (vii).”

In China, in the absence of an approved drug or vaccine, it soon became apparent that it was necessary to isolate patients, track down suspicious temperatures, establish sanitation perimeters around health care facilities, protect health care personnel, and immobilize contact cases, who were the sources of infection through quarantine. Prevention (strict hygiene with soapy water, disinfection of suspect areas, physical distancing, wearing of masks and gloves), screening by testing and preservation or strengthening of the immune system proved to be key methods for blocking the spread of the disease. In addition to closing down educational institutions, restricting movement and banning gatherings, healthy people were confined to their homes and sanitation perimeters were established around domestic supply sites. It is too early to know what proportion of the population has been affected and the ones who have developed immunity, if any at all. The success of these practices in China, Japan, Hong Kong and South Korea should have been a lesson for the rest of the world, especially for rich countries such as those in Europe and North-America. Instead, the United Kingdom, the United States, the Netherlands and Sweden initially chose to use a herd immunity approach, protecting the most vulnerable people (I.e. seniors, persons who are immunocompromised) and allowing large segments of the population to become infected at the risk of provoking high mortality. However, these positions have now changed with the U.S and the U.K. using drastic measures (shutdown of all non-essential business, closing of borders, imposed telework and enforcement of social distancing measures), as in other jurisdictions, to slow down the spread of the disease and flatten the curve.

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There has been unusual scientific cooperation at the global level, with nations taking advantage of recent protocols or existing standardized forms of collaboration (viii). A grateful world salutes the solidarity demonstrated by countries such as China, Russia, Venezuela and especially Cuba. Their willingness to reach out stands in sharp contrast to Europe’s lack of solidarity even within its own borders and among member countries as well.

Xenophobia towards Asians and foreigners accused of spreading the disease has become widespread. A nationalist chill has set in everywhere, with border closures accompanied by a resurgence of racist and populist fears, conspiracy theories, rumour-mongering and lies circulating through social media. As nothing proves that China will not face another outbreak in a few months, the fact that it appears to have contained the disease and major cities are slowly returning to normal, that it is rescuing nations which ask for help, alongside Cuban doctors, adds to the endless conspiracy theories.

The first recorded cases in Africa occurred in mid-February. Our doctors are used to infectious diseases and are skilled in treating them. Most African states have gradually imposed measures which are being applied with relative success, considering regions, available means, and the quality of information systems or social conditions. For now, the disease appears to be spreading more slowly in Africa than on the other continents. However, weak trans-national connectivity, a younger population and poor testing practices may also be blurring a potentially insidious spread. Many Africans have denounced in a declaration initiated by RASA (Rapport Alternatif Sur l’Afrique), the alarmist tone and condescending attitude of interference in African affairs by the WHO and the UN.
“On the contrary, to date, the penetration of the virus into Africa, imported mainly from Europe, seems to be under control with few serious cases recorded and a very low death rate (less than 3%), despite the fact that the virus has been present on the continent for more than 45 days. We are calling on the above-mentioned authorities of the international organizations to consider the seriousness of their unguarded claims, and questioning the scientific foundations of their forecasts which seem more like the outcome of some Machiavellian schemes detrimental to Africans, or even of veiled threats against them. (ix)”

It is still much too early to describe the epidemiological or clinical characteristics of the cases, their geographical particularities, or the impact of this health crisis. Chances are this virus will be around for longer than we think, and that its impact will not be confined to health. Instead it might be socio-economic, political or geopolitical. This challenge requires us to be vigilant and organized in resisting it.
Since the 2008 financial crash, the capitalist crisis has continued on its erratic path. Global indebtedness has reached historically unprecedented levels. Austerity measures have continued with states and peoples unsuccessful in regaining the initiative. The prospect of a serious contraction of economic production and increased unemployment due to the health crisis risks amplifying the problems of underdevelopment in the global South and in Africa. Multilateral and private donors, panicking at the prospect of economic collapse, are already offering crisis and recovery funds, prioritizing the rescue of oligopolies and other monopolistic groups. Their efforts are as likely to breathe new life into the economy of our countries as they are to foster a new kind of dependency. The United States has announced a $6 trillion recovery plan for its own economy and negotiated exclusive lines of credit with the European Central Bank, the central Banks of England, Canada, Japan and Switzerland, and singled out Australia, Brazil, South Korea, Mexico and Sweden for preferential access to $60 billion. Denmark, New Zealand and Norway will have $30 billion. The rest of the world will have to line up to borrow from the IMF and World Bank. African countries that promote the neo-liberal approach or who dare not oppose it, will be privileged. This will further fragment pan-African solidarity which is an imperative under present circumstances. The IMF, if it so consents, could release a huge amount of SDRs (Special Drawing Rights) to relieve our countries, but under what conditions? The World Bank is dangling $160 billion over the next 15 months alone as assistance to countries from the South. There is talk of a temporary freeze on debt repayment, but the conditionalities are unknown. Many of these transnational corporations and financial bodies have been the main vehicles for exploiting workers, supporting the neo-colonial oppression of peoples, plundering raw materials, funding imperialist wars and degrading nature in a manner that accelerates the circulation of viruses.

Pan-Africans will not tolerate additional donor conditionalities resulting from the management of this crisis. We need to establish a common pan-African front both for a united approach to the pandemic and for a global response to the economic stakes of this crisis.

Similarly, it is out of the question for Africa to serve as the testing ground for vaccines that benefit the COVID-19 business or other snake oil salespersons. Within the pharmaceutical industry, some unscrupulous people and complicit laboratories are eager to find African political regimes that would bet against their population’s health for crumbs and turn the masses into guinea pigs. Africa must stand united against such irresponsible regimes. The precautionary approach requires that testing be done in epicenters in Asia, North America and Europe over a long period of time. Testing must provide proof that an immune response has neutralized the virus, is safe and does not cause harmful effects. In principle, it takes more than three months to validate publication on a randomized clinical trial for drugs. There are attempts to save volunteer patients by injecting them with antibodies from the plasma of patients who have recovered. Among the drugs currently under consideration are Remdesivir, an antiviral drug already tested on Ebola; Kaletra, used to treat HIV, which can be used in combination with interferon-beta, as done for MERS coronavirus control; and hydroxychloroquine, used in short-term malaria prophylaxis and treatment or against rheumatoid arthritis. In view of the exceptional situation, some practitioners have taken ethical liberties and tested some of these drugs on voluntary patients.
In order to treat and stop the outbreak, physicians, virologists and epidemiologists are debating the stage of the disease at which these drugs should be administered and whether they should be used as prophylaxis for all exposed to contacts of affected patients. The battle around access, the supply of medicines and their intellectual property rights – generic or similar – has only just begun.

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Several private health and pharmaceutical companies are taking advantage of state disinvestment in social services and the liberalization of the health and education sectors. For more than three decades, the retreat of the State under structural adjustment, has shrunk our health infrastructure, led to a brain drain among hospital staff and made access to health care problematic for a large segment of vulnerable populations. It is not too far-fetched to consider the risk of a higher rate of transmission, given the apparent slower rate of spread, household size, intergenerational cohabitation, population density in some peri-urban areas or shantytowns and camps for displaced persons with less access to water and proper hygiene (x). In addition, there is a temptation to continue social gatherings, mass prayers and ceremonies, not to mention the interaction of the virus with prevalent co-morbidities, malnutrition, tuberculosis, and the lack of intensive care, especially outside major cities (xi).
The equipment shortage for care and protection (masks, gloves, gowns, visors), testing and detection equipment (thermometers, reagents), and machines (respirators, ventilation) is aggravated by the fact that physical distancing measures, protective behaviors and sanitation tools will be hard to operationalize. Dependence on the importation of machines, reagents and medical supplies as well as in other sectors monopolized by the private business is to be expected given the antisocial nature of capitalism.

We object to this crisis being used to promote greater foreign interference in African affairs, conferring health management authority on those who selectively promised financial, material or medical aid. All of this mandates that the State should have more room in which to maneuver and that there be a pan-African and civic responsibility for a global, integrated approach to:
• Provide and participate in gathering as much health information as possible in coordination with health monitoring and surveillance mechanisms under the aegis of the African Union (xii) and its sub-committees, Africa Task Force for Coronavirus (AFTCOR) and Africa’s CDC’s Incident Management System.

• Ensure epidemiological information at the pan-African level in order to provide credible risk assessment. To consult and disseminate the document annexed hereto and the health provisions endorsed by this declaration (xiii).

• Pay attention to the African Union initiative. They are providing each of its Member States with 20,000 laboratory test cases, 100,000 medical masks and 1,000 suits and face protection. Since this may not be enough, further public and private support is expected.

• Support the work of the World Health Organization’s director general, Tedros Adhanom Ghebreyesu and demand and increase budget for the institution

• Ensure food security for our populations. Access to an emergency supply of food for several days, must be available in the event of an extension of confinement or curfew measures. Obviously, this must not only apply to the portion of our population below the poverty line, but will also cover a significant portion of our unpaid masses, who live from day to day and need to replenish their food supplies through the informal sector. Here, we must ensure that the health and safety of workers and vendors are also protected and that adequate supplies of products are made available to them.

• Urge States to provide unemployment benefits to laid-off workers and a social safety net for the most disadvantaged, especially those who might be confined. A universal program of financial support for the persons in need is essential to sustain confinement. The national budget and external aid packages must be prioritized accordingly. All delivery mechanisms should be considered: cash transfers, telephone, door-to-door…

• Ensure that, out of a sense of patriotism, goods are equitably distributed without discrimination based on gender, race, disability, socio-economic class, ethnic or religious affinity.

• Promote the social acceptance of health measures which necessitates a cultural understanding of society, gender and generational sensitivity using an approach that is empathetic and non-oppressive. Popular education should be accompanied by required materials such as soap, water, as well as food (for strengthening the immune system) and, if possible, masks and gloves given in priority to patients and care personnel. We must listen to the scientific personnel, protect them so that they can protect us, respect for protective behaviors to make sure that we protect themselves and their immediate circle. Special attention must be paid to our elders, children and those who are immunocompromised. Those who are 65 years or older represents around 3% of our global population which is therefore young and sometimes reluctant to follow discipline. We appeal to their sense of responsibility. They are a force to be reckoned with and can not only look after our elders but also their own future, while participating in this period of collective resistance. Even if they are more robust, they can also spread infection more quickly.

• Refuse to sacrifice Africans and Afro-descendants as guinea pigs unless volunteers are included, under independent international supervision, in an equivalent cross-section of Asians, Europeans, Australians and Americans, for the advancement of science and the common good (xiv). Oppose with all our energy the ID2020 program of electronic identification advocating general vaccination as a biometric model from birth, which could take advantage of this pandemic to expand their programs (xv).

• Protect workers from unfair dismissals by companies using the crisis as an excuse. Special attention needs to be paid to farmers who ensure continuous production and the maintenance of farms under challenging conditions.

• Protect rural populations- whose immune systems are less exposed to urban promiscuity- against the risks of an urban exodus to rural areas.

• Provide absolute protection for the fauna and flora and ecology in general.

• Provide staff and equipment to clinics in suburban and remote areas, or provide ambulatory medical services.

Make and wear masks, even rudimentary ones, using tailors or doing so at home by making them with triple layers of cloth, and keeping them as sterile as possible. However, this is no substitute for protective behaviors, physical distancing and good hand washing (use tippy-tap when there is no tap water, see footnotes).

• Ensure that all health personnel and all individuals who serve the public on the front lines are fully protected. In this regard, we should pay special attention and offer our solidarity to those women who make up the majority of people most exposed to risks (nurses, orderlies, home care workers, personal support workers as well as production and distribution workers). We should also take advantage of this health crisis to redress the unjust gender and racialized wage gap.

• Significantly increase the health and social security budget as well as provide for the re-employment of volunteer expatriate doctors. Provide for intensive training and the legal employment of nurses and orderlies.

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• Salute the scientific enquiry of the African research community and hope for positive outcomes.

• Boldly introduce the nationalization of private health facilities if hospital capacity is lacking, as well as requisition hotels and sports facilities when necessary.

• Set up a solidarity and patriotic emergency fund from a tax on large fortunes.

• Finance and equip research bodies, laboratories, and furnish tools that enhance awareness and communication. To fund a watchdog surveillance team that uses serological screening (xvi). To provide funding for intensive care units and infrastructure, as well as promote research in our pharmacopoeias and traditional knowledge system, in order to safeguard African ownership on our intellectual property in biodiversity.

• Raw inspiration from the professional training methods as well as social and health policies of Cuba, which has 8 doctors per 1000 inhabitants, in order to secure the civic and health education of our population.

• Ensure the protection and care of foreign nationals and African nationals or citizens who do not reside in their territory of birth.

• Call upon governments to implement a Pan-Africanist holistic gender equity lens that acknowledges African women’s resilience, takes into account their multiple challenges and provides financial resources and support to ensure that their basic needs are met during and after the pandemic. Provide emergency relief and adequate income support to women in need and develop sustainable plans that will support women on their own terms. Involve grassroots indigenous women’s organizations with a Pan-Africanist gender equity lens and African women at all levels of decision making.

• Protect the population from mercantilism and corruption that could result from this exceptional health situation, and shield them from the abuse of persons in positions of authority likely to embezzle materials and funds intended for the pandemic.

• Make provisions against the risks of speculative inflation and shady merchandising.

• Protect the population from the religious or cultural instrumentalization of the pandemic.

• Create space for civil society and its most influential progressive voices to relay essential preventive health information and keep social cohesion wherever unpopular and discredited political regimes are in office.

• Protect populations from human rights abuses that may occur under the emergency measures legislation being used to address the health crisis. Quite often, states spontaneously resort to coercion using the forces of law and order as well as the army. The militarization of health care should only be a last resort, when civilian structures are unable to cope. The militarization of the discourse and approach to the pandemic, is everywhere. It must be put into perspective with regard to the experiences of civilian and military collaboration during previous epidemics. On those occasions there was a tendency to manage vulnerable populations in a warmongering manner that is hostile to public health policy (xvii). Restraint and popular education must prevail over degrading disciplinary behaviour that disrespects human dignity.

• Demonstrate greater solidarity among our peoples and stand in solidarity with the victims of the international order. Stop the embargoes, sanctions and economic exclusion measures against Cuba, Venezuela, Iran and Palestine that violate international law, affect their populations and prevent them from effectively organizing themselves against the pandemic (xviii).

• Revive the Bandung spirit by promote South-South co-operation.

• Have a focus and concern for all countries in the diaspora with Afro-descended populations given that this is the UN International Decade for People of African descent, and the impact of COVID-19 on Afro-descended people.

• Overcome nationalist tendencies in order to regain the momentum of a pan-African internationalist solidarity, and defend humanity as well as the common good by rebuilding values for a different economy based on equity, equal opportunity, democratic and popular decision-making and respect for gender, generations and Nature.

• Restore the nation-state’s capacity to accelerate African integration and free ourselves from restrictive rules on deficits or indebtedness so that, counting on our own strengths (xix), relying on the local transformation of raw materials and natural resources, we can again orient development towards our basic needs and infrastructure.

• Be aware that the post-pandemic transition will offer an opportunity to both a deepening of imperialism and reactionary forces to redouble their effort in recolonizing Africa.
Simultaneously the COVID-19 pandemic provides an opportunity for pan-African forces to rally Africans for the reconstruction and defence of the sovereignty of our continent and its diaspora, for the advent of the continental federal state where popular development is viable, equitable and sustainable. In keeping with that goal, we let us use this opportunity to rebuild political consciousness and democracy so the pan-African masses can control the transition towards a more just world post COVID-19.

References
i COVID-19: the gendered impacts of the outbreak
ii Stephen S Morse, Jonna A K Mazet, Mark Woolhouse, Colin R Parrish, Dennis Carroll, William B Karesh, Carlos Zambrana-Torrelio, W Ian Lipkin, and Peter Daszak, Prediction and prevention of the next pandemic zoonosis,Lancet. 2012 Dec 1; 380(9857): 1956–1965.
iiiQun Li, M.Med., Xuhua Guan, Ph.D., Peng Wu, Ph.D., Xiaoye Wang, M.P.H., et al , Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia, N Engl J Med 2020; 382:1199-1207,
iv Des chercheurs chinois ont divulgué, en accès libre le 5 janvier, l’identité du génome viral et la Chine a informé l’OMS le 7 janvier et le monde le 8 janvier 2020, mais il a fallu attendre le 20 janvier pour qu’elle fasse état de la contagiosité entre humains et de l’ampleur de la catastrophe.
v covid-19-islande-lecons-symptomes-tests-aleatoires-depistage-grande-echelle
Vi (la perte de l’odorat), phénomène observé et attesté aussi chez certains
vii Maladies à Coronavirus,
viii Investigations épidémiologiques et cliniques pre?coces du COVID-19 pour la re?ponse en sante? publique,
ix Déclaration pour une réponse africaine souveraine à la pandémie du Covid-19. Dakar le 30 mars 2020.
x x
Ou Une façon sécuritaire de laver ses mains sans robinets, le Tippy-tap :
x1 Maysoon Dahab, Kevin van Zandvoor, Stefan Flasche, Abdihamid Warsame, Paul B. Spiegel, Ronald J Waldman, Francesco Checchi, COVID-19 control in low-income settings and displaced populations: what can realistically be done, London School of Hygiene and tropical medicine
xii Solidarity Message of the African Union Commission Chairperson to African Member States,
xiii African Union,
xiv Conformément à la Déclaration d’Helsinki et aux lignes directrices internationales relatives aux aspects éthiques de la recherche biomédicale sur des sujets humains.
xv La pandémie de coronavirus COVID-19: Le vrai danger est l’Agenda ID2020 , Mondialisation.Ca,
xvi Lignes directrices, Surveillance mondiale de l’infection humaine par le nouveau coronavirus,
xvii Gibson-Fall, Fawzia, Coronavirus: how to avoid military responses becoming double-edged swords,
xviii Fembargo-and-blockade-during-a-pandemic-attacks-on-the-integrity-of-peoples-condemned-by-international-law
xix Kako Nubukpo, « Après le coronavirus, une autre Afrique est possible et ce n’est pas une utopie » Le monde,