26 Feb 2018
RIGHT TO HEALTHCARE
In January, the Wall Street Journal reported that the US Centres for Disease Control and Prevention (CDC) is planning to downscale its epidemic control programmes in 39 out of 49 countries. The reason is that a five-year, US$600m disease detection programme is running out next year, with President Donald Trump’s administration wanting to cut it by two-thirds.
The disease surveillance programme was instrumental in fighting the 2014 Ebola outbreak in West Africa. It has also funded a biosecure lab in Uganda, trained over a hundred disease detectives in Liberia, and created an emergency operations centre in the Democratic Republic of Congo. US public health experts say the cuts are short-sighted, and that by scaling back its investment now the country might end up paying more later when outbreaks occur.
But the US CDC is not the only agency epidemic-monitoring and disease-fighting agency on the continent. The Bill & Melinda Gates Foundation, the World Health Organisation and the governments of Japan, Germany, Canada and the UK were all major players in the Ebola response. China, which is fast catching up with the US in terms of its scientific output, has its own CDC based in Beijing.
Africa also has its own CDC, created in 2015 and formally launched a year ago. Its director, John Nkengasong, told Africa Portal that it is observing the US CDC’s actions closely. “Any scale back that the US CDC does affects our continental outlook and our ability to address our continental ambition,” he said over the phone from the Africa CDC headquarters in Addis Ababa, Ethiopia.
On the flip side, he said, uncertainty about the US budget is making his job easier to lobby for additional support for African disease surveillance, not only from African governments but also from other global organisations. “Any disease outbreak that occurs in the continent can easily become a global threat. We’d have to go back to the drawing board and say: How do we work collectively to fill that gap?”
Much as it’s built significant momentum in its first few years in operation, however, the Africa CDC is facing funding challenges all of its own. According to Nkengasong the centre’s five-year operational plan assumes a total budget of US$230 million for the plan’s duration. In 2016 African heads of state committed 0.5% of their annual financial contributions to the AU towards the African CDC. But how much this commitment translates to in money terms remains murky.
In 2016 African countries were meant to contribute US$170m to the AU, based on which the Africa CDC would have received US$8.5m. However, the AU has generally only been able to recover 60% of its member contributions, so the actual amount would have been less. Either way, it’s a pittance compared to the roughly US$180m per year that the US spent on disease surveillance under its special programme.
It’s even trickier to calculate what 0.5% of member states’ contributions would look like this coming year. In 2016 the AU adopted a new funding formula, collecting a 0.2% levy on imports from outside Africa. Championed by the AU’s current chairman Paul Kagame, Rwanda’s long-serving president, it is designed to secure the AU’s budget and reduce its dependence on international development partners.
However, the formula faces significant opposition, not least from large economies like South Africa, Egypt and Nigeria. Being the largest contributors to the AU budget, their support is essential for the scheme to work. Critics also maintain that the levy might not be compatible with trade agreements under the World Trade Organisation. And so the question remains: The AU’s contribution to the Africa CDC’s budget will be 0.5% of what?
Nkengkasong did not want to be drawn on his organisation’s 2018 budget. However, the AU’s 2017 annual report, published on 5 February, described the Africa CDC’s operating budget and staffing in the year under review as “very limited” and added that “this constraint limited its ability to carry out its mandated activities”.
Given the uncertainty at the AU, the Africa CDC will need partners, and signs are that its leadership knows that. In December, it signed an agreement to partner with the Japan International Cooperation Agency. And on 8 February China committed RMB500m (about US$80m) over five years for the Africa CDC. Without these new friends and their deep pockets, the African CDC will be helpless should its US counterpart slash its programmes on the continent.
(Main image: John Moore/Getty Images)