By Adelyn Wangusi
Amref Health Africa has launched the COVID-19 Response Governance Mapping Initiative, a study on the sustainability and effectiveness of COVID-19 response efforts implemented in Kenya, Uganda, Tanzania, Ethiopia, Senegal, and Malawi.
The initiative is a joint project between researchers based at AMREF International University (Kenya). The University of Edinburgh (Scotland), the Somali Institute of Development Research and Analysis, the University of the Witwatersrand (South Africa), the University of Kinshasa (the Democratic Republic of the Congo), the National Institute of Public Health in Burundi, the University of Sydney (Australia), and UC Louvain (Belgium).
The COVID-19 pandemic has amplified the challenges in health systems and demonstrated the importance of strong and effective governance in response efforts. As such, the study examined the pandemic response governance under three levels of information: political and legal order, key actors involved, and the nature of measures taken.
The study also identified executive committees as the primary decision-makers in the COVID-19 response, with advisory committees established to advise decision-makers and coordination committees set up to manage the implementation of policies and measures. These key actors, drawn from existing and newly established task force groups, cut across government institutions, security agencies, private sector, civil society and religious groups, business, and the scientific community.
The African countries reviewed revealed similarities in policies and measures taken to control the spread of COVID-19. At the core of efforts to respond to the pandemic, countries declared states of emergency, enforced mandatory lockdowns and travel restrictions, banned public gatherings, and prescribed quarantine measures.
Unsystematic execution of select policies and measures led to a notable increase in the stigmatization of COVID-19, violation of human rights including the freedom of information and expression, and double standards towards adherence to measures, especially by the political class. These loopholes led to protests, injury and loss of life, shut down of internet services and censorship and gagging of media, exposing the lack of accountability by key actors involved.
The findings of the study showcase the indispensable need for accountability in governance related to the provision of essential services, emergency responses, intergovernmental and private sector coordination, and community engagement during the pandemic.
‘‘Governance involving health actors needs to have moral and ethical considerations. When lives are at stake, decision making on the acceptable, appropriate and sustainable measures and policies need to be for the greater good and protect people’s lives,” said Dr. Githinji Gitahi, Group CEO, Amref Health Africa. He added: “Strengthening governance related to planning, coordination, and implementation of COVID-19 response efforts needs accountability and transparency to enhance public participation, protect people’s lives and increase the effectiveness of the emergency response.”