Malawi

MALAWI The pandemic and lessons learnt from Malawi's healthcare ecosystem

The best defence against the pandemic is a strong health system. COVID-19 has exposed how fragile Africa’s health systems and services are, forcing us to make difficult decisions on how to best meet the needs of our people.

The importance of initial and ongoing purpose data, surveillance and the experiences of other countries served as a warning to Malawi, hence the advantage of making preparations in advance. Malawi continuously applied different data to a multisectoral intervention toolkit against the coronavirus.

There has been active government collaboration in respect of international support and the country’s national-level response and preparedness, which led to rapid-purpose strategic responses such as accelerated development and expansion of treatment capacity. Malawi needs to be proactive to revive its fragile health system and adapt to a more targeted response while minimising collateral damage. We need to abolish parallel reporting systems, recruit more healthcare workers to avoid attention-split between competing healthcare needs, and reorganise health system resources, inter alia, reclaiming lost services like the essential healthcare package without losing control of COVID-19.

The country needs to find innovative ways of achieving this that require minimal effort, are as localised as possible and are resourceefficient. It needs a hyperresponse approach to a possible second wave. Current public health law requires updating; research and innovation must be considered critical; ethics processes must be speeded up and a more robust policy approach is needed. In this regard we need to adapt and apply a demand/epidemic stage-based approach.

Malawi has to develop feasible mitigation strategies such as reinforcing central capabilities, strengthening international collaboration, intensifying publicity to safeguard social behavioural change and strengthen monitoring, evaluation, and learning to feed into the country’s initiatives.

African countries should maximise economies of scale for scientific collaboration. Countries can collaborate on a number of issues such as Africa’s own pharmaceutical solutions; improved technological advancements; data-sharing and the need to leverage existing regional networks and operations to catalyse an immediate, large-scale response. Good examples of leveraging capacities are the Regional Disease Surveillance System Enhancement Program of west and central Dr MacFenton Bashir Shariff, Chief Operations Officer: MedHealth Ltd

Africa, and the East Africa Public Health Laboratory Networking Project.

Africa needs serious rapid resurgence planning.