West Africa has recorded its highest number of COVID-19 deaths since the pandemic began as several countries grapple with outbreaks of cholera, Ebola Virus Disease and Marburg Virus Disease that threaten to further strain the already stretched emergency response capacity in the region.

COVID-19 fatalities in West Africa over the past four weeks increased by 193% from 348 in the previous four weeks to 1018 in the week ending on 15 August. Although the case fatality ratio, or the proportion of people diagnosed with the disease who have died, stands at 1.4% below the continental average of 2.5% it is higher than the previous two waves in the sub-region, a sign that health systems are feeling the strain of a heavy caseload. While new cases in West Africa have dropped this week, they were surging for eight consecutive weeks.

Overall Africa recorded over 244 000 new cases in the week ending on 15 August, an 11% drop from the week before and a second straight week of declining cases. However, nine out of 23 countries experiencing a resurgence are in West Africa. Cote d’Ivoire, Guinea and Nigeria are experiencing a surge in cases and all three countries are tackling other outbreaks.

West Africa health systems are even more fragile than those in other sub-regions. A World Health Organization (WHO) assessment of the functionality of health systems in West Africa found that they were 21% lower than in Southern Africa,

“We are particularly concerned about West Africa and we can expect the pressure of COVID-19 to hit health services harder and faster,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “In addition to the strain of COVID-19, comes Ebola and other outbreaks. Fighting multiple outbreaks is a complex challenge.”

COVID-19 vaccines deliveries

West Africa has to date received around 29 million vaccine doses almost the same amount as East and Southern Africa. However, the rollout has been slow, with 38% of the doses administered compared with 76% in East and Southern Africa and 95% in North Africa. West Africa has delivered 2.4 doses per 100 people. In East and Southern Africa, the figure stands at 4.8 doses per 100 people.

Vaccine shipments to Africa have picked up with the COVAX Facility delivering almost 10 million doses to Africa so far in August that is nine times what was delivered in the same period in July. The African Union has so far delivered 1.5 million doses to nine countries. Since June, the number of doses administered per 100 people in sub-Saharan Africa has almost tripled form 1.2 per 100 people to 3.4 per 100 people.

“While COVID-19 vaccine shipments seem to be taking off, Africa is encountering headwinds. Moves by some countries globally to introduce booster shots threaten the promise of a brighter tomorrow for Africa. As some richer countries hoard vaccines, they make a mockery of vaccine equity,” said Dr Moeti.

Ebola outbreak

Cote d’Ivoire declared an outbreak of Ebola on 14 August the country’s first since 1994 n the commercial capital of Abidjan, home to nearly 5 million people. As of 18 August, there was one confirmed case and three suspected cases that later tested negative. Six high-risk contacts have been quarantined and 131 contacts listed. No deaths have been reported.

The confirmed case is currently hospitalized in Abidjan. She is a Guinean national and travelled to Cote d’Ivoire from a rural community in Guinea. Investigations are ongoing into the source of the outbreak.

WHO has deployed expert teams to Cote d’Ivoire and Guinea to support the national authorities rapidly scale up measures including infection prevention and control, diagnostics, contact tracing, case management, community mobilization and cross-border surveillance to contain the latest hemorrhagic fever outbreaks. Cote d’Ivoire has started to vaccinate contacts, contacts of contacts and health workers.

Guinea is collaborating with Cote d’Ivoire on the investigation into the outbreak. As of 18 August, 49 contacts have been listed in Guinea and health authorities are preparing to vaccinate high-risk contacts.

“These new outbreaks are a clear reminder that other health emergencies are not taking a back seat just because we are busy battling a global pandemic. We must remain alert and quick to respond so that other dangerous diseases are denied the chance to spread and cause further devastation,” said Dr Moeti.

Marburg outbreak

On 9 August, Guinea detected a case of Marburg virus disease which is in the same family as Ebola. No new cases have since been recorded. A total of 173 contacts have been identified.

The Marburg virus, the first such outbreak in West Africa, was detected in a locality in southern Guinea close to the border with Liberia and Sierra Leone. It is also the same region where cases of the 2021 Ebola outbreak in Guinea as well as the 2014–2016 West Africa outbreak were initially confirmed.

Dr Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Hon Mr Pierre N’Gou Dimba, Cote d’Ivoire Minister of Health, Public Hygiene and Universal Health Coverage, and Hon Dr Rémy Lamah, Minister of Health, Guinea.

Also on hand to answer questions were Dr Jean-marie Vianny Yameogo, WHO Representative in Cote d’Ivoire, Dr Georges Ki-Zerbo, WHO Representative in Guinea, as well as Dr Phionah Atuhebwe, New Vaccines Introduction Officer, WHO Regional Office for Africa, and Dr Gilson Paluku, Routine Immunization and New Vaccines Introduction Officer, WHO Regional Office for Africa.

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