African nations are scrambling to prevent swine flu from reaching a continent already struggling with the burden of AIDS and malaria, fearing an outbreak could wreak much more devastation than in North America or Europe.
There have been no confirmed cases of the virus in Africa, and medical workers have stepped up surveillance at airports and border posts although funds for such efforts are limited. If worst fears are realized, experts say the disease could collapse weak health systems and take a huge human toll.
Some 22 million people are living with HIV in sub-Saharan Africa, and their weakened immune systems could make them particularly vulnerable to swine flu, especially in rural areas with little access to health facilities.
“People living with HIV/AIDS would be much affected by the disease because their immune system is already weak,” said Dr. Sam Zaramba, director of health services in Uganda.
The threat of swine flu also comes as southern African countries are heading into winter when even seasonal influenza causes sickness and death worsened by poverty, lack of decent shelter and food and overcrowding.
Swine flu has killed 29 people in Mexico and two people in the United States. Although the number of deaths is low, there are fears that if the virus spreads, it could mutate into a more dangerous form and that there could be a second, more lethal wave.
‘Overly hysterical response’
And yet, as global attention focuses on swine flu — which has infected more than 1,600 people in more than 20 countries — thousands of Africans die unseen and unnoticed every day of preventable and treatable diseases.
“Why isn’t there such an emergency mobilization against diarrheal diseases which kill 2.5 million children a year?” said David Sanders, professor of public health at the University of the Western Cape. “Maybe it (swine fever) is a huge threat but it does seem to have triggered an overly hysterical response,” he said Tuesday of the global mobilization.
“One can’t help but wonder if there isn’t a North-South divide expressing itself here,” said Sanders, one of South Africa’s top public health experts.
The burden of ill health in Africa is crippling. Nearly 3,000 children die each day of malaria, often for lack of a simple bed net. More than 1,900 people have died and 56,000 people have been sickened since January in a meningitis epidemic that has swept Nigeria, Niger and Chad but gained little international attention.
The chaotic health system in Nigeria has prompted concern about whether authorities in Africa’s most populous nation would be able to trace or control swine flu cases. Zimbabwe struggled to cope with easily treatable cholera, resulting in an epidemic that killed more than 4,000 people and sickened 80,000 — in an ominous sign of what might happen in the event of the swine flu virus taking hold.
The continent’s richest nation, South Africa, is also beset by health problems, with an estimated 1,000 people dying each day from HIV/AIDS and even more become newly infected with the virus. In the worst-hit South Africa urban sprawls, tuberculosis has reached four times the level classified as an emergency by the World Health Organization.
“We are in a country that faces several health emergencies on a regular basis and we have few resources to deal with them,” said Eric Goemaere, a veteran with Medecins Sans Frontieres who cares for people with HIV and TB in a sprawling township near Cape Town. “We just don’t have the luxury to build up stocks of Tamiflu where we have lots of other priorities.”
Burkina Faso’s government, for example, has no stock of Tamiflu but has sent a request to the World Health Organization, according to Dr. Ousmane Badolo, head of department of epidemiologic surveillance at the country’s health ministry.
Doing their best
Despite a lack of Tamiflu stocks and sophisticated surveillance equipment, African countries are doing their best to keep the continent clear of the virus.
In Zambia, authorities stationed medical doctors and epidemiologists at border crossing points and international airports for round-the-clock surveillance and held training sessions for airport staff on how to handle suspected flu carriers. Airports near the famed Victoria Falls and the sprawling Luangwa game sanctuary also have established special screening rooms.
Ugandan Health Minister Stephen Malinga said Tuesday that the eastern African nation would oblige all arriving visitors at airports and border posts to fill out forms and would monitor everyone who had visited a country with reported cases of swine fever.
“We take their contacts like phone numbers, addresses of places they’re going. We then tell them about swine flu symptoms and what they should do if they get such symptoms,” Malinga told journalists. He said one hospital near the airport and another in the capital Entebbe had been designated for swine flu cases.
In Ethiopia, the ministry of health has alerted hospitals and regional health bureaus and set up an examination center and 10-bed quarantine unit at the main international airport, according to spokesman Ahmed Emano.
And authorities in South Africa — where two suspected cases tested negative — plan to install a thermal image detection system at the main international airport to check passengers for fever. South Africa is the regional air hub and handles millions of passengers each year. It is expecting an influx of visitors in the coming weeks for sporting events including soccer’s Confederations Cup.
South Africa also had been due to host a big international influenza conference next week, according to Lucille Blumberg, deputy director of South Africa’s National Institute for Communicable Diseases.
She said the symposium had now been canceled — delegates said they couldn’t attend because they were too busy.