Context

Large-scale epidemics are becoming more and more frequent and constitute a health, economic, social and security threat. Resource-limited, at-risk settings are most vulnerable to the burden and amplification of epidemics — particularly in Africa.

This is notably true of the novel coronavirus (CoVID-19), which scientists isolated on 7 January 2020 following an outbreak of pneumonia of unknown cause in Wuhan, China.

Days later, a real-time polymerase chain reaction (RT-PCR) diagnostic test specific for the new virus was developed. The availability of a molecular diagnostic for CoVID-19 early in the outbreak has proven critically important in tracking the spread of the virus. Additional tools are required to boost surveillance and optimize the public health response until a vaccine or drug are ready to be administered for control of CoVID-19.

Indeed, new diagnostics will aid in the appropriate validation of vaccines and new therapies and will synergize with other pillars of response (infection, prevention, control (IPC) measures, risk communication, community engagement) to control the epidemic. Capacity to respond and control epidemics in Africa is limited but is readily scalable with experienced partners.

Hence, the Institut Pasteur de Dakar was selected by the Africa CDC, WHO and the regional disease surveillance center of WAHO/ECOWAS to deliver an accelerated training program in February for over 31 national public health laboratories across Africa in 2 workshops within a month and on short notice. Respiratory infections are likely the most common communicable infectious diseases worldwide.

The most common causative agents are viruses such as rhinoviruses, respiratory syncytial virus, influenza virus, parainfluenza virus, human metapneumovirus, measles, mumps, adenovirus, and coronaviruses. Coronaviruses are of special interest for they infect a wide variety of host vertebrates and often lead to respiratory, enteric, and neurological infections in humans. Coronaviruses were not considered to be highly pathogenic to humans until the outbreak of severe acute respiratory syndrome (SARS) in 2002 and 2003 in Guangdong province, China. Before that time the coronaviruses regularly identified in humans included HCoV-NL63, HCoV-229E, HCoV-OC43 and HKU1 mostly caused mild infections except some severe infections in infants, young children and elderly individuals.

The SARS-CoV-1 epidemic resulted in >8000 infections with a ~10% case fatality rate. Ten years after SARS, another highly pathogenic coronavirus, Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in Middle Eastern countries. MERS-CoV had been reported in more than 27 countries across the Middle East, Europe, North Africa and Asia.

Since 2012, the World Health Organization has been informed of 2220 laboratory-confirmed cases resulting in at least 790 deaths, with a majority of these cases from the Arabian Peninsula. The two SARS and MERS viruses likely emerged from bats. On 31 December 2019, the WHO country office in China was informed of cases of pneumonia of unknown etiology in the city of Wuhan, Hubei Province in China.
Then, from 31 December 2019 through 3 January 2020, 44 new cases of pneumonia of unknown etiology were reported to WHO by local authorities. Initial investigations establish an epidemiological link of cases to the Huanan Seafood Wholesale Market where there was also sale of live animals including wild fauna. On 7 January 2020, a new coronavirus (SARS-CoV-2) was identified as the causative agent.

Genome sequencing of the SARS-CoV-2 was rapidly performed by Chinese scientists, and the genetic sequence of the SARS-CoV-2 became available to the WHO on 12 January 2020 which greatly facilitated laboratories to produce specific diagnosis RT-PCR tests for detecting the novel infection. On 13 January 2020, Thailand reported a first case imported from Wuhan and confirmed SARS-CoV-2. Then on 15 January 2020, it was Japan's turn to report a confirmed case, imported from Wuhan.

The virus has rapidly spread to other Chinese provinces and to several countries. As of 5 May 2020, the virus infected more than 3 600 106 humans, and 251 898 deaths were reported so far. Currently, the SARS-CoV-2 virus had been detected in more than 40 African countries, including Senegal. Moreover, the massive exchange of population between countries with notable local transmission and Africa is likely to bring more infected humans on the African continent. Mitigating the risk of extension of the SARS-CoV-2 epidemics in Africa is of the utmost importance to preserve the continent as much as possible from the human and economic consequences associated with a possible large-scale spread of the virus.

Objectives

This action proposes a strategic framework to reinforce preparedness and response to CoVID-19 in Africa as well as to implement an innovative approach to address unmet needs of diagnostics and health services through mobile platforms delivering laboratory and health services to detect, respond, control and prevent epidemics in Africa focusing on access driven business models, local capacities and sustainability.

The scientific program aims at addressing immediate needs for response and preparedness in Africa for the CoVID-19 in affected and non-affected countries respectively through the concerted approach of Africa CDC/WHO Afro/WHO/ECOWAS along with Institut Pasteur de Dakar (IPD) as a regional center designated by the 3 organizations and (ii) building a more sustainable and affordable ecosystem to support health system with mobile platforms for diagnostics and health services provided by Praesens Care (PC).