Dec. 22 2020

How Our Experts Are Guiding Pandemic Response in Africa and Beyond

On April 13, renowned South African infectious disease scientist Salim Abdool Karim held a two-hour live televised briefing on COVID-19, in his capacity as the country’s chief scientific advisor on the pandemic. As millions tuned in, Abdool Karim, a professor at the Columbia Mailman School, explained why a lockdown was needed to control the spread of the virus and did not sugar-coat the “difficult truth” that the country could not totally escape the ravages of the virus when restrictions were eased. (Watch video of his presentation.)

The following day, headlines praised his careful explanation of the science undergirding his recommendations, calling his presentation an example of “a great mind at work,” and responsible for a sea change in the public’s understanding of the government’s decisions on pandemic response. According to a study by researcher Marina Joubert examining the public profile of Abdool Karim, the pandemic made the professor a household name, South Africa’s equivalent of Anthony Fauci. The hashtag #ProfKarim trended on Twitter.

Just as Abdool Karim advised leaders in South Africa, so too did ICAP leaders, working closely with officials in 24 countries in Africa, Asia, and the Americas. Support from ICAP, the global health organization based at Columbia Mailman, was partly responsible for efforts that prevented the uncontrolled spread of the virus in the nations they severe. (Of course, the School’s faculty have also been active helping guide pandemic response in the United States.)

A Master Communicator

The first COVID case in South Africa was confirmed on March 5—a 38-year-old man who had recently traveled to Italy. In days following, as cases climbed and community transmission became apparent, President Cyril Ramaphosa declared a national state of disaster and his Minister of Health assembled a committee of 50 scientists, epidemiologists, virologists, and researchers to advise government policy on the pandemic. That committee was led by Salim Abdool Karim.

For three decades, Salim Abdool Karim, MS ‘88, along with his wife and scientific collaborator, Quarraisha Abdool Karim, MS ‘88, have led the fight against HIV and tuberculosis in South Africa. In 2010, they announced the first effective microbicide gel for HIV and herpes simplex virus type 2 in women. Salim Abdool Karim holds multiple academic appointments, global health leadership positions, and is the recipient of numerous honors. Last year, he was inducted into the prestigious Royal Society. This month, he was awarded the John Maddox Prize 2020 for standing up for sound science during the pandemic, an honor he shared with Anthony Fauci. On December 15, President Ramaphosa sent the professor a congratulatory letter, writing, “It is a richly deserved recognition of the sterling work you have done in service of your country.”

This spring, Abdool Karim and other scientists feared a huge spike in COVID-19 like what was seen in New York. In developing recommendations, the professor spent long hours poring over the data and consulting with experts in South Africa and beyond—including the World Health Organization, the Chinese CDC, and Anthony Fauci. On March 26, the country closed its border and began a five-week lockdown. Officials also took the bold step to temporality ban alcohol and cigarettes, an action followed by a precipitous drop in emergency room admissions.

Thankfully, the worst didn’t happen. The country hit a peak of 14,000 daily cases in July, after which cases declined until rising again recently. Few hospitals were overwhelmed, and the death toll was significantly lower than expected. To explain why his country has been spared the worst, Abdool Karim told the BBC that a number of factors could be in play, including underreporting and under-testing, a relatively youthful population, the potential effect of a relatively warmer climate, and an effective lockdown. He also pointed to systems in place to fight HIV and tuberculosis that “assisted us and better prepared us to cope with COVID.”

Another reason South Africa has been relatively successful in fighting the pandemic could be public trust in the country’s pandemic brains trust—especially in its lead scientist. According to the Joubert study, Abdool Karim was successful owing to a communication style “characterized as inclusive, transparent, frank, truthful, succinct, consistent and compassionate, as well as the acknowledgment of uncertainty and ambiguity that are often inherent to a crisis.” No doubt, adept communications of this kind will be needed in South Africa—and the rest of the world—as they work to control a surge in cases and ensure their populations are vaccinated.

ICAP on the Front Lines

Since the early days of the pandemic, ICAP leaders have advised leaders in countries in 24 countries in Africa, Asia, and the Americas, building on nearly two decades of experience in responding to the world’s most significant public health challenges and harnessing its longstanding partnerships with ministries of health across the globe. In partnership with stakeholders in each of the countries, ICAP directed its teams to create firewalls of detection, prevention, and response to stand between the spreading virus and the communities in its path.

In Sierra Leone, ICAP senior staff work closely with the National COVID-19 Response Committee, a group established and chaired by Sierra Leone President Julius Maada Bio. They helped develop strategic and operational plans for surveillance and data management, case management, testing, and other aspects of emergency response. Meanwhile, they analyzed epidemiologic and surveillance data to inform policy changes and developed guidelines for the reopening of schools and the land border. Recently, the government has directed ICAP to coordinate the roll-out of the COVID-19 vaccine.

Much in the way it has built healthcare capacity around HIV/AIDS and tuberculosis, ICAP has supported training for frontline workers on COVID-19—a plan carried out in more than a dozen countries. In Eswatini, a small country bordering South Africa, ICAP worked with the Ministry of Health and implementation partners to identify a training gap in the Manzini region, the epicenter of the COVID-19 crisis in the country. ICAP staff embedded in the Ministry of Health developed a curriculum and training materials, then trained master trainers in infection prevention and control, as well as mental health screening; these trainers went on to train frontline workers across the country.

“ICAP’s work is helping keep many communities safe and helping point the way to bringing COVID-19 under control,” said Wafaa El-Sadr, ICAP director and University Professor at Columbia in the School of Public Health. “With so much at stake, we are working at full pitch and will not rest in our efforts to stem the tide of this pandemic and to support the communities in its path.”

Watch video of Salim Abdool Karim on television, April 13, 2020: