In 2013, Guinea, Liberia, and Sierra Leone were hit with the worst global public health crisis in their respective histories. The Ebola epidemic was a national and regional crisis. The international community rallied, despite numerous issues, to raise funds and send technical support to tackle this monumental challenge. The African Union sought a lead role in the assistance process, which led to the 1st Meeting of African Ministers of Health in Luanda, Angola in April 2014, where it was agreed that they would establish an African Center for Disease Control. On April 13, 2015, this commitment became a reality with a landmark agreement signed by the African Union and the U.S. Department of State. With this Memorandum of Cooperation, the United States committed to supporting the AU in the creation of a Centers for Disease Control and Prevention (CDC) in Africa and “provide expert technical help to support a surveillance and response unit and an emergency operations center as well as provide fellowships for African epidemiologists who will provide their services to the new center in Addis Ababa”.
The establishment of such a center in Africa is not a particularly new idea; talks on the need for more effective means to combat epidemics on the continent were held in July 2013 at the Special Summit of the African Union on HIV/AIDS, Tuberculosis, and Malaria, in Abuja, Nigeria.
In her opening remarks at that meeting, AU Chairwoman Dr. Nkosazana Dlamini-Zuma emphasized the need for the AU to act and for “the final push” to tackle HIV/AIDS, TB and Malaria. These sentiments echoed those made at previous meetings on the matter. The fact that this was not the first time this issue has been discussed at such a high level, raised doubts as to the ability of the African Union to undertake such an endeavor.
Two main, and related, reasons for these doubts are the AU’s current financial capacity and the political will of its member nations. It is common knowledge that the AU faces significant funding challenges, compounded by the fact that many member states continuously fail to pay their annual contributions. This inability to contribute to the AU’s operating budget casts doubt on member state willingness to prioritize AU activities while facing their own domestic, often economic, challenges. Such reservations are what made the joint announcement by the AU and the U.S. Department of State, notable. With the signing of this memorandum, for the first time there is a tangible commitment to a center that the continent has been in dire need of for decades.
This announcement came at the start of the AU-U.S. High Level Summit, held in Washington, D.C. The Summit focused on four areas: economic growth and investment, opportunity and development, democracy and governance, and peace and security. U.S. Secretary of State Kerry emphasized that this was an AU initiative, and that the AU had a key role to play in addressing the current economic and political challenges facing the continent. “We have learned that diplomatic and peace-making initiatives in Africa work best when they are African-led,” he said. At the same time, there was no mistaking the role the international community is to play, especially the U.S.. It was noted that the U.S. alone contributed over 1 billion dollars to combatting the Ebola crisis.
It is for this reason that, although it may not have been the intention, this support for an African CDC comes across as more of a conditional agreement than a true partnership, in the sense that one side clearly has the upper hand. The continued reliance on U.S. aid highlights the AU’s lack of capacity in tackling continental issues. Will this African CDC really be an African CDC? Will African governments truly be able to set its agenda?
The Center is set to open in June 2015 but again, considering the significant need for Western support (despite efforts to move away from this reliance), and the failure to address the highly flawed elections in Sudan, the persistent conflicts in the Central African Republic, Libya, Somalia, and others, the question of whether or not the AU is really ready to take the reins remains. And yet, in spite of these reservations, this development is a major step in the right direction and, if managed correctly, this institute could redefine approaches to public health challenges in Africa.