In Practice

Comparative strategic approaches to COVID-19 in Africa: Balancing public interest with civil liberties

A E Obasa, S Singh, E Chivunze, T Burgess, F Masiye, T Mtande, J Ochieng, V Chalwe, B Mokgatla, S Rennie, K Moodley

Abstract


As COVID-19 spreads rapidly across Africa, causing havoc to economies and disruption to already fragile healthcare systems, it is becoming clear that despite standardised global health strategies, national and local government responses must be tailored to their individual settings. Some African countries have adopted stringent measures such as national lockdown, quarantine or isolation, in combination with good hand hygiene, mandatory wearing of masks and physical distancing, to prevent an impending healthcare crisis. The impact of stringent measures in low- to middle-income African countries has bought time for healthcare facilities to prepare for the onslaught of COVID-19 cases, but some measures have been challenging to implement. In some settings, public health measures have been associated with serious violations of individual rights owing to abuse of power and gaps in implementation of well-intentioned policy. Collateral damage with regard to non-COVID-19 diseases that were suboptimally managed in pre-pandemic times may mean that lives lost from other diseases could exceed those saved from COVID-19. While individuals complying with lockdown regulations have embraced an acceptance of the concept of the common good, at a broad community level many are finding the transition from individualism to collective thinking required during a pandemic difficult to navigate. In this article, we look at government responses to the pandemic in six African countries (Malawi, South Africa, Uganda, Zambia, Zimbabwe and Botswana), and highlight ethical concerns arising in these contexts.


Authors' affiliations

A E Obasa, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

S Singh, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Discipline of Dentistry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

E Chivunze, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, South Africa

T Burgess, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, South Africa

F Masiye, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Directorate of Research, Postgraduate Studies and Outreach, Malawi University of Science and Technology, Ndata Farm, Thyolo, Malawi

T Mtande, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; University of North Carolina Project, Tidziwe Centre, Lilongwe, Malawi

J Ochieng, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda

V Chalwe, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; National Health Research Authority, Ministry of Health, Zambia

B Mokgatla, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; International AIDS Vaccine Initiative, Botswana

S Rennie, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Department of Social Medicine, UNC Bioethics Center, University of North Carolina at Chapel Hill, USA

K Moodley, Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Full Text

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Keywords

COVID-19; SARS-CoV-2; Public health; World Health Organization; Africa; South Africa; Ethics

Cite this article

South African Medical Journal 2020;110(9):858-863.

Article History

Date submitted: 2020-08-13
Date published: 2020-08-13

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