COVID-19 pandemic in Economic Community of West African States (ECOWAS) region: implication for capacity strengthening at Point of Entry

11 janvier 2022Wathinote Covid-19

Author: Virgil Kuassi Lokossou, Aishat Bukola Usman, Issiaka Sombie, Moussiliou Noel Paraiso, Muhammad Shakir Balogun, Chukwuma David Umeokonkwo, Josephine Gatua, John Wagai, Edgard-Marius Ouendo, and Patrick Nguku

Affiliated organization: International Cooperation and Global Partnerships

Type of publication: Academic article

Link to the official document

With the Coronavirus Disease 2019 (COVID-19) pandemic, one of the first measures in many ECOWAS countries was the closure of air, land, and sea borders, with probable economic consequences. With the spread of COVID-19 across the ECOWAS since February 2020, a growing interest in the public health response is to analyze regional and national capacities at PoEs to limit the potential spread of the infectious diseases while ensuring free movement of people and goods. Capacities at PoEs are of high interest because most of the COVID-19 index cases in West African region came into these countries through the airports. An official PoE, i.e., airport, port, and ground crossing, as recognized by the decree of each country, facilitates passage for international entry or exit of travelers, baggage, cargo, containers, conveyances, goods, and postal parcels. Points of entries play not only a pivotal role in enabling collaboration and coordination between countries but also in the prevention and control of the international spread of infectious diseases outbreaks. Under the International Health Regulations (IHR 2005), designated PoEs are required to establish and maintain minimum capacities including effective contingency plans, risk management, surveillance and contact tracing, communication and coordination including risk communication and community engagement, management of ill travelers, laboratory capacities, cross-border collaboration, infection prevention and control measures, environment health including sanitation and vector control, and multisectoral collaboration.

Risk communication and community engagement are very important in managing public health emergencies. To make these strategies effective, implementers should use the most appropriate media based on preferred communication channels, such as digital media or printed materials (e.g. posters, banners, pamphlets, advisory material). Furthermore, implementers should incorporate recognition of signs and symptoms of COVID-19 and basic protective measures against the virus that causes COVID-19 into their messaging. This should be done in the appropriate languages, with an attention to literacy level, and a culturally relevant manner.

Strength, challenges, opportunities and threats at the PoE in the ECOWAS Region

Table 3, Table 3 (suite), Table 3 (suite 1) show the strengths, challenges, opportunities, and threats analysis of IHR core capacities such as PoE organization, coordination, legal enforcement and planning, surveillance, early detection and management of cases, infection prevention and control, risk communication and community engagement, infrastructure, capacity building, workforce, management and transportation of ill travelers, and community engagement. The key strengths were existence of decrees and ministerial acts in some ECOWAS countries, availability of international guidance documents such as the IHR (2005), establishment of national taskforces focusing on the COVID-19 response at PoEs in the ECOWAS region, cross-border cooperation mechanism between Mali and its seven neighboring countries, and existence of the networks of national public health institutes and port health services. The keys challenges were porous borders, strategies to detect ill travelers at the PoE and monitor travelers for illness after arrival, community stakeholder engagement, poor intersectoral coordination, lack of harmonized traveler screening measures with other countries, shortage of staff to cater for all PoEs, insufficient material and financial resources for the implementation of surveillance activities at PoE, and lack of a framework/platform for exchanges of information between PoE stakeholders. Despite all these challenges there are opportunities within the PoE such as leveraging on the regional cross-border poliomyelitis and Lassa fever coordination and control mechanism willingness of technical and financial partners to support PoE activities (WHO, AFENET, Africa CDC, IOM, ALCOL, Pro Health International, US CDC), existence of network of infection prevention and control specialists, availability of training centers and a network of field epidemiologists. However, political instabilities in some countries pose a threat to government commitments to PoE activities.

Way forward

Based on our findings and to enhance capacities at PoEs in ECOWAS region according to IHR (2005) requirements for COVID-19 pandemic response, we would like to propose following suggestions to the policy makers:

Governance and leadership: development and implementation of an ECOWAS regional strategy for multisectoral and multi-country collaboration, partnerships, and networks.

Funding: setting up a sustainable (internal and external) and multisectoral funding mechanisms for COVID-19 pandemic preparedness and response activities and other public health emergencies at PoEs.

Human resource and capacity building: creating and operating a regional platform or network of PoE workers in the ECOWAS region and development of capacity building plan and harmonized training curriculum for PoE workers.

Operations and Service Delivery: strengthening the organization of PoEs (air, sea, and land); enhance necessary infrastructure (workspace for teams) and provide work equipment including adequate supplies of personal protective equipment; strengthen the public health intervention package (epidemiological surveillance, laboratory, case management, infection prevention and control; risk communication and community engagement) for emergency preparedness. Health Information Systems: promote a digital platform for real-time or near real-time information sharing within the ECOWAS region. Cross border coordination: Support the implementation of ECOWAS guidelines on the COVID-pandemic and related recovery actions for the harmonization and facilitation of cross-border trade and transport and mitigation of health risks in the ECOWAS region, validated by the 58^th ordinary session of the authority of heads of states and governments on 23^rd January 2021.

Limitations of this evaluation: the opinions expressed during FGD and KII and the responses from the self-assessment checklist by the representatives of the member countries may not completely reflect the reality in each country. Also, this study was conducted early in the pandemic and may not reflect improvements made by each country since then.

Conclusion

West Africa is facing the COVID-pandemic and other outbreaks of infectious diseases. Responses to previous public health emergencies that involved cross-border spread of infectious diseases emphasize the important role of preparedness at PoE. The proposed strategies will enable the ECOWAS countries to respond more effectively to future infectious disease emergencies and help achieve the ECOWAS vision including free movement in the region.

Despite the European focus on migration from Africa to Europe, most mobility within West Africa is regional, especially within ECOWAS.

Migration from the perspective of the free movement protocols in ECOWAS encompasses both cross-border mobility (short-term movement) and migration (longer-term movement for more than a year). Cross-border mobility often involves ethnic communities—mostly pastoralist communities traveling with their livestock (transhumance).

The reality, however, is that apart from the visa-free entry of people, the rights to establishment and residency are far from being implemented. Even with visa-free entry, an identity document is needed to cross the borders, which is an obstacle for the many ECOWAS citizens who do not have an ID. Combined with widespread corruption and abuse of migrants, free movement is largely limited to an ideal (Olusegun Bolarinwa 2015). Nonetheless, the porous nature of many borders in West Africa also means that crossing borders still happens as part of normal everyday life, especially for cross-border communities (see also Kleist and Bjarnesen 2019; Okyerefo and Setrana 2018).

The influence of European interests in managing mobility has been criticized by scholars and activists in the region. European efforts in West Africa may undermine daily mobility practices, increase border harassment, and even put trade at risk; in the long run they may affect development, which is dependent on cross-border movement. At best this is outside the spirit of ECOWAS, and at worst it is an outright contradiction. While these concerns are not new (e.g. De Haas 2008), they are being raised with growing frequency (Andersson 2016; Castillejo 2019; Idrissa 2019; Uzelac 2019; Tchingankong Yanou 2018).

ECOWAS at the center of competing interests

More recently, ECOWAS has also shown strong leadership in managing public health crises, including epidemics like Ebola and the global COVID-19 pandemic. The West African Health Organization (WAHO) and the ECOWAS Centre for Disease Control (CDC) have assisted states in achieving a coordinated regional response to the coronavirus crisis (Medinilla, Byiers, and Apiko 2020). Through measures like risk communication, expert policy advice, and standard operating procedures in implementing border closures, states have responded to the crisis with similar approaches intended to maintain trade and avoid hampering economic activity (closely linked to the movement of people) within the region. On the whole, however, when it comes to migration issues and implementing free movement, ECOWAS as an institution is still limited in its impact. Member countries aiming to advance their own interests can undermine fulfillment of ECOWAS protocols, effectively juxtaposing regional integration with the sovereignty of member states (Okunade and Ogunnubi 2018).

For both the EU and ECOWAS member states, this combination of sovereign aspirations and other interests means that bilateral deals are often preferred to multilateral ones. In other words, countries within ECOWAS not only pursue their own interests, but also deal with European interests, which are increasingly centered on specific transit countries like Niger. This can more easily translate into bilateral rather than regional cooperation.

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COVID-19 pandemic in Economic Community of West African States (ECOWAS) region: implication for capacity strengthening at Point of Entry

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