The coronavirus disease of 2019 (COVID-19) pandemic gripped the world with shock and overwhelmed the health care systems of most nations. The World Health Organization (WHO) declared the novel human coronavirus disease (COVID-19) outbreak, which began in Wuhan, China on December 8, 2019, a Public Health Emergency of International Concern (PHEIC) on January 30, 2020, with over seven million cases globally as of June 7, 20201.
In July 2020, over 663,000 confirmed Covid-19 cases were recorded in Africa with more than 343,000 recoveries and 14,000 deaths. 324,211 cases were recorded in South Africa with 4,699 deaths, followed by 34,854 confirmed cases in Nigeria and 769 deaths, 26,125 confirmed cases and 139 deaths in Ghana. Countries currently with the lowest cases in the region are Gambia, Seychelles and Eritrea. Southern Africa is the most affected area across the continent in terms of positive Covid-19 cases and Northern Africa closely follows2.
Nigeria is one of 13th high risk African countries with respect to the spread of Covid-19 given the fragile state of its healthcare system characterized by poor access to basic healthcare services, vulnerability of communities to infectious diseases and gross shortage of healthcare workers3. The projection is that Africa could bear the final weight of the COVID-19 pandemic if nations do not institute compelling measures to battle the pandemic.
In preparation for the global surge, various country teams were set up across the continent to activate its incident system to respond to emergencies. In Nigeria, the Corona Virus Preparedness Group was constituted on January 31, 2020 and on February 27, 2020, Nigeria recorded its first index case4. This case raised several concerns ranging from the effectiveness of airport surveillance, and by extension the country’s general readiness to tackle the pandemic, to the terribly insufficient healthcare systems and inadequate planning. Following the index case, the Presidential Task Force (PTF) for Corona infection was introduced on March 9, 2020 and the National Centre For Disease Control (NCDC) enacted a Multi-Sectional Emergency Operations Center (EOC) to manage the nation’s reaction to COVID-19.
Between February 27 and March 17, confirmed COVID-19 cases were reported following the return of travelers into Nigeria. Lagos State accounted over half (50%) of the cases in Nigeria, trailed by Abuja (20.3%) and Osun State (8.6%). The highest number of new cases in the first 100 days was recorded on May 30, while the Case Fatality Rate (CFR) and the number of discharged patients within this period increased5. Signs of community transmission were first publicized at a press briefing on April 16.
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The Private Sector Response to Covid-19 in Africa
COVID-19 has produced one of the most emotive conversations amongst public health professionals, sub-national and national governments. The abrupt emergence of the Coronavirus jolted task forces around the world to take initiatives to mitigate the plethora of issues caused by its emergence and to also make giant strides in the fight against further spread of the disease. While medical experts and researchers continue to explore breakthrough treatment protocols and vaccines, in Nigeria, the private sector took the initiative to the Sector Coalition Against COVID-19 (CA-COVID) – a coalition of private sector individuals, CEOs, and private organizations under the leadership of Aliko Dangote, Dangote Foundation. The coalition is backed by various Nigerian banks, leading professional service firms, oil and gas players, energy, real estate, hospitality, telecommunications, financial investment institutions, private individuals and organizations.
The mandate of the coalition is to raise relief funds in support of the Presidential Task Force to control the spread of the coronavirus and to carry out plans to support vulnerable households and communities across the country. The mission of CA-COVID is to work together with the government to provide aid for public and private health cares’ ability to respond to the emergency. It is intended to provide the resources needed to set up testing, isolation and treatment facilities in all geo-political zones. A secondary purpose of the coalition is to offer support to the most vulnerable with palliatives to make the affected receive the quality care they need and those in society the right information to understand and adhere to safety measures.
The initiative was additionally set up to provide operational and technical support by pulling resources, administration and assets, across industries in a bid to build advocacy, increase overall public mindfulness, give fully equipped medicinal facilities to respond to the emergency as well as support government activities. Other objectives include increasing general public awareness of the existence of coronavirus and to provide direct support to the private and public health care’s ability to respond to this crisis.
With over 120 organizations and over 60 individuals who have contributed funds in complementing federal government efforts, the Coalition is providing and equipping medical facilities in the six geopolitical zones in Nigeria7. The creation of testing, isolation and treatment centers, the provision of Intensive Care Units (ICUs) and molecular testing labs. CA-COVID also seeks to increase the number of isolation centers and support the Surveillance Outbreak Response Management and Analysis System (SORMAS) and incurring logistics cost of ambulances and movement of patients.
What has CA-COVID taught us about the role of Private Sector
The private sector-led coalition, CA-COVID, is an attempt to build a credible vehicle to deploy philanthropic capital from companies, foundations and individuals. The establishment of CA-COVID was hinged on a common goal of serving as aid catalysts in the funding, management and operation of the national COVID response. As at July 2020, N30,148,637,264.27 (US$79.2 million) has been raised (35% of fund raising goal) out of which N23,147,266,506.40 (US$60.8 million) is earmarked to be spent on palliatives program for the purchase of food items to be distributed to 1.7 million families amounting to about 10 million people across the 774 local governments in the country, including the Federal Capital Territory8. Each state allocation was decided by the Nigeria Governors Forum (5% of palliative funds shared across each state), 15 Billion Naira (US$39.4 million) was allocated to support state governments with medical equipment and to strengthen their response capacity and outright building of isolation facilities in about 38 centres.
While there have been similar interventions in the past, CA-COVID as a vehicle, has been successful because individual organizations put aside their personal interest and quest for standalone visibility to plug into the common vision and strategy of supporting the government’s efforts. Hence the platform as well as its contributors have enjoyed the backing from government at all levels from policy, legal and operational perspectives.
Below are some strategies for sustaining momentum of the private sector responses:
- Transparency & Accountability: For the palliatives toaffected families, the state governors and the FCT minister are responsible for the appointment of the various coordinators who would, through the State Implementation Committee, diligently record and send an accurate and complete copy of the inventory tracker and goods delivery notes to the CA-COVID Operations Centre daily. In measuring and tracking performance, through the State CA-COVID representative these coordinators would ensure timely and efficient delivery and proper transparency and accountability.
- Policy & Political flexibility: The COVID-19 pandemic has taught the world that our economies and lives are indeed fragile, hence one cannot be too prepared for the rainy day. Government must take deliberate measures to review its legal and policy framework to enable participation of private sector in driving social development beyond goodwill. Philanthropic donations can do much more, investment capital can deliver both financial and social returns, and communities can drive their own change if empowered and equipped to do so.
- Coordination is Key: Through the Nigeria Governors Forum, the Technical Committee (responsible for intellectualleadership around testing issues, treatment protocols, isolation centres, amongst others), the Operations Committee (responsible for project management, logistics and communication) and the Funding Committee (responsible for funding and raising funds for the efforts) CA-COVID shall coordinate the distribution and disbursement of relief materials, funds and establishment of health care facilities, etc. It is expected that the state government, through the State Implementation Committee organize representatives of all the state local government areas (LGAs) to collect the allocations for each LGA and oversee the redistribution to each ward and onto each eligible beneficiary at the grassroots subsequently based on an agreed distribution schedule.
- Introduce Innovation in distributing palliatives: While CA-COVID as a vehicle might be new, the tools and approachesfor deploying philanthropic capital to relevant organizations and palliatives may be obsolete. For the CA-COVID palliative program to be successful, the use of digital technologies for mapping, profiling and responding to the needs of the 1.6 million households targeted should be considered. There is need to explore measures to connect beneficiaries directly to food aid in a manner that activates a community-driven ecosystem that sustains the demand and supply of these palliatives.
- Think Blended Financing Long-Term: Nigeria will be recovering from the health impact of the pandemic and facinga steep economic trajectory at the same time. Private sector must look beyond delivering just philanthropy capital in exchange for tax breaks to actually powering their philanthropic vehicles into patient capital to catalyze economic growth and social resilience. The pandemic has unveiled potentials in many sectors that may have been obscure to mainstream investors such as healthcare, technology-enabled sectors such as AgriTech, EdTech, HealthTech, FinTech. The time is ripe to think about inequality differently and pay attention to the MSMEs and informal sectors.
- Outcome-Based Contracting: We suggest implementing an Outcomes Based Contracting model to be used inengaging all the suppliers/vendors on this project. With outcome-based contracting, an agreement is made that a supplier or provider of services must achieve specific goals and is paid only when those objectives are met. But, in these cases, the specific goals that must be met would be social goods.
- Evidence-based approach: The failure to adopt the right technology and measurement protocol have traditionallylimited the true value-creating potential that catalytic philanthropy and impact investing holds. Data is key in monitoring, measuring and managing the social and economic impact of social investment. Connecting data and people, from the ground to the capital source, on a single platform is a needed step towards true transparency. Facilitating data management through such platforms is also a step towards successful and relevant impact measurement and management.
Addressing today’s problems require the collective action of government, civil society, communities and businesses. Many organizations have the goodwill and resources to contribute to and create social change but lack the expertise, technical and operational momentum to influence government, scale their impact, collaborate across sectors and systematically track their impact. Delivering social impact has been the exclusive reserve of philanthropies in the past. However, philanthropies can do good by doing better with their resources.
Recognizing the growing need for businesses to be purpose-driven and mission-focused, organizations can optimize their philanthropic giving and unlock a whole new channel of solutions that delivers social and economic impact.
CA-COVID is charged with a momentous task requiring logistical and supervisory support and the coalition has its work cut out. From mobilizing the private sector through thought leadership to finding ways to raise funding to ensuring that this funding is used to provide much needed support to the private and public healthcare’s ability to respond to crisis, a lot of processes and personnel come into the mix. This means that if this goal is to be realized, adequate logistics is required to be in place. From manpower through processes to structures, it takes collective efforts to keep such machinery oiled.
As we continue to explore the path from pandemic to prosperity, it is important to document the lessons from the ongoing private sector response through the CA-COVID platform. As donors continue to diversify the ways they choose to give, the need for a comprehensive system to organize these various vehicles and mechanisms is needed.
Through the right tools and strategies, platforms such as this can enable transformative changes in social and economic systems through self-sustaining mechanisms that lead to resilient and responsive societies. The following are some key takeaways and recommendations for the CA-COVID stakeholders:
- No one-size-fits-all solution: It is important to tailor solutions to the local context and deploy funding based onthe contextual understanding of the systems and processes. It is imperative that multiple potential solutions are evaluated in order to determine what might be most appropriate for the local context. Even then, those solutions may provide good bases from which to start, but they likely require significant additional development and iterations.
- Isolated solutions will fail: We must recognize that the communities are a critical part of the response, not justbeneficiaries of the goodwill of the platform. Initiatives that are not community-owned and driven will fail. It is therefore critical for local supervisors to play an active role in following up with and supporting users in order for such programs to be effective—but supervision does not stop at the community level. Data must be actively captured within the system to adapt disease response plans, channel resources to areas that need it most, and monitor changes in disease trends. These data should then guide solution iteration, policy changes, resource mobilization, and community engagement.
- Embrace Technology: The pandemic has brought home the mantra that the world indeed is a digital village – wemust accept it. Government and private sector must continue to invest in the infrastructure, capacity-building, and policy environment needed for an integrated digital system. Beyond identity management and bank enrolment strategies, the palliative program offers the best opportunity for a digital census – we must not fail at this chance.
- Monitor and Measure: One way of understanding the impact of the CA-COVID partnership is by measuringSocial Return on Investment along with other program-related metrics. This is done by aggregating and analyzing high quality data and introducing high quality financial proxies for social impact consistent with Impact Monitoring and Measurement parameters.
1Africa Center for Disease Control https://africacdc.org/covid-19/
2 World Health Organization, 2020. Coronavirus Disease 2019 (COVID-19) Situation Report – 37. https://www.who.int/docs/default–source/coronaviruse/situation-reports/20200226-sitrep-37-covid-19.pdf?sfvrsn=2146841e_2
4Jimoh Amzat, 2020 ‘Coronavirus outbreak in Nigeria: Burden and socio-medical response during the first 100 days’ https://www.ijidonline.com/article/S1201-9712(20)30502-6/pdf
5 Nigeria Centre for Disease Control, 2020. ‘COVID-19 Outbreak in Nigeria: Situation Reports’ https://ncdc.gov.ng/diseases/sitreps
6 S. Oyeleke, 2020 ‘Source of Infection in 203 COVID-19 Cases Unknown, NCDC’ https://punchng.com/source-of-infection-in-203-covid-19-cases-unknown-ncdc/
- List of Contributors to the CACCOVID Relief Fund as at 30 June 2020, https://www.cacovid.org/pdf/list_of_contributors_to_the_cacovid_relief_fund_as_at_30_June_2020.pdf
Ikechukwu Ibeawuchi is Head, Strategy and Growth at Sociocapital Impact Group