Header graphic for print

Cov Africa

Ebola Spurs Global Cooperation to Prevent, Detect and Respond to Future Health Crises

Posted in Public Health

This post was authored by  Anne Pence.

Well before Ron Klain was named as the U.S. Ebola czar, the USG was urging the international community to confront the fact that the world is not ready for a deadly pandemic of any sort, much less one as daunting as Ebola.  Aware that Ebola alone could kill over 1 million people if international efforts fail, President Obama — joined by Secretary of State Kerry, Health and Human Services Secretary Burwell, Secretary of Defense Hagel, and his National Security Advisor Susan Rice — met on September 26 to discuss global health security with Ministers and experts from 44 nations, the World Bank, the UN World Health Organization (WHO), the UN Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE).

President Obama challenged participants that, “… it is unacceptable if, because of lack of preparedness and planning and global coordination, people are dying when they don’t have to.”  In his call to action, President Obama referenced not only Ebola, but many other deadly biologic threats from superbugs to terrorists seeking to use biological weapons.  He warned that, “in a world as interconnected as ours, outbreaks anywhere…have the potential to impact everybody, every nation.” Political, financial, legal and regulatory changes to accelerate and facilitate private investment and international cooperation are now under discussion.

The President and Cabinet members cited security, humanitarian and economic threats posed by global health disasters, which could easily dwarf the costs of terrorism. “Never has it been clearer that the world’s health security depends on paying attention to our weakest links,” HHS Secretary Sylvia Burwell said.  Even the United States is unprepared.  The Inspector General of the Department of Homeland Security (DHS) has reported that DHS does not have adequate supplies of ready to use equipment and drugs or effective procedures in place to undertake critical operations during a pandemic.[iv]  Yet, the US is helping to lead the way forward globally.

“Together, our countries have made over 100 commitments both to strengthen our own security and to work with each other to strengthen the security of all countries’ public health systems,” the President said.  These commitments address 11 “Lines of Action” which focus on making progress within five years to combat anti-microbial resistance, improve biosecurity, prevent animal-to-human disease transmission, ensure effective immunization systems, accelerate detection, diagnosis and information-sharing regarding public health threats and to develop work force competencies and emergency facilities, procedures and relevant policy and legal structures. Going forward, 10 countries have agreed to serve on the GHSA Steering Group.  Chaired by Finland in 2015, it includes Canada, Chile, Finland, India, Indonesia, Italy, Kenya, the Kingdom of Saudi Arabia, the Republic of Korea, the United States and international organizations.

The private sector can and must play a key role in developing, producing and supplying medicines, medical devices and technologies, health information systems, protective gear, disinfectants, management systems, waste disposal technologies, etc.  As these efforts ramp up over the next 5 years, substantial new resources and incentives (public, philanthropic and private) will flow into these activities — and efforts to strengthen health systems –  worldwide.  Laws, regulations and procedures will change to enable more effective action and investment and the private sector will want to engage vigorously in the process.

IBM and Metropolitan Health Announce Africa’s First Commercial Application of Watson Engagement Advisor

Posted in Consumer Products and Goods, Corporate and Investment, Current Events, Public Health

IBM and Metropolitan Health–one of South Africa’s largest financial services and healthcare companies–recently announced Africa’s first commercial application of IBM’s Watson Engagement Advisor (“Watson”).  Watson is a potentially revolutionary cognitive computing application that can “comprehend” a question posed to it in natural language, process relevant data equivalent to about one million books, and provide a tailored, evidence-based response to the query, all in approximately three seconds.  In South Africa, the application will function as a “virtual coach” to supplement the healthcare advice provided by Metropolitan Health’s Customer Service Agents, who assist approximately three million clients annually.  The IBM application is currently being used in over 25 countries around the world to provide services in a variety of industries, but its ability to generate personalized, fast, and comprehensive healthcare information could make it particularly impactful within the African healthcare sector.  

Africa shoulders a disproportionate share of the world’s disease burden, and cognitive computing platforms like Watson could enable healthcare providers to better surmount the financial, geographical, educational and human resource obstacles that currently limit African’s access to healthcare.  Watson conveys information through a cloud or mobile device, thereby giving clients access to Big Data that can assist them in making informed healthcare decisions at any time and in any location equipped with a mobile or cloud connection.  Cognitive analytical platforms learn from experiences and actually process information faster as they gain new information.  As a result, the consistent usage of Watson should eventually allow the platform to proactively share healthcare information with clients and to anticipate client concerns, consequently shortening the number of visits required to a health facility and potentially expediting the treatment process.

The use of mobile devices and applications to fight disease and provide medical advice in Africa is not new; telemedicine services that connect Africans to doctors abroad, and the use of mobile apps to track contagious diseases like the Ebola virus have all been successfully relied upon.  However, the adaptability of cognitive computing platforms could open new possibilities for healthcare interactions, particularly if these platforms became adept at “speaking” multiple languages. 

In addition to launching Watson in South Africa, IBM will open a global Watson headquarters in New York, create five new Watson Client Experience Centers around the world, and develop a Watson platform that “speaks” Spanish.  The field of cognitive analytics is still in its early stages of development, yet these announcements clearly indicate IBM’s intentions to become a leader in the global cognitive computing industry, and the company’s confidence in computer analytics’ ability to transform client

World Bank Identifies Prospects and Challenges for Sub-Saharan Africa

Posted in Corporate and Investment, Current Events

The October 2014 Africa’s Pulse released by The World Bank confirms that economic growth in Sub-Saharan Africa continues to be strong.  The average growth in the region is projected to increase to 5.2 percent during 2015-16 (up from 4.6 percent in 2014) and to 5.3 percent in 2017.  Some markets and industries are looking to be more promising than others but certain regional challenges continue to present unknown variables.

The Markets. Although growth in the region generally remains favorable, the differing fortunes of the region’s largest economies has moderated that growth.  Economic activity in Nigeria remains robust with the growth strengthening from 6.2 percent in the first quarter to 6.5 percent in the second quarter.  Low-income countries — including Cote d’Ivoire, Ethiopia, Mozambique, and Tanzania — also enjoyed healthy economic growth.  In contrast, the economies of South Africa, Angola, and Ghana each experienced far more modest expansion.

The Industries. The primary drivers of growth are significant public infrastructure investment (e.g., power, ports, and transportation), “a rebound in agriculture,” and the services sector (e.g., telecommunications, financial services, and tourism).  Importantly, the services sector has been “the big gainer” in the region’s economic transformation and presents “an important path” for economic diversification and accelerating poverty reduction.  However, weak global growth (and related factors) has resulted in a decrease in foreign direct investment, which is an important financing source for all of these industries.

Regional Challenges. The Ebola outbreak has ravaged economic activities in Guinea, Liberia, and Sierra Leone.  Initial estimates are that the combined output loss to the countries could total $359 million, which would translate to a 3 percent drop in the GDP growth of Sierra Leone and a halving of the GDP growth of both Guinea and Liberia.  This crisis must be addressed and the private sector should play a critical role.  Provided rapid control of further contagion, regional spillover is projected to be modest and limited to Ghana and Nigeria, which already has contained the outbreak.  However, a slower containment presents a far more dire scenario for the countries and the region.  Regional disruptions also may result from further intensification of the conflict in South Sudan and/or the Boko Haram insurgency in Nigeria.

Contract Farming Increases Productivity, Reduces Post-Harvest Loss

Posted in Food Security and Agriculture

Agricultural experts recently gathered in Tanzania to urge African government officials to adopt and improve contract farming in their countries.  Government officials should consider heeding these calls as should smallholder farmers and the private sector.  Contract farming presents a prime opportunity to achieve food security in Africa both by increasing productivity and reducing post-harvest loss.

According to the International Food Policy Research Institute, contract farming can encourage agricultural productivity by addressing a variety of constraints faced by smallholder farmers.  By agreeing upfront to purchase a particular quantity of product at a particular price, buyers provide farmers with valuable market information that reduces the commercial risk of underproduction or overproduction.  Buyers also can provide inputs (on credit), extension services, or other technical assistance to assist farmers who lack the liquidity or technical know-how to realize the full potential of their holdings.  Ultimately, contract farming is an effective “tool to organize and link production capacities and market needs to increase and diversify the availability of products on local and global markets, and to improve value chain efficiency.”

With estimates that nearly one-fourth of available food in Sub-Saharan Africa is lost or wasted, post-harvest loss presents as daunting a challenge as increasing productivity.  Furthermore, this loss has a negative impact across the entire value chain since it reduces the income of value chain actors by as much as 15% and potential consumers lose an average of 545 kilocalories per person per day.  The Global Knowledge Initiative has identified improvements in contract farming as one of the top ten “potential big win opportunities” for reducing post-harvest loss in Africa.  In particular, improving these mechanisms can “help mitigate the risks that can come from these arrangements, such as side selling (by farmers) and unbalanced leverage (by buyers).”

By increasing productivity and reducing post-harvest loss, contract farming addresses two fundamental pillars to achieving food security.  It also presents a win-win-win for government, business, and smallholder farmers in a way that ultimately accrues to communities at large.

Ebola Containment and Prevention: Nigeria Provides Lessons for the World

Posted in Current Events, Public Health, Public Policy and Government Affairs

This week, the U.S. Centers for Disease Control (“CDC”) reported that the outbreak of Ebola in Nigeria could be coming to an end, with no new Ebola cases since August 31, and the last patient under surveillance released on September 23. In light of this positive development, the CDC has reduced its travel alert for Nigeria from a Level 2 alert to a Level 1 alert, and the World Health Organization has stated that if there are no further cases, Nigeria will be declared Ebola-free on October 20th.

Nigeria’s success in preventing the spread of Ebola has garnered the attention of health authorities in the U.S. and Spain, who are now grappling with the first cases of Ebola in those countries. Indeed, Nigeria’s containment of Ebola is being seen as a model, particularly in light of the challenging circumstances in which Ebola was introduced into the country. Nigeria’s “Patient Zero” was already contagious and dying when his flight arrived in Lagos — Nigeria’s most populous city and a major transportation hub. In contrast, the Ebola patient in the U.S. was not symptomatic until after he arrived in the United States from Liberia, which significantly reduced the number of people was in contact with while contagious.

So what did Nigeria do right? A number of things, sources say.

  1. Effective contact tracing. Upon identifying its first case of the virus, Nigerian health officials quickly issued notifications and began tracking down every person who may have had contact with Patient Zero, including the 72 other passengers on his flight into Lagos. Nigerian officials developed a list of 281 people from this single patient, and every one of those individuals was required to provide twice-a-day updates to health officials about their well-being. In the end, trained contact tracers conducted 18,500 face-to-face visits to assess potential symptoms.
  2. Establishment of a centralized incident management and response center. Drawing on resources established to fight polio, Nigeria established an Ebola Incident Management Center to handle the potential outbreak, and developed a staffing plan and outreach strategy to reach more than more than 26,000 households of people living around the contacts of Ebola patients. In addition, Nigeria reassigned 40 doctors trained in epidemiology from its polio response team to the Ebola center.
  3. Community involvement. Nigeria took a “whole community” approach to the problem, engaging community leaders and military officials to discuss the response to the virus.
  4. De-stigmatization. Finally, Nigeria encouraged people to be forthcoming about their contacts and the status of their health, engaging in a campaign to make people feel like they were doing something good for their country by being honest and reporting to health officals.  As one person who helped with the Ebola response in Nigeria put it, Nigerian officials sent a message to “really make them look like heroes.”

The CDC has now sent personnel to study Nigeria’s Ebola containment strategy, noting that “[Nigeria’s] extensive response to a single case of Ebola shows that control is possible with rapid, focused interventions.”

Ebola Response Missing A Critical Player

Posted in Public Health

The Obama Administration has mobilized a number of government agencies to respond to the Ebola crisis in West Africa and to prevent its spread into the U.S. At the frontline of the Administration’s response is the Pentagon, the Department of Health and Human Services, the Center for Disease Control, the U.S. Agency for International development and, more recently, the Department of Transportation.

Conspicuously missing, however, is the Department of Commerce, which traditionally is the link to the U.S. private sector.

This omission is significant because U.S. companies are likely to get materials to the stricken countries of Liberia, Sierra Leone and Guinea more quickly than the Pentagon.  In the instances in which they operate locally, the companies provide a valuable source of information and delivery infrastructure.

For example, in mid-August, more than 20 leading medical companies shipped 40 tons of supplies and protective equipment to Liberia.  The airlift was coordinated  by the California-based NGO, Direct Relief, and facilitated by Fedex. Companies such as Pfizer, Teva, Merck, Kimberly-Clark and Mylan Laboratories contributed 2.3 million gloves, 65,000 masks and 185,000 tabs of antibiotics. As of September 20th, Direct Relief had coordinated 11 shipments of supplies.

Equally important is the Ebola Private Sector Mobilization Group (EPSMG) which is a network of more than 40 companies active in West Africa and, especially, Liberia, Guinea and Sierra Leone. Chaired by ArcelorMittal and including companies such as Chevron, Rio Tinto and BHP Billiton, the group seeks to provide a single access point for the private sector to help mobilize and coordinate a response.  The group’s first principal is to “be part of the region’s long-term economic and social recovery and development.” EPSMG has met with Dr. Margaret Chan, Director General of the World Health Organization, and the U.S. ambassador to Liberia, Deborah Malac, and engaged with organizations such as the UN Ebola Task Force, the World Bank and various NGOs.

The in-country private sector plays other important roles.  ArcelorMittal, which has a workforce of nearly 3000, provides health care for its workers and their families and uses its internal communications network to convey accurate and timely information about the epidemic.  Firestone Rubber, which has been in Liberia since 1926, detected in first case of Ebola on march 30th, according to NPR. Since then, the company went into crisis mode, built its own treatment center and developed a comprehensive response that effectively stopped the transmission of the virus among more than 80,000 employees and family members who live on the sprawling plantation.

Local companies such as the National Oil Company of Liberia and the Sierra Leone Produce Marketing Company have also made contributions to combatting the virus.

The importance of the private sector’s role in responding to health emergencies cannot be underestimated.  Companies such as Anglo-American, SABMiller and Ford Motor Company played critical roles in combatting the HIV/AIDS crisis in South Africa by making medicines and quality health care available to their employees and their families, and they continue to play this role.

The U.S. Chamber of Commerce and the Corporate Council on Africa are to be applauded for the role that they have played in helping to coordinate and publicize the U.S. private sector response to the Ebola crises.

The Obama Administration has effectively integrated the private sector into key development initiatives such as Power Africa and the New Alliance for Food Security and Nutrition, which is the private sector component of Feed the Future.  It would do well to establish a similar mechanism as part of its Ebola response. Controlling the spread of Ebola and the development of viable health care systems in the three affected countries will require the sustained engagement of governments, NGOs, international organizations and agencies and the private sector.  The sooner that all parties are able to coordinate their efforts the more likely this virus will be controlled.

Facebook Makes Strides in Africa by Enabling the Market and then Tailoring to It

Posted in Media, Internet, and Technology

Although it groups the African region within its “Rest of World” operating segment, Facebook’s attention to — and resulting successes on — the continent indicate that Africa has the potential to play a significant role in the company’s future.

This month, Facebook reached 100 million active users in Africa, a figure that represents half of the continent’s Internet-connected population.  Importantly, Facebook is keenly aware of the fact that 80 percent of these users access Facebook through mobile devices but that the user experience is negatively impacted by issues with affordability and connectivity.  To address these barriers in Africa and other emerging markets, Facebook co-founded a multi-sector global partnership to bring the Internet to the nearly two-thirds of the world’s population who still are without affordable and reliable access.  One of the partnership’s first projects has been the launch of an app that provides a set of free basic Internet services “as well as local resources about human rights, women’s rights, and civic engagement.”  The app currently is available to Airtel mobile subscribers in Zambia and the partnership intends to introduce it more widely across the region.  In addition, the Facebook Connectivity Lab is exploring innovative new ways to deliver the Internet such as through drones, satellites and lasers.

Facebook also has tailored its online advertisements — one of its primary sources of revenue — to be more compatible with these access barriers.  Facebook has introduced a feature that allows advertisers to target users based on the type of network connection that the users typically use to access Facebook.  This “targeting by mobile network type allows advertisers to select advertisements that will run smoothly on any given device and connection speed.”

Finally, in recognition of the fact that the continent is more than a consumer market but also a source of innovation, last week Facebook hosted its first ever “Creative Hackathon.”  Done in partnership with Creative Week Cape Town, the Hackathon offered young creative designers “the opportunity to work in teams on a real creative brief for the Loeries Creative Future Scholarship.”  Facebook also used Creative Week to “[talk] about how to unlock the potential of technology with creativity.”

Consistent throughout these initiatives are the themes of investing in an enabling environment and tailoring one’s products and services to realities on the ground.  These are simple but important lessons for any company looking to succeed on the continent.

Note: Facebook Inc. is a current client of Covington & Burling LLP.

Governance Challenges, Social Barriers, and the Upcoming U.S. Mission to Fight Ebola

Posted in Current Events, Public Health, Public Policy and Government Affairs, Uncategorized

President Obama recently announced that approximately 3,000 U.S. troops will deploy to West Africa in an effort to combat the Ebola epidemic, which has struck more than 4,985 people and resulted in over 2,461 deaths.  The U.S. Africa Command will establish its Joint Force Command headquarters in Monrovia, Liberia to coordinate regional assistance to Guinea, Liberia, Sierra Leone, Nigeria and Senegal.  The additional health facilities, medical expertise, equipment, and supplies that the U.S. will provide are desperately needed, yet the mission’s effectiveness will depend in part on the United States’ ability to adequately address the underlying governance challenges and social dynamics that are propelling this debilitating virus.

On September 18, the international non-profit IREX sponsored a Washington, D.C. event entitled Ebola in Liberia: The Challenges of Preserving Peace in a Public Crisis.  Panelists in the field of healthcare, media and civil society development, and justice sector reform offered useful observations concerning Liberia’s governance obstacles and their effect on the Ebola outbreak.  The experts highlighted the social realities that have hindered the fight against Ebola and identified potential opportunities for the upcoming U.S. mission to maximize its impact in Liberia.

Continue Reading

Africa Sees Opportunities in Islamic Finance

Posted in Corporate and Investment

More states in Africa seem keen on joining the global Islamic finance sector, which is projected to be worth $2 trillion by the end of 2014.  According to Moody’s Investors Service, global issuance of sovereign Islamic bonds – also known as “sukuk” – is expected to increase 30 percent in 2014 to reach $30 billion.

In September 2014, South Africa sold its first-ever sukuk at a record low borrowing cost.  The $500 million 5.75-year sukuk has been launched at a yield of 3.9 percent.  Almost 60 percent of investors participating in the deal are from the Middle East. BNP Paribas SA, KFH Investment, and Standard Bank Group Ltd. reportedly arranged the sale.

Other sub-Saharan states have made or contemplated similar moves recently.  In June 2014, Senegal raised $208 million through its first sukuk.  Also, it has been reported that sukuk is part of Nigeria’s strategic framework through 2017.  And Kenya may offer sukuk to broaden its investor base.

Islamic finance also has gained traction in North Africa, where states have introduced new regulations as they seek alternative funding.  In July 2014, Tunisia passed a new law allowing the issuance of sukuk.  In June 2014, Morocco’s lower house of parliament approved an Islamic banking bill. Now before the country’s upper house of parliament, the bill is being evaluated by Morocco’s Economic, Social and Environmental Council (CESE), which offered revisions in August 2014.  Egypt has been keen on tapping into the sukuk market, but its sukuk law has stalled since 2013.  The government reportedly plans to submit a revised draft law to the new parliament which may be elected later this year.  According to Standard & Poor’s, the use of sukuk could help diversify investors’ base for some of the projects currently underway or in development for North Africa, including renewable energy, transport infrastructure, and communications.  Still, the process is expected to be gradual.

As Africa creates its own footprint in the Islamic finance sector, it may see several new investors and opportunities in the years ahead.

Emerging Opportunities from the U.S.-Africa Leaders Summit

Posted in Corporate and Investment

When President Obama announced his intention to convene the first-ever U.S.-Africa Leaders Summit, policymakers, pundits, and other interested parties made numerous predictions as to how the historic event would fare, especially in comparison with the summits convened by China, the European Union, and others. Now that the activity of what came to be known as “Africa week” has settled down, it is time to take stock of what was achieved and what comes next.

So what was achieved at the U.S. Africa Leaders Summit?

Continue Reading