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Competing Interests: Competing interests: None declared.

Due to the recent developments in the delivery of teaching-learning processes when COVID-19 hit the world with a health crisis and pandemic, it is crucial to look into the quality of courses delivered via online means or through distance education modality. This paper examines implementation and application of quality assurance (QA) landscape in Distance Education (DE). A documentary review using bibliographic inquiry is used as a methodology approach to gather relevant information to address the study questions. Previous studies on QA in DE are examined and arranged into themes using thematic analysis. Findings revealed that most of the literature on QA in DE in Africa and Asia based on the reviewed Open and Distance Learning (ODL) institutions are basically dealing with frameworks, outcomes and performance, instructional design, student services and challenges as well as parity in terms of quality with the traditional institutions. Therefore, this paper concludes that more studies are needed for QA in DE to match the post-COVID-19 trends on improving QA. This implies that there is a need to expand research on QA in DE to include areas of artificial intelligence.

Purpose: The outbreak of COVID-19 in 2020 has had a profound impact on education institutions at all levels. Open universities, with their privileged delivery method, have been in an advantageous position. In the earlier stages of the pandemic, they made remarkable contributions to assuring learning continuity. However, with more and more conventional universities migrating online, great changes have taken place in the field of higher education, and it is imperative for open universities to adjust their strategies in order to maintain their leading role in a technology-enabled education context. This paper aims to examine what challenges have been faced by open universities during the pandemic and how they will transform in the future. Design/methodology/approach: Six open universities in Asia, Africa and Europe were selected as cases in this research to make a comparative study based on the papers in the volume beyond distance education. Similarities and differences among the cases were analyzed in order to identify the developing trend for open universities in the international context. Findings: The results showed that (1) open universities in these regions demonstrated their resilience in the pandemic; examples were that new technologies have been leveraged to implement totally online delivery with short notice and huge amount of learning resources were offered to the society. (2) However, they encountered challenges of delivering fully online examination due to the lockdown and quarantine policies, and open universities in African and the sole private institution suffered financial pressure due to improving information and communication technology infrastructure and staff training. Another challenge was the fierce competition from conventional universities that open universities in Asia and Europe came across. (3) Four main areas were identified for future development in order to respond to the challenges: No.1 is that programs such as health care, psychology, epidemiology, virology, immunology, data analytics, biology and bio-informatics have stimulated interest for African open universities to develop in the future; No. 2 is that open universities were seeking to innovate their teaching formats; short courses, such as micro credentials, might be developed as agile and flexible offerings which are expected to be suitable to learners in the pandemic context; No 3 is that programs and courses for upskilling in the context of digitalization will be implemented; and No. 4 is that lifelong learning is given a higher priority in order for open universities to stand securely in the higher education sector. Originality/value: The study may give open university leaders a quick insight into their future development.

In developing countries as in developed countries, the COVID-19 crisis has led to near universal school closures that will affect children's ability to learn, especially in countries with limited infrastructure for distance learning. While most children are likely to return to school when they reopen, quite a few may drop out. In addition, the economic recession generated by the crisis will affect livelihoods, leading to higher rates of poverty and food insecurity. This also may have negative impacts on both Catholic schools and their students. This paper, the second in a set of two, looks at likely impacts of the COVID-19 crisis on Catholic Schools in developing countries, with a focus on sub-Saharan Africa, a vulnerable region given the comparatively weak performance of its education systems and the limited availability of resources for governments to protect education budgets (acknowledging that many Catholic schools in the region are public schools). How Catholic schools will be able to respond to the twin challenges of school closures and the economic downturn may affect their comparative advantage for the medium term. A key aim of the paper is to make Catholic school teachers and leaders aware of some of the discussions on how to respond to the crisis, and provide links to resources online that may be useful. [For Part I of the series, see EJ1278497.]

A documentary review was conducted on the production and publication of research papers on studying the variable Digital Transformation, Education and COVID-19. The bibliometric analysis proposed in this document aims to know the main characteristics of the volume of publications registered in the Scopus database from 2020 to 2022, achieving the identification of 464 publications in total. The information provided by this platform was organized using tables and figures, categorizing the information by Year of Publication, Country of Origin, Area of Knowledge and Type of Publication. Once these characteristics were described, the position of different authors regarding the proposed topic was referenced through qualitative analysis. Among the main findings of this research, it is found that Spain, with 49 publications, was the country with the highest global production. The area of knowledge that made the most significant contribution to the construction of bibliographic material related to the study of Digital Transformation, Education and COVID-19 was the area of Social Sciences with 253 published documents, and the type of publication that was most used during the period mentioned above was the journal article, representing 54% of the total scientific production.

After more than a year of living with the COVID-19 pandemic, much experience has been accumulated by countries around the world. There have been many failures, and there have been some things that have gone well. Adult learning and education in some form has played a significant role in public health since, without the ongoing continuing educational interventions mainly via the mass media, the number of doctors and hospital beds would likely have been insufficient. In this paper we focus on the role of group behaviours in relation to the risk of contagion and we argue that any attempts to define a strategy to combat the pandemic must include a strong commitment to information dissemination and to the training of the populations in order to encourage behaviour change necessary to mitigate the spread of the virus. Against the backdrop of the United Nations Sustainable Development Goals, this article argues for commitment by governments to use adult learning and education as a tool for health prevention and health awareness and to prepare populations for whatever pandemics and national disasters that might emerge in the twenty-first century, the "century of pandemics". We therefore argue that populations must have at least a basic level of literacy and numeracy as foundational skills essential for enabling citizens to receive and act on vital information during a pandemic or disaster in order to engender greater resilience.

Surprisingly, distance education is quite an old concept. Its origins date back to the first correspondence-based course, which took place via the postal service in Boston, USA, in the 18th century. Rapid technological developments, especially in video and audio streaming, have increased the availability of such courses and moved learning into the virtual world. Due to the ongoing COVID-19 pandemic, we are witnessing an accelerated revolution in the learning process, as nearly all forms of education have been shifted online. Will this have a destructive effect on the human psyche? Is humanity sufficiently aware and ready for such a dramatic change? Will we return to physical in-classroom studies, or is remote distance education set to become the new norm? In particular, in medicine, computer science, fine arts, or architectural design, such a rapid change in the way students learn can be quite challenging. In this paper, we provide an overview of the history of distance learning, taking into account teachers' and students' points of view in both secondary and higher education.

This paper presents research on girls' and boys' gendered perceptions of their learning during school closures due to COVID-19. The research was conducted in ten countries affected by displacement across Asia, the Middle East, Africa, and Latin America. We applied statistical analysis using multivariate logistic regression models from the results of a survey conducted with parents or caregivers and their children. We complemented the quantitative study with qualitative methodology, which provided a nuanced understanding of girls' and boys' perceptions of their learning and their voiced concerns during the COVID-19-related school closures. Our results show that the children in the displaced settings are likely to perceive a decline in learning during the pandemic, and that the factors influencing this perception differ between boys and girls. Girls' perceptions of learning "nothing" or only "a little bit" were more strongly associated with material barriers, such as limited access to learning materials and household economic circumstances, than was the case for boys. The boys' experience of learning "a little bit" or "nothing" was more strongly associated with increased negative feelings, including feeling sad or worried, increased violence in the home, and increased responsibility for looking after siblings or other children. This research notes the importance of supporting displaced children by providing adequate resources to enable equitable access to learning, and calls for cross-sectoral programming to support displaced children who are dealing with emotional pressure.

The COVID-19 pandemic has attracted a plethora of research from medical-related disciplines other than sociological and migration disciplines . While a significant number of research papers have considered the impacts of the COVID-19 lockdowns and school closures on students, their observations are not directly applicable to the over 5.3 million international students across the globe. The purpose of this study is to understand how African Student Migrants (ASMs) used technologies for social services during the COVID-19 pandemic in Moscow. This study adopted a qualitative research approach to understand the use of digital technologies for social services among 40 ASMs sampled through purposive and snowballing techniques. The findings established that, the use of digital technologies by ASMs played an instrumental role in social services such as accommodation, learning and purchasing patterns rather than social communication, religious or cultural practices, psychological and physical health, and dieting during the COVID-19 pandemic. For policy-level recommendations, tech-savvy developers, the International Organization for Migration (IOM), the United Nations Educational Science and Cultural Organization (UNESCO) and the African Union (AU) should collaborate and create digital technologies that are suitable for social services; devise an information platform to capture basic information about ASMs that will enable them to streamline welfare stimulus packages essential to their survival in times of pandemics. This will also serve as a coping mechanism for society to prepare for new social emergencies and use digital technologies to calibrate international education and inform future policies on public health, school closures and mobility beyond borders.

While blended learning is well entrenched in many developed countries as a solution towards enabling access to educational resources and managing student diversity, this may not be the same for rural based universities in developing countries. Yet, blended learning is ideal for the current terrain of the COVID-19 pandemic which requires learning modalities that promote social distancing to reduce the spread of the disease while ensuring that students have access to quality teaching and learning materials and to frequently stay engaged. For many rural based universities, successful blended learning implementation implies an exploration of possible ways to strengthen existing practices. This paper, using the document analysis method, sought to explore the prospects and pitfalls of implementing blended learning in rural- based universities in Southern Africa. The blended learning implementation framework by Graham, Woodfield and Harrison (2013) served as a guiding framework as it was specifically designed to determine success in blended learning adoption and implementation in education. This framework utilises the constructs of strategy, structure and support to differentiate the stages of adopting blended learning. These three stages are in a continuum and comprise awareness and exploration as stage 1, adoption or early implementation as stage 2 and mature implementation and growth as stage 3, with stages differing depending on the extent of formalisation of the institutional strategy, structure and support. Findings indicated prospects of blended learning entail providing opportunities for flexible learning, enabling access to a wide range of educational resources and limiting alienation associated with purely online education delivery. For many institutions, however, implementation of blended learning is still a mirage with the majority still at the first stage of Graham "et al."'s (2013) blended learning adoption and implementation framework owing to technical resource constraints related to unstable or non-existent network coverage characteristic in rural locations, curricular deficit stemming from the blended learning model not aligning to context, thus lowering morale for wider implementation. This is exacerbated by weak goodwill and limited policy guidelines on a specific blended learning model. The study concludes that creating conducive conditions for blended learning in rural based universities necessitates a context friendly implementation model where institutional evaluation data inform strategies, support and pedagogical approaches and related resources that can be used locally. The study recommends governmental support for resourcing rural universities to acquire affordable and usable resources to offset challenges hindering blended learning. Rural institutions should also strive to strengthen support to students and staff to build confidence in the potential of blended learning.

Background: The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs)., Methods: We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes during public health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach., Results: Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically., Conclusions: There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics., (© 2024. The Author(s).)

To what extent has Covid-19 policy responses exacerbated the already existing multiple vulnerabilities of female migrants in Southern Africa? Using strategic conversations, the paper explores personal experiences of key conversants, to explore how gender blind policy responses to the pandemic have heightened female migrants' socio-economic challenges. The paper recommends gender sensitive and context specific policy responses to mitigate the existing socio-economic challenges. [ABSTRACT FROM AUTHOR]

This paper discusses multidisciplinary international research collaboration team formation during the COVID-19 pandemic, challenges faced, strategies adopted, achievements and dynamics in the implementation of research on Coronavirus disease-2019 (COVID-19), by the African Translational Research Group (ATReG). The paper also discusses the lessons learnt and future opportunities for global collaborative research. In-depth virtual interviews were conducted with consenting members of ATReG. Questions were designed to provide rich, deep, and insightful opinions, lived experiences and perspectives of ATReG group members on group formation, challenges, strategies and achievements. Interview data was transcribed and analysed thematically, and the results were presented with important quotations presented. The ATReG consisted of English (n = 13) and French (n = 1) speaking sub-Saharan African (SSA) researchers who specialise in public health, epidemiology, optometry, information technology, supply chain management, psychiatry, community health, general medical practice, nutrition and biostatistics. Most members of the group reported an informal but well-coordinated structure of the group. Formed during the pandemic, all group meetings were held online, and many members are yet to meet each other in person. The group collected data from Africans and published 10 peer reviewed journal articles on COVID-19 within two years. It presented in international conferences, engaged with the media and the public and was awarded a national competitive funding in Nigeria all of which which contributed to career progression and academic promotion of some members. There have been challenges in sustaining the research collaboration and maintaining productivity. Challenges include difficulties meeting deadlines and obtaining funding for research activities. However, these challenges have been addressed through a collaborative problem-solving approach. The study found the need for operational and methodological flexibility, centralised coordination, and established funding sources as being essential for long term sustainability and performance of the group. The ATReG's objective of providing useful data on COVID-19 and generating useful knowledge about COVID-19 in SSA has been achieved. In such a multi-disciplinary international collaborative team relaiant on the online medium to operate, the experiences and challenges can be a model for learning for researchers intending to form international multidisciplinary collaborative groups. Nonetheless, there are still many important areas of research which ATReG will continue to pursue. [ABSTRACT FROM AUTHOR]

The aim of this paper is to propose that the development and legitimization of African knowledge and validation systems on a pragmatic basis is an efficient and effective means of responding to a myriad of health problems plaguing Africans, particularly the COVID-19 pandemic. Whenever there is a novel disease outbreak, the norm is to wait for the development of scientifically proven vaccines for its treatment. However, the scientific validation of drugs is a rigorous and lengthy process, thereby inappropriate for dealing with health emergencies like the COVID-19 outbreak. The alarming rapidity with which the novel COVID-19 pandemic rages globally and decimates humanity has brought to the fore the need for Africa to look inwards in search of viable and efficient alternative approaches to the pandemic. In this paper, I examine pragmatism as a theoretical framework and relate it to proposed African epistemic and validation frameworks with a particular reference to homegrown orthodox and alternative/complementary medicines. I argue that the validation and approval of any knowledge claim based on pragmatism is a more expeditious mode of attending to COVID-19 and other prevalent diseases in Africa. The application of knowledge that brings practical success in dealing with health challenges in Africa without necessarily following rigid and lengthy scientific validation procedures will go a long way toward improving human conditions and well-being. I conclude that pragmatic considerations should ultimately inform local approval to homegrown African medicines for use in Africa. [ABSTRACT FROM AUTHOR]

Corona virus disease 2019 (COVID-19) remains an incurable, progressive pneumonia-like illness characterized by fever, dry cough, fatigue, and headache during its early stages. COVID-19 has ultimately resulted in mortality in at least 2 million people worldwide. Millions of people globally have already been affected by this disease, and the numbers are expected to increase, perhaps until an effective cure or vaccine is identified. Although Africa was initially purported by the World Health Organization (WHO) to be severely hit by the pandemic, Africa recorded the least number of cases during the first wave, with lowest rates of infections, compared to Asia, Europe, and the Americas. This statistic might be attributed to the low testing capacity, existing public health awareness and lessons learnt during Ebola epidemic. Nonetheless, the relatively low rate of infection should be an opportunity for Africa to be better prepared to overcome this and future epidemics. In this paper, the authors provide insights into the dynamics and transmission of the severe acute respiratory syndrome corona virus (SARS-CoV-2) during the first wave of the pandemic; possible explanations into the relatively low rates of infection recorded in Africa; with recommendations for Africa to continue to fight Covid-19; and position itself to effectively manage future pandemics., (© 2021 Emahi I et al.)

Background: The COVID-19 pandemic has created unprecedented challenges to the systematic and timely sharing of COVID-19 field data collection and management. The World Health Organization (WHO) is working with health partners on the rollout and implementation of a robust electronic field data collection platform. The delay in the deployment and rollout of this electronic platform in the WHO African Region, as a consequence of the application of large-scale public health and social measures including movement restrictions and geographical area quarantine, left a gap between data collection and management. This lead to the need to develop interim data management solutions to accurately monitor the evolution of the pandemic and support the deployment of appropriate public health interventions., Objective: The aim of this study is to review the design, development, and implementation of the COVID-19 Data Summarization and Visualization (DSV) tool as a rapidly deployable solution to fill this critical data collection gap as an interim solution., Methods: This paper reviews the processes undertaken to research and develop a tool to bridge the data collection gap between the onset of a COVID-19 outbreak and the start of data collection using a prioritized electronic platform such as Go.Data in the WHO African Region., Results: In anticipation of the implementation of a prioritized tool for field data collection, the DSV tool was deployed in 18 member states for COVID-19 outbreak data management. We highlight preliminary findings and lessons learned from the DSV tool deployment in the WHO African Region., Conclusions: We developed a rapidly deployable tool for COVID-19 data collection and visualization in the WHO African Region. The lessons drawn on this experience offer an opportunity to learn and apply these to improve future similar public health informatics initiatives in an outbreak or similar humanitarian setting, particularly in low- and middle-income countries., (©Kamran Ahmed, Muhammad Arish Bukhari, Tamayi Mlanda, Jean Paul Kimenyi, Polly Wallace, Charles Okot Lukoya, Esther L Hamblion, Benido Impouma. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 14.10.2020.)

The first wave of the COVID-19 pandemic to hit Africa (February-September 2020) was not particularly virulent either in terms of cases detected or lethality. However, the presence of the virus and the subsequent restrictions exacerbated pre-existing inequalities based on ethnicity, class and gender. This paper analyses the impacts of the pandemic on refugee women, who are subject to "structural vulnerability" and "multisystemic violence" in Africa. After analysing the ten African countries with the largest refugee populations, the different forms and levels of these impacts are systematised, along with the consequences and implications for refugee women in the long term, highlighting the need for strategies to be adopted towards this group at various levels. [ABSTRACT FROM AUTHOR]

Due to the high transmission rate and mortality index of the current coronavirus pandemic, many settings in Africa instituted lockdowns to reduce its rate of spread and avert exponential growth rate. At the early stage, this measure seemed to heighten awareness of the virus and subsequently minimized exponential growth of cases. However, these lockdowns have had great consequences on the weak health systems and frail economy in place in many African countries. In this paper, we examine the impact of lockdown measures in these countries and provides key recommendations in dealing with present and future pandemics. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caught the world unprepared, with containment measures impacting both global supply chains and agri-commodity flows. The public health crisis raised some urgent questions: "how can fish and other aquatic foods and supply chains be prioritized as health-related interventions to avert both a malnutrition crisis and gender inequality?" Furthermore, "what are the integrated responses, investment opportunities, and governance mechanisms to effectively address the pandemic?" As "super foods," diets of fish and aquatic foods provide animal-source protein, omega-3 fatty acids, and micronutrients, including both vitamins and minerals, necessary for both the ill and the healthy. The affordability and accessibility of fish could address food and nutrition security needs under lockdown and border closures, boost immune systems, and increase commodity trade. This analytical piece focuses on the continent of Africa, where malnutrition is pervasive, but also where local aquatic food supplies can be utilised during lockdowns and border closures. The paper provides governance insights on national budget support programs and portfolio restructuring to strengthen local aquatic foods production systems to meet dietary needs. Furthermore, the authors advocate for a coordinated multi-sectoral intervention across several well-being domains in the immediate and medium-term involving various partnerships. These integrated responses will mutually limit the contagion while providing support to functional fish value chains for healthy diets, livelihoods, cross-border trade, and long-term macroeconomic recovery. [ABSTRACT FROM AUTHOR]

We investigate the relationship between HIV, marriage and nonmarital sexual activity, with a focus on adolescent behaviors. We use data from 45 Demographic and Health Surveys to examine how adolescent behavior among women born from 1958 to 1965 are related to the subsequent spread of HIV over time. These women were adolescents during the early 1980s, a time when HIV had started to spread but the cause was still unknown. We find that areas with currently high HIV rates had greater female education and more premarital sexual activity in the cohorts that came of age before HIV was understood. [ABSTRACT FROM AUTHOR]

The East African Integrated Disease Surveillance Network (EAIDSNet) was formed in response to a growing frequency of cross-border malaria outbreaks in the 1990s and a growing recognition that fragmented disease interventions, coupled with weak laboratory capacity, were making it difficult to respond in a timely manner to the outbreaks of malaria and other infectious diseases. The East Africa Community (EAC) partner states, with financial support from the Rockefeller Foundation, established EAIDSNet in 2000 to develop and strengthen the communication channels necessary for integrated cross-border disease surveillance and control efforts. The objective of this paper is to review the regional EAIDSNet initiative and highlight achievements and challenges in its implementation. Major accomplishments of EAIDSNet include influencing the establishment of a Department of Health within the EAC Secretariat to support a regional health agenda; successfully completing a regional field simulation exercise in pandemic influenza preparedness; and piloting a web-based portal for linking animal and human health disease surveillance. The strategic direction of EAIDSNet was shaped, in part, by lessons learned following a visit to the more established Mekong Basin Disease Surveillance (MBDS) regional network. Looking to the future, EAIDSNet is collaborating with the East, Central and Southern Africa Health Community (ECSA-HC), EAC partner states, and the World Health Organization to implement the World Bank-funded East Africa Public Health Laboratory Networking Project (EAPHLNP). The network has also begun lobbying East African countries for funding to support EAIDSNet activities. [ABSTRACT FROM AUTHOR]

Objective: The paper projects the contribution to 2011-2015 international targets of three major pandemics by programs in 140 countries funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the largest external financier of tuberculosis and malaria programs and a major external funder of HIV programs in low and middle income countries. Design: Estimates, using past trends, for the period 2011-2015 of the number of persons receiving antiretroviral (ARV) treatment, tuberculosis case detection using the internationally approved DOTS strategy, and insecticide-treated nets (ITNs) to be delivered by programs in low and middle income countries supported by the Global Fund compared to international targets established by UNAIDS, Stop TB Partnership, Roll Back Malaria Partnership and the World Health Organisation. Results: Global Fund-supported programs are projected to provide ARV treatment to 5.5-5.8 million people, providing 30%-31% of the 2015 international target. Investments in tuberculosis and malaria control will enable reaching in 2015 60%-63% of the international target for tuberculosis case detection and 30%-35% of the ITN distribution target in sub- Saharan Africa. Conclusion: Global Fund investments will substantially contribute to the achievement by 2015 of international targets for HIV, TB and malaria. However, additional large scale international and domestic financing is needed if these targets are to be reached by 2015. [ABSTRACT FROM AUTHOR]

An essay is presented on a review of several books related to HIV/AIDS in Africa. These books include "African Women's Unique Vulnerabilities to HIV/AIDS: Communication Perspectives and Promises," by Linda K. Fuller, "Twenty-Eight Stories of AIDS in Africa," by Stephanie, and "AIDS, Sex, and Culture: Global Politics and Survival in Southern Africa," by Ida Susser. The author stresses the aspect of prevention and biomedical treatment as a means of controlling the said human disease pandemic.

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A continent-wide Africa Task Force for Coronavirus with its six technical working groups was formed to prepare adequately and respond to the novel Coronavirus disease (COVID-19) outbreak in Africa. This research in practice article aimed to describe how the infection prevention and control (IPC) technical working group (TWG) supported Africa Centre for Disease Control and Prevention (Africa CDC) in preparedness and response to COVID-19 on the continent. To effectively address the multifaceted IPC TWG mandate of organizing training and implementing rigorous IPC measures at healthcare service delivery points, the working group was sub-divided into four sub-groups—Guidelines, Training, Research, and Logistics. The action framework was used to describe the experiences of each subgroup. The guidelines subgroup developed 14 guidance documents and two advisories; all of which were published in English. In addition, five of these documents were translated and published in Arabic, while three others were translated and published in French and Portuguese. Challenges faced in the guidelines subgroup included the primary development of the Africa CDC website in English, and the need to revise previously issued guidelines. The training subgroup engaged the Infection Control Africa Network as technical experts to carry out in-person training of IPC focal persons and port health personnel across the African continent. Challenges faced included the difficulty in conducting face-to-face IPC training and onsite technical support due to the lockdown. The research subgroup developed an interactive COVID-19 Research Tracker on the Africa CDC website and conducted a context-based operation and implementation research. The lack of understanding of Africa CDC's capacity to lead her own research was the major challenge faced by the research subgroup. The logistics subgroup assisted African Union (AU) member states to identify their IPC supply needs through capacity building for IPC quantification. A notable challenge faced by the logistics subgroup was the initial lack of experts on IPC logistics and quantifications, which was later addressed by the recruitment of professionals. In conclusion, IPC cannot be built overnight nor can it be promoted abruptly during outbreaks of diseases. Thus, the Africa CDC should build strong national IPC programmes and support such programmes with trained and competent professionals. [ABSTRACT FROM AUTHOR]

The importance of tourism for development is widely recognized. Travel restrictions imposed to contain the spread of COVID-19 have brought tourism to a halt. Tourism is one of the key sectors driving change in Africa and is based exclusively on natural assets, with wildlife being the main attraction. Economic activities, therefore, are clustered around conservation and protected areas. We used night-time light data as a proxy measure for economic activity to assess change due to the pandemic. Our analysis shows that overall, 75 percent of the 8427 protected areas saw a decrease in light intensity in varying degrees in all countries and across IUCN protected area categories, including in popular protected area destinations, indicating a reduction in tourism-related economic activities. As countries discuss COVID-19 recovery, the methods using spatially explicit data illustrated in this paper can assess the extent of change, inform decision-making, and prioritize recovery efforts. [ABSTRACT FROM AUTHOR]

Background: The recent 2018 Declaration of Astana recognized primary health care (PHC) as a means to achieve universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs). Following this declaration, country progress on operationalization of the PHC agenda and attainment of UHC has been stalled by the new challenges posed by the COVID-19 pandemic. The pandemic has also disrupted the continuity of essential health service provision and tested the resilience of the region's health systems. Methods: In accordance with this, the WHO Regional Office for Africa convened the Fifth Health Sector Directors' Planning and Policy Meeting across the 47 Member States of the Region. The two-day forum focused on building health system resilience to facilitate service continuity during health threats, PHC revitalization, and health systems strengthening towards UHC. Results: The Regional Forum provided evidence on building resilient health systems in the WHO African Region and engaged participants in meaningful and critical discussion. It is from these discussions that four key themes emerged: (1) working multisectorally/intersectorally, (2) moving from fragmentation to integration, (3) ensuring implementation and knowledge exchange, and (4) rethinking resilience and embracing antifragility. These discussions and associated groupings by thematic areas lend themselves to recommendations for the WHO. Conclusions: This paper details the proceedings and key findings on building resilient health systems, the four themes that emerged from participant deliberation, and the recommendations that have emerged from the meeting. Deliberations from the Regional Forum are critical, as they have the potential to directly inform policy and program design, given that the meeting convenes health sector technocrats, who are at the helm of policy design, action, and implementation. [ABSTRACT FROM AUTHOR]

COVID-19 is a global pandemic that continues to spread around the world, including to Africa where cases are steadily increasing. The African Centres for Disease Control and Prevention is leading the pandemic response in Africa, with direction from the World Health Organization guidelines for critical preparedness, readiness, and response actions. These are written for national governments, lacking nuance for population and local differences. In the greater Horn of Africa, conditions unique to pastoralists such as inherent mobility and limited health and service infrastructure will influence the dynamics of COVID-19. In this paper, we present a One Health approach to the pandemic, consisting of interdisciplinary and intersectoral collaboration focused on the determinants of health and health outcomes amongst pastoralists. Our contextualized public health strategy includes community One Health teams and suggestions for where to implement targeted public health measures. We also analyse the interaction of COVID-19 impacts, including those caused directly by the disease and those that result from control efforts, with ongoing shocks and vulnerabilities in the region (e.g. desert locusts, livestock disease outbreaks, floods, conflict, and development displacement). We give recommendations on how to prepare for and respond to the COVID-19 pandemic and its secondary impacts on pastoral areas. Given that the full impact of COVID-19 on pastoral areas is unknown currently, our health recommendations focus on disease prevention and understanding disease epidemiology. We emphasize targeting pastoral toponymies with public health measures to secure market access and mobility while combating the direct health impacts of COVID-19. A contextualized approach for the COVID-19 public health response in pastoral areas in the Greater Horn of Africa, including how the pandemic will interact with existing shocks and vulnerabilities, is required for an effective response, while protecting pastoral livelihoods and food, income, and nutrition security. [ABSTRACT FROM AUTHOR]

This article examines the impact of the COVID‐19 pandemic on ride‐hailing drivers in Africa. It argues that, although ride‐hailing offers paid work to some African workers, the commodified and informalized nature of this work results in poor job quality, the effects of which were greatly amplified during the pandemic. Drawing on a mixed methods approach involving in‐depth interviews with ride‐hailing drivers in Nairobi and digital ethnography, it also provides accounts of drivers' hustles to demonstrate strategies of resilience, reworking and resistance among informal workers. The article concludes by highlighting the need for adequate regulatory frameworks and on‐the‐ground solidarity networks to ensure decent working conditions, and to push back against precarity in the gig economy. [ABSTRACT FROM AUTHOR]

Africa experienced the third wave of the coronavirus disease in 2019, which caused an 18% rise in cases in most parts of the continent. As of January 2022, the region had an estimated 10.4 million cumulative cases and more than 233,000 deaths, which add up to the burden on the fragile healthcare system, which continues to face a shortage of staff and resources. In addition, the progression of the pandemic further threatens the supply of healthcare workers in Africa due to the increased risk of infection and death, where more than 10,000 healthcare workers in 40 countries have been infected with the virus. This is amid low vaccination coverage, with only 27% of healthcare workers in Africa being fully vaccinated against the disease. Despite the delayed start and slow progression of the pandemic in Africa, there are increasing concerns over the challenges on the African healthcare workers such as economic insecurity and stressful working conditions, which are associated with limited access to personal protective equipment and other vital resources such as ventilators. In addition, the pandemic further predisposes African healthcare workers to social stigma, burnout, insomnia, depression, and fear of safety in their families. The aim of this study is to highlight the challenges faced by African healthcare workers, provide recommendations for change, and emphasize the need to prioritize their physical and mental well‐being. [ABSTRACT FROM AUTHOR]

Living in an increasingly interconnected world, epidemics and pandemics are increasingly likely to be a vista for the future. This, coupled with the likely devastating effects of climate change, means that humanitarian crises are likely to increase. Now, more than ever before, is the time to scale up investment in prevention and preparedness strategies, and to review our current approaches to delivering health services, including those that address neglected tropical diseases. The Ascend West and Central Africa programme has illustrated the importance of innovation, multisector partnerships, resilience and the opportunity for change. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused over 500 million cases and over six million deaths globally. From these numbers, over 12 million cases and over 250 thousand deaths have occurred on the African continent as of May 2022. Prevention and surveillance remains the cornerstone of interventions to halt the further spread of COVID-19. Google Health Trends (GHT), a free Internet tool, may be valuable to help anticipate outbreaks, identify disease hotspots, or understand the patterns of disease surveillance. We collected COVID-19 case and death incidence for 54 African countries and obtained averages for four, five-month study periods in 2020–2021. Average case and death incidences were calculated during these four time periods to measure disease severity. We used GHT to characterize COVID-19 incidence across Africa, collecting numbers of searches from GHT related to COVID-19 using four terms: 'coronavirus', 'coronavirus symptoms', 'COVID19', and 'pandemic'. The terms were related to weekly COVID-19 case incidences for the entire study period via multiple linear and weighted linear regression analyses. We also assembled 72 variables assessing Internet accessibility, demographics, economics, health, and others, for each country, to summarize potential mechanisms linking GHT searches and COVID-19 incidence. COVID-19 burden in Africa increased steadily during the study period. Important increases for COVID-19 death incidence were observed for Seychelles and Tunisia. Our study demonstrated a weak correlation between GHT and COVID-19 incidence for most African countries. Several variables seemed useful in explaining the pattern of GHT statistics and their relationship to COVID-19 including: log of average weekly cases, log of cumulative total deaths, and log of fixed total number of broadband subscriptions in a country. Apparently, GHT may best be used for surveillance of diseases that are diagnosed more consistently. Overall, GHT-based surveillance showed little applicability in the studied countries. GHT for an ongoing epidemic might be useful in specific situations, such as when countries have significant levels of infection with low variability. Future studies might assess the algorithm in different epidemic contexts. [ABSTRACT FROM AUTHOR]

Genomic characterization of circulating influenza type-A viruses (IAVs) directs the selection of appropriate vaccine formulations and early detection of potentially pandemic virus strains. However, longitudinal data on the genomic evolution and transmission of IAVs in Africa are scarce, limiting Africa's benefits from potential influenza control strategies. We searched seven databases: African Journals Online, Embase, Global Health, Google Scholar, PubMed, Scopus, and Web of Science according to the PRISMA guidelines for studies that sequenced and/or genomically characterized Africa IAVs. Our review highlights the emergence and diversification of IAVs in Africa since 1993. Circulating strains continuously acquired new amino acid substitutions at the major antigenic and potential N-linked glycosylation sites in their hemagglutinin proteins, which dramatically affected vaccine protectiveness. Africa IAVs phylogenetically mixed with global strains forming strong temporal and geographical evolution structures. Phylogeographic analyses confirmed that viral migration into Africa from abroad, especially South Asia, Europe, and North America, and extensive local viral mixing sustained the genomic diversity, antigenic drift, and persistence of IAVs in Africa. However, the role of reassortment and zoonosis remains unknown. Interestingly, we observed substitutions and clades and persistent viral lineages unique to Africa. Therefore, Africa's contribution to the global influenza ecology may be understated. Our results were geographically biased, with data from 63% (34/54) of African countries. Thus, there is a need to expand influenza surveillance across Africa and prioritize routine whole-genome sequencing and genomic analysis to detect new strains early for effective viral control. [ABSTRACT FROM AUTHOR]

Population growth, even if coupled to economic growth, and resources, were already on a collision course, especially in Africa. The 2019 United Nations World Water Development Report provided a dramatic status of world water, however without questioning the main drivers of an imminent water crisis, that were unbounded, unequal, economic, and population growth, within the context of reducing resources in a finite world. Despite the report was a small step forward in awareness, still, it was not proposing satisfactory remedies. With business-as-usual, without acting on the drivers of water scarcity, regional water crises were inevitable in the next 3 decades, starting from Africa. Constrained by political, financial, and energy burdens, the technological improvements that have helped humanity to deal with the increased demand for water, food, and energy over the last 70 years, were likely not enough to avoid the water crisis. On top of forecast is the Covid19 pandemic. Coronavirus cases are (August 4, 2020) 18,446,065 and fatalities are 697,202 worldwide, and still growing. The containment measures enforced for Covid19 infection following the examples in the United Kingdom have already produced significant damage to the world economy. This will limit social expenditures in general, and the expenditures for the water issue in particular. The water crisis will consequently become worse in the next months, with consequences still difficult to predict. This will be true especially for Africa, where the main problem has always been poverty. There is the opportunity of significant health, food, and water crisis, especially in Africa. While the concepts of washing hands and social distancing that are difficult to apply haven't produce so far major issues with the Covid19 outbreak in Africa, borders closure, restrictions on movement, and more poverty will translate in a lack of food and water potentially much more worrying than the virus spreading. [ABSTRACT FROM AUTHOR]

Background: The Human Immunodeficiency Virus (HIV) epidemic is more pronounced in sub- Saharan Africa. The ever-increasing prevalence of HIV infection and the continued improvement in clinical management has increased the likelihood of these patients being managed by healthcare workers. The aim of the review was to assess current literature on the risks of transmission of HIV infection and protection of the healthcare worker. Methods: A literature review was performed using MEDLINE articles addressing 'human immunodeficiency virus', 'HIV', 'Acquired immunodeficiency syndrome', 'AIDS', 'HIV and Surgery'. We also manually searched relevant surgical journals and completed the bibliographic compilation by collecting cross references from published papers. Results: Transmission is by contamination with body fluids for example needle-stick injury and blood splashes. The risk of HIV transmission from patient to healthcare worker always exists. The risk oftransmission is very small and depends on the type of discipline and type of procedure. Hollow needles are more dangerous than suture needles. Sero-conversion is, however, very minimal. Universal precautions are emphasised. In case of needle-stick injury or splash it is important that affected healthcare workers take post-exposure prophylaxis. Conclusion: Occupational HIV transmission is lower than that for other infections. However, protection of all health care personnel should be the prime objective. Universal infection control guidelines must be accepted and strictly enforced. A prompt response to blood contact is crucial and post-exposure prophylaxis is essential. [ABSTRACT FROM AUTHOR]

Background: Artificial Intelligence (AI) platforms, increasingly deployed in public health, utilize robust data systems as a critical component for health emergency preparedness. Yet, Africa faces numerous challenges in the availability, analyses, and use of data to inform health decision-making. Countries have limited access to their population data. Those with access, struggle to utilize these data for program improvements. Owing to the rapid growth of mobile phone ownership and use in the region, Africa is poised to leverage AI technologies to increase the adoption, access and use of data for health. To discuss and propose solutions for responsible development and adoption of innovations like AI in Africa, a virtual workshop was organized from the 21st to 24th June, 2021. This report highlights critical policy dimensions of strengthening digital health ecosystems by high-level policymakers, technical experts, academia, public and private sector partners. Method: The four days' workshop focused on nine sessions, with each session focusing on three themes. Discussions during the sessions concentrated on public and private sectors, the academia and multilateral organizations' deployment of AI. These discussions expanded participants' understanding of AI, the opportunities and challenges that exist during adoption, including the future of AI for health in the African region. Approximately 250 participants attended the workshop, including countries representatives from ministries of Health, Information and Technology, Developmental Organizations, Private Sector, Academia and Research Institutions among others. Results: The workshop resolved that governments and relevant stakeholders should collaborate to ensure that AI and digital health receive critical attention. Government ownership and leadership were identified as critical for sustainable financing and effective scale-up of AI-enabled applications in Africa. Thus, government is to ensure that key recommendations from the workshop are implemented to improve health sector development in Africa. Conclusions: The AI workshop was a good forum to deliberate important issues regarding AI for health in the African context. It was concluded that there is a need to focus on vital priorities in deploying AI in Africa: Data protection, privacy and sharing protocols; training and creating platforms for researchers; funding and business models; developing frameworks for assessing and implementing AI; organizing forums and conferences on AI; and instituting regulations, governance and ethical guidelines for AI. There is a need to adopt a health systems approach in planning for AI to reduce inefficiencies, redundancies while increasing effectiveness in the use of AI. Thus, robust collaborations and partnerships among governments and various stakeholders were identified as key. [ABSTRACT FROM AUTHOR]

Objective: In Africa, most countries continue to battle COVID-19 with cases of newly infected still being recorded. In this note, we investigate how socioeconomic and demographic factors affected individuals awareness on the methods for controlling/preventing the spread of COVID-19 in some parts of Africa at the onset of the pandemic. Results: Based on regression modelling, we find that having full awareness does not depend on religious affiliation. Men, urban dwelling, holding bachelors or higher degrees, operating multiple social media accounts or being employed are associated with having full awareness of the recommended practices for the prevention and control of COVID-19 at the early stage of the pandemic. No occupation, business or older people are associated with not having full awareness. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic is heterogeneous throughout Africa and threatening millions of lives. Surveillance and short-term modeling forecasts are critical to provide timely information for decisions on control strategies. We created a strategy that helps predict the country-level case occurrences based on cases within or external to a country throughout the entire African continent, parameterized by socioeconomic and geoeconomic variations and the lagged effects of social policy and meteorological history. We observed the effect of the Human Development Index, containment policies, testing capacity, specific humidity, temperature, and landlocked status of countries on the local within-country and external between-country transmission. One-week forecasts of case numbers from the model were driven by the quality of the reported data. Seeking equitable behavioral and social interventions, balanced with coordinated country-specific strategies in infection suppression, should be a continental priority to control the COVID-19 pandemic in Africa. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to visualize the global spread of the COVID-19 pandemic over the first 90 days, through the principal component analysis approach of dimensionality reduction. Methods: This study used data from the Global COVID-19 Index provided by PEMANDU Associates. The sample, representing 161 countries, comprised the number of confirmed cases, deaths, stringency indices, population density and GNI per capita (USD). Correlation matrices were computed to reveal the association between the variables at three time points: day-30, day-60 and day-90. Three separate principal component analyses were computed for similar time points, and several standardized plots were produced. Results: Confirmed cases and deaths due to COVID-19 showed positive but weak correlation with stringency and GNI per capita. Through principal component analysis, the first two principal components captured close to 70% of the variance of the data. The first component can be viewed as the severity of the COVID-19 surge in countries, whereas the second component largely corresponded to population density, followed by GNI per capita of countries. Multivariate visualization of the two dominating principal components provided a standardized comparison of the situation in the161 countries, performed on day-30, day-60 and day-90 since the first confirmed cases in countries worldwide. Conclusion: Visualization of the global spread of COVID-19 showed the unequal severity of the pandemic across continents and over time. Distinct patterns in clusters of countries, which separated many European countries from those in Africa, suggested a contrast in terms of stringency measures and wealth of a country. The African continent appeared to fare better in terms of the COVID-19 pandemic and the burden of mortality in the first 90 days. A noticeable worsening trend was observed in several countries in the same relative time frame of the disease's first 90 days, especially in the United States of America. [ABSTRACT FROM AUTHOR]