2019-nCoV: With daunting and likely impacts in African countries, cost of three-month global response to novel coronavirus is $676m, WHO says

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Rabita Aziz is in Geneva, representing the Infectious Diseases Society of America (which produces this blog) at the the World Health Organization Executive Board Meeting Feb. 3-8.

GENEVA – The World Health Organization estimates $675 million will be required between February and April to support responses to the 2019 novel coronavirus outbreak, officials said here, for measures that include strengthening preparedness and response capacities in highly vulnerable countries. These include low- and middle-income countries at high risk of imported cases and with underdeveloped outbreak response capacities and weak healthcare systems, officials said.

Sudan, among other countries in Africa, falls into that category, members of the Sudanese delegation said. Currently battling six outbreaks, including outbreaks of cholera and dengue, in a volatile political landscape, Sudan does not have the capacity or resources to effectively respond to an outbreak of 2019 nCoV, Ministry of Health representatives said. The country is evacuating 225 Sudanese students from Hubei province in China, home to the epicenter of the outbreak, representatives said, increasing the nation’s vulnerability to imported cases.

Only two WHO reference labs in Africa have the capability to diagnose 2019 nCoV, WHO representatives said, but that will change at the end of the week when WHO will send out diagnostic kits to most African countries. With the high flow of traffic between Africa and China – Ethiopian Airlines alone has 20 flights between Addis and China every week – there are likely infections that are going undiagnosed, experts say.

The 24 labs in Africa receiving testing kits will also receive training on proper diagnosis, WHO officials said. WHO is sending out 250,000 diagnostic testing kits to 70 labs globally this week.

WHO estimates it would cost $1.5 million to respond to 10 cases of imported coronavirus infection, $10 million for 100 cases of person-to-person transmission, and $55 million for a cluster of 1,000 localized transmissions. In a country like Sudan, with a fragile public health and healthcare system, a cluster of 1,000 infections is not hard to imagine but would be nearly impossible to respond to, Ministry of Health officials said.

For the short term, WHO needs $61.5 million for its own response efforts for the next three months. This includes rapidly establishing global and regional teams to coordinate technical expertise, officials said, and to provide support to high risk, high vulnerability countries, including providing essential supplies, equipment for diagnostics and technical and operational support.

Discussions around developing funding mechanisms to help resource-limited countries respond to the outbreak have already begun, officials said, and they have a framework for moving forward. “We did it with Ebola,” Dr. Michael Ryan, executive director of the WHO Health Emergencies Program said, “thanks to the generous contributions of donors.”

“We would be open to coordinating and streamlining a donations process,” he added.

Rabita Aziz, MPH, is senior specialist in global health policy for the Infectious Diseases Society of America.

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