Breathing a sigh of relief into Angola’s COVID-19 response

One hundred ventilators have arrived in Angola, and so, we breathe a sigh of relief for Angola’s health system. In a small room designated as the Intensive Care Unit (ICU) of Cazenga Municipal Hospital in Luanda, two men surrounded by a dozen curious onlooking health professionals hastily assemble three brand new ventilators procured as part of the World Bank support to the government strategy to strengthen and reinforce its immediate capacity to respond to the COVID-19 (coronavirus) pandemic. The distribution and installation of the ventilators, together with training to front-line health workers, is well underway. In the first phase, ventilators are being installed in hospitals across Angola’s capital Luanda, COVID-19’s hardest hit city. In a second phase, they will be installed in Provincial hospitals to strengthen capacity country-wide, as COVID-19 continues to spread throughout the country. 

COVID-19 arrived in Angola on March 21, 2020 with two imported cases. While the pandemic commenced slowly in Angola, staying at below 300 cases through the end of June 2020, the arrival of community transmission in the country led to an exponential spike with cases reaching more than 1,000 by the end of July, and more than 2,000 in August. Throughout the month of August, 45 new cases of COVID-19 were reported each day on average, compared to six new cases reported on average during the month of May.

While the rise in cases is concerning, it is also a sign of the country’s increased capacity for laboratory testing and contact tracing. This reflects the government’s commitment to strengthen the capacity of its health system by not only increasing case detection, but also case management of severe and critical cases such as the newly established ICUs equipped with ventilators. In addition, Angola also put in place strong mitigation measures at the onset of the pandemic. This began with a declaration of a state of emergency on March 27, 2020 which placed restrictions on public circulation and convening, measures to enforce personal protective measures, closing of public venues, among others. The state of emergency was scaled down to a state of calamity on May 26, 2020 which remains in place, easing the restrictions to allow limited circulation in support of local economic livelihood activities, while still imposing widespread use of masks, social distancing and other mitigation strategies. 

The Bank has been a key partner to the government in its COVID-19 response which has included financing support, technical assistance, and fiduciary guidance.

• On the financing support, the Bank made available an immediate $15 million for the urgent health sector response through the active Health System Performance Strengthening Project (PFSS). Further financing was made available with the activation of the $60 million Regional Disease Surveillance (REDISSE) Project which supports activities that respond to COVID-19 with a focus on medium and longer-term health system strengthening and activities that are part of the multi-sectoral response (agriculture, digital development, energy/electricity, statistics, transport, and water). The government multi-sectoral response is further supported through the Bank-wide portfolio of projects across key sectors such as agriculture, education, social protection, and water. 
• On technical assistance, the government engaged the World Bank early-on to assess the government’s COVID-19 Contingent Emergency Plan to align it to World Health Organization reference values in line with International Health Regulations (IHR) capacities, group activities in structured technical pillars, and formulate monitoring indicators based on the Joint External Evaluation. The World Bank, through the health program implementation unit, was the lead partner to the government in developing the quantification of the COVID-19 needs which established a system to inform procurements and support donor coordination of COVID-19 donated and purchased equipment and materials. 
• On fiduciary guidance, the World Bank provided the financial management, procurement, and safeguards frameworks to ensure emergency purchases were made available to the country in an efficient manner with respect to cost, timeliness, and support to functioning and installation, as applicable for specific equipment. The Bank put in place flexible measures across procurement to engage reliable providers, in financial management to advance funding to support urgent activities, and under safeguards to ensure plans were available to mitigate risks of COVID-19 activities. 

Angola must continue its commitment to building its capacity to remain vigilant and responsive to the challenges of COVID-19, on top of the already high burden of communicable diseases that pressures the fragile health system.

While Angola has seen a rise in COVID-19 cases, with the measures and actions taken by the government to date—such as state of emergency and calamity risk mitigation measures, planning and quantifying the COVID-19 needs, and prioritizing the purchase of essential medicines and equipment, such as ventilators—we can breathe of sigh of relief as an important step to saving lives has been taken. 

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