Resilience of health systems to disease outbreaks: COVID-19 - a comparative analysis of South Africa and other BRICS countries using the Global Health Security Index

COVID-19 and other recent disease outbreaks, such as Influenza A, Ebola, Nipah and Zika, have brought to the fore the fragility of health systems around the world, irrespective of income category or level of development of countries. In the case of COVID-19, which entered various phases in most parts of the world, the worst hit were developed countries in the Global North and Europe which had more sophisticated health systems than emerging, developing and less developed countries. Although a few developing countries like Brazil, India and Russia also had high levels of infection, China (the purported origin of the virus) recovered at a rather fast pace but was hit again with outbreaks in cities like Wuhan in 2022. In Africa, the pandemic did not have the same severe effect in terms of infections and deaths as expected. This has been attributed to several factors that have not been scientifically proven, such as the hot climate, herd immunity to malaria fever, and the role of indigenous knowledge systems (IKS) and traditional medical remedies (Sanogo 2020). A typical example is Artemisia Annua, which is being tested for its efficacy and side effects as a potential treatment for COVID-19 in Brazzaville with the support of the World Health Organisation (WHO 2020). However, it is suspected that the absence of comprehensive mechanisms for testing and contact tracing due to poor physical and health infrastructure could be the reason for the low levels of known COVID-19 incidence, recoveries and deaths in Africa and other developing or less developed regions (Soy 2020). The exception in Africa is South Africa, where infections exceeded the one-million mark; several phases of the pandemic emerged with unique strains of the virus; and the death toll kept rising, with official estimates of deaths suspected to be more mooted than the reality.