Africa’s crisis is exacerbated by restricted access to global vaccine supplies

Africa is currently in the worst stage of a pandemic and there is little hope of relief.

Delta variants are spread throughout the continent. Namibia and Tunisia report higher per capita deaths than any other country. Hospitals across the continent were full, oxygen supplies and health care workers grew thinly, and recorded deaths surged 40% last week alone.

However, only about 1% of Africans are fully vaccinated. And even the modest goal of the African Union to vaccinate 20% of the population by the end of 2021 seems out of reach.

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Rich countries have bought most doses in the future, but often far more than they can think of. Hundreds of millions of shots from global vaccine sharing efforts have not been realized.

Supply to African countries is unlikely to increase significantly in the coming months, making it the most effective tool for COVIDs and vaccines, which are of little use in the current wave. Instead, many countries are suing blockades and curfew.

A year from now, supply may not be enough to meet the demand of 1.3 billion people in Africa, unless richer countries share stockpiles and rethink how distribution systems work. not.

Dr. Githinji Gitahi, Commissioner of the Africa COVID-19 Response, a task force on the continent, said: “Vaccine delay is vaccine refusal.”

African countries that were unable to trade vaccines early relied on a global partnership, COVAX, to provide free doses to countries in need of vaccines.

However, distribution of COVAX has ceased after imposing export restrictions on the AstraZeneca vaccine as India responded to this year’s resurgence.

Even if everything goes according to plan, COVAX officials say that by October, about 7% of the population will not be able to deliver more than 200 million doses to Africa, which is sufficient to fully vaccinate. I’m predicting.

According to data from analytics firm Airfinity, African countries have little room to buy their own doses. Almost all vaccines expected to be manufactured in 2021 are already on the market. Most of the surplus supply includes the Chinese vaccine and the Indian vaccine, Kovacin.

By the end of August, some of the world’s wealthiest countries will be given 1.9 billion more doses than needed to vaccinate their population, according to the One campaign. The magnitude of their oversupply evoked the wrath of African leaders, scientists and rights groups who called for accountability and warned that protected trade principles and stockpiles would only contribute to a prolonged pandemic.

“COVAX is a really nice idea,” said Andrea Taylor, assistant director of the Duke Global Health Innovation Center. But she added: “It didn’t take into account how human behavior actually works. It should have been because we didn’t expect wealthy nations to act for their own benefit. “

Prognosis of severe vaccines in Africa

In Africa, the pace of vaccination remains much slower than in other parts of the world. Europe and South America are dispensing vaccines almost 20 times faster than population-tuned Africa. According to the World Health Organization, about three-quarters of the 70 million doses received by African countries have already been administered.

According to the WHO, at the current vaccination pace, only eight small African countries are set to achieve the global goal of immunizing at least 10% of each country’s population by September. is. According to COVAX, the supply of vaccines to Africa is not expected to increase until then.

Even the modest vaccination goals for Africa this year seem to be out of reach.

The African Union was aware of the challenge of getting enough vaccines and wanted to immunize 20% of its population by the end of the year. The International Monetary Fund has proposed more ambitious goals. This year we have 40% immunization and by mid-2022 we have 60% immunization. However, achieving any of these goals will require significant changes to current immunization rates.

Logistic failure to delivery

India’s decision in March to significantly reduce vaccine exports, especially from the Indian Serum Institute of India, on which COVAX was dependent, disrupted the deployment of vaccines in Africa. Due to inventory depletion, immunity campaigns in Africa slowed or were stopped altogether in May, despite the beginning of a brutal third wave.

Vaccine exports and raw material restrictions in the United States and the European Union have also undermined efforts to manufacture and deliver vaccines.

One lesson from this crisis was that Africa could not “depend on other sovereign states” for supplies, Gitahi said. The postponement of delivery left many front-line workers and families vulnerable to infection and death, he said. Recent studies show that people experiencing severe COVID in Africa lack equipment in intensive care units and are prevalent in chronic illnesses such as HIV and diabetes in other parts of the world. It turns out that they are more likely to die than patients.

But even when the vaccines arrived, some African countries struggled to distribute them. From the beginning, many countries lacked the planning, funding, labor, refrigeration and transportation networks needed to vaccinate citizens.

After the first vaccine began to be rolled out in December, scientists and activists in South Africa (one of the most devastating countries on the continent at the time) said they had no vaccination strategy and left a high-risk population. Criticized the government. In Kenya, frontline workers lamented that they didn’t know where to register or where to inoculate, as authorities were preparing to receive the first dose in early March. Also, after suspending the initial deployment due to concerns about blood clots, Congo provided 1.3 million of the 1.7 million AstraZeneca doses received from COVAX because they could not be given before the expiration date.

“There’s still a lot to do to speed up the country,” said Dr. Matshidiso Moeti, WHO Africa Regional Director, when it comes to ensuring that citizens are vaccinated.

The ultra-low temperature storage requirements for some vaccines also pose challenges for the continent. African countries, such as Rwanda, were capable of receiving the Pfizer-BioNTech vaccine, which at that time had to be stored at sub-zero temperatures after becoming the first vaccine to receive WHO emergency approval in December. Was very small.

A public-private partnership to help COVAX take the lead, Gavi is working to procure thousands of cold boxes, vaccine carriers, refrigerators and freezers for 71 low-income countries, 39 of which are in Africa, according to a Gavi spokeswoman. I’m out. He said the equipment would include a solar refrigerator that could keep the vaccine cold for several days in the absence of electricity and an ice-lined refrigerator. According to the World Bank, even the electricity needed to refrigerate vaccines can be difficult to obtain. Only 28% of sub-Saharan African healthcare facilities have reliable electricity.

Hitesh Hurkchand, Senior Advisor to the World Food Program, who advises the African Union on refrigerated logistics and vaccine supply, ensures that the device arrives in time to deliver doses to rural and hard-to-reach areas. He said that was still a concern. chain.

Hesitation and false alarms

Some Africans are hesitant to take them, even in areas where vaccine doses may be readily available.

Approximately 68% of those surveyed expressed concern about vaccine safety in a March study published by the Africa Centers for Disease Control and Prevention in 15 countries. Willingness to accept vaccines varies from country to country, but more than half of the people surveyed said they were “not very well or not well informed about vaccine development.”

In Malawi, health experts said skepticism about the vaccine affected slow dose distribution and final expiration. In Congo, vaccination campaigns are driven by many factors, including concerns about rare blood clots associated with the AstraZeneca vaccine, low confidence in the government system, and the belief that diseases such as Ebola and measles are more threatening than COVID. It has been hindered. In Senegal, vaccine hesitation was fueled by false information spread on social media platforms. In Uganda, the Minister of Health had to refute the accusations that she pretended to have been shot.

Health officials say vaccinations have increased as doses arriving on the continent have increased. Still, Dr. Marina Joubert, a senior science communication researcher at Stellenbosch University in South Africa, warned that conspiracy remains persistent, for example, the COVID-19 vaccine causes infertility, or Africans “vaccine”. “Guinea Pig” to test the safety and effectiveness of.

Social scientists and health professionals need to work closely with the government to develop public awareness initiatives to combat false information, Jubert said. “It’s a kind of balancing of the skills of speaking in a way that incorporates timing, accuracy, consistency, reliability, complex science and provides it in a way that people can understand,” she said.

Things that can speed up vaccination

WHO and the Africa CDC say they expect vaccine delivery to gain momentum in the coming weeks, both bilateral and from COVAX. COVAX Managing Director Aurélia Nguyen said last week that he plans to deliver 520 million vaccines to Africa by the end of the year and 850 million vaccines by the end of the first quarter of 2022. It was.

Until then, wealthy countries with overdose began sharing vaccines. COVAX will soon be working with the African Union to provide over 20 million Johnson & Johnson and Pfizer-BioNTech vaccines donated by the United States to 49 African countries. A group of seven countries also announced in June that they would share at least 870 million doses with low-income countries, including Africa.

Some countries are also considering manufacturing to increase the availability of vaccines. According to a recent survey, only seven African countries have companies operating in vaccine manufacturing chains. Kenya has announced plans to build a factory to package the COVID-19 vaccine and distribute it locally. Moroccan and Egyptian companies are aiming to begin manufacturing China’s Sinopharm and Sinovac vaccines, and Rwanda has signed a contract with the European Union to strengthen its vaccine production capabilities. The US-Europe joint plan will invest more than $ 700 million in a South African plant to produce more than 500 million Johnson & Johnson vaccines by the end of 2022.

Taylor of the Duke Global Health Innovation Center said the availability of more vaccine types around the world could help control the virus in Africa.

However, even as more people are vaccinated, the effectiveness of certain vaccines offered to African countries remains a concern. This is the case in Seychelles, which competed to vaccinate a population of just over 100,000 in China’s China National Pharmaceutical Group, but only faced a surge in coronavirus infection. WHO and the Africa CDC have stated that they are investigating the situation in Seychelles, but both agencies have so far advised countries to continue to use one of the COVID-19 vaccines listed for emergency use. Encourage.

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