As Europe and America begin to roll out a mass COVID-19 vaccination effort to prevent the continuous spread of the novel coronavirus, a World Health Organization (WHO) analysis has found that “Africa is far from ready” to embark on a similar delivery plan.
Africa is just 33 percent ready for what WHO describes as the “continent’s largest ever immunization drive,” a figure far below the desired benchmark of 80 percent.
The international health agency’s analysis of COVID-19 immunization readiness — sourced from data from 40 countries on the continent — revealed only 24 percent of the countries have adequate plans for resources and funding to roll out a mass vaccination. Only 49 percent of the countries have identified the priority populations for vaccination and have plans in place to reach them, while only 17 percent have data collection and monitoring tools ready. And just 12 percent have plans to communicate with communities to build trust and drive demand for immunization. The analysis also shows only 44 percent of African countries have coordination structures in place for the adequate distribution of COVID-19 vaccines.
Dr. Matshidiso Moeti, WHO Regional Director for Africa, said the organization is “doubling down on planning and preparation because this will make or break this unprecedented endeavor. Vaccination, in combination with tried and tested public health measures, will help end this pandemic,” she told a virtual media briefing.
WHO is now helping African countries develop COVID-19 vaccine introduction plans that will seek to leverage “our vast network of polio and immunization staff on the ground,” among other among other forms of assistance.
The United Kingdom and the United States have both begun mass immunization programs. US President-elect Joe Biden has assured up to 100 million COVID-19 vaccines will be distributed in his first 100 days in office, beginning Jan. 20. American biotechnology company Moderna has received “emergency use authorization” from the US Food and Drug Administration for its COVID-19 vaccine, which has an efficacy rate of at least 94 percent. Moderna says it will have 20 million doses of the vaccine ready for shipping by end of the year, and will be able to deliver between 500 million and 1 billion doses globally in 2021.
Prof. Omu Anzala of the Department of Medical Microbiology at the University of Nairobi – Kenya estimates the first batch of COVID-19 vaccines will not reach Africa until after the first quarter of 2021. He is concerned logistical challenges will make distributing the vaccine across Africa difficult.
“The costs of the individual vial may not be a problem,” he told a virtual media briefing organized by the Africa Science Media Center (AfriSMC). “The problem may be distribution and administration.”
The WHO says it is working with various international partners to help African countries secure enough doses of COVID-19 vaccines currently under development for the benefit of the African population. The organization is estimating it will cost about US$5.7 billion to roll out the vaccines for the benefit of priority populations in Africa. This is minus the 15-to-20 percent cost of delivery of vaccines, training for health workers, supply logistics, community mobilization and other related expenses.
Logistics for distribution
The logistics of vaccine distribution will be a huge one. The COVID-19 vaccine produced by Moderna has a life span of six months and has to be transported and stored at a temperature of -20℃. When it finally reaches a clinic or pharmacy, where it will be kept in a regular refrigerator, it can remain there for in good quality for a maximum of 30 days. The vaccine produced by Pfizer/BioNTech must also be stored at -70℃ and has a shelf life of just five days at standard refrigeration temperatures. In Sub-Saharan Africa, the World Bank estimates only about 48 percent of residents have access to electricity, which will make storing the vaccines at freezing temperatures extremely difficult.
“If the right infrastructure isn’t in place, a lot of waste could ensue,” Liz Breen of the University of Bradford and Sarah Schiffling of the Liverpool John Moores University observed. “According to the WHO, up to 50 percent of vaccines are wasted globally due to inadequate logistics infrastructure. Applied to COVID-19, this could translate to the loss of billions of vaccine doses.”
Anzala said African countries need to plan better to ensure the COVID-19 vaccines get to residents on the continent. “We cannot wait for someone out there globally to resolve our issues. We must also learn to resolve our issues,” he told the media briefing.
Some African countries say they are committed to getting the COVID-19 vaccines delivered to their citizens. “Bottom line is that we have a team that is looking at what is happening on the vaccine front, whether we are going to go with Pfizer or Moderna,” Dr. Benrard Oko Boye, Ghana’s deputy minister for health, told Joy News TV. “We know that when vaccines become available, you can reduce rates of hospitalization, morbidity and mortality. And so, it’s an important chapter in the fight against the virus. Once a vaccine is coming out, that marks the beginning of an end of the pandemic.”
Misinformation as a barrier
Daniel Otunge, director of the AfriSMC, told the Alliance for Science in an interview that misinformation about COVID-19 vaccines could hinder their acceptance. He is calling for more education and said the AfriSMC is committed to working with policymakers, health experts and the media to champion accurate, factual and credible information about vaccines and all scientific issues.
“Misinformation on vaccines must not be allowed to firmly take root in Africa, as it would lower the rate of uptake of the vaccines, thereby leading to failure to achieve the levels of herd immunity required to contain further spread of the virus among the population in Africa,” he said. “It is critically important that measures (including policy, regulatory, communication and advocacy) are taken by African governments, the media and the international community, among others, to combat fearmongering against COVID-19 vaccines in order to decrease hesitancy in uptake of the vaccines in Africa
Caution over second wave of COVID-19
Africa has reported more than 2.1 million COVID-19 cases and about 50,000 deaths. Although the figure is markedly lower than other parts of the world, the African Centers for Disease Control has warned a second wave of the pandemic is possible if care is not taken. “We are not seeing hospitals being overwhelmed with COVID patients… That doesn’t tell us that the second wave will not happen. It only tells us that we have to prepare,” Dr. John Nkengasong, director of the Africa Centers for Disease Control and Prevention, told a teleconference.
Anzala wants Africans to take preventative measures more seriously. “Some people have just thrown caution to the wind. Or some people believe COVID is not a reality. But we are seeing COVID mortality among health care professionals on a regular basis. So, ladies and gentlemen, COVID is real. Wherever we are, let’s communicate. If you see a crowded place, stay away. All these things you must choose and pick to reduce your own risk,” he told the media briefing by the AfriSMC.
The WHO regional director is urging “various African countries to reach out to communities, listen to their concerns and give people a voice in the process of developing and implementing delivery strategies” aimed at delivering COVID-19 vaccines to them. “Communities have played an incredibly important and central role in stopping the spread of COVID-19 and they will be central in the roll out of the vaccines… [Communities] are also critical to fight against false anti-vaccine information,” Moeti added.