COVID-19 in Africa: Doses are there but vaccine frequency remains high

The World Health Organization on Friday announced the launch of a Covid-19 vaccine production program in Africa. Six countries (South Africa, Egypt, Kenya, Nigeria, Senegal and Tunisia) will be equipped with production lines to manufacture doses of mRNA vaccines, in an initiative aimed at reducing the continent’s dependence on vaccine imports and increasing low immunization rates.

France 24 spoke to Professor Jaap Bom, representative of Epicenter, the research arm of Doctors Without Borders, about the evolution of the epidemic on the continent.

A staunch advocate of vaccine equality, the United Nations is concerned about the slow spread of vaccines on the African continent, where only 11.3% of the population is fully vaccinated – despite a massive increase in doses in recent months.

The World Health Organization warned in early February that “vaccination rates must increase sixfold if the continent is to reach the 70% coverage target set for the end of the first semester of 2022.”

France 24 spoke to Professor Jaap Bom, representative of Epicenter, the research arm of Doctors Without Borders, about the evolution of the epidemic in Africa and the launch of vaccines on the continent.

FRANCE 24: Kenyan President Uhuru Kenyatta hailed the announcement of a program to produce a vaccine against Covid-19 as an “event of historic significance”. Do you share his enthusiasm?

Yap Bom: This is indeed a very important announcement in many ways. The COVID-19 pandemic has exposed Africa’s over-reliance on global health supplies, with 98% of its vaccines coming from abroad. In this context, Africa, which is at the mercy of donor goodwill and the necessities of external production, has experienced delays in immunizing its population. We saw it when India was hit by a sudden outbreak of Covid-19 and had to curtail its exports of the AstraZeneca vaccine through the Covax Program [Editor’s note: which provided jabs to many African countries].

The vaccine production program announced by the World Health Organization is a giant step forward as vaccines can now be manufactured according to need, providing an appropriate response to local situations.

This initiative will also advance research on the continent, allowing Africa to participate in the global effort to develop better vaccines to end the epidemic – not just to slow it down and prevent severe forms, as is currently the case. On the research front, this program will also enable clinical trials to take place in Africa. This point is crucial, as the efficacy of vaccines can vary depending on the context and population. So far, only one study has been conducted on the continent, by AstraZeneca in South Africa.

Since the start of the pandemic, the World Health Organization has been working hard to provide better access to Covid-19 vaccines. However, despite improved supplies, uptake of vaccines in Africa remains low. Why is it so?

First, we have to admit that WHO chief Tedros Adhanom Ghebreyesus and CDC chief in Africa John Nkengasong have done a remarkable job of lobbying for these vaccines. But display is only one part of the problem. Today, the doses are here, but vaccine frequency is still high. This is partly due to misinformation, but also and above all to the health situation in most African countries where, despite higher pollution rates compared to Europe, deaths remained much lower.

For example, Cameroon has recorded 2,000 deaths linked to Covid-19 alone since the start of the pandemic. While this figure does not include those who died within local communities, it is still much lower than what is observed in European countries. Of course, not all African countries are in the same boat: Morocco, Algeria and South Africa have been hit hard. But the low vaccination rate is based on a simple logic: the less people realize the risks, the less they feel the need to vaccinate.

The World Health Organization has called on African countries to speed up the release of vaccines. Are there still logistical problems hindering access to vaccines? What about awareness campaigns?

Vaccination campaigns today are largely focused on cities, and it is sometimes difficult to get doses to remote areas. This is a problem of financing but also a problem of logistical organization, which is sometimes difficult to place in isolated areas with poorly developed infrastructure.

To raise awareness about vaccination, governments need to focus on targeted campaigns and set the right priorities. The role of the World Health Organization is to set the continental targets, but then these rules must be adapted to the specific situation of each country in order to be relevant. For example, Niger, where 50% of the population is underage, will only be able to reach the 70% target if it vaccinates children en masse – clearly not a priority at the moment.

In Cameroon, only 7.9% of the elderly and 6.2% of people with pre-existing diseases received at least one dose. On average, the vaccination rate among vulnerable groups is lower than the vaccination rate in the general population (7.8%). Therefore, there is an urgent need to focus vaccination efforts on these groups, which account for the bulk of deaths associated with Covid-19.

This article was translated from the original in French.

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