Funding, climate and fear trouble Africa's Covid vaccine plans

by AFP bureaus in Africa
·4-min read

The struggle to get Covid vaccine to the world's population has often been likened to a race -- in which case, Africa finds itself hobbled by an array of financial, technical and cultural problems.

Of these, funding is predictably Hurdle No. 1 for Africa, home to some of the world's poorest countries.

The Africa director of the World Health Organization (WHO), Matshidiso Moeti, last week identified the goal of vaccinating three percent of Africans by March 2021 and 20 percent by the end of next year.

Getting the vaccine to "priority" population sectors will cost $5.7 billion, plus 15-20 percent for delivery, syringes and other injection material, the WHO's Africa region estimates.

But of the 47 countries in the region, "only around a quarter have adequate plans" for resources and financing, it says.

Lower- or middle-income African countries can look to help from COVAX, an international coalition which is negotiating lower vaccine prices with Big Pharma.

So far, the continent -- home to endemic diseases from malaria to HIV -- has been relatively spared by Covid-19.

It has recorded around 2.2 million cases, of which 52,000 have been fatal, in a population of 1.25 billion.

South Africa, which with 800,000 cases is the worst-hit country, hopes to acquire its first vaccines through COVAX "in the middle of next year," said eminent epidemiologist Salim Abdool Karim, who also advises the government.

"Even if we can target vaccinating roughly 30-40% of the population, or at least the adult population, that would assist us greatly in terms of managing the transmission of the virus," said Shabir Madhi, a professor at the University of the Witwatersrand in Johannesburg.

- Hot climate, cold problem -

So far, three vaccines, each with important differences, have been announced by their makers as a success after Phase III trials.

The first, Pfizer/BioNTech, has to be kept chilled to -70 degrees Celsius (-94 Fahrenheit) -- a task that is costly and onerous even for rich countries, but especially so in Africa.

The second, Moderna, can be kept in long-term storage at -20 C (-4 F), which is still a major challenge in hot, poor countries.

The third, made by AstraZeneca and Oxford University, can be stored, transported and handled at normal refrigerated conditions of between two and eight degrees Celsius (36-46 F) for at least six months.

That's a plus and so, from Africa's viewpoint, is its cost.

AstraZeneca says it will be sold at cost price, of 2.5 euros, or around $3, which is far cheaper than its rivals.

The downside is that the trial results give this vaccine 70 percent effectiveness compared with more than 90 percent for the other two.

For Madhi, the lower effectiveness is not a bar.

"From a public health perspective, we would save many more lives by introducing a vaccine that has got 60 or 70 percent efficacy that can be rolled out to the mass level to a significant percentage of the population, than a vaccine that has got 90 percent efficacy, that is unaffordable by any means in terms of vaccinating 50 percent of the population," he said.

In a group of volunteers who received an initial half-dose followed by a full dose of this third vaccine, effectiveness jumped to 90 percent -- a finding that is being further studied.

- Vaccine hesitation -

Nigeria, the most populous country in Africa with around 200 million inhabitants, has given the priority to vaccinating around 44 million people who are considered most vulnerable, including the elderly and those with underlying ailments.

"We are in conversation with all the countries and firms including the US, China and Pfizer, (that are) developing the vaccines," said the head of the NPHCDA health authority, Shuaib Faisal.

"Some 44 million Nigerians -– consisting of the most vulnerable, the elderly and people with underlining ailments –- will be first targeted when the vaccines are available," Faisal said.

Nigerian scientists are also working to develop local vaccines "which will be cheaper and more suitable to our environment," he said.

Some African countries are ambivalent about the vaccine, aware of skepticism or fear among their public.

Madagascar is one of them.

"We haven't adopted a position about the vaccine yet," government spokeswoman Lalatiana Rakotondrazafy Andriatongarivo said late last month.

In South Africa, around a third of the population has reserves about the vaccine, according to Karim.

"If communities are not associated and convinced that the vaccine will protect their health, we will make little progress," the WHO's Moeti warned.

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