Some African countries may not receive enough covid-19 vaccine doses to reach herd immunity for years to come, according to an internal report by a World Health Organization (WHO) initiative to coordinate vaccine roll-out.
Vaccinations aren’t likely to begin in Africa until mid-2021, according to the Africa Centres for Disease Control and Prevention. It could take years to secure the doses needed to immunise 60 per cent of the continent’s 1.3 billion people, the threshold at which herd immunity may be achieved. In comparison, on 8 December, the UK, which has bought enough doses to vaccinate the entire population three times over, became the first country to begin its vaccination programme, using the covid-19 shot made by pharmaceutical companies Pfizer and BioNTech.
Nearly all of the countries in Africa have signed up to participate in the COVAX scheme, a global initiative launched by the World Health Organization (WHO) in which high-income nations will subsidise vaccines at a maximum price of $3 per dose. It aims to deliver enough doses by the end of 2021 to protect 20 per cent of the populations in the 92 low and middle-income countries that have signed up to receive financial help to access vaccines, mostly in Africa, Asia and the Americas.
Advertisement
Officials in South Africa, the African country with the most coronavirus cases, have said the country plans to vaccinate 10 per cent of its population of 58 million via a separate part of the COVAX scheme, through which 80 countries are pooling funds to purchase vaccines.
In Kenya, the African country with the seventh most coronavirus cases, officials have said the country plans to vaccinate 20 per cent of its population of 53 million through the COVAX scheme.
COVAX’s plans, both for countries funding their own vaccine purchases and those requesting subsidies, rely heavily on cheaper vaccines that are still in development or aren’t yet widely available.
For example, the Sanofi vaccine may not obtain regulatory approval until the second half of 2021 or later, and the vaccine created by AstraZeneca and the University of Oxford has so far been approved only in the UK, which happened on 30 December. This latter vaccine will cost $3 to $4 per dose, and two doses are required. The Pfizer/BioNTech and Moderna vaccines, which have been approved for use in some countries, cost around $20 and $38 per dose, respectively, and each requires two doses.
Countries involved in COVAX won’t simply use vaccines because COVAX or the WHO have given them their approval, although they may follow their lead. It is up to individual countries to approve each vaccine.
“The delays of getting the vaccines for many African countries are of great concern,” says Richard Mihigo, the Africa coordinator for vaccine development at the WHO. “COVAX will only provide, if everything goes well, supplies to cover up to 20 per cent of the population [in any country]. Herd immunity cannot be realised realistically in 2021. To achieve global equity and solidarity, there is an urgent need to consider the vaccination of at least the priority high-risk groups such as front-line healthcare workers.”
“The vaccine must be used by the people most in need. We’ve been fighting for equity and fairness. Equity for us as Africans is making sure that we are in the discussion,” says Yap Boum, Africa representative for Epicentre, the research arm of Médecins Sans Frontières/Doctors Without Borders.
An internal COVAX report in mid-December reveals that the organisations coordinating COVAX believe they face a “very high” risk of failure, due to a lack of funds, supply risks by relying on vaccines that haven’t yet received approval and complex contractual arrangements that are in some cases non-binding. This could potentially leave people in some countries without access to any vaccines until as late as 2024, according to the report.
Gavi, an international alliance of governments, charities, drug companies and international organisations that is co-leading COVAX, did not respond to a request for comment from żěè¶ĚĘÓƵ. However, a Gavi spokesperson told Reuters that the body remains confident it can achieve its goals and that “it would be irresponsible not to assess the risks inherent to such a massive and complex undertaking”.
COVAX says it has raised about $2.4 billion to date and requires an additional $4.6 billion in 2021 to meet its goals. The UK is the biggest donor, followed by Canada, the Bill and Melinda Gates Foundation, and Saudi Arabia while the US and China haven’t yet made financial commitments.
“This vaccine case fundamentally speaks to a much broader inequity in global health, particularly as a lot of the trials were taking place in lower-income countries,” says Clare Wenham at the London School of Economics. “Even if it does succeed, the market share of COVAX is tiny.”
A released in December by the People’s Vaccine Alliance – a campaign group including charities Amnesty International, Frontline AIDS and Oxfam – warned that high-income countries such as Canada have bought enough doses to vaccinate their entire populations five times over, according to an analysis of supply deal data. The report estimated that 67 low-income countries, including Afghanistan, Senegal and Myanmar, will only be able to vaccinate one in 10 people.
“The vast majority of the limited supply has been bought by rich countries,” says Anna Marriott at Oxfam. “That’s a massive problem. It’s a critical moment for COVAX. We definitely need to see more funding for it.”
Marriott says drug companies should “waive intellectual property rights” to allow countries to produce their vaccines until the world achieves herd immunity. “Otherwise this could be a problem for years to come and the mutation of the virus could be even more possible,” she says.
Sign up to our free Health Check newsletter for a round-up of all the health and fitness news you need to know, every Saturday
