“The doses are there, but the hesitation to vaccination remains high”
The World Health Organization (WHO) announced on Friday the launch of a production program for Covid-19 vaccines in Africa. Six countries (South Africa, Egypt, Kenya, Nigeria, Senegal and Tunisia) will be equipped with production lines to manufacture doses of mRNA vaccines, as part of an initiative to reduce the continent’s dependence on vaccine imports and boost low immunization rates.
FRANCE 24 spoke with Professor Yap Boum, representative of Epicenter, the research arm of Doctors Without Borders, about the evolution of the pandemic on the continent.
A staunch defender of vaccine equality, the UN organization is concerned about the slow deployment of injections on the African continent, where only 11.3% of the population is fully vaccinated – despite a considerable increase in doses in recent months .
“Vaccination rates must increase sixfold for the continent to reach the 70% coverage target set for the end of the first half of 2022″, warned the WHO in early February.
FRANCE 24 spoke with Professor Yap Boum, representative of Epicenter, the research arm of Doctors Without Borders, about the evolution of the pandemic in Africa and the deployment of vaccines on the continent.
FRANCE 24: The announcement of this Covid-19 vaccine production program was hailed as an “event of historic importance” by Kenyan President Uhuru Kenyatta. Do you share his enthusiasm?
Yap boom: This is indeed a very important announcement in many ways. The Covid-19 pandemic has exposed Africa’s overreliance on global health supplies, with 98% of its vaccines sourced from abroad. In this context, Africa, at the mercy of the goodwill of donors and the imperatives of external production, has experienced delays in the vaccination of its population. We saw it when India was hit by a sudden outbreak of Covid-19 and had to cut 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 WHO is a giant step in that vaccines can now be manufactured according to need, providing a response adapted to local situations.
This initiative will also boost research on the continent, allowing Africa to participate in the global effort to develop better vaccines to end the pandemic – and not just to slow it down and prevent severe forms, as is the case currently. In terms of research, this program will also make it possible to conduct clinical trials in Africa. This point is crucial, because the effectiveness of vaccines can vary according to the context and the populations. So far only one study has been conducted on the continent, by AstraZeneca in South Africa.
Since the beginning of the pandemic, the WHO has been working hard to provide better access to vaccines against Covid-19. Yet, despite improved supply, immunization coverage in Africa remains low. Why is this so?
First, we have to acknowledge that WHO President Tedros Adhanom Ghebreyesus and Africa CDC President John Nkengasong have done an outstanding job of lobbying for these vaccines. But supply is only part of the problem. Today, the doses are there, but the reluctance to vaccinate remains high. This is partly due to misinformation, but also and above all to the health situation in most African countries where, despite high contamination rates comparable to Europe, deaths have remained much lower.
For example, Cameroon has recorded only 2,000 deaths linked to Covid-19 since the start of the pandemic. Although this figure does not include those who died within local communities, it is still well below what has been seen in European countries. Of course, not all African countries are in the same boat: Morocco, Algeria and South Africa have been hardest hit. But the low vaccination rate is based on a simple logic: the less people perceive the risk, the less they feel the need to get vaccinated.
The WHO has called on African countries to accelerate the deployment of their vaccines. Are there still logistical problems preventing access to vaccines? What about awareness campaigns?
Today’s vaccination campaigns are heavily focused on cities, and it is sometimes difficult to get doses in more remote areas. It is a problem of funding but also of logistical organization, which is sometimes difficult to set up in isolated areas with poorly developed infrastructures.
To raise awareness about vaccination, governments need to focus on targeted campaigns and set the right priorities. The role of the WHO is to set continental targets, but these rules must then be adapted to the specific situation of each country to be relevant. For example, Niger, where 50% of the population is underage, will only be able to reach the 70% target if it massively vaccinates children – which is clearly not the priority at the moment.
In Cameroon, only 7.9% of elderly people and 6.2% of people with pre-existing conditions received at least one dose. On average, the vaccination rate of vulnerable groups is even lower than that of the general population (7.8%). Therefore, there is an urgent need to focus vaccination efforts on these groups, which account for the bulk of Covid-19 related deaths.
This article has been translated from the original in French.