By Collins Mtika

With Africa-bound COVID-19 vaccine doses from the Serum Institute of India delayed for the foreseeable future, slow vaccine rollouts and new variants making inroads, the risk of a new wave of infections in Africa remains high.

Delays and shortages of vaccine supplies are driving African countries to slip further behind the rest of the world in the COVID-19 vaccine roll out and the continent now accounts for only 1% of the vaccines administered worldwide, down from 2% a few weeks ago.

COVID-19 vaccine rollouts have been exemplary in some African countries, yet around half, or 19 million, of the 37 million COVID-19 vaccine doses received in Africa have been administered so far, according to reports from African countries. 

Initial deliveries through COVAX to 41 African nations have been staggered since early March, yet nine countries have administered less than a quarter of the doses they have, and 15 countries have given less than half. Eight countries have given all of their COVAX doses.

“While we call for vaccine equity Africa must also knuckle down and make the best of what we have. We must get all the doses we have into people’s arms, “said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “It’s a race against time and the virus. Given the limited supply we recommend that countries prioritize giving the first dose to as many high-risk people as possible in the shortest amount of time.”

Modelling suggests that vaccinating more people in the highest priority population groups with one dose as opposed to vaccinating half that number with two doses will substantially reduce death rates.

Africa’s vaccination coverage is the lowest for any region of the world. While globally, 150 doses of the vaccine have been administered per 1000 people, in sub-Saharan Africa it’s about 8 doses per 1000 people. Low vaccination coverage places African countries at higher risk of a massive upsurge in cases.

Vaccine patent waiver could be ‘game changer’ 

South Africa and India are leading efforts to temporarily waive patent protections for COVID-19 vaccines and medicines at the World Trade Organization (WTO). The United States has offered its support to waive intellectual property rights for COVID-19 vaccines. 

“This could mark a game-changer for Africa, unlocking millions more doses and saving countless more lives. We commend the leadership shown by these countries and urge others to back them at the WTO, including for life-saving therapeutics. We hope negotiations are quickly wrapped up so we can ramp up the manufacturing and roll-out of safe and effective vaccines. No country is safe until all countries are safe,” said Dr Moeti 

COVAX and WHO are exploring all options to mitigate the impact of the global vaccine supply shortage, including supporting the reallocation of excess doses, boosting manufacturing and encouraging suppliers with extra capacity to support and prioritize COVAX.

WHO is assisting African member states efforts to roll-out COVID-19 vaccines with preparation, coordination, training of health professionals, providing policy and technical guidance and assisting with communications to boost the uptake of vaccines.

New variants and risk of resurgence

New variants also place the continent at risk of a third wave. The B.1.617 variant that was first found in India has been reported in at least one African country. The B1.351 strain, first found in South Africa, is spreading in 23 African countries and the B1.1.7 strain, first found in the United Kingdom, has been found in 20 countries.

With new variants circulating, low vaccination levels, population fatigue in adhering to preventive measures, and easing of restrictions, the conditions are present for a resurgence.

“The tragedy in India does not have to happen here in Africa, but we must all be on the highest possible alert. Governments must maintain strong surveillance and detection systems, reassess and bolster their treatment capacities, step up the supply of critical medicines, including medical oxygen and ensure there are enough beds for severely ill patients.” said Dr Moeti.

Africa’s readiness

Although capacities have improved over the past year, hospital beds with capacity to deliver oxygen, and oxygen supplies, remain limited in most countries. Whereas most high-income countries globally have at least two intensive care beds per 100 000 people, only nine countries in the African Region have this many.

WHO is supporting countries to increase their oxygen supplies by providing technical assistance to high-risk countries in how to build oxygen production plants, as well as delivering more than 3,500 oxygen concentrators. WHO is collaborating with professional medical and nursing associations on the continent to scale up critical care training in member states.

In Africa, there have now been almost 4.6 million COVID-19 cases and 123,000 lives lost to this virus. In the past two weeks there has been a slight decrease in cases after a six-week plateau. However, in nine countries there is an upward trend, including in Angola, Cabo Verde, Cameroon and Eritrea.

Dr Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Thabani Maphosa, Managing Director, Country Programmes, Gavi, the Vaccine Alliance. Also on hand to answer questions were Dr Richard Mihigo, Immunization and Vaccine Development Programme Coordinator, WHO Regional Office for Africa and Dr Ngoy Nsenga, WHO COVID-19 Incident Manager.