Universal access to COVID-19 vaccines must remain a critical goal if we are to win the battle against the disease. However, write Dr Heinrich C Volmink, a Johannesburg-based public health medicine specialist and Dr Wilmot James, a senior research scholar at Columbia University in New York in Business Day, despite laudable calls for an equitable global rollout, vaccine nationalism appears to have the upper hand for the moment. While it is hoped that an eventual “course correction” will cause a return to a co-ordinated global effort aimed at a fairer rollout, from a global health perspective it is important to assess where individual countries stand in terms of their COVID-19 vaccination plans, especially those in Africa.
They write that research led by a Columbia University/Brenthurst Foundation team as part of the Futures Forum on Preparedness (organised by Schmidt Futures) and released last week includes an analysis of five large countries on the continent, namely Egypt, Ethiopia, Kenya, Nigeria and South Africa. Together, these countries represent about 40% of the continent’s population and more than half of its GDP.
A combination of early efforts to secure vaccine doses and pre-existing manufacturing capacity (in the form of Vacsera, one of only a few vaccine manufacturers on the continent) has placed Egypt in a favourable position, Volmink and James write.
However, they say, Ethiopia appears to be in more difficult position. Political instability, including the Tigray conflict, has placed the country under substantial strain, which will undoubtedly weaken its health system.
They write that Kenya’s participation in vaccine trials may, like Egypt, prove to be an important factor. It actively participated in trials related to the Oxford/AstraZeneca candidate vaccine, with support provided in-country via the KEMRI/Wellcome Trust Research Programme.
In Nigeria, the authors write that the federal government responded proactively to the pandemic through the establishment of the presidential task force on COVID-19. Considerable capacity is also available in terms of existing government agencies – the National Agency for Food & Drug Administration & Control is prepared to fast-track regulatory assessment processes related to COVID-19 vaccines; the National Primary Health Care Development has successfully conducted large-scale programmes for other vaccine-preventable diseases in the past; and the Nigeria Centre for Disease Control, under the exceptional leadership of Dr Chikwe Ihekweazu, has substantial institutional memory that can be leveraged for COVID-19 vaccine rollout planning.
There are two vaccine manufacturers in the country, Biovaccines Nigeria and Innovative Biotech Nigeria, both of which could boost vaccine production, but, Volmink and James write, despite these advantages, Nigeria has had problems regarding vaccine access.
South Africa’s efforts in terms of vaccine acquisition and rollout planning have followed a challenging path. The authors note that the establishment of the ministerial advisory committee on coronavirus vaccines in September was a good first step, creating the potential for co-ordinated planning guided by experts.
South Africa also has pre-existing vaccine manufacturing capability in the form of the Biovac Institute, a public-private partnership, and possible future manufacturing capacity through an agreement entered into between Johnson & Johnson and South Africa-based Aspen that could translate into greater access for the country. However, Volmink and James write that despite these encouraging developments, there have been significant setbacks.
They say the ability of these five countries to acquire COVID-19 vaccines, and their respective readiness in terms of vaccine rollouts, is varied making the point that the common obstacle faced by all relates to the underlying inequity of access to vaccines.
They write that a renewed commitment to a fairer global rollout by, for example, rallying around the People’s Vaccine initiative and advocacy of COVID-19 vaccines as a global public good, is perhaps what is most urgently needed, not just for these countries but the continent and global community as a whole.
And, they point out, there is also the further challenge of vaccine resistance to overcome.
[link url="https://www.businesslive.co.za/bd/opinion/2021-01-17-how-sas-vaccine-efforts-compare-with-other-african-countries/"]Full Business Day report[/link]
[link url="https://assets.website-files.com/5fdfca1c14b4b91eeaa7196a/5ffd408b0e86740eb60d95eb_EPRiA%20Report%202020.pdf"]Epidemic/Pandemic Response in Africa: Covid-19 in Egypt, Ethiopia, Kenya, Nigeria and South Africa – Columbia University/Brenthurst Foundation report[/link]