By Mohamed Jalloh
Since the outbreak of the Covid -19 pandemic in December 2019, Africa has so far kept her head above waters by registering the least number of cases and deaths.
Governments in Africa have been striking a thin balance between protecting the population from a national health convulsion and easing socio-economic lockdowns to maintain the livelihoods of people.
With the exception of South Africa that was hit by the Delta variant in the middle of 2021; the rest of Africa was able to get over more deadly variants by avoiding the epicenter characterization that has marred other continents.
A rather dissimilar situation to the Ebola outbreak that had a cataclysmic impact on every socio-economic life in the countries it ravaged in Africa.
In comparism to other worst hit continents such as Europe, Asia, America and Australia that are still grappling with the scourge, the continent has been able to stave off a health catastrophe through vaccination and the imposition of public health and social measures. Apart from the attendant economic consequences resulting from lockdowns, the negative impacts of Covid-19 is less severe in the continent than anywhere else in the world.
Perhaps, it is one of the reasons that could be touted for the snail pace Covid-19 vaccination trend in the continent. People have refused to see Covid-19 as an issue because it has not translated into spiraling death figures as was the case with the Ebola scourge.
Vaccines have been pouring in the continent from the Covax facility and through bilateral channels from China that has donated thousands of Sinopharm vaccines to individual African countries. The torrential availability of vaccines in the continent has not necessarily translated into jabs. There is vaccine availability but there are less corresponding arms to be vaccinated. The most important factor that could play a role in future vaccine uptake is access to vaccination. This includes having the means to get to the vaccination site, whether by transport, money or physical ability.
Vaccine hesitation, apathy and skepticism due to misconceptions about safety concerns have further led to a disparity in vaccine administration between Africa and other continents. Increased anxiety leading to public confusion has solidified the mistrust between government and the people.
South Africa stopped using the AstraZeneca vaccine due to concerns of blood clots formation and intakers of the Johnson and Johnson vaccine have reported a rare type of spinal inflammation called transverse myelitis as one of the side effects.
In fact, many African countries destroyed stockpiles of vaccines after the World Health Organization (WHO) recommends that they should be disposed off for fear of administering expired doses on people. Some were stored in poor refrigerated facilities due to insufficient power supply and has to lose its efficacy.
The continent as a whole has vaccine experience as was the case with massive immunization campaigns in the case of measles, polio, yellow fever and cholera.
But, it has been difficult for the Covid-19 immunization message to sink in that could prompt people to visit vaccination centres in droves.
Even though it is hard to quantify the impact of vaccine skepticism, concerns over safety and efficacy of vaccines in general could be responsible for the slow intake in many African countries.
“It took a while to convince people” Austin Demby Sierra Leone`s Minister of Health an Sanition noted. Despite the political will vaccination centres are virtually empty. Centres were only flooded when it became a prerequisite to show proof of vaccination before entering public places or accessing public services. When the vaccination card restriction was waivered in public places, vaccination centres are nearly empty. Those in need of health passport for travel purposes sometimes pay in excess for vaccination card without been vaccinated.
Generally, skepticism is borne out of the fact that even though vaccines are effective at reducing hospitalization and death they don’t completely stop viral transmissions.
Chronic disorders such as Tuberculosis, HIV/AIDS, diabetes are opportunistic diseases that could create breakthrough infections in those who are vaccinated. The former United States Secretary of State Collin Powell died of such complications after been vaccinated. Individuals who are 60years and above are at high risk of succumbing to health complications. Multiple comorbidities may increase risk of adverse reactions following vaccination. People between the age bracket of 18yrs and 5o are considered to be of low risk in terms of health vulnerability. Even if they are infected from Covid-19, health complications could be mild and they could convalesce within shorter periods.
For many people in Africa Covid-19 is more of an economic issue than a health concern.
In Sierra Leone for example Covid-19 disruptions to distribution channels and global supply lines have translated into slight increment in imported commodities.
This view is further reechoed by Dr Sarah Songwe UN under Secretary General and Executive Secretary of the economic Commission For Africa.
“For every month of lockdowns in the continent cost us $29Billion of production that was lost, when we say that Covid-19 is an economic issue we need to respond to it, to be able to recover and reset our economies. We need to see how we can bring together global financial structures to ensure that we actually respond to this crisis. We know that scarcity means increased cost and we cannot afford today as a continent that kind of scarcity.”
A global consensus among governments, health experts and pharmaceutical companies is a prioritized push for vaccines to be the panacea to render the world Covid-19 free.
African leaders did not mince their words at the convening of the world leaders at the UN general assembly in September 2021.
In a unanimous clarion call they have demanded vaccine equity and a global cooperation on vaccine supply and access.
If the only way out of the Covid-19 health and economic quagmire is sustained vaccination, they have argued on the need for global solidarity to ensure vaccine availability and accessibility. The World Health Organization (WHO) has set a target for 70% of vaccination of the population of all countries by mid-2022. Even though, more than 5.7 billion doses have been administered globally, only 2% of those have been administered in Africa.
“The longer vaccine inequity persists, the more the vaccine will keep circulating and changing, the longer social and economic disruptions will continue and the higher the chances that more variants will emerge that render vaccines less effective” Dr Tedros Adhanom Ghebreyesus, Director General WHO pointed out. Therefore, the world should spare no effort to increase vaccine supply for lower income countries.
This could be done by removing all barriers to scaling up manufacturing including waiving intellectual property rights, freeing up supply chains and technology transfer. To that end, WHO and COVAX partners announced the first COVID-19 technology transfer hub to be set up in South Africa. Moreover, the immunization message must be spread as if they are selling a product to convince people. Far from being pessimistic, it should be noted that a 4th wave have been projected for sometimes in December 2021.
Therefore, a coordinated multi-faceted campaign could have a greater impact on a single programme to ensure a massive vaccine uptake.