The number of fully vaccinated people in Africa stands at barely 4 per cent of the continent’s population, compared to up to 80 per cent for some of the high-income countries; despite having a near 75 per cent acceptance rate. This is a supply and not a demand problem.
Policy makers in Africa and communities at all levels should be outraged!
The recently concluded Global COVID-19 Summit hosted by US President Joe Biden on Ending the Pandemic and Building Back Better Health Security to Prepare for the Next, served its objective – to marshal more doses and financial support to developing nations where COVID-19 tools; vaccines, treatments and supplies remain scarce.
Several commitments were announced at the summit, including the delivery of at least 2.6 billion vaccines to accelerate vaccination, hoping to vaccinate 40 per cent of the world’s population by the end of 2021, and up to 70 per cent by September 2022.
As plans are underway to ensure commodity security, we welcome the additional contributions of approximately 850 million COVID-19 vaccine doses (for the world) and commitments from leaders of countries and organizations to save lives now and build back better.
These are the first, in a long line of steps to secure Africa’s ability to fight for its future. We applaud South Africa’s President Cyril Ramaphosa for underscoring the need for a sustainable plan on how developing countries will meet targets around vaccination, oxygen, diagnostics and personal protective equipment, as well as boost manufacturing.
Summit goals met?
The Summit certainly met its goals to garner support; however, we are still miles away from COVID-19 pandemic control and building better health security for Africa.
At Amref Health Africa, we have been at the forefront of engaging communities on the continent, providing technical assistance to ministries of health, educating and supporting deployment of health workers and defining a new way of doing public health in Africa.
As we move forward, the 5 imperatives for ending vaccine injustice in Africa are the following:
- Donations not loans! Vaccines that come at a cost, however low, or those acquired through World Bank loans increase the debt burden.
Africa, a continent that is home to 17 per cent of the world’s population but accounts for only 2.7 per cent of global production cannot afford more than $50 per capita of public expenditure on health even at maximum tax efficiency, maximum allocation to health and 100 per cent budget execution. For an African country to buy its own COVID-19 vaccines, it has to spend more than 30 per cent of its total health budget. Therefore, COVID-19 vaccinations to Africa cannot be through loans but through multilateralism. Health, just like climate change mitigation, is a GLOBAL PUBLIC GOOD.
- End vaccine injustice! Demand that rich countries stop stockpiling COVID-19 vaccines. Vaccine manufacturers and countries with vaccine stockpiles should prioritize and accelerate dose commitments to COVAX and the African Vaccine Acquisition Task Team (AVATT) giving these mechanisms room to move forward in the queue.
Timely delivery of these vaccines is critical; only 15 per cent of pledged doses have been delivered in Africa to date. Delays mean continual spread of the virus and the increase in the virus variants, regression of hard-earned gains made for health systems and prolonged economic recession. An explicit timeline must be shared with COVAX to enable transparent and equitable distribution and the eventual end to this pandemic suffering.
- Strengthen existing global architecture: Before creating new mechanisms, we need to strengthen what we have. African governments must sign on to calls to support the strengthening of WHO’s pandemic preparedness instruments and existing global and regional health architecture. These include the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the Africa Centers for Disease Control and Prevention (Africa CDC) and so on; as well as civil society platforms for community mobilization and accountability.
- Invest in people-centered health systems: Specifically, realistic, country-specific plans focused on communities and individuals, their needs, and their concerns. We have to re-imagine our health as defined in Africa CDC’s new Public Health Order for Africa. It addresses health systems broadly, and the systems needed to improve health security in Africa. It aims at strengthening public health capacity, especially in national public health institutes; increasing investments in health financing and harmonizing regulatory policies to enable flow of commodities and labour; investing in training Africa’s public health workforce; increasing local manufacturing of health commodities; and leveraging partnerships to meet these goals.
- Build manufacturing capacity now to guarantee commodity security: We also acknowledge South Africa’s new role in hosting the WHO technology transfer hub for the region. Manufacturers need to share licenses, technology and other tools to boost manufacturing for Africa.
African governments, through the African Union, must commit to fund regional manufacturing hubs (at a minimum) and shaping markets to ensure supply matches demand with minimal duplication and waste.
Amref Health Africa is firmly committed to ending COVID-19 vaccine injustice and we continue to fight for vaccine equity.
Africa must be uncomfortable with the status quo.
Dr. Githinji Gitahi is the Group CEO, Amref Health Africa