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Why Vaccines Haven't Reached African Countries As Efficiently As Hoped


The Delta variant is rapidly spreading across the African continent in a third wave of COVID-19 infections, and only about 1% of Africans are fully vaccinated against COVID-19, making people vulnerable. The majority of African countries participate in COVAX, a global initiative created to improve equity in vaccine distribution. But vaccines haven't reached people as efficiently as hoped. Dr. Phionah Atuhebwe is the World Health Organization's new vaccines introduction officer for Africa. The WHO is one of the organizations leading COVAX.

PHIONAH ATUHEBWE: Right now, African countries are at a point where we shall take any vaccine handed to us. But right from the beginning, the COVAX facility had set a minimum of 50% efficacy for all the scientific studies showed if a vaccine meets a minimum 50% efficacy rate, then it is able to actually prevent severe disease, hospitalization and deaths.

FADEL: I spoke with Dr. Atuhebwe about how individual African countries are doing.

ATUHEBWE: So indeed, some countries are doing better than others. For instance, we have Angola, Eswatini, Gambia, Namibia, Rwanda, Uganda - countries that have used up 100% of their COVAX doses because they all had a robust vaccine rollout. Countries with trained health staff, logistics, capacity in place have been able to roll out vaccines the fastest. But we also have countries that reports on lack of operational funds. In Africa, this time around, there was no vaccine introduction grants to help them roll out the vaccine, to train health workers, to do the communication and social mobilization, to transport these vaccines from the national stalls to the subnational stalls and then finally to the service delivery points.

FADEL: You spoke about some of the success stories here and some of the challenges, but there are some 20 countries that received doses but didn't roll out more than half of them. What were the challenges there? And also what countries aren't doing so well, and what are the challenges there?

ATUHEBWE: So the World Bank estimates that Africa will need about $12 billion for procurement and distribution of COVID-19 vaccines to reach sufficient numbers to ensure adequate protection of the African population. And many countries, African countries, must fund the costs of procuring the additional vaccines while at the same time investing in immunization systems to be able to distribute the vaccine. Then we also have seen an issue with vaccine acceptance. We know that we have disparities between, for example, West and Central Africa, which have a low vaccine confidence, and then East and Southern Africa, that have a higher vaccine confidence.

FADEL: So what accounts for the variance in vaccine acceptance?

ATUHEBWE: Different countries in Africa were affected at different levels by the pandemic. So there are countries that still think that COVID is still a myth to them. They have not seen the real impact of COVID, so they think it's something political. Then we have led community engagement. The vaccines are right in the countries before the communities are engaged, and education has not yet taken place. So it's difficult for them to understand, is this vaccine going to cause the disease? Is it something - again, the usual Western world trying to finish Africa - things like that.

But we've also noted the level of trust by the public in their government and medical institutions. We've had a lot of African presidents, for example, come out and publicly get vaccinated to increase confidence in the population. And that has worked in many countries where the heads of states have been publicly vaccinated.

FADEL: How much of this incredibly low vaccination rate is really about vaccine hesitancy versus lack of access?

ATUHEBWE: So there's a myth that vaccine supply shortages are contributing to vaccine hesitancy, which is not what we are finding as WHO. And this has come from this third wave that has hit the continent. Because of the Delta variant that we know that and we've seen that the transmissibility is really high, if they brought in doses right now, much more doses, this is the right time to vaccinate Africa because people have seen the impact of what these other waves have done to us, and they now are willing to take the vaccine.

FADEL: How do you get the needed vaccines into the countries that need them right now?

ATUHEBWE: Right now, to be honest, we are at the mercy of the richer countries that are having much more vaccine than they require, given that in Africa we have not even vaccinated 1% of our population, let alone vaccinating the priority groups. We have health workers in Africa working in COVID treatment centers and have not been vaccinated because they cannot access the vaccine dose. And that's ethical and moral obligation that we think the Western world has to the African population. We know that we are a global village. See what the Delta variant has now done, even to countries that have vaccinated huge populations.

FADEL: And there's been some setbacks too. Many African countries were supposed to receive vaccines from India, but then India's own COVID crisis led to export restrictions. What's being done to replace those vaccines that were expected?

ATUHEBWE: One, the cry out for donations and the G7 countries responding and more countries that had extra doses responding and donating some of their doses to Africa. This can never meet what we were expecting to get from India, but that's just a small part. Then, as you know, the COVAX facility is also exploring increasing the manufacturing sites for the AstraZeneca. But also the WHO has really expedited and increased the number of approved vaccines for emergency use listing. So now we've added the Chinese vaccines, the Johnson & Johnson, which we are also anticipating later in the third quarter, and much more of the Johnson & Johnson doses at the beginning of the year.

FADEL: So really, a crisis moment, taking whatever you can get to make sure people have some type of immunity against this variant.

ATUHEBWE: Exactly. And we are saying that every African should take the vaccine they first land their hands on. What we need right now is immunity.

FADEL: Dr. Atuhebwe, thank you so much for joining us.

ATUHEBWE: My pleasure.

(SOUNDBITE OF MULATU ASTATKE'S "GAMBELLA") Transcript provided by NPR, Copyright NPR.