Rates of vaccination against COVID-19 are still disappointingly low in Africa, with just around 8 percent of the continent’s population fully vaccinated against the disease. And this average masks large differences between countries. Mauritius and Morocco, for example, already fully vaccinated 72 and 62 percent of their populations respectively, but in countries like Democratic Republic of the Congo and Burundi, vaccination rates remain well under one percent.
Since the emergence of the more transmissible Omicron variant, the number of COVID-19 infections is on the rise, but the number of deaths still remain relatively low on the continent. Nevertheless, given the known weaknesses of African health sectors, including the limited number of intensive care beds, there are fears that if the Omicron variant continues its rapid spread – or worse, a more transmissible and deadly variant emerges – Africa could find itself in the middle of an unprecedented public health crisis. Thus, front-loading vaccination appears to be the only available option to prevent a new disaster on the continent.
Unfortunately, due to several interconnected factors, Africa is not expected to reach the global target of 70 percent vaccination set for mid-2022 until the end of 2024, according to the World Health Organization (WHO). Beyond its consequences for the population of the continent, that miss will likely have large and negative spillover effects on the rest of the world in terms of the emergence of new, potentially more harmful variants.
The main reason behind low vaccination rates in Africa has been the low supply. Indeed, high-income countries have been hoarding vaccines, most recently for third “booster” doses, leaving low-income countries, including many in Africa, unable to access enough doses even for their most vulnerable populations and frontline health workers.
The limited shelf life of vaccines – three to six months on average – also had an effect on vaccination rates in Africa, as it made it highly difficult for vaccine-abundant nations to transfer their excess doses to vaccine-poor nations before they expire.
But vaccine manufacturers around the world are ramping up production, and demand for vaccines is slowly but steadily declining in high-income countries. According to The International Federation of Pharmaceutical Manufacturers and Associations, at least 1.5 billion doses of COVID-19 vaccine are currently being produced every month, and the total number of vaccine doses produced is expected to reach 24 billion by June 2022. By that time vaccine supplies will likely outstrip global demand. What all this means is that the supply shortage in Africa will likely come to an end in the near future. This is undoubtedly good news for the continent. But now, African states need to focus their efforts on overcoming local bottlenecks, such as poor logistics, lack of capacity to administer doses and vaccine hesitancy, which could hinder future vaccination drives.
Failure to address these bottlenecks swiftly and efficiently could result in more and more vaccine doses being returned to manufacturers or destroyed, especially considering the short shelf life of most doses.
The continent has endemic logistical problems. Many of Africa’s leading ports, for example, are suffering from high levels of corruption which is already causing significant delays in and adding costs to imports. These problems could also derail the continent’s COVID-19 vaccination drives. Furthermore, Africa’s cold chain infrastructure is highly insufficient, which is readily causing 50 percent of the food produced by African countries on average to be wasted. Considering COVID-19 vaccines need to be refrigerated – some at very low temperatures – this inadequacy can also pose a threat to vaccination campaigns.
And even if these logistics problems are resolved, most African nations do not currently have the means to put all the doses they are expected to receive in the arms of Africans before they expire. For one thing, there are not nearly enough nurses or other trained health professionals to administer the vaccines. The average number of nurses in sub-Saharan Africa countries is one per thousand of the population, compared to 10 per thousand in The Organisation for Economic Co-operation and Development or OECD member countries and 15 per thousand in North America according to the World Bank. Furthermore, many of these countries also do not have enough syringes for widespread vaccination drives.
Low urbanisation levels in many African countries are also an obstacle to vaccine campaigns. While the urbanisation rate has rapidly increased on the continent over the past few decades, it remains relatively low, making it harder to administer the vaccine to all citizens. Six in 10 sub-Saharan Africans still live in rural areas according to the World Bank. To reach segments of the population in remote areas, Ivory Coast deployed mobile clinics across the country and Ghana used drones to deliver doses to remote areas. Other African countries should also invest in such initiatives if they want to reach their vaccination targets in time.
On top of these logistical problems, vaccine hesitancy also poses a problem. Reports that the AstraZeneca vaccine can cause blood clots, and the decision by several European countries to not administer this particular vaccine to their citizens, has increased hesitancy on the continent. Moreover, social media platforms, including Facebook, which is synonymous with the internet in many African countries, have become vehicles for COVID-19 vaccine misinformation and led many Africans to become hesitant about taking the vaccine. Many African states failed to respond efficiently to these misinformation campaigns by providing accurate information on vaccines. Regrettably, several respected public figures, including political leaders, also directly contributed to the spread of misinformation and baseless doubts about the safety of vaccines.
As more doses arrive on the continent, domestic bottlenecks will become the main constraints to the vaccination efforts. African leaders with the support of development institutions should set clear vaccination plans, invest strategically in improving logistics and digitalising their systems to better track doses. They should also expand and improve their cold chain infrastructures. They should invest in initiatives to ensure doses reach segments of the population in remote areas. To address vaccine hesitancy, politicians, whether in power on not, should partner with popular public figures, such as football players, music stars, and social media influencers, to encourage Africans to get vaccinated. Financial incentives such as conditional cash transfers via mobile phones can also help stimulate vaccination, and provide the needed relief to households who have suffered greatly during the pandemic.
Source: Aljazeera by Rabah Arezki
Senior fellow at the Harvard Kennedy School