Africa vaccinates 7.2 million but faces threats to progress

In Africa, 7.2 million people have been vaccinated against Covid-19 and 28 countries have received 16 million doses of the AstraZeneca vaccine by Thursday, says Africa CDC director Dr John Nkengasong.

Africa had 4.1 million cases of Covid and 110,000 deaths at the time of the weekly briefing. New infections are stable overall, decreasing by 1% on average over the past month although rising again in East Africa.

Nine countries have received more than 720,000 doses of the AstraZeneca vaccine from the one million doses the Africa Vaccine Acquisition Task Team acquired from SA.

Nkengasong said they were “extremely appreciative” of their deliveries, listing the countries and the doses they had been allocated by AVATT as: Gambia (15,000), Ghana (165,000), Guinea-Bissau (12,000), Liberia (27,000), Mauritania (27,000), Nigeria (300,000), Senegal (90,000), Sierra Leone (42,000) and Togo (45,000) with Malawi expecting 102,000 doses by the weekend.

AstraZeneca is safe and effective for countries unless the variant has been proven to be dominant in those countries.

—  Africa CDC director Dr John Nkengasong

Part of an MTN donation of $25m to vaccinate healthcare workers in Africa was used to help pay for the AstraZeneca deal between SA and the AU, but the exact cost of the sale has not been made public.

Nkengasong said of the AstraZeneca vaccine: “It is safe and effective for countries unless the variant has been proven (to be dominant) in those countries. SA stopped using those AstraZeneca vaccines not because of safety but because of the variant that predominates.”

But now the critical AstraZeneca pipeline to the continent could be at risk because the Serum Institute of India, the biggest producer for Africa, this week paused all major exports of the vaccine reportedly to prioritise Indian demand.

All the vaccines distributed by the global platform Covax to Africa are AstraZeneca and some of AVATT acquisitions, which means the continent’s fledgling rollout could stall if the supply were to be delayed.

Nkengasong said of the decision: “This will significantly impact our ability to fight this virus ... Based on the statistics, it is fair to say we are edging towards the third wave, and without rapid access to vaccines, we will continue to be challenged and more lives will be lost.

“I feel a sense of helplessness but remain hopeful that the power of humanity will prevail,” he said, adding that countries had to work collectively to stop Covid-19. “No part of the world will be safe unless every country is safe.”

AVATT, under the leadership of then-AU president Cyril Ramaphosa, secured 270 million doses of the J&J and Pfizer vaccines and was in the final phase of signing those contracts, said Nkengasong.

Covax has promised Africa to supply 20% of its requirement to meet herd immunity. Africa aims to vaccinate at least 60% of its 1.2 billion population – 700 million people.

Another 10 million doses have been received by 18 countries who struck bilateral deals.

Nkengasong reassured countries that the April 30 expiry date on the consignment from SA had been further evaluated and could last another six weeks.

“The Serum Institute of India did its own supplementary analysis and determined the expiry date could be extended until July 17 and certified that.”

However, he said he was confident the countries would use up their doses before the end of April. “Those numbers are relatively small; the largest is 300,000 for Nigeria. In our estimate, Nigeria could use up those vaccines in two days,” he said.

Countries such as Morocco have vaccinated more than 2.5 million people already. The SA national vaccine rollout has not yet been launched, but more than 200,000 healthcare workers have been vaccinated with the J&J vaccine, proved to be 57% effective against the variant.

Nkengasong said detecting a few cases of the variant in other countries was not a reason to stop using the AstraZeneca vaccine.

I feel a sense of helplessness but remain hopeful that the power of humanity will prevail.

“We don’t think it has evolved to a threshold where it should not be used, except for countries in the southern region like Zimbabwe, where it is the dominant strain,” he said.

“If [for example] Kenya analysed the virus months ago and has seen a trend of the variant increasing, that would be cause for concern. If we find it in 20 samples in a cross-sectional analysis, this is no cause for concern.”

The variant identified first in SA is being reported in 16 other countries and a related variant in 15 countries.

In the past week Botswana, Namibia and island nations are among those countries reporting the highest number of new cases per million population per day: Seychelles (650), Botswana (152), Libya (133), Cabo Verde (93) and Namibia (73).

East Africa is the region where new cases are rising fastest over the past month, increasing on average by 20% — with Kenya rising 51% and Ethiopia by 21%.

Central Africa increased on average by 4% and the northern region by 3%, while Southern Africa dropped on average by 13% and West Africa by 9%.

The status of the Ebola outbreak in the DRC and Guinea remains unchanged from a week ago. Fifteen of the 30 people infected have survived, with a 50% death rate.

Wrapping up on Covid-19, Nkengasong said: “I remain hopeful that the power of humanity will prevail … No matter how smart you are, if you are to vaccinate all your people and the virus still circulating in other parts of the world, especially in Africa with a population of 1.2bn people, [the virus will not be defeated].

“I remain hopeful wisdom will prevail over time. There is absolutely no need, absolutely no need, for us as humanity to go into a vaccine war in this pandemic. We will all be losers.”