‘Mass fatalities are putting Africa on brink of collapse. We need help, now’

“Mass fatalities from Covid-19 have begun in Africa,” writes Dr Mosoka Fallah, the former director-general of the National Public Health Institute of Liberia, in the journal Nature this week.

By Thursday, the Africa CDC reported that 167,181 people had died of Covid-19 — the death rate has gone up 17% during the past month — and 6,6-million had been infected.

A third wave of infections is being experienced by 31 African countries (56%), with Botswana and Ghana among the latest to be hit by rising numbers.

But as Fallah’s article reveals, the numbers don’t give the full story.

“Enough statistics,” he writes, under the headline “The wealthy world must rally or nations will collapse across Africa”.

“The number of graves being dug each day in Liberia recalls the 2014 Ebola catastrophe. Like Ebola, Covid-19 infects and kills a disproportionate number of healthcare workers, and Liberia already has far too few.

“My social media used to be alive with wishes for happy birthdays and anniversaries. Now it is inundated with ‘rest in peace’. The moment for high-income nations to come to the aid of Africa, a continent they depend on for an abundance of human and natural resources, has almost passed ...

“As I and my peers across African health ministries see it, rich countries are hoarding vaccines, allowing doses to expire while unvaccinated people who want to be immunised die.”

Only 1,46% of Africa’s population is fully vaccinated, even though enough doses have been given worldwide “to fully vaccinated 25,9% of the global population”, according to Bloomberg, reporting on lopsided distribution.

“Countries and regions with the highest incomes are getting vaccinated more than 30 times faster than those with the lowest,” Bloomberg reports.

My social media used to be alive with wishes for happy birthdays and anniversaries. Now it is inundated with ‘rest in peace’.

—  Dr Mosoka Fallah, the former director-general of the National Public Health Institute of Liberia

WHO Africa director Dr Matshidiso Moeti joined Africa CDC director Dr John Nkengasong at his weekly Covid-19 briefing on Thursday, where they reported on vaccination progress and concerns.

He said: “Remarkable progress has been made with respect to acquiring the 220-million doses of vaccines (secured by AVATT, the African Vaccine Acquisition Task Team) and then even moving into the [target of] 400-million doses.

“Through efforts and partnerships with the World Bank it is very possible we will get to 400-million. Many more countries are coming forward to acquire additional vaccines.”

The distribution of these will start next week, with “Unicef mainly distributing them on behalf of AVATT”, he said.

“We anticipate the first eight million will be rolled out in coming days to members states,” said Nkengasong.

The Africa CDC has been in communication with countries to alert them to the vaccines’ arrival. “It almost seemed like an eternity [to acquire these vaccines] and today we are discussing when the delivery will occur.”

Africa has a target of immunising at least 60% of its 1,2-billion population by the end of 2022, which would require at least 1,6-billion if two shots are needed per person.

“We are a long way from achieving this target,” said Nkengasong, adding that the Delta variant could push the target up. “We may need more vaccines than previously estimated.”

Nkengasong urged countries making donations to Africa to ensure the vaccines have a shelf life of at least three to four months. Moeti strongly supported this request.

She said the distribution of vaccines across countries is being driven by the principal of equity, along with the capacity of each country to absorb the doses.

“We have learnt a lot from the first round of delivering vaccines,” she said, emphasising the need to mobilise additional resources to register people and do all the logistics for an effective vaccination programme.

Planning and capacity are critical in the rollout, said Moeti. “Going from a kind of a drought to a flood which is uncoordinated would be one of the worst-case scenarios, which we need to avoid.”

The WHO Africa director said any decisions about booster shots could have huge implications for the supply of doses to Africa and should be based on robust data.

She noted that populations are exhausted by facing successive waves of the pandemic, but everyone had to be agile and responsive, learning from each wave that has come before.

“We very much need that the global solidarity which is starting to emerge will emerge more strongly,” said Moeti, encouraging the global sharing of vaccines.

As I and my peers across African health ministries see it, rich countries are hoarding vaccines, allowing doses to expire while unvaccinated people who want to be immunised die.

—  Dr Mosoka Fallah, the former director-general of the National Public Health Institute of Liberia

Given the restricted access Africa had to vaccines until recently, Nkengasong said people will need to continue to practise public health measures, since that is “what has worked so far for us and ... these are the only tools we have in hand that work.

“Vaccinations are coming, but it will take time to reach a critical level,” he warned.

The balancing act between saving lives and livelihoods is taking a huge toll on the continent and, as Moeti pointed out, the recent looting in SA “may have been triggered by particular events, but it had, as background, the severe economic impact of the Covid-19 pandemic, including the measures of lockdown that had to be imposed”.

In Nature, Fallah sombrely warns: “Let me say this as an African: our world as we know it is on the brink; we face huge death tolls, and the collapse of economies and nations. What is the real meaning of humanity? For all lives to be given the same value, irrespective of geography or economy.”

He calls on the world to develop a new “Marshall Plan”, similar to the one which salvaged countries devastated by World War 2, “if not for ... their consciences, then for health security.

“Regions where Covid-19 cases are allowed to soar are the places where the next variant will emerge. That could undo all the advances made with the vaccine rollout in developed countries.”