At last Africa’s vaccine famine is ending. Now we must play catch-up

International donors have failed to deliver millions of Covid-19 vaccines to Africa this year as promised, according to Strive Masiyiwa, AU special envoy, outlining the vaccine supply pipeline at the weekly Africa CDC coronavirus briefing on Thursday.

But the good news is the continent’s wait for a predictable supply is over. Thursday marked the start of monthly shipments of vaccines acquired by the AU/African Vaccine Acquisition Trust (AVAT) to member states.

By August, Africa had received only about 10% of the Covid-19 doses pledged by donors, said Masiyiwa. “This is where the crisis is for us ... We were supposed to have received 320-million doses by now and we didn’t get them.”

“If you go to graveyards right now, they are burying people from Covid,” he said, noting that vaccines have protected 99% of people from hospitalisation and death in the US.

Sounding congested and looking fatigued, Africa CDC director Dr John Nkengasong said he was recovering from Covid-19 and was certain that being vaccinated had saved his life.

By Thursday 173 000 people had reportedly died of Covid-19 in Africa and nearly half (24) of its states were reporting a case fatality rate higher than the global average of 2.1%. Egypt, Somalia and Sudan were reporting an average death rate above 5%.

On the continent only 1,5% of people are fully vaccinated and a dire shortage of Covid-19 vaccine doses has stalled its vaccination programme.

International donors promised African leaders they would supply half of the 780-million doses needed to protect 60% of the population, but delays in this supply have effectively torpedoed the continent’s vaccine plans.

The AVAT was set up to provide the other half, needed to vaccinate 60% of the population in Africa. “We declare today we have met our end of the deal,” said Masiyiwa.

“We expect that the donors will meet their end of the deal, even though they are significantly behind the targets that they themselves gave us.”

Minister after minister, from Senegal to Malawi, said how people are in a queue in the street with arms held out, waiting for vaccines to be administered.

—  Strive Masiyiwa, AU special envoy

India’s decision not to export Covid-19 vaccines during its deadly wave of infections earlier this year led to a shortfall in expected supply to Africa.

But supply shortages are easing, with millions of doses of the Johnson & Johnson (J&J) vaccine arriving this month through AVAT and Covax donations.

The AVAT doses will be produced at the Aspen Pharmacare facility in Gqeberha and shipped to Unicef for distribution.

By December:

• AVAT will deliver about 45-million doses of J&J vaccine to cover 45-million people; and
• The US government and other donors will deliver about 95-million Pfizer doses to cover about 47-million people.

Masiyiwa said 27 countries, including eight in the Caribbean on the AVAT platform, would be getting 6,4-million doses this month. This would rise to 10-million doses to 45 countries next month.

“We will exponentially ramp up until there are 25-million doses a month by January. We intend to clear all 400-million doses (from AVAT) by September next year,” he said.

The Mastercard Foundation has pledged $1,3bn (about R18,7m and amounting to 67-million doses) to support AVAT’s purchases and MTN has provided another $25m (about R360m) in funding.

AVAT initially purchased 220-million doses, with the option to increase this amount to 400-million when it secured funds, which it has.

Praising the commitment of the African Export-Import Bank (Afreximbank), Masiyiwa said: “This one African bank put up the $2bn (about R29bn) before a single country had paid for a vaccine. They put up that ... because Africans were dying. This is a bank without a big balance sheet.”

He also commended the “extraordinary efforts” of then-AU chairperson and AU Covid-19 champion President Cyril Ramaphosa for stepping in whenever they ran into trouble.

At a recent meeting of African health and finance ministers, Masiyiwa said the leaders expressed how the demand for vaccines had shot up.

“Minister after minister, from Senegal to Malawi, said how people are in a queue in the street with arms held out, waiting for vaccines to be administered.”

Reiterating the need for African countries to have a unified public health strategy, Nkengasong said: 'Ebola was a signal of something to come. Covid is another signal of something even worse to come if Africa is not organised.'

At first some countries would not participate and a month ago Eritrea, Tanzania and Burundi were not yet on board. Nkengasong said: “I have met with the head of state in Tanzania and, once I’ve recovered, I want to try exploring ways to get to Eritrea and Burundi.”

“Our strategy is simple: leave no country behind,” he said of the vaccination rollout.

Once the target of 60% is achieved it could be adjusted to meet the increased threat of variants, which erode vaccine efficacy against infection, but not against death.

Meanwhile, 32 of Africa’s 55 member states are in the grip of a third wave, with 78% of them severely hit. Kenya, Algeria and Tunisia are already into their fourth wave, said Nkengasong.

Last week, deaths decreased by 4% on average, even though infections continued to rise by 14% on average.

From July 5 to August 1 the continent overall saw “a persistent 2% increase of new cases across regions”, said Nkengasong, except in the south.

“The 7% decrease in Southern Africa is mainly due to the vast decrease being experienced in SA,” he said.

But deaths have increased on average by 6% in the past month, rising by 89% in Nigeria and 29% in the Democratic Republic of the Congo (DRC).

Reiterating the need for African countries to have a unified public health strategy, Nkengasong said: “Ebola was a signal of something to come. Covid is another signal of something even worse to come if Africa is not organised.

“We are moving steadily from a vaccine famine to a vaccine feast, but we should all do our part to say that vaccines save lives.”