How Vaccine Inequality can Prolong the Covid-19 Pandemic in Africa

Picture: Timothy Bernard/African News Agency(ANA)

By Kelly-Jane Turner

THE world is two and a half years into the Covid-19 pandemic that continues to underline global health inequalities, particularly on the African continent.

Covid-19 vaccines have been available since early 2021 and despite a plentiful supply of doses, equitable access remains a pressing challenge in many parts of the world. Access, demand, and uptake are low, with low-income countries remaining furthest behind.

Globally, 61.3 percent of the world’s population has been fully vaccinated. Gavi, the Vaccine Alliance, estimated that across the African region, only 19 percent of the population is vaccinated against Covid-19.

This translates to only 25 in 100 people having received at least one dose. Marie-Ange Saraka-Yao, Managing Director, Resource Mobilisation, Private Sector Partnerships and Innovative Finance at Gavi, says there is a concerning global vaccine equity gap that still exists and disproportionately affects the African continent.

“Vaccine equity is very important and that's why it continues to be researched." Unless you have a sufficient number of people vaccinated or immune, you're bound to have more variants emerge,” she said.

Saraka-Yao said the Covid-19 pandemic has brought health to the forefront and highlighted its importance on the African continent.

“With the global vaccine roll out, some people may think that the pandemic may be over, but that is not the case until the majority of the world is vaccinated." We do need to keep an eye on it and in some countries, including high-income countries, we have seen a spike in cases,” she said.

African countries currently have a mixed bag of vaccination rollouts, where some countries are vaccinating close to 70 percent of their population and others are not even breaching the 10 percent mark.

Last week, the World Health Organization (WHO) revealed that Sudan surpassed its 10 percent Covid-19 vaccination milestone. Dr Richard Mihigo, the director of Covid-19 vaccine delivery, co-ordination, and integration at Gavi, said it is a significant step for the country towards protecting lives and curbing vaccine inequity.

“With Covax now having enough supply to help Sudan and other (lower-income) countries achieve targets and ensure populations are fully protected, it is important to seize the opportunity to achieve vaccine equity,” he said.

According to the Africa Centres for Disease Control and Prevention (CDC), countries including Niger, Madagascar, Burundi, Cameroon, Mali, the Democratic Republic of Congo, Lesotho, and Eswatini have vaccinated under 10 percent of their populations.

Cold chain logistics issues, multiple-dose series, and weak health infrastructure are often obstacles to providing and distributing Covid-19 vaccines in Africa.

Last month, President Cyril Ramaphosa called on BRICS nations to support the drive of the African Union to ensure that vaccines destined for African countries are procured from African manufacturers. Speaking at the virtual 14th BRICS Leaders’ Summit, he said that developing economies continue to face challenges of poverty and inequality, which the Covid-19 pandemic has only exacerbated.

“Lack of access to lifesaving vaccines and treatments is still holding back the recovery of millions across the world.

“We cannot have a swift and inclusive global economic recovery unless the issue of vaccine inequality is urgently addressed,” the president said.

The South African situation

In South Africa, where we have been living mask and restriction-free for close to a month due to a sustained decrease of infections, the virus may seem to have evolved to become more manageable.

Since the country exited its unofficial fifth wave in May, case numbers have plummeted. Reported cases from the past week have been under 400 daily. Last week, the National Institute for Communicable Diseases (NICD) said the reduced severity of Covid-19 in the country led to the institute ceasing to publish surveillance data over weekends.

Scientists have debated whether South Africa could be heading toward the disease becoming endemic in the country. When a disease is endemic, it means the infection in the population is constantly maintained at a baseline level.

Dr Alex de Voux, from the Division of Epidemiology & Biostatistics, at the University of Cape Town (UCT) said it would be difficult to definitively tell if the outbreak is becoming endemic in the country.

“We need to continue to monitor test positivity and remain alert regarding the emergence of Covid-19 variants,” he said. Senior scientist at the Centre for the Aids Programme of Research in South Africa (CAPRISA), Dr Aida Sivro, said the word ‘endemic’ is often misused and misinterpreted when it comes to Covid-19.

“The best way to prevent further, potentially more dangerous viral variants from emerging is to reduce transmission and that requires many integrated public health measures, including increased vaccination,” she said.

Endemic doesn’t necessarily mean harmless, said Sivro, as the impacts and dangers of long-Covid are still being studied. “We need to continue developing and implementing both public health and pharmaceutical measures in order to reduce the risk of infection/reinfection and to minimise the long-term health effects of Covid-19,” she said.

Another Omicron variant was detected

Experts from the WHO have flagged a new subvariant of the coronavirus for special attention. The BA.2.75 subvariant, an offspring of the omicron BA.2 variant, has led to an increase in cases in India, the country of the first detection.

WHO’s chief scientist, Soumya Swaminathan, said the subvariant has been detected in over 10 countries. “It’s still too early to know if this sub-variant has properties of additional immune invasion or of being more clinically severe,” she said.

The WHO committee and the technical advisory group on Virus Evolution (TAG VE) are currently tracking the variant and looking at the data from around the world. “There are still limited sequences available to analyse, but this sub-variant seems to have a few mutations in the receptor-binding domain of the spike protein.

”That's a key part of the virus that attaches itself to the human receptor, so we have to watch that,” Swaminathan said.

Turner is a multi-media journalist at African News Agency (ANA)

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