Africa Defense Forum
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Global Alliances Boost Africa’s Access to Vaccines

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As COVID-19 vaccines begin rolling out around the world, African nations are uniting in a two-pronged approach to ensure they are not left behind.

Along with nearly 150 other nations, African countries have signed on to COVAX, a consortium that aims to provide billions of vaccine doses for middle- and lower-income countries. COVAX is led by the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance.

“Under this scheme, even poor nations should have enough vaccines to protect health-care workers and the most vulnerable 20% of their populations,” Dr. John Nkengasong, director of the Africa Centres for Disease Control and Prevention (Africa CDC), wrote in Nature magazine recently.

Those initial doses will go to health care workers and people at high risk of dying from COVID-19, including the elderly and those with health conditions, such as diabetes. The WHO Africa regional office has said vaccinations could begin in March. Nkengasong believes they will begin later.

Beyond COVAX, African nations have created their own continentwide arrangement to buy vaccines in bulk. The African Vaccine Acquisition Task Team (AVATT) is led by South African President Cyril Ramaphosa, who also chairs the African Union. AVATT aims to negotiate directly with vaccine manufacturers and assemble the funding needed to acquire doses for the continent.

South Africa paid $22 million to secure enough vaccines through COVAX to cover 10% of its population. In an address at the end of December, Ramaphosa said his country is negotiating its own separate deals for vaccines in addition to being part of COVAX and AVATT.

The Africa CDC estimates it will cost $12 billion to buy enough doses to vaccinate 60% of the continent’s 1.3 billion residents — the point at which the population achieves herd immunity and blocks the uncontrolled spread of the COVID-19 virus.

The African Export-Import Bank has committed $5 billion from its members. The African Union is working with the World Bank and other donors to pin down the remaining funds.

Even with COVAX and AVATT at work, it’s likely to be mid-2021 before Africa sees its first vaccination. There are several reasons why:

  • Vaccine-producing countries already have internal orders for the first batches of vaccines coming off the production line.
  • While COVAX works to secure vaccine doses, individual member countries are negotiating separately with COVAX about when and how they will receive their vaccine allotments.
  • The ultra-low temperature storage facilities needed for the Pfizer and Moderna vaccines present logistical challenges for many African nations lacking cold storage facilities.

All these conditions have African health authorities looking ahead for alternative vaccines that may better fit their budgets, their populations and their technical capabilities.

“That really is a subject of negotiating with manufacturers for supply, and also our evaluation of the vaccines themselves looking at various things — the efficacy, the safety and the suitability for the country,” Professor Barry Schoub, chairman of South Africa’s Ministerial Advisory Committee on COVID-19, told broadcaster eNCA.

COVAX is working on deals with several vaccine makers to reach a goal of 2 billion doses. The list so far includes: Oxford/AstraZeneca (170 million doses), Johnson & Johnson (500 million), Serum Institute of India (200 million) and Sanofi/GSK (200 million). On top of those, COVAX has options for up to another 900 million doses of either Oxford/AstraZeneca or Novavax vaccines. Neither has been approved for use so far, however.

“We are going to take the first quarter [of 2021] to be sure we have what we need in place for distribution,” Dr. Nicaise Ndembi, senior science advisor on vaccines for the Africa CDC, told ADF.

In the meantime, countries such as Angola, Ghana, Morocco, Nigeria and South Africa are working to improve their ability to manufacture the COVID-19 vaccine to meet future needs, reduce import costs and build faith in it.

Ndembi added that the delayed rollout of a COVID-19 vaccine raises the specter of medical treatments, such as for HIV or polio, that came to African countries long after other nations and sometimes proved to be substandard.

Any vaccine accepted for Africa will be vetted by the WHO, he said.

“We’re not accepting substandard vaccines.”

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