African countries must not be at back of queue for Covid-19 vaccine

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  • Two Covid-19 vaccine trials have shown promising results during recent weeks
  • Vaccines could start reaching people before the end of the year, experts say
  • However, the threat of vaccine nationalism has increasingly become a concern

Two vaccine candidates from pharmaceutical and biotech companies Pfizer and Moderna have shown promising results, but African countries need to ensure they aren’t left behind when vaccine rollouts start happening.

These were the words of the Regional Director of the World Health Organization (WHO) Regional Office for Africa, Dr Matshidiso Moeti, during a virtual discussion hosted by Doha Debates on Wednesday.

“It’s true we need to wait for full efficacy and safety data to be available, but we are all gearing up to make sure there is equitable distribution in Africa,” Moeti said. “Coming from Africa, I have to say our experience in the past has been that when a new technology comes out, African countries are at the back of the queue to get it.

“We’ve seen sometimes it takes a decade for a new technology to be available in Africa, in a scaled-up fashion in our health systems.”

'Vaccine nationalism'

In comments made earlier this year, Professor Helen Rees, executive director of the Wits Reproductive Health and HIV Unit (RHI), stressed that the opportunity to participate in trials must ensure that Africa is not left behind like it was in the past.

If trials are limited to the North, Rees cautioned that it will result in "vaccine nationalism", which typically occurs when a country’s government manages to secure vaccine doses for its own citizens before it’s made available to other countries – something that has already been seen in the US and UK. 

According to The Telegraph, the UK has already put in an order for five million doses of the Moderna vaccine, while CNBC reported in July that the US struck an agreement with Pfizer to get 100 million doses of their vaccine, and acquire 500 million additional doses if needed.

Rees commented then on the crisis with the pandemic flu vaccine and HIV antiretrovirals in the past, where Africa got left behind and ultimately received very little vaccine and months too late. “We cannot allow that to happen again,” she said. 

COVAX Facility

Moeti also drew attention to the COVAX Facility – led by Gavi, the Vaccine Alliance, along with the WHO and the Coalition for Epidemic Preparedness Innovation – an alliance that finances vaccine development in order to guard against inequity in the distribution of the vaccine to developing countries.

By September, the Gavi COVAX Advance Market Commitment (AMC) had raised around US$ 700 million from sovereign donors as well as philanthropy and the private sector, against an initial target of US$ 2 billion in seed funding needed by the end of 2020, the WHO stated.

Funding the Gavi COVAX AMC is critical to ensuring that the ability to pay is not a barrier to accessing Covid-19 vaccines, “a situation which would leave the majority of the world unprotected, with the pandemic and its impact continuing unabated”, the organisation noted.

However, Moeti cautioned that wealthier countries, mainly the Western countries, are already entering into advanced purchase agreements with vaccine manufacturers to reserve doses. 

“From the African perspective, we are very concerned but also hoping that we hold to this principle of equity and that we don’t have deals being entered into with countries that then sweep up the supplies,” Moeti said.

Moeti said that they are hoping for at least 20% of populations to be covered in Africa, initially, starting with the most vulnerable. “We hope we do not have inequality based on geography, income level of countries and also racial inequality,” she commented.

Covid-19 vaccine for distribution in Africa: Where do we stand?

South Africa had not yet managed to secure any doses of vaccines from Pfizer, whose vaccine was shown to be over 95% efficacious this week, or any other manufacturer, Spotlight recently reported, adding that the country also missed the first deadline to commit to COVAX.

However, spokesman for the Department of Health, Popo Maja, confirmed to Spotlight that although SA had not concluded any vaccine deal, negotiations with manufacturers and COVAX were underway.

“My staff and I, with partners, are doing all our best to persuade the African countries to go for it, to go looking for the money. Let’s have a pooled approach so that we constitute a market that’s going to be competing,” said Moeti.

“We’re working with the African countries to get ready now. In fact, we are doing an assessment of their readiness and preparing to roll out the vaccine in terms of all the logistics, the technical work that needs to be done. 

“I do think one of the best experiences from the HIV era was the solidarity among people. Covid-19 has become very political, much more than HIV did,” she said.

READ | Pfizer ends Covid-19 vaccine trial with 95% efficacy, to seek emergency-use authorisation in US

READ | Covid-19: Two of the vaccine front runners have already reported promising evidence - so what now?

READ | Why vaccines need to be tried and tested in different populations across the world

Image: Getty/mrgao

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