More than 14.7 million doses of the COVID-19 vaccine have been administered across the African continent, but rollout campaigns have stalled in many countries. Africa has lagged behind in the race to acquire coronavirus vaccines since it began. It was clear individual governments would not be able to compete against wealthier nations purchasing limited stocks, so a collective effort quickly got underway.
Africa has gotten most of its vaccine doses through the COVID-19 Vaccines Global Access (COVAX) initiative, backed by the World Health Organization, the European Commission, and Gavi, the Vaccine Alliance, which pools donor funding to allow developing countries to acquire shots—primarily AstraZeneca, which doesn’t require below-freezing storage. COVAX now needs an additional $2 billion to continue its work.
But even that might not be enough if there are no shots to be found. The initiative has depended on the private Serum Institute of India, the world’s largest vaccine producer, for its supply. But grappling with soaring cases, India has halted vaccine exports and disrupted COVAX’s efforts in 36 African countries.
Last week, John Nkengasong, the director of the Africa Centres for Disease Control and Prevention, called on India to lift its export restrictions. “If you finish vaccinating your people before Africa or other parts of the world, you have not done yourself any justice because variants will emerge and undermine your own vaccination efforts,” he said.
Stalled rollouts. With COVAX’s efforts undermined, it’s now unclear when the next batch of vaccines will arrive on the continent. The COVID-19 African Vaccine Acquisition Task Team, created by African Union heads of state, has raised money to acquire purchases of doses separately, but its efforts are also stalled by global shortages.
In the meantime, Rwanda and Ghana have nearly exhausted their vaccine supplies, their otherwise efficient rollout strategies hampered by shortages. Many people who received their first shot through COVAX have no idea when the second will arrive, and there are fears the wait could weaken the vaccine’s efficacy. In Malawi and South Sudan, where rollouts were already challenged by weak public health infrastructure, AstraZeneca doses have expired and will have to be destroyed.
Scaling up local vaccine production could help solve distribution issues, but U.S. and European pharmaceutical companies are still closely guarding patent rights to the COVID-19 vaccines. Even as Nkengasong made the case for urgently setting up local manufacturing at a conference on April 12, he conceded that some African states may have to wait until 2023 until they are able to access the vaccine.
Going it alone. South Africa—which has seen the highest number of infections in Africa, at more than 1.5 million cases—has also had its vaccine rollout disrupted by forces beyond its control. As a middle-income country, it can’t make full use of COVAX’s tiered distribution system and is now trying to punch above its weight in the fight for shots. South Africa paid for more than 1 million AstraZeneca doses, but they proved less effective against the variant first identified in the country. In February, it pivoted to Johnson & Johnson’s single-shot vaccine instead, planning to rely on a local production facility contracted to make it.
After vaccinating nearly 290,000 health care workers, South Africa halted the rollout after six people in the United States developed rare blood clots after receiving Johnson & Johnson shots. South African Health Minister Zwelini Mkhize revealed big pharmaceutical companies were subjecting the country to unreasonable demands. “We have found ourselves in the precarious position of having to choose between saving our citizens’ lives and risking putting the country’s assets into private hands,” he told parliament last week.
Compared to other regions, Africa seems to have been spared the worst of the coronavirus pandemic, but the emergence of new variants shows no one is protected until everyone is. Scientists warn the longer it takes to inoculate a population, the more resistant COVID-19 could be to vaccines when they eventually arrive.