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Most of Africa will not have access to Covid-19 vaccines for up to a year after approval

AP Photo/Siphiwe Sibeko
A volunteer receives a Covid-19 test vaccine injection developed at the University of Oxford in Britain in Soweto, Johannesburg

Researchers have been warning for months that production constraints and hoarding could limit Covid-19 vaccine supplies. For most of Africa, this may mean not having access to the vaccines for up to a year after approval.

With the EU recently joining the scramble for potential Covid-19 vaccine and securing 300 million doses, this is becoming more likely.

Several wealthy countries have already negotiated bilateral deals with Covid-19 vaccine developers to secure vaccines for their citizens. The US has secured 100 million doses of a potential vaccine and the UK 90 million doses. While Brazil has a deal for 100 million doses, the country and other top emerging economies such as India, China, and Russia are making their vaccines. Though a Covid-19 vaccine trial is going on in South Africa there is no primary vaccine development currently in Africa.

Several stakeholders including the WHO have called for equitable access future Covid-19 vaccine in Africa. “Too often, African countries end up at the back of the queue for new technologies, including vaccines. These life-saving products must be available to everyone, not only those who can afford to pay”, says Dr. Matshidiso Moeti, WHO regional director for Africa.

Though several pharmaceutical companies have made deal with governments and private funders to ramp up their vaccine production capacity and mass-produce Covid-19 vaccine in advance, not all of the vaccine candidates will be successful.

Currently, there are about ten Covid-19 vaccines on clinical trials but a study shows that the probabilities of success of clinical trials for an industry-sponsored vaccine program is 39.6%.

By the time successful vaccines are approved, they will become the most sought after medicine, requiring billions of doses to be made available quickly. But researchers are saying scaling up manufacturing quickly will be a big challenge due to inadequate funding and the diversity of the vaccine types being developed—hence the needed infrastructure.

As wealthy nations scramble for Covid-19 vaccine crowding out poorer countries, there are concerns that history is being repeated. During the 2009 H1N1 pandemic, wealthy countries likewise scrambled for and hoarded vaccines. As a result, it took one year after vaccine approval for all 34 African countries that qualified for vaccine donation to receive it.

The recent show of “treatment nationalism” by the US, the UK, and India give a glimpse of what to expect with Covid-19 vaccines. The US bought the global supply of Remdesivir, the UK banned the export of Dexamethasone and India the export of Hydroxychloroquine—all these drugs have been reported as a treatment for COVID-19.

Most African countries have relied on WHO to assess vaccines. WHO funded two-thirds of the 2009 H1N1 vaccines that it delivered to Sub-Saharan Africa during the last pandemic but during the Ebola outbreak the organization was slow to respond due to lack of funds. This year the WHO division-leading the global Covid-19 response was found to be “chronically” underfunded.

However, the WHO is collaborating with Gavi, the Vaccine Alliance, and the Coalition for Epidemic Preparedness Innovations (CEPI) to ensure equitable access to Covid-19 vaccines through the COVAX Facilities.

The COVAX Facility, a mechanism for countries to pool buying power and collectively secure several vaccines gives African countries a chance for early access to vaccines. Under this facility, 300 million doses of potential vaccine have been secured—a relative a small amount. However, only Botswana, Mauritius, and Seychelles in Africa have shown interest publicly to purchase vaccines through the facility with their funds.

Though about 37 African countries are eligible for the Advance Market Commitment (AMC)—a mechanism within the facility that will support poor countries with vaccines, the number of doses that will be available is dependent on donations or development assistance. The AMC has so far raised only $600 million against an initial target of $2 billion to secure doses for 92 economies.

Locals barriers such as insecurity, lack of vaccine cold storages, large disenfranchised populations that usually hinder quick access to vaccines in Africa still exists and will affect Covid-19 vaccine access.

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