India’s crisis has Africa’s Covid-19 vaccine drives scrambling

Workers offload AstraZeneca/Oxford vaccines as Ghana receives its first batch of Covid-19 vaccines under the Covax scheme on Fe. 24.
Workers offload AstraZeneca/Oxford vaccines as Ghana receives its first batch of Covid-19 vaccines under the Covax scheme on Fe. 24.
Image: Reuters/Francis Kokoroko
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Covid-19 is a global disease. That means, as the Guardian’s Hannah Ellis-Petersen recently pointed out, that India’s crisis is the world’s crisis.

India’s devastating second wave is already impacting Africa. In March, Covax, the global vaccine-sharing initiative, confirmed its plans to allocate the AstraZeneca vaccine to African countries, which make up 40 of the 64 low-income countries being supported by the initiative. Using population size as a guide, Covax’s first allocation round divided up 64.5 million doses of the vaccine to be distributed to African nations through May 2021, all to be manufactured by the Serum Institute of India (SII).

That plan came to a grinding halt when the SII restricted exports of vaccines towards the end of March, as a second, more virulent wave of Covid-19 swept through the country. “As India confronts a truly dreadful wave of the pandemic, it is clear that all Indian vaccine production—for the next month at least—will be committed to protecting its own citizens,” a spokesperson for Gavi, the vaccine alliance helping to coordinate Covax, told Quartz Africa. The group is working to secure vaccines from other manufacturers and high-income countries before announcing further allocations.

With some of the vials already distributed, vaccine programs on the continent have been thrown into disarray, as countries scramble to delay and find supplies for a second dose.

The heat map below, which shows the proportion of initial vaccines allocated through this program to Africa, illustrates the degree to which the continent was dependent on India for its vaccine drives.

Covax’s current portfolio includes some Pfizer doses. In February, it announced plans to procure Novavax vaccines—also to be produced by SII.

A vaccine portfolio that has several options with diverse manufacturing and distribution arms has been critical to the success of vaccine drives in countries like the US. Africa is playing catch up in this regard. In early April, the African Union (AU) decided to ditch plans to secure more AstraZeneca doses itself to avoid duplicating Covax, and has secured 400 million doses from Johnson & Johnson. They will be delivered from the start of the third quarter of the year, says Dr John Nkengasong, the director of the Africa Centre for Disease Control.

“That is what we have in the hands, and we are doing all we can to address the situation from the African Union side as much as possible,” he said in a weekly press briefing on Thursday. “But we find ourselves collectively in a very very dire situation.”

The pandemic has raised critical questions over why Africa was unable to develop its own vaccine, and why its efforts to distribute them have been so slow. According to the Africa CDC, African nations had received more than 37 million vaccine doses and administered only about 18 million. This week, the Democratic Republic of Congo returned 1.3 million doses of the AstraZeneca vaccine, which it had received through Covax, because it did not believe it could distribute them before their expiration date. They will be sent to nearby countries where vaccination campaigns are already underway.

Dr. Nkengasong attributed the slow vaccination to Africa’s “fragile” health systems. Not only are there insufficient healthcare workers to vaccinate people, those that are in action need to be trained and equipped to deal with Covid-19.

“In other vaccination scenarios like measles, polio, you don’t need to wear a whole suit, set up things. But here, you still have to make sure that you maintain the infection-prevention-control measures as much as possible,” he said.

While African governments can do a lot to improve their vaccine portfolios, procurement, and distribution plans, they shouldn’t stand alone. Western countries are starting to catch up to the fact that their own recovery from the pandemic is intimately linked to the recovery of the world’s most neglected nations.

Yes, countries like the US, Canada, and the UK are pouring money and equipment into the problem. A more powerful approach would be to stand shoulder to shoulder with those most vulnerable by unlocking their own surplus of vaccines and waiving intellectual property protections in order for countries to manufacture their own generic versions at home.

The coronavirus pandemic is a creature of a globalized world, which means, as the Guardian’s Hannah Ellis-Petersen recently said, India’s crisis is the world’s crisis.  The only way to bring about its end is if the world confronts that fact together.

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