Why mass vaccine donations to Africa aren’t working

A shipment of donated covid-19 vaccine doses at the Jomo Kenyatta International Airport in Nairobi.
A shipment of donated covid-19 vaccine doses at the Jomo Kenyatta International Airport in Nairobi.
Image: Reuters/Baz Ratner
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Africa has received millions of covid-19 vaccine doses as donations during the pandemic, as countries try to support the continent in protecting more people from the disease.

A new joint statement by the African Vaccine Acquisition Trust (Avat), the Africa Centres for Disease Control and Prevention (Africa CDC), and Covax say that most donations of covid-19 vaccine doses to Africa have been done in an “ad hoc” manner, with little notice and with doses that have short shelf lives, making it “extremely challenging” for countries to plan vaccination campaigns and increase vaccine absorption.

The bodies call for a change in approach to achieve higher coverage rates in the continent.

“Countries need predictable and reliable supply,” they said in the statement on Nov. 29, without calling out any donor country.

How African countries get covid-19 vaccines

African countries typically get their vaccines from the open market as well as through bilateral agreements with other countries, through the global vaccine distribution program Covax, and through the African Union’s Avat, which was launched to complement initiatives such as Covax. Donations go through these organizations or directly to the countries for distribution.

But with the continent lagging behind in securing vaccines due to reasons including vaccine hoarding by rich countries, some countries come in to donate doses to African countries, in addition to vaccinations they are selling to the continent. Large donors include the US, with 50 million doses, and China, with 16 million doses. These countries and others have further pledged millions more in vaccine doses.

The total vaccine donation pledges made directly to Africa was 130.1 million doses as at October, according to Duke University’s Global Health Innovation Center. This figure excluded pledges to Covax of 944.7 million vaccine doses, most of which will go to Africa. The estimate was also made before China’s recent ambitious pledge of 1 billion vaccine doses to Africa.

More than 90 million donated doses have so far been delivered to Africa through Covax and Avat and millions more through bilateral arrangements.

Vaccine donations to Africa have been done improperly

However, Covax, Avat, and the Africa CDC say most of these donations have been done without proper arrangements.

“Having to plan at short notice and ensure uptake of doses with short shelf lives exponentially magnifies the logistical burden on health systems that are already stretched,” the organizations say

They add that such impromptu supply uses human resources, infrastructure, cold chain resources that could otherwise be directed towards long-term successful and sustainable rollouts of vaccine doses. It also increases expiry risk once doses with short shelf-lives arrive in a country, they say.

Meanwhile, China on Nov. 29 announced a pledge of 1 billion covid-19 doses to Africa, with 600 million doses as donations and the rest provided through other avenues such as joint production by Chinese companies and African countries

The Asian country has so far delivered 107 million out of 155 million pledged doses to the continent during the pandemic, with 16 million as donations, according to Bridge Consulting, a Beijing-based organization that tracks China’s vaccine outreach.

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