So far Africa has survived the first and second waves of the COVID-19 pandemic in spite of its weak health systems, limited health care workforce and crumbling infrastructure. The continent as a whole experienced low official case and death rates either due to inadequate testing (and treatment) or other factors such as age, genetics and previous infections. This has led to a degree of complacency- many countries have abandoned social distancing, mask wearing, and hand washing while others have encouraged large social, political and religious gatherings. Decreased community testing has undermined any efforts to determine the true magnitude of community transmission or the spread of new variants. At the same time, Africa has the fewest vaccines of any continent in the world, with only 32 million people receiving a dose, from a total population of over 1.3 billion people. Compare this to India where 255.3 million people have received one dose and the US where more than 311 million doses have been administered. Accordingly, Dr. Matshidiso Moeiti, Regional Director for the WHO in Africa, has pointed out that, “In sub-Saharan Africa, we are at an average of one COVID-19 vaccine dose per 100 people, compared to a global average of 23, and 62 in high-income countries.” This translates to 1% vaccines access, while the global average is 23% and the Global North is 62%.
The continent has a dismally low supply of oxygen cylinders, monitors and other relevant tools needed to treat infected patients. Added to its original low supplies, the continent has received just 3,700 oxygen concentrators, 1,300 patient monitors and 700 ventilators through the United Nations Supply Portal since the start of the pandemic. For a continent with 1.3 billion people, these paltry supplies are nowhere near sufficient.
Dr. Moeti has spoken about the status of the pandemic in Africa on 10th June: “In the past week, 88,000 new COVID-19 cases were reported – an increase of 9 percent over the previous week. We are seeing rising cases in South Africa and Uganda, and cases have increased abruptly in 8 countries, including Sierra Leone, Guinea-Bissau and Nigeria.”
In Liberia, the B117 COVID-19 variant has been detected with a 64% mortality rate within 28 days, which is deeply worrying. The country has reported 202 cases in the past week, the highest number of cases in any previous one week period. In Uganda patients are dying outside hospitals while waiting for beds. In Namibia, COVID-19 has overwhelmed all existing hospitals leading to the suspension of all life-threatening surgeries, while in South Africa the intensive care hospitals are filling up at alarming rates. In West Africa, there are one to four variant strains in all 16 ECOWAS countries.
Africa is woefully unprepared for a massive third wave of the kind that has been faced by South Asia recently.
The COVAX platform-created to make vaccines available to the most vulnerable populations has been hamstrung by vaccine nationalism and vaccine diplomacy. Most countries in Africa have received less than 2% of the vaccines expected through the COVAX platform. Ghana, the first country in Africa to receive the COVAX doses got 600,000 doses for its 31.4 million population- representing a 0.96% potential coverage for the two-dose vaccine regimen. Zambia received 228,000 doses against its 18.8 million population translating to a 0.6% potential coverage of the double dose vaccine. If we are to support African countries to vaccinate their populations, the COVAX donors need to rapidly ramp up their deliveries or we need to find ways to arrange bilateral vaccine donations.
We have been working with Ebola response veterans and a global team of doctors, scientists, bioethicists, and professors to advance practical solutions to avert a COVID-19 driven catastrophe in Africa. This involves a focus on vaccine donations now to the countries most in need; additional funding for COVAX to purchase and distribute 225 million more doses of vaccines for Africa; and tiered pricing for vaccines so African countries can procure vaccines directly.
To overcome the challenges we face, the world must come together- as it did during the Ebola crisis of 2014/15- to overcome geopolitical differences, counter bottlenecks in production and increase the pace of vaccinations globally. All countries should immediately underwrite initiatives aimed at increasing access to vaccines by supporting ethical standards that call on improved global vaccine access.
The COVID-19 situation in India recently has been an unmitigated disaster- the potential for a similar crisis in Africa is clear. Our continent is not adequately equipped to handle a major surge of the coronavirus. We must prepare for the worst and hope for the best.