The World Health Organisation (WHO) announced on Friday the launch of a Covid-19 vaccine production programme in Africa. Six countries (South Africa, Egypt, Kenya, Nigeria, Senegal and Tunisia) will be equipped with production lines to manufacture doses of mRNA vaccines, in an initiative aimed at reducing the continent’s reliance on vaccine imports and boosting low immunisation rates.
FRANCE 24 spoke to Professor Yap Boum, representative of Epicentre, the research arm of Doctors Without Borders, about the evolution of the pandemic on the continent.
A strong advocate for vaccine equality, the UN organisation is concerned about the slow deployment of jabs on the African continent, where only 11.3% of the population is fully vaccinated – despite a considerable increase in doses in recent months.
"Vaccination rates must increase sixfold if the continent is to reach the 70% coverage target set for the end of the first semester of 2022," the WHO warned in early February.
FRANCE 24 spoke to Professor Yap Boum, representative of Epicentre, the research arm of Doctors Without Borders, about the evolution of the pandemic in Africa and the continent’s vaccine rollout.
FRANCE 24: The announcement of this vaccine production programme against Covid-19 has been hailed as an "event of historic importance" by Kenyan President Uhuru Kenyatta. Do you share his enthusiasm?
Yap Boum: This is indeed a very important announcement in many ways. The Covid-19 pandemic has exposed Africa's over-reliance on global health supplies, with 98% of its vaccines coming from abroad. In this context, Africa, at the mercy of donor goodwill and external production imperatives, has experienced delays in immunising its population. We saw this when India was hit by a sudden Covid-19 outbreak and had to curtail its exports of the AstraZeneca vaccine through the Covax programme [Editor’s note: which provided jabs to many African countries].
The vaccine production programme announced by the WHO is a giant step forward in that vaccines can now be manufactured according to need, providing an appropriate response to local situations.
This initiative will also boost research on the continent, allowing Africa to participate in the global effort to develop better vaccines to put an end to the pandemic – and not just to slow it down and prevent severe forms, as is currently the case. On the research front, this programme will also enable clinical trials to be conducted in Africa. This point is crucial, as the effectiveness of vaccines can vary depending on context and populations. So far, only one study has been conducted on the continent, by AstraZeneca in South Africa.
Since the beginning of the pandemic, the WHO has been working hard to provide better access to Covid-19 vaccines. Yet, despite improved supply, vaccine uptake in Africa remains low. Why is this so?
First, we must acknowledge that WHO President Tedros Adhanom Ghebreyesus and Africa CDC President John Nkengasong have done a remarkable job of lobbying for these vaccines. But supply is only one part of the problem. Today, the doses are here, but vaccine hesitancy remains high. This is partly due to misinformation, but also and above all to the health situation in most African countries where, despite high rates of contamination comparable to Europe, deaths have remained much lower.
For example, Cameroon has recorded only 2,000 Covid-19-related deaths since the start of the pandemic. While this figure does not include those who have died within local communities, it is still far lower than what has been observed in European countries. Of course, not all African countries are in the same boat: Morocco, Algeria and South Africa have been more severely affected. But the low vaccination rate is based on a simple logic: the less risk people perceive, the less they feel the need to get vaccinated.
The WHO has called on African countries to accelerate their vaccine rollouts. Are there still logistical problems impeding access to vaccines? What about awareness campaigns?
Today's vaccination campaigns are heavily focused on cities, and it is sometimes difficult to get doses to more remote areas. This is a problem of financing but also of logistical organisation, which is sometimes difficult to put in place in isolated areas with poorly developed infrastructure.
To raise awareness around vaccination, governments need to focus on targeted campaigns and set the right priorities. The role of the WHO is to set continental targets, but these rules must then be adapted to each country’s specific situation in order to be relevant. For example, Niger, where 50% of the population is underage, will not be able to reach the 70% target unless it vaccinates children en masse – which is clearly not the priority at the moment.
In Cameroon, only 7.9% of the elderly and 6.2% of people with pre-existing conditions have received at least one dose. On average, the vaccination rate among vulnerable groups is even lower than that of the general population (7.8%). Therefore, there is an urgent need to focus vaccination efforts on these groups, which account for the bulk of Covid-19-related deaths.
This article has been translated from the original in French.
